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Cardiac self efficacy and Mediterranean diet adherence in patients with coronary heart disease.

Created on 14 Jul 2026

Authors

Muna H Shakhshir, Kholood K Khalil, Hiba T Fakhoury, Lana K Hamuda, Adham Abu Taha, Yahia Ismail, Sa'ed H Zyoud

Published in

Scientific reports. Volume 16. Issue 1. Apr 27, 2026. Epub Apr 27, 2026.

Abstract

A Mediterranean diet (MD) is an ideal dietary pattern that has favourable effects on the prevention and treatment of coronary heart disease (CHD). Cardiac self-efficacy (CSE), which reflects patients’ confidence in managing their cardiac condition, may be associated with adherence to recommended lifestyle behaviors in CHD patients. Therefore, the purpose of this study was to assess the relationship between CSE and adherence to an MD in patients with CHD. A cross-sectional study was conducted between August 2023 and May 2024 among 296 adults with diagnosed CHD attending An-Najah National University Hospital, Al-Watani Governmental Hospital, and primary healthcare facilities in Nablus, Palestine. Sociodemographic and clinical data were collected. Adherence to the MD was assessed via a 14-item questionnaire, the Mediterranean Diet Adherence Screener. CSE was assessed via Sullivan’s cardiac self-efficacy scale (SCSES), which contains 13 items. This study included 296 individuals with CHD, of whom 55.7% were men and 44.3% were women. The majority of the participants were married (76%), lived with family (84%), and had been diagnosed for five years or fewer (69.6%). The median patient age was 65.0 (58.0–74.0) years. The median overall MD adherence score was 7.00 (interquartile range: 5.00–8.00). The median overall SCSES score was 24.00 (interquartile range: 17.00–33.00). There was a statistically detectable but modest positive correlation between the overall SCSES score and the MD adherence score (r = 0.153, p = 0.008), indicating a small effect size. Higher overall MD scores were obtained for males (p = 0.009). The findings of the multiple linear regression model revealed that being male (p = 0.009) and having high SCSES scores (p = 0.019) were significant factors that contributed to increased adherence to the MD. Most participants moderately adhered to the MD. Adherence to the MD was affected by sex and was positively correlated with increased CSE among patients with CHD. Interventional and sex-specific studies are still needed to establish robust relationships.

PMID:
42045456
Bibliographic data and abstract were imported from PubMed on 14 Jul 2026.

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