Date Presented 04/22/2023
Dietary behavior performance and training is limited after stroke. Qualitative findings identify unmet clinical needs that should be addressed and can inform clinical practice and future research regarding dietary behavior intervention.
Primary Author and Speaker: Ryan R. Bailey
Contributing Authors: Sarah Waddoups
PURPOSE: Following a healthy dietary pattern is recommended to decrease recurrent stroke risk (Kleindorfer et al., 2021). Prior research indicates that post-stroke dietary quality is poor (Lin et al., 2019), but it is unclear how stroke-related disability in performing dietary behaviors (e.g., selecting, accessing, and preparing healthy foods) contributes to this problem. The purpose of this study was to explore post-stroke dietary behaviors to inform clinical practice and future research.
DESIGN: Phenomenological qualitative study. Participants were a subset of individuals who participated in an online survey (Bailey & Waddoups, in press). Eligibility criteria: ≥6 months since stroke; community-dwelling; 30-70 years of age; no more than moderate disability (i.e., Rankin score ≤2), mild aphasia, and mild cognitive impairment.
METHOD: Participants (n=7) participated in two 90-minute focus groups. Focus group questions examined changes in dietary behaviors and sources of dietary behavior training. Two researchers analyzed interview transcripts using inductive content analysis (Elo & Kyngas, 2008) and a qualitative descriptive approach to identify key themes.
RESULTS: Data analysis yielded three key themes. First, changes in dietary behavior performance occurred, with a decrease in some behaviors and in increase in others (e.g., healthy eating). Second, compensatory strategies and adaptive equipment facilitated dietary behavior performance. Third, healthcare-based dietary behavior education was limited and deemed insufficient.
CONCLUSION: Dietary behavior performance is limited post-stroke and varies across behaviors but can be supported through compensatory strategies and adequate training.
IMPACT STATEMENT: Findings provide insight into how stroke survivors perform dietary behaviors and identify unmet clinical intervention needs; this information can inform clinical practice and future research regarding dietary behavior intervention following stroke.
References
Bailey, R., & Waddoups, S. (in press). Performance of dietary behaviors in chronic community-dwelling stroke survivors: A mixed-methods study. Occupational Therapy in Health Care.
Elo, S., & Kyngas, H. (2008). The qualitative content analysis process. Journal of Advanced Nursing, 62(1), 107-115. https://doi.org/10.1111/j.1365-2648.2007.04569.x
Kleindorfer, D. O., Towfighi, A., Chaturvedi, S., Cockroft, K. M., Gutierrez, J., Lombardi-Hill, D., … Williams, L. S. (2021). 2021 Guideline for the prevention of stroke in patients with stroke and transient ischemic attack: A guideline from the American Heart Association/American Stroke Association. Stroke, 52(0), e364–e467. https://doi.org/doi:10.1161/STR.0000000000000375
Lin, A. M., Lin, M. P., Markovic, D., Ovbiagele, B., Sanossian, N., & Towfighi, A. (2019). Less than ideal: Trends in cardiovascular health among US stroke survivors. Stroke, 50(1), 5-12. https://doi.org/doi:10.1161/STROKEAHA.118.022644
