Abstract

Aims and objectives. This study aimed to explore the issues that influence the dietary choices made by patients attending asecondary prevention clinic following a myocardial infarction.Background. Secondary prevention clinics play an important role in promoting dietary advice, yet evidence suggests that manyindividuals are neither implementing nor maintaining the lifestyle changes recommended. Research largely focuses on complianceto lifestyle changes in general, and only a small number of quantitative studies address the issues surrounding adherenceto dietary advice.Design. Phenomenology was selected as the most appropriate approach for this qualitative study, enabling patients’ livedexperiences of dietary decision-making to be explored.Method. A purposive sample of nine participants was selected from a cardiac secondary prevention clinic. Semi-structuredinterviews were taped, transcribed and analysed using an interpretative approach.Results. Data analysis produced six central themes contributing to patients’ decision-making. Fear, determination and selfcontrolwere enabling factors and poor recall of information, a need for additional support and a lack of will power weredisabling factors. Findings suggest that patient motivation and ability to make sustainable dietary change can decline asdisabling factors reduce determination and self-control, and initial fear of their heart condition subsides.Conclusion. In this study, patients’ motivation regarding dietary decision-making changed over time and was strongly influencedby a fear of future heart problems.Relevance to clinical practice. Health care professionals need to understand the temporal nature of decision-making postmyocardialinfarction and adopt a wide repertoire of responsive strategies that support patients to follow a healthy diet in thelonger term.