An Application of the Social Cognitive Theory to Adherence to a Low-Salt Diet in Patients with Hypertension

Background & aim: High blood pressure is one of the most important causes of premature death worldwide. One of the ways to control high blood pressure is lifestyle modification, especially paying attention to nutritional behaviors, such as reducing the consumption of salt-containing foods, therefore the purpose of the present study was to investigate the application of social cognitive theory in adherence to a low-salt diet in patients with high blood pressure. Methods: The present descriptive-cross-sectional study was conducted in 2021 on 100 patients with high blood pressure covered by comprehensive health centers in the city of Charam, located in the Kohgiluyeh and Boyer-Ahmad province. Data collection tools included a questionnaire on adherence to a low-sodium diet, based on a modified version of the self-care activities level adjustment questionnaire in hypertension, and a researcher-made questionnaire consisting of components from the Bandura Social Cognitive Theory, including self-efficacy, social support, and self-regulation. Patients meeting the inclusion criteria were randomly selected, and with the assistance of a disease specialist, questionnaires were completed. The collected data were analyzed using Pearson correlation and linear regression statistical tests. Results: The participants' age ranged from 40 to 69 years, with a mean of 57.26 ± 29.7. 61% were female and 39% were male. 34 participants (34%) were illiterate, while 20 participants (20%) had university education. 27% had a family history of hypertension. The mean systolic blood pressure was 136.95 ± 10.22, and the mean diastolic blood pressure was 85.56 ± 5.44. The adherence rate to a low-salt diet among the studied patients was 32% (34% for females and 33% for males). Linear regression analysis revealed that the social cognitive theory predicts for 20% of the variance in adherence to a low-salt diet Conclusion: The findings indicated a low level of adherence to a low- salt diet among the studied patients. This can serve as a warning sign for both these patients and the healthcare system. Implementing interventional treatment programs and utilizing educational strategies, particularly in the areas of family social support and self-regulation, can play a significant role in increasing adherence to a low-sodium diet and controlling hypertension for these individuals.