Observational Study
Copyright ©The Author(s) 2017. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Mar 14, 2017; 23(10): 1881-1890
Published online Mar 14, 2017. doi: 10.3748/wjg.v23.i10.1881
Role of illness perception and self-efficacy in lifestyle modification among non-alcoholic fatty liver disease patients
Shira Zelber-Sagi, Shiran Bord, Gali Dror-Lavi, Matthew Lee Smith, Samuel D Towne Jr, Assaf Buch, Muriel Webb, Hanny Yeshua, Assy Nimer, Oren Shibolet
Shira Zelber-Sagi, Assaf Buch, Muriel Webb, Hanny Yeshua, Oren Shibolet, Liver Unit, Department of Gastroenterology, Tel-Aviv Medical Center, Tel-Aviv 6423906, Israel
Shira Zelber-Sagi, Shiran Bord, Gali Dror-Lavi, School of Public Health, University of Haifa, Haifa 3498838, Israel
Matthew Lee Smith, Institute of Gerontology, College of Public Health, The University of Georgia, Athens, GA 30602, United States
Matthew Lee Smith, Samuel D Towne Jr, Texas A&M University, School of Public Health, College Station, TX 77843, United States
Assaf Buch, Muriel Webb, Hanny Yeshua, Oren Shibolet, The Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv 6423906, Israel
Hanny Yeshua, Family Medicine Department, Tel-Aviv and Dan Petach-Tikva, Clalit Health Services, Rabin Medical Center, Tel-Aviv 49100, Israel
Assy Nimer, Internal medicine A Galler medical Center, Bar-Ilan University, Ramat-Gan 5290002, Israel
Author contributions: Zelber-Sagi S and Bord S contributed equally to this study; Zelber-Sagi S conceived the study; Zelber-Sagi S, Bord S and Dror-Lavi G designed the study; Zelber-Sagi S, Dror-Lavi G, Buch A, Webb M and Yeshua H performed the data collection; Shibolet O conducted on data collection; Zelber-Sagi S, Bord S, Smith ML and Towne SD Jr wrote the manuscript; Nimer A and Shibolet O critically reviewed the manuscript.
Institutional review board statement: The study was approved by the institutional review board of Tel Aviv medical center.
Informed consent statement: All participants signed an informed consent.
Conflict-of-interest statement: We declare that in this manuscript there was no Conflict of interest and no financial support.
Data sharing statement: Technical appendix, statistical code, and dataset available from the corresponding author at zelbersagi@bezeqint.net.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Dr. Shira Zelber-Sagi, RD, PhD, Liver Unit, Department of Gastroenterology, Tel-Aviv Medical Center, Tel-Aviv 6423906, Israe. zelbersagi@bezeqint.net
Telephone: +972-3-6973984 Fax: +972-3-6966286
Received: December 3, 2016
Peer-review started: December 6, 2016
First decision: December 28, 2016
Revised: January 9, 2017
Accepted: February 6, 2017
Article in press: February 8, 2017
Published online: March 14, 2017
Processing time: 100 Days and 14 Hours
Core Tip

Core tip: Dietary modification is a main route of treatment in non-alcoholic fatty liver disease (NAFLD), however it is difficult to maintain in the long term and better ways for implementation are needed. Higher perceptions of understanding the illness and a higher self-efficacy are positively related to better nutritional habits, and therefore its enhancement should be part of the behavioral treatment. Emphasizing to patients that although NAFLD is a chronic condition, it is effectively treatable by diet, increases their self-efficacy. “Scaring” the patients and leading them to believe that NAFLD has severe consequences may lead to the undesirable outcome of reduced self-efficacy and worse dietary habits.