Abstract
Objective 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. Methods 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. Results 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. Conclusions 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.
| Original language | English |
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| Article number | e0228465 |
| Number of pages | 19 |
| Journal | PLoS ONE |
| Volume | 15 |
| Issue number | 1 |
| DOIs | |
| Publication status | Published - 31 Jan 2020 |
Funding
This research is co-financed by the National Taskforce for Applied Research SIA (www.regieorgaan-sia.nl), part of the Netherlands Organisation for Scientific Research (NWO), grant number RAAK.PUB03.029. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. We are very grateful to Daphne Heemskerk (D.H.) for coding and analysing the focus group discussions. We acknowledge the participants of the focus groups for sharing their opinions and thoughts regarding a healthy lifestyle. Finally, we thank the professionals who assisted in organizing the focus groups: M. Hagoort and M. van Raaij. WHEELS-study group: L.E. van den Akker, L. Alpay, H. Bijwaard, J.M. Dallinga, M. Deutekom, R. Doms, J.F.M. Holla (program coordination): Inholland University of Applied Sciences, Haarlem, The Netherlands. T. Dadema, J.M. Dallinga, S. Dankers, M. Deutekom, R.H. Engelbert, M. Tieland, B. Visser, P.J.M. Weijs: Amsterdam University of Applied Sciences, Amsterdam, The Netherlands. S. de Groot, J.F.M. Holla, T.W.J. Janssen: Amsterdam Rehabilitation Research Centre, Reade, Amsterdam, The Netherlands. H. Houdijk, L.J. Valent: Heliomare Rehabilitation Centre, Wijk aan Zee, The Netherlands. S. de Groot, L.H.V. van der Woude: University Medical Centre Groningen, Groningen, The Netherlands. J.B.J. Bussmann: Erasmus University Medical Centre, Rotterdam, The Netherlands. N. van Schijndel: Virtuagym B.V., Amsterdam, The Netherlands.