Exploring barriers and facilitators of behavioural changes in dietary intake and physical activity: a qualitative study in older adults undergoing transcatheter aortic valve implantation

• Published in: European geriatric medicine Vol. 14; no. 3; pp. 503 - 510
• Main Authors: van Erck, Dennis, Dolman, Christine D., Henriques, José P., Schoufour, Josje D., Delewi, Ronak, Scholte op Reimer, Wilma J. M., Snaterse, Marjolein
• Format: Journal Article
• Language: English
• Published: Cham Springer International Publishing 01.06.2023
• Subjects: Aged; Aged, 80 and over; Eating; Exercise; Female; Geriatrics/Gerontology; Health Behavior; Humans; Internal Medicine; Medicine; Medicine & Public Health; Qualitative Research; Research Paper; Transcatheter Aortic Valve Replacement; Dietary intake; Physical activity; Patient perspectives; Behaviour change; Cardiac patients
• ISSN: 1878-7649; 1878-7657; 1878-7657
• DOI: 10.1007/s41999-023-00774-1

Key summary points Aim To explore barriers and facilitators regarding dietary intake and physical activity behaviour change in older patients undergoing transcatheter aortic valve implantation. Findings Three following themes were identified as barriers: (1) low physical capability, (2) healthy dietary intake and physical activity are not a priority at an older age and (3) ingrained habits and preferences. Three themes were identified as facilitators: (1) knowledge that dietary intake and physical activity are important for maintaining health, (2) norms set by family, friends and caregivers and (3) support from the social environment. Message Given the prevalent ambivalence among older cardiac patients towards behaviour change, healthcare professionals should address this mindset before implementing interventions to promote behaviour modification. Purpose The majority of older patients, scheduled for a cardiac procedure, do not adhere to international dietary intake and physical activity guidelines. The purpose of this study was to explore barriers and facilitators regarding dietary intake and physical activity behaviour change in older patients undergoing transcatheter aortic valve implantation (TAVI). Methods We conducted a qualitative study using semi-structured interviews with patients undergoing TAVI. Interviews were analysed by two independent researchers using thematic analysis, the capability, opportunity and motivation behaviour model was used as a framework. Results The study included 13 patients (82 ± 6 years old, 6 females) until data saturation was reached. Six themes were identified, which were all applicable to both dietary intake and physical activity. Three following themes were identified as barriers: (1) low physical capability, (2) healthy dietary intake and physical activity are not a priority at an older age and (3) ingrained habits and preferences. Three following themes were identified as facilitators: (1) knowledge that dietary intake and physical activity are important for maintaining health, (2) norms set by family, friends and caregivers and (3) support from the social environment. Conclusion Our study found that older patients had mixed feelings about changing their behaviour. The majority initially stated that dietary intake and physical activity were not a priority at older age. However, with knowledge that behaviour could improve health, patients also stated willingness to change, leading to a state of ambivalence. Healthcare professionals may consider motivational interviewing techniques to address this ambivalence.