The Relationship Between Adherence of High-Calorie, High-Protein Diet with Nutritional Knowledge and Attitudes Among Postoperative Patients at Grandmed Hospital in Lubuk Pakam
DOI:
https://doi.org/10.35451/jkg.v9i1.4026Keywords:
Obesity, Adolescents, Consumption Frequency, Sugary Packaged BeveragesAbstract
Postoperative wound healing requires adequate nutritional intake, including a High-Calorie, High-Protein (HCHP) diets. However, adherence to this diet may be influenced by patients’ nutritional knowledge and attitudes. This study aimed to analyze the association between nutritional knowledge and attitudes and adherence to the HCHP diet among postoperative patients at Grandmed Hospital, Lubuk Pakam. This observational analytical study employed a cross-sectional design. A total of 35 patients who had undergone cesarean section were recruited using consecutive sampling. Data were collected using questionnaires and analyzed using the chi-square test. The results showed that 42.9% of respondents had poor nutritional knowledge, 57.1% had negative nutritional attitudes, and 60% did not adhere to the HCHP diet. Bivariate analysis revealed significant associations between nutritional knowledge and adherence to the HCHP diet (p = 0.003) and between nutritional attitudes and adherence to the HCHP diet (p < 0.001). These findings indicate that nutritional knowledge and attitudes are significantly associated with dietary adherence among postoperative patients. Strengthening postoperative nutrition education may improve patients’ understanding of nutritional requirements, foster positive attitudes toward dietary recommendations, and support adherence to the HCHP diet during recovery. Further research involving larger samples is recommended to explore additional factors associated with dietary adherence in postoperative patients.
Downloads
References
[1] Weimann, A., Bezmarevic, M., Braga, M., Correia, M. I. T. D., Funk-Debleds, P., Gianotti, L., Gillis, C., Hübner, M., Inciong, J. F. B., Jahit, M. S., Klek, S., Kori, T., Laviano, A., Ljungqvist, O., Lobo, D. N., Loinaz Segurola, C., Montroni, I., Reddy, B. R., Saur, N. M., ... Bischoff, S. C. (2025). ESPEN guideline on clinical nutrition in surgery—Update 2025. Clinical Nutrition, 53, 222–261. https://doi.org/10.1016/j.clnu.2025.08.029
[2] Weimann, A., Braga, M., Carli, F., Higashiguchi, T., Hübner, M., Klek, S., Laviano, A., Ljungqvist, O., Lobo, D. N., Martindale, R. G., Waitzberg, D., Bischoff, S. C., & Singer, P. (2021). ESPEN practical guideline: Clinical nutrition in surgery. Clinical Nutrition, 40(7), 4745–4761. https://doi.org/10.1016/j.clnu.2021.03.031
[3] Mengistu, D. A., Alemu, A., Abdukadir, A. A., Husen, A. M., Ahmed, F., Mohammed, B., & Musa, I. (2023). Global incidence of surgical site infection among patients: Systematic review and meta-analysis. INQUIRY: The Journal of Health Care Organization, Provision, and Financing, 60. https://doi.org/10.1177/00469580231162549
[4] Mojtahedi, M. F., Sepidarkish, M., Almukhtar, M., Eslami, Y., Mohammadianamiri, F., Behzad Moghadam, K., Rouholamin, S., Razavi, M., Jafari Tadi, M., Fazlollahpour-Naghibi, A., Rostami, Z., Rostami, A., & Rezaeinejad, M. (2023). Global incidence of surgical site infections following caesarean section: A systematic review and meta-analysis. Journal of Hospital Infection, 139, 82–92. https://doi.org/10.1016/j.jhin.2023.05.019
[5] Islam, N., Thalib, L., Mahmood, S., Varol, S. A., Adel, I., Aqel, A., et al. (2025). Regional variations in incidence of surgical site infection and associated risk factors in women undergoing cesarean section: A systematic review and meta-analysis. Intensive and Critical Care Nursing, 89, Article 103951. https://doi.org/10.1016/j.iccn.2025.103951
[6] World Health Organization. (2018). Global guidelines for the prevention of surgical site infection (2nd ed.). https://www.who.int/publications/i/item/9789241550475
[7] Thibault, R., Abbasoglu, O., Ioannou, E., Meija, L., Ottens-Oussoren, K., Pichard, C., Rothenberg, E., Rubin, D., Siljamäki-Ojansuu, U., Vaillant, M.-F., & Bischoff, S. C. (2021). ESPEN guideline on hospital nutrition. Clinical Nutrition, 40(12), 5684–5709. https://doi.org/10.1016/j.clnu.2021.09.039
[8] Adjepong, D., Jahangir, S., & Malik, B. H. (2020). The effect of zinc on post-neurosurgical wound healing: A review. Cureus, 12(1), Article e6770. https://doi.org/10.7759/cureus.6770
[9] Zhang, Y., Tan, S., & Wu, G. (2021). ESPEN practical guideline: Clinical nutrition in surgery. Clinical Nutrition, 40(9), 5071. https://doi.org/10.1016/j.clnu.2021.07.012
[10] Monahan, M., Jowett, S., Pinkney, T., Brocklehurst, P., Morton, D. G., Abdali, Z., & Roberts, T. E. (2020). Surgical site infection and costs in low- and middle-income countries: A systematic review of the economic burden. PLOS ONE, 15(6), Article e0232960. https://doi.org/10.1371/journal.pone.0232960
[11] World Health Organization. (2018). Preventing surgical site infections: Implementation approaches for evidence-based recommendations. https://www.who.int/publications/i/item/preventing-surgical-site-infections
[12] Saputra, Y. Y. (2022). Hubungan pengetahuan dan sikap tentang pemenuhan nutrisi dengan proses penyembuhan luka ibu post sectio caesarea di RSUD Leuwiliang tahun 2021. Indonesian Scholar Journal of Nursing and Midwifery Science, 1(8). https://doi.org/10.54402/isjnms.v1i08.143
[13] Weimann, A., Braga, M., Carli, F., Higashiguchi, T., Hübner, M., Klek, S., Laviano, A., Ljungqvist, O., Lobo, D. N., Martindale, R. G., Waitzberg, D., Bischoff, S. C., & Singer, P. (2017). ESPEN guideline: Clinical nutrition in surgery. Clinical Nutrition, 36(3), 623–650. https://doi.org/10.1016/j.clnu.2017.02.013
[14] World Health Organization. (2020). Global guidelines for the prevention of surgical site infection: Web annex. https://www.who.int/teams/integrated-health-services/infection-prevention-control/surgical-site-infection.
[15] Contento, I. R. (2020). Nutrition education: Linking research, theory, and practice (2nd ed.). Jones & Bartlett Learning.
[16] Arnold, M., & Barbul, A. (2006). Nutrition and wound healing. Plastic and Reconstructive Surgery, 117(7 Suppl.), 42S–58S. https://doi.org/10.1097/01.prs.0000225432.17501.6c
[17] Guo, S., & DiPietro, L. A. (2010). Factors affecting wound healing. Journal of Dental Research, 89(3), 219–229. https://doi.org/10.1177/0022034509359125
[18] Stechmiller, J. K. (2010). Understanding the role of nutrition and wound healing. Nutrition in Clinical Practice, 25(1), 61–68. https://doi.org/10.1177/0884533609358997
[19] Berger, M. M., Shenkin, A., Schweinlin, A., Amrein, K., Augsburger, M., Biesalski, H.-K., Bischoff, S. C., Casaer, M. P., Gundogan, K., Lepp, H.-L., de Man, A. M. E., Muscogiuri, G., Pietka, M., Pironi, L., Rezzi, S., Cuerda, C., & Bischoff, S. C. (2022). ESPEN micronutrient guideline. Clinical Nutrition, 41(6), 1357–1424. https://doi.org/10.1016/j.clnu.2022.02.015
[20] Ajzen, I. (1991). The theory of planned behavior. Organizational Behavior and Human Decision Processes, 50(2), 179–211. https://doi.org/10.1016/0749-5978(91)90020-T
[21] Sørensen, K., Van den Broucke, S., Fullam, J., Doyle, G., Pelikan, J., Slonska, Z., & Brand, H. (2012). Health literacy and public health: A systematic review and integration of definitions and models. BMC Public Health, 12, Article 80. https://doi.org/10.1186/1471-2458-12-80
[22] World Health Organization. (2003). Adherence to long-term therapies: Evidence for action. World Health Organization. https://iris.who.int/bitstream/handle/10665/42682/9241545992.pdf
[23] Rosenstock, I. M., Strecher, V. J., & Becker, M. H. (1988). Social learning theory and the Health Belief Model. Health Education Quarterly, 15(2), 175–183. https://doi.org/10.1177/109019818801500203
[24] DiMatteo, M. R., Martin, L. R., & Haskard-Zolnierek, K. B. (2025). Health behavior change and treatment adherence: Evidence-based guidelines for improving healthcare (2nd ed.). Oxford University Press. https://doi.org/10.1093/oso/9780197778586.001.0001
Downloads
Published
Issue
Section
License
Copyright (c) 2026 Siti Aisyah, Raisha Octavariny
This work is licensed under a Creative Commons Attribution 4.0 International License.
Copyright in each article is the property of the Author.
