Exploring challenges to nutrition intervention adherence using COM-B model among patients with wet age-related macular degeneration: a qualitative study

BMJ Open. 2022 Nov 29;12(11):e064892. doi: 10.1136/bmjopen-2022-064892.

Abstract

Objectives: To explore challenges to nutrition intervention adherence using the Capability, Opportunity and Motivation-Behaviour (COM-B) model among wet age-related macular degeneration (AMD) patients. These factors should be considered in the development of potential support and intervention programmes to address these problems.

Design: A qualitative study was conducted with one-to-one and face-to-face interviews with wet AMD patients using a semi-structured question guide. Data were analysed based on COM-B model: capability (physical and psychological), opportunity (physical and social) and motivation (reflective and automatic).

Setting: Southwest Hospital of Chongqing Province in China.

Participants: A convenient and purposive sample of 24 wet AMD patients were recruited.

Results: The themes and subthemes were identified: psychological capability: (1) insufficient knowledge of nutrition; (2) misconceptions about the disease and treatment; (3) knowledge conflict; physical capability: (1) physical restriction; (2) limited access to nutrition knowledge; physical opportunity: (1) communication between providers and patients; (2) health insurance and extra charges; (3) food environment; social opportunity: (1) stigma of disease; (2) family influence; reflective motivation: (1) self-efficacy; (2) attitude; (3) outcome expectancies; (4) lack of professional support; automatic motivation: (1) difficulties in changing eating habits; (2) mindset.

Conclusion: Medical staff should pay much attention to the process of patients' nutrition intervention. In addition, it is also necessary to develop professional and internet-based intervention to modify the dietary behaviour and improve the management skills of the patients.

Keywords: NUTRITION & DIETETICS; PUBLIC HEALTH; Vetreoretinal.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Humans
  • Knowledge
  • Motivation*
  • Qualitative Research
  • Self Efficacy
  • Wet Macular Degeneration* / therapy