Document Type : Original Article


1 Department of Health Education and Promotion, Tehran University of Medical Sciences, Tehran, Iran

2 Department of Epidemiology and Biostatistics, Tehran University of Medical Sciences, Tehran, Iran


BACKGROUND: Healthy dietary adherence might be one of the effective and modifiable factors
for hypertension (HTN) control; therefor, empowering patients for self‑care management including
healthy food patterns play a key role in guiding their care, in partnership with health care providers.
This study aimed to identify the factors predicting nutritional knowledge, illness perceptions, and
adherence to a diet based on transtheoretical model (TTM) among hypertensive middle‑aged women.
MATERIALS AND METHODS: A cross‑sectional survey was conducted on 164 patients with
HTN attending west health centers of Tehran, Iran, in 2020. Simple random sampling was used.
Sociodemographic characteristics of the respondents were collected, a valid and reliable measure
on nutritional knowledge, illness perceptions, and adherence to diet, and a researcher‑made
measure based on TTM constructs through in‑person interview was applied. Descriptive statistics
and general linear model were utilized for data analysis using SPSS version 25. The significance
level was considered less than 0.05.
RESULTS: Mean and standard deviation of participants was 50.82 ± 8.77 years. Multivariate
regression analysis indicated that family income (P < 0.001) and body mass index (P < 0.001) predicted
nutritional knowledge and adherence to diet, respectively. Decisional balance and self‑efficacy
constructs predicted nutrition knowledge and illness perceptions (P < 0.001). In adherence to diet,
overcoming the temptation construct was indicated as the only predictor (P < 0.001).
CONCLUSION: Study findings highlighted the necessity of tailoring and implementing interventions
based on TTM using appropriate strategies to promote quality of HTN management approach in
nutritional knowledge, illness perceptions, and dietary adherence.


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