Determinants of dietary behaviour in wheelchair users with spinal cord injury or lower limb amputation: Perspectives of rehabilitation professionals and wheelchair users

• Published in: PloS one 2020-01, Vol.15 (1), p.e0228465
• Main Authors: Holla, Jasmijn F M, van den Akker, Lizanne E, Dadema, Tessa, de Groot, Sonja, Tieland, Michael, Weijs, Peter J M, Deutekom, Marije
• Format: Article
• Language: English
• Subjects: Adult; Aged; Amputation; Amputation - rehabilitation; Analysis; Appetite; Attitudes; Biology and Life Sciences; Body mass index; Boredom; Cooking; Counseling; Data analysis; Diet; Disabilities; Disabled persons; Disabled Persons - rehabilitation; Eating; Education; Engineering and Technology; Environmental aspects; Environmental factors; Exercise; Fatigue; Female; Focus Groups; Food; Food preparation; Food supply; Goal setting; Health; Health behavior; Health education; Health planning; Health Promotion; Humans; Influence; Information management; Injuries; Intervention; Kitchens; Lifestyles; Male; Medicine and Health Sciences; Middle Aged; Motivation; Nutrition; Nutrition research; Obesity; Obesity - prevention & control; Perception; Physical fitness; Physically disabled persons; Questionnaires; Rehabilitation; Risk management; Risk perception; Self control; Self Efficacy; Setting (Literature); Social Sciences; Social work; Spinal cord injuries; Spinal Cord Injuries - rehabilitation; Suffering; Surveys and Questionnaires; Therapists; Wheelchairs
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0228465

This study aims to identify determinants of dietary behaviour in wheelchair users with spinal cord injury or lower limb amputation, from the perspectives of both wheelchair users and rehabilitation professionals. The findings should contribute to the field of health promotion programs for wheelchair users. Five focus groups were held with wheelchair users (n = 25), and two with rehabilitation professionals (n = 11). A thematic approach was used for data analysis in which the determinants were categorized using an integrated International Classification of Functioning, Disability and Health and Attitude, Social influence and self-Efficacy model. Reported personal factors influencing dietary behaviour in wheelchair users were knowledge, boredom, fatigue, stage of life, habits, appetite, self-control, multiple lifestyle problems, intrinsic motivation, goal setting, monitoring, risk perception, positive experiences, suffering, action planning, health condition, function impairments, attitude and self-efficacy. Reported environmental factors influencing dietary behaviour in wheelchair users were unadjusted kitchens, monitoring difficulties, eating out, costs, unfavourable food supply, nutrition education/counselling, access to simple healthy recipes, eating together, cooking for others, and awareness and support of family and friends. Important modifiable determinants of dietary behaviour in wheelchair users that might be influenced in lifestyle interventions are knowledge, fatigue, habits, self-control, intrinsic motivation, risk perception, attitude and self-efficacy. It is recommended to involve relatives, since they appear to significantly influence dietary behaviour.