Introduction: The adherence to dietary behaviour among kidney transplant recipients(KTRs) is typically low, and their dietary behaviour differed from the recommended post-transplant diet due to variations in dietary acculturation and dietary habits. The aim of this study was to explore the effects of psychosocial factors on dietary behaviour in KTRs based on the health promotion model (HPM).
Method: This was a multi-center, cross-sectional study involving 289 KTRs from four transplant centers during October 2022 to March 2023. Standard questionnaires were used to measure the psychosocial variables. A structural equation model was employed to examine the associations among depression, perceived benefit, perceived barrier, self-efficacy, attitude, social support, and dietary behaviour.
Results: Among the 289 KTRs, 58.82% were male. The mean age of the recipients was 44.37±10.37 years(min:18;max:74). The participants reported high levels of attitude, and perceived behaviour benefit and moderate levels of dietary behaviour, social support, self-efficacy and perceived behaviour barrier. The final structural model showed that depression(β= -0.207, P <0.001), perceived behaviour benefit(β= 0.220, P < 0.001), perceived behaviour barrier(β= -0.234, P < 0.001), attitude(β= 0.135, P =0.026) and social support(β= 0.166, P =0.001) exhibited direct effects on dietary behaviour in KTRs. Depression, attitude and social support also exhibited indirect effects on dietary behaviour through perceived benefit and perceived barrier. The final model showed a suitable fit of the data: χ2 / df =2.079, RMSEA=0.061, CFI=0.945, TLI=0.912, SRMR=0.067. The model explained 38.06% of the variance in dietary behaviour of KTRs.
Conclusion: Dietary behaviour in KTRs can be influenced by complex variables. We will consider KTRs' status of depression, attitude, social support, perceived benefit, and perceived barrier when developing interventions to improve their dietary behaviour. (Ethics: We declare that autonomous consent free from coercion was obtained from the donors or their next of kin, and that organs were not sourced from executed prisoners or prisoners of conscience.)