Aim: To analyze the concept of diet adherence in type 2 diabetes mellitus (T2DM). Background: Different healthcare providers widely use the concept of adherence. In the 1970s, the term compliance was commonly used as the patients' views on treatment decisions were neglected. With consideration of patients' perspectives in treatment choices and treatment management, the concept of "compliance" has been increasingly replaced by "adherence." Adhering to a healthy diet is very challenging among patients with T2DM, and empirical studies show a low adherence rate to a healthy diet. Methods: The Walker and Avant (2011) method of concept analysis was implemented. Scientific databases were probed for research articles in the English language published between 2010-2020 using the search terms: compliance, adherence, treatment adherence, diet adherence, T2DM, and concept analysis. Results: Diet adherence as a concept includes, following diet recommendations, self-monitoring, maintenance, and relapse prevention. Antecedents include motivation, understanding of diet recommendations, health beliefs, self-efficacy, goal setting, and social support. Consequences include overall health promotion, health-related quality of life, and improved disease-specific parameters such as lower body mass index, HbA1c, a better level of triglycerides, LDL-cholesterol, non-HDL-cholesterol, and lower diastolic blood pressure. Diet adherence is frequently measured using the Perceived Dietary Adherence Questionnaire, Patient Diet Adherence in Diabetes Scale, the Compliance Praxis Survey-Diet, multiday food diaries, 24-hour recalls, and food frequency questionnaires. Conclusion: Adherence to a healthy diet for patients with T2DM is a primary determinant of management, but diet adherence is frequently inadequate. Poor diet adherence attenuates optimum expected outcomes; hence more research is needed to promote diet adherence.

Background Globally, cardiovascular disease (CVD) accounts for 45% of all chronic non-communicable disease deaths and 31% of all deaths. CVD has remained the primary cause of death in the world for the past fifteen years. Compared to other continents, CVD and its risk factors are highly prevalent in Africa, but the continent also displays a low-level of knowledge and awareness of CVD, and poor perception of its risk factors. Little research has been done on the connection between the daily lived experiences of African people and the high prevalence and poor perception of CVD and its risk factors on the African continent. The aim of this study is to provide an in-depth understanding of the daily, lived experiences of African people and the connections between these experiences and the prevention, control, and management of CVD and its risk factors. Methods A systematic search was performed in PubMed, CINAHL, EMBASE, Psych INFO, and Web of Science databases to identify published English qualitative studies of CVD and its risk factors. Qualitative metasynthesis included structured techniques of data immersion and quality appraisal, thematic synthesis, and reciprocal translation. Results Seven studies met the inclusion criteria. Four major themes were identified from the metasynthesis: 1) understanding and beliefs about CVD; 2) perceived causes/risk factors for CVD; 3) understanding and belief about obesity; 4) perceived treatment options for CVD. The metasynthesis identified a consistent disconnect among African people between seeing CVD as a deadly and chronic disease and their perceptions of the minimal signs and symptoms of the disease in the early stages. This was further compounded by the gap between traditional healers and health care professionals. Conclusions Perceptions of CVD, its risk factors, and treatments were influenced by religious and cultural factors. Given the minimal signs and symptoms experienced in the early stages of the disease, there was a consistent disconnect among African people between seeing CVD as a deadly and chronic illness. Further investigations of the religious and cultural influences and educational programs related to these areas of disconnect are needed to improve the knowledge, attitudes, and beliefs of African people.

Among women, cardiovascular disease is the leading cause of mortality worldwide. After experiencing an acute cardiovascular event, a woman's physical health, the prevalence of morbidities, likelihood of being treated with coronary artery bypass graft surgery, likelihood for referral for cardiac rehabilitation are less favourable than men. The social support resources of marginality and religiousness are associated with physical and mental health outcomes following cardiovascular crises. This study aimed to evaluate the reliability and validity of the translated versions (Japanese, Ukrainian, Tagalog, Hispanic and Arabic) of the Koci Marginality Index and the Duke University Religion Index among 282 women (aged 35-92 years) representing seven cultures. Results showed that reliability and validity were strong (coefficient alpha of 0.79 and 0.84). Understanding a woman's social isolation and whether she has a connection to religious groups assists health-care professionals to identify a woman's social support resources during recovery following acute cardiovascular episodes.

Worldwide, 3.4 million women die each year from cardiovascular disease. After experiencing a cardiovascular event, a woman’s physical health, the women’s likelihood of being treated with coronary artery bypass graft surgery, likelihood for referral for cardiac rehabilitation are less favorable than men. An established conceptual model depicts psychosocial stressors and the influence of behavioral risk factors on the pathogenesis of atherosclerosis and the occurrence of CV events. The woman’s social stressors of role quality and behavioral risk factors of low self-efficacy for physical activity are associated with physical and mental health outcomes following cardiovascular crises. The study aimed to evaluate the reliability of the translated versions (Japanese, Ukrainian, Tagalog, Hispanic and Arabic) of the worker, partner, mother Role Quality and the Self Efficacy of Lifestyle Physical Activity indices among 282 women (aged 35-92 years) representing seven cultures. The study was performed in a multi-center, multicultural context. Translations followed an established process. Results showed reliability was strong (coefficient alphas of 0.93 and 0.88). These instruments underwent first-time confirmatory factor analyses with acceptable, though borderline fit, thus providing valuable input for strengthening in future studies. Understanding a woman’s role quality and self-efficacy for lifestyle physical activity provides valuable information that assists health-care professionals to co-develop with the woman an individualized plan to reduce role stress and to initiate increased physical activity following cardiovascular episodes.