An Application of the Social Cognitive Theory to Adherence to a Low-Salt Diet in Patients with Hypertension

,; Khobani, Masomeh; Majlesi, Majid; Haroni, Javah; Zinat motlagh, Fazel

[Home ] [Archive]

[ فارسی ]

Main Menu

Home

Journal Information

Articles archive

For Authors

For Reviewers

Registration

Contact us

Site Facilities

Indexing & Abstracting

Publication Ethics

Search in website

Receive site information

Indexing & Abstracting

DOAJ
GOOGLE SCHOLAR

Volume 29, Issue 1 (3-2024)

__Armaghane Danesh__ 2024, 29(1): 67-79

Back to browse issues page

An Application of the Social Cognitive Theory to Adherence to a Low-Salt Diet in Patients with Hypertension

Masomeh Khobani¹

, Majid Majlesi²

, Javah Haroni¹

, Fazel Zinat motlagh

1- Department of Health Education and Promotion, Yasuj University of Medical Sciences, Yasuj, Iran
2- Department of Nutrition Sciences, Yasuj University of Medical Sciences, Yasuj, Iran
3- Department of Health Education and Promotion, Yasuj University of Medical Sciences, Yasuj, Iran , motlaghf@yahoo.com

Abstract: (950 Views)

Background & aim: High blood pressure is one of the most important causes of premature death worldwide. One of the ways to control high blood pressure is lifestyle modification, especially paying attention to nutritional behaviors, such as reducing the consumption of salt-containing foods, therefore the purpose of the present study was to investigate the application of social cognitive theory in adherence to a low-salt diet in patients with high blood pressure.

Methods: The present descriptive-cross-sectional study was conducted in 2021 on 100 patients with high blood pressure covered by comprehensive health centers in the city of Charam, located in the Kohgiluyeh and Boyer-Ahmad province. Data collection tools included a questionnaire on adherence to a low-sodium diet, based on a modified version of the self-care activities level adjustment questionnaire in hypertension, and a researcher-made questionnaire consisting of components from the Bandura Social Cognitive Theory, including self-efficacy, social support, and self-regulation. Patients meeting the inclusion criteria were randomly selected, and with the assistance of a disease specialist, questionnaires were completed. The collected data were analyzed using Pearson correlation and linear regression statistical tests.

Results: The participants' age ranged from 40 to 69 years, with a mean of 57.26 ± 29.7. 61% were female and 39% were male. 34 participants (34%) were illiterate, while 20 participants (20%) had university education. 27% had a family history of hypertension. The mean systolic blood pressure was 136.95 ± 10.22, and the mean diastolic blood pressure was 85.56 ± 5.44. The adherence rate to a low-salt diet among the studied patients was 32% (34% for females and 33% for males). Linear regression analysis revealed that the social cognitive theory predicts for 20% of the variance in adherence to a low-salt diet

Conclusion: The findings indicated a low level of adherence to a low- salt diet among the studied patients. This can serve as a warning sign for both these patients and the healthcare system. Implementing interventional treatment programs and utilizing educational strategies, particularly in the areas of family social support and self-regulation, can play a significant role in increasing adherence to a low-sodium diet and controlling hypertension for these individuals.

Keywords: Adherence to a low-salt diet, Social cognitive theory, Hypertension, Self-regulation, Family social support

Full-Text [PDF 586 kb] (113 Downloads)

Type of Study: Research | Subject: Educational health
Received: 2023/07/8 | Accepted: 2023/10/21 | Published: 2024/01/10

References

1. data WGHOG. raised blood pressure: situation and trends 2016 [Available from: http://www.who.int/gho/ncd/risk_factors/blood_pressure_prevalence_text/en/,.

2. Bijani M, Parvizi S, Dehghan A, Sedigh-Rahimabadi M, Rostami-Chijan M, Kazemi M, et al. Investigating the prevalence of hypertension and its associated risk factors in a population-based study: Fasa PERSIAN COHORT data. BMC Cardiovascular Disorders. 2020;20(1):1-8. [DOI:10.1186/s12872-020-01797-3] [PMID] []

3. Padwal RS, Bienek A, McAlister FA, Campbell NR, Program ORTFotCHE. Epidemiology of hypertension in Canada: an update. Canadian Journal of Cardiology. 2016;32(5):687-94. [DOI:10.1016/j.cjca.2015.07.734] [PMID]

4. Filippou CD, Tsioufis CP, Thomopoulos CG, Mihas CC, Dimitriadis KS, Sotiropoulou LI, et al. Dietary approaches to stop hypertension (DASH) diet and blood pressure reduction in adults with and without hypertension: a systematic review and meta-analysis of randomized controlled trials. Advances in Nutrition. 2020;11(5):1150-60. [DOI:10.1093/advances/nmaa041] [PMID] []

5. Organisation WH. Hypertension 2020 [Available from: : https://www.who.int/news-room/fact-sheets/detail/hypertension. Accessed 26 Feb 2020.

6. Nikroy F, Roustaei N, Eslami A. Cognitive Factors Association with Medication Adherence Among Hypertension Patients. Iranian Evolutionary and Educational Psychology Journal. 2022;4(4):204-12. [DOI:10.52547/ieepj.4.4.204]

7. Lopez-Lopez JP, Cohen DD, Alarcon-Ariza N, Mogollon-Zehr M, Ney-Salazar D, Chacon-Manosalva MA, et al. Ethnic differences in the prevalence of hypertension in Colombia: association with education level. American Journal of Hypertension. 2022;35(7):610-8. [DOI:10.1093/ajh/hpac051] [PMID] []

8. Sani RN, Connelly PJ, Toft M, Rowa-Dewar N, Delles C, Gasevic D, et al. Rural-urban difference in the prevalence of hypertension in West Africa: a systematic review and meta-analysis. Journal of Human Hypertension. 2022:1-13. [DOI:10.1038/s41371-022-00688-8] [PMID]

9. Zhou B, Carrillo-Larco RM, Danaei G, Riley LM, Paciorek CJ, Stevens GA, et al. Worldwide trends in hypertension prevalence and progress in treatment and control from 1990 to 2019: a pooled analysis of 1201 population-representative studies with 104 million participants. The Lancet. 2021;398(10304):957-80. [DOI:10.1016/S0140-6736(21)01330-1] [PMID]

10. Atibila F, Hoor Gt, Donkoh ET, Wahab AI, Kok G. Prevalence of hypertension in Ghanaian society: a systematic review, meta-analysis, and GRADE assessment. Systematic Reviews. 2021;10(1):1-15. [DOI:10.1186/s13643-021-01770-x] [PMID] []

11. Mills KT, Bundy JD, Kelly TN, Reed JE, Kearney PM, Reynolds K, et al. Global disparities of hypertension prevalence and control: a systematic analysis of population-based studies from 90 countries. Circulation. 2016;134(6):441-50. [DOI:10.1161/CIRCULATIONAHA.115.018912] [PMID] []

12. Mirzaei M, Mirzaei M, Bagheri B, Dehghani A. Awareness, treatment, and control of hypertension and related factors in adult Iranian population. BMC Public Health. 2020;20:1-10. [DOI:10.1186/s12889-020-08831-1] [PMID] []

13. Katibeh M, Moghaddam A, Yaseri M, Neupane D, Kallestrup P, Ahmadieh H. Hypertension and associated factors in the Islamic Republic of Iran: a population-based study. Eastern Mediterranean Health Journal. 2020;26(3). [DOI:10.26719/emhj.19.042] [PMID]

14. Rajati F, Hamzeh B, Pasdar Y, Safari R, Moradinazar M, Shakiba E, et al. Prevalence, awareness, treatment, and control of hypertension and their determinants: Results from the first cohort of non-communicable diseases in a Kurdish settlement. Scientific reports. 2019;9(1):12409. [DOI:10.1038/s41598-019-48232-y] [PMID] []

15. Najafipour H, Nasri HR, Rostamzadeh F, Amirzadeh R, Shadkam M, Mirzazadeh A. Prevalence and incidence of pre-hypertension and hypertension (awareness/control) in Iran: findings from Kerman coronary artery diseases risk factors study 2 (KERCADRS). Journal of Human Hypertension. 2022;36(5):461-72. [DOI:10.1038/s41371-020-00392-5] [PMID]

16. Pourmand G, Doshmangir L, Ahmadi A, Noori M, Rezaeifar A, Mashhadi R, et al. An application of the theory of planned behavior to self-care in patients with hypertension. BMC Public Health. 2020;20:1-8. [DOI:10.1186/s12889-020-09385-y] [PMID] []

17. Afsargharehbagh R, Rezaie-Keikhaie K, Rafiemanesh H, Balouchi A, Bouya S, Dehghan B. Hypertension and pre-hypertension among Iranian adults population: a meta-analysis of prevalence, awareness, treatment, and control. Current Hypertension Reports. 2019;21:1-13. [DOI:10.1007/s11906-019-0933-z] [PMID]

18. Faragzadeh Z, Kaheni S, Saadatjoo A. Relation between stress and hypertension and coping ways. J Birjand Univ Med Sci. 2005;12(1):2.

19. Yang S-H, Ha J-C, Kim M-J. Salty taste test for a low-salt diet to control blood pressure. Clinical Hypertension. 2023;29(1):12. [DOI:10.1186/s40885-023-00236-7] [PMID] []

20. Sun J-k, Li W-q, Ke L, Tong Z-h, Ni H-b, Li G, et al. Early enteral nutrition prevents intra-abdominal hypertension and reduces the severity of severe acute pancreatitis compared with delayed enteral nutrition: a prospective pilot study. World Journal of Surgery. 2013;37:2053-60. [DOI:10.1007/s00268-013-2087-5] [PMID]

21. Houston MC. The role of nutrition, nutraceuticals, vitamins, antioxidants, and minerals in the prevention and treatment of hypertension. Alternative therapies in health and medicine. 2013;19:32.

22. Grillo A, Salvi L, Coruzzi P, Salvi P, Parati G. Sodium intake and hypertension. Nutrients. 2019;11(9):1970. [DOI:10.3390/nu11091970] [PMID] []

23. Chaudhary P, Wainford RD. Association of urinary sodium and potassium excretion with systolic blood pressure in the Dietary Approaches to Stop Hypertension Sodium Trial. Journal of human hypertension. 2021;35(7):577-87. [DOI:10.1038/s41371-020-0375-8] [PMID] []

24. Mente A, O'Donnell MJ, Rangarajan S, McQueen MJ, Poirier P, Wielgosz A, et al. Association of urinary sodium and potassium excretion with blood pressure. New england journal of medicine. 2014;371(7):601-11. [DOI:10.1056/NEJMoa1311989] [PMID]

25. Marketou ME, Maragkoudakis S, Anastasiou I, Nakou H, Plataki M, Vardas PE, et al. Salt‐induced effects on microvascular function: a critical factor in hypertension mediated organ damage. The Journal of Clinical Hypertension. 2019;21(6):749-57. [DOI:10.1111/jch.13535] [PMID] []

26. . WHOW. Salt reduction [Internet]. Geneva: WHO 2020 [Available from: : https://www.who.int/news-room/fact-sheets/detail/salt-reduction.

27. Graudal NA, Hubeck-Graudal T, Jurgens G. Effects of low sodium diet versus high sodium diet on blood pressure, renin, aldosterone, catecholamines, cholesterol, and triglyceride. Cochrane Database of Systematic Reviews. 2020(12). [DOI:10.1002/14651858.CD004022.pub5] [PMID] []

28. Bjoernsbo KS, Riis NL, Andreasen AH, Petersen J, Dahl Lassen A, Trolle E, et al. Salt reduction intervention in families investigating metabolic, behavioral and health effects of targeted intake reductions: study protocol for a four months three-armed, randomized, controlled "real-life" trial. International Journal of Environmental Research and Public Health. 2019;16(19):3532. [DOI:10.3390/ijerph16193532] [PMID] []

29. Vijayaraghavan M, Jacobs EA, Seligman H, Fernandez A. The association between housing instability, food insecurity, and diabetes self-efficacy in low-income adults. Journal of Health Care for the Poor and Underserved. 2011;22(4):1279-91. [DOI:10.1353/hpu.2011.0131] [PMID]

30. Sanuade OA, Boatemaa S, Kushitor MK. Hypertension prevalence, awareness, treatment and control in Ghanaian population: Evidence from the Ghana demographic and health survey. PloS one. 2018;13(11):e0205985. [DOI:10.1371/journal.pone.0205985] [PMID] []

31. Glanz K, Rimer BK, Viswanath K. Health behavior and health education: theory, research, and practice: John Wiley & Sons; 2008.

32. Borhaninejad V, Iranpour A, Shati M, Tahami AN, Yousefzadeh G, Fadayevatan R. Predictors of self-care among the elderly with diabetes type 2: using social cognitive theory. Diabetes & Metabolic Syndrome: Clinical Research & Reviews. 2017;11(3):163-6. [DOI:10.1016/j.dsx.2016.08.017] [PMID]

33. Warren-Findlow J, Seymour RB, Brunner Huber LR. The association between self-efficacy and hypertension self-care activities among African American adults. Journal of community health. 2012;37:15-24. [DOI:10.1007/s10900-011-9410-6] [PMID] []

34. Bandura A. Self-efficacy: toward a unifying theory of behavioral change. Psychological review. 1977;84(2):191. [DOI:10.1037/0033-295X.84.2.191] [PMID] []

35. Arabshahi A, Gharlipour Z, Hosseinalipour SA, Mohebi S. Assessment of adherence to self-care behaviors in hypertensive patients in Qom. Qom University of Medical Sciences Journal. 2020;14(2):55-66. [DOI:10.29252/qums.14.2.55]

36. Pirzadeh A, Peyman TS, Hassanzadeh A, Mostafavi F. Adherence to self-care behaviors among hypertensive patients. Journal of Health Literacy. 2019;4(3):17-24.

37. Motlagh SFZ, Chaman R, Sadeghi E, Eslami AA. Self-care behaviors and related factors in hypertensive patients. Iranian Red Crescent Medical Journal. 2016;18(6). [DOI:10.5812/ircmj.35805] [PMID] []

38. Labata BG, Ahmed MB, Mekonen GF, Daba FB. Prevalence and predictors of self care practices among hypertensive patients at Jimma University Specialized Hospital, Southwest Ethiopia: cross-sectional study. BMC Research Notes. 2019;12(1):1-8. [DOI:10.1186/s13104-019-4125-3] [PMID] []

39. AlHadlaq RK, Swarelzahab MM, AlSaad SZ, AlHadlaq AK, Almasari SM, Alsuwayt SS, et al. Factors affecting self-management of hypertensive patients attending family medicine clinics in Riyadh, Saudi Arabia. Journal of family medicine and primary care. 2019;8(12):4003. [DOI:10.4103/jfmpc.jfmpc_752_19] [PMID] []

40. Rezaei S, Mahmoudi Z, Sheidaei A, Aryan Z, Mahmoudi N, Gohari K, et al. Salt intake among Iranian population: the first national report on salt intake in Iran. Journal of hypertension. 2018;36(12):2380-9. [DOI:10.1097/HJH.0000000000001836] [PMID]

41. Rad GS, Bakht LA, Feizi A, Mohebi S. Importance of social support in diabetes care. Journal of education and health promotion. 2013;2. [DOI:10.4103/2277-9531.120864] [PMID] []

42. Mohebi S, Parham M, Sharifirad G, Gharlipour Z, Mohammadbeigi A, Rajati F. Relationship between perceived social support and self-care behavior in type 2 diabetics: A cross-sectional study. Journal of education and health promotion. 2018;7. [DOI:10.4103/jehp.jehp_73_17] [PMID] []

43. Bahari G, Scafide K, Krall J, Mallinson RK, Weinstein AA. Mediating role of self‐efficacy in the relationship between family social support and hypertension self‐care behaviours: A cross‐sectional study of Saudi men with hypertension. International journal of nursing practice. 2019;25(6):e12785. [DOI:10.1111/ijn.12785] [PMID]

44. Safari M, Shojaei-Zadeh D, Ghofranipour F, Heydarnia A, Pakpur A. Theories, models and methods of health education and health promotion. Tehran: Asaresobhan. 2009:64-75.

45. Ghoreishi M-S, Vahedian-Shahroodi M, Jafari A, Tehranid H. Self-care behaviors in patients with type 2 diabetes: Education intervention base on social cognitive theory. Diabetes & Metabolic Syndrome: Clinical Research & Reviews. 2019;13(3):2049-56. [DOI:10.1016/j.dsx.2019.04.045] [PMID]

46. Barati M, Darabi D, Moghimbeigi A, Afsar A. Self-regulation behaviors of hypertension and related factors among hypertensive patients. Journal of Advanced Biomedical Sciences. 2011;1(3):116-22.

Send email to the article author

Add your comments about this article

Mendeley

Zotero

RefWorks

Khobani M, Majlesi M, Haroni J, Zinat motlagh F. An Application of the Social Cognitive Theory to Adherence to a Low-Salt Diet in Patients with Hypertension. armaghanj 2024; 29 (1) :67-79
URL: http://armaghanj.yums.ac.ir/article-1-3503-en.html

Rights and permissions
	This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

Volume 29, Issue 1 (3-2024)

Back to browse issues page

Persian site map - English site map - Created in 0.06 seconds with 39 queries by YEKTAWEB 4657