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Abstract

Outpatient cardiac rehabilitation (CR) programs comprise exercise and education,
including nutrition education (NE), and are offered after hospitalisation in order
to minimise the risk of further cardiac events. A five-part evaluation of NE in
outpatient CR programs in Victoria was undertaken. Initially, a survey-based
process evaluation of all outpatient programs (N = 74) found that most had a very
limited amount of NE. Dietary fat was a topic common to all and most programs
used knowledge-based, didactic education that was not based on a specific model
of behaviour change. In a second process evaluation, CR participants (n = 317)
were surveyed by questionnaire before NE. The majority were older, overweight,
English-speaking men who were myocardial infarction and/or cardiac surgery
patients. Knowledge of dietary fat was generally poor but attitude to healthy
eating was positive and fat intake was relatively low. A quasi-experimental
comparison group program trial was used for an impact evaluation of the
effectiveness of NE, with one experimental group (n = 80) having one hour of
NE, a second experimental group (n = 80) having 41/2 hours of NE, with
additional access to the dietitian, and a comparison group (n = 80) having no NE.
The 41/2-hour group improved in attitude to healthy eating and had a greater
improvement in dietary fat knowledge and a greater reduction in fat intake. In a
third survey-based process evaluation, most participants were found to be
satisfied with NE but older participants were less satisfied. The amount of NE
was weakly associated with satisfaction. A one-year follow-up outcome
evaluation of CR participants (n = 44) showed that most were overweight at CR
and had increased their BMI at follow-up. Fat knowledge, attitude and intake had
not changed and subjects' diets generally accorded with recommendations for
patients with heart disease, although mean saturated fat intake was higher. Further
research is required to determine the most appropriate behaviour change model
for NE in CR programs and the most effective format and educational strategies
for facilitating compliance with diets for heart disease.

Item Type:	Thesis - PhD
Authors/Creators:	Paxton, Fay
Copyright Holders:	The Author
Copyright Information:	Copyright the Author - The University is continuing to endeavour to trace the copyright owner(s) and in the meantime this item has been reproduced here in good faith. We would be pleased to hear from the copyright owner(s).
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