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Dietary resilience in patients with severe COPD at the start of a pulmonary rehabilitation program

Authors ter Beek L, van der Vaart H, Wempe JB, Dzialendzik AO, Roodenburg JLN, van der Schans CP, Keller HH, Jager-Wittenaar H

Received 15 September 2017

Accepted for publication 30 January 2018

Published 23 April 2018 Volume 2018:13 Pages 1317—1324


Checked for plagiarism Yes

Review by Single anonymous peer review

Peer reviewer comments 2

Editor who approved publication: Dr Richard Russell

Lies ter Beek,1–3 Hester van der Vaart,2 Johan B Wempe,2 Aliaksandra O Dzialendzik,4 Jan LN Roodenburg,3 Cees P van der Schans,1,5,6 Heather H Keller,7,8 Harriët Jager-Wittenaar1,3

1Hanze University of Applied Sciences, Research Group Healthy Ageing, Allied Health Care and Nursing, Groningen, the Netherlands; 2University of Groningen, University Medical Center Groningen, Department of Pulmonary Diseases and Tuberculosis, Center for Rehabilitation, Groningen, the Netherlands; 3University of Groningen, University Medical Center Groningen, Department of Maxillofacial Surgery, Groningen, the Netherlands; 4Hanze University of Applied Sciences, Department of Applied Psychology, Groningen, the Netherlands; 5University of Groningen, University Medical Center Groningen, Department of Rehabilitation Medicine, Groningen, the Netherlands; 6University of Groningen, University Medical Center Groningen, Health Psychology Research, Groningen, the Netherlands; 7University of Waterloo, Schlegel Research Institute for Aging, Waterloo, ON, Canada; 8University of Waterloo, Department of Kinesiology, Waterloo, ON, Canada

Background: COPD may impact food-related activities, such as grocery shopping, cooking, and eating. Decreased food intake may result in an unhealthy diet, and in malnutrition, which is highly prevalent in patients with COPD. Malnutrition is known to negatively impact clinical outcome and quality of life.
Aims: In this qualitative study, we aimed to explore strategies used to overcome food-related challenges, ie, dietary resilience, and whether these led to a healthy diet. Furthermore, we aimed to identify the key themes of motivation for dietary resilience in patients with severe COPD.
Methods: In October 2015 to April 2016, 12 patients with severe COPD starting a pulmonary rehabilitation program were interviewed. Qualitative description and thematic analysis were performed.
Results: All participants mentioned the use of strategies to overcome challenges. Key themes of motivation for dietary resilience were identified as “wanting to be as healthy as possible”, “staying independent”, and “promoting a sense of continuity and duty”. Two out of 12 participants met the criteria for a healthy diet.
Conclusion: Our study showed a variety of motivational factors and strategies reported by patients with severe COPD to overcome food-related challenges. However, the majority (n=10) of the participants did not meet the criteria for a healthy diet. The identified key themes can be used to develop education to support patients with severe COPD to improve their diet.

Keywords: chronic obstructive pulmonary disease, malnutrition, diet, resilience, health behavior, qualitative

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