OBJECTIVEEvaluate the effectiveness of a diabetes mellitus educational program in primary health care.METHODSThis cluster randomized trial was conducted in a sample of 470 people with type 2 diabetes mellitus from eight health units, randomly assigned to two groups: intervention (n = 231) and control (n = 239). The intervention group participated in the educational program composed of three strategies: group education, home visit, and telephone intervention. Simultaneously, the control group was monitored individually. Group monitoring took place over nine months in the year 2012. Clinical evaluations were performed at the initial time (T0), three (T3), six (T6) and nine (T9) months after the beginning of the intervention.RESULTSAfter nine months of follow-up, 341 users remained in the study, 171 in the control group and 170 in the intervention group. The average age of users was 60.6 years. In both groups, statistically significant differences were observed in mean HbA1c levels over the follow-up time (p < 0.05). However, the mean HbA1c level at T3, T6 and T9 times were significantly lower among the people in the intervention group (p < 0.05).CONCLUSIONSThe educational program model developed was effective to improve the glycemic control of the intervention group participants.
OBJECTIVE To translate, cross-culturally adapt and validate the Diabetes Empowerment Scale – Short Form for assessment of psychosocial self-efficacy in diabetes care within the Brazilian cultural context.METHODS Assessment of the instrument’s conceptual equivalence, as well as its translation and cross-cultural adaptation were performed following international standards. The Expert Committee’s assessment of the translated version was conducted through a web questionnaire developed and applied via the web tool e-Surv. The cross-culturally adapted version was used for the pre-test, which was carried out via phone call in a group of eleven health care service users diagnosed with type 2 diabetes mellitus. The pre-test results were examined by a group of experts, composed by health care consultants, applied linguists and statisticians, aiming at an adequate version of the instrument, which was subsequently used for test and retest in a sample of 100 users diagnosed with type 2 diabetes mellitus via phone call, their answers being recorded by the web tool e-Surv. Internal consistency and reproducibility of analysis were carried out within the statistical programming environment R.RESULTS Face and content validity were attained and the Brazilian Portuguese version, entitled Escala de Autoeficácia em Diabetes – Versão Curta, was established. The scale had acceptable internal consistency with Cronbach’s alpha of 0.634 (95%CI 0.494– 0.737), while the correlation of the total score in the two periods was considered moderate (0.47). The intraclass correlation coefficient was 0.50.CONCLUSIONS The translated and cross-culturally adapted version of the instrument to spoken Brazilian Portuguese was considered valid and reliable to be used for assessment within the Brazilian population diagnosed with type 2 diabetes mellitus. The use of a web tool (e-Surv) for recording the Expert Committee responses as well as the responses in the validation tests proved to be a reliable, safe and innovative method.
Objective: To examine the functionalities of mobile applications for self-care of adolescents with type 1 diabetes mellitus. Methods: Integrative review targeting articles in journals indexed in the following databases: Cumulative Index to Nursing and Allied Health Literature, Cochrane Library, Latin American Health Sciences Literature, PubMed (National Library of Medicine), Scopus, and Web of Science in the period between 2012 and 2017 using the following descriptors and their respective descriptors in English and Spanish: mobile applications, self-care and type 1diabetes mellitus. Results: Databank query yielded 248 articles, out of which 12 articles met the selection criteria and were included in the final analysis. Applications were examined in terms of functionalities catering for glycemic control, insulin therapy, diet, physical activity, sentiment analysis and social relationships. No article reported on an application featuring all of the examined functionalities. Conclusion: Mobile application functionalities were pointed out as essential aids in glycemic control of adolescents with type 1 diabetes mellitus. ResumoObjetivo: Examinar os recursos de aplicativos para dispositivos móveis destinados ao autocuidado de adolescentes com diabetes mellitus tipo 1. Métodos: Revisão integrativa por meio da busca de artigos nos periódicos indexados nas bases de dados: Cumulative Index to Nursing and Allied Health Literature, Cochrane Library, Literatura Latino-Americana em Ciências da Saúde, PubMed (National Library of Medicine), Scopus, e Web of Science no período de 2012 a 2017, utilizando os seguintes descritores: aplicativos móveis, autocuidado e diabetes mellitus tipo 1, bem como respectivos descritores em inglês e espanhol. Resultados: A busca gerou um total de 248 artigos, dos quais 12 artigos atenderam os critérios de seleção. Os recursos dos aplicativos foram examinados a partir das funções de controle glicêmico, insulinoterapia, alimentação, atividade física, abordagem dos sentimentos e relações sociais. Observou-se que nenhum artigo descreveu um aplicativo que integrasse todos os recursos examinados. Conclusão: Os recursos de aplicativos para dispositivos móveis foram apontados como necessários para auxiliar no controle glicêmico de adolescentes com diabetes mellitus tipo 1.
Objective: to translate, adapt and validate the contents of the Diabetes Medical Management Plan for the Brazilian context. This protocol was developed by the American Diabetes Association and guides the procedure of educators for the care of children and adolescents with diabetes in schools. Method: this methodological study was conducted in four stages: initial translation, synthesis of initial translation, back translation and content validation by an expert committee, composed of 94 specialists (29 applied linguists and 65 health professionals), for evaluation of the translated version through an online questionnaire. The concordance level of the judges was calculated based on the Content Validity Index. Data were exported into the R program for statistical analysis: Results: the evaluation of the instrument showed good concordance between the judges of the Health and Applied Linguistics areas, with a mean content validity index of 0.9 and 0.89, respectively, and slight variability of the index between groups (difference of less than 0.01). The items in the translated version, evaluated as unsatisfactory by the judges, were reformulated based on the considerations of the professionals of each group. Conclusion: a Brazilian version of Diabetes Medical Management Plan was constructed, called the Plano de Manejo do Diabetes na Escola.
RESUMOO objetivo do presente estudo foi verificar a visão dos profissionais da saúde sobre o Mapa de Conversação em Diabetes como estratégia educativa. Trata-se de pesquisa qualitativa, exploratória e descritiva, realizado com 14 profissionais da saúde inseridos em unidades básicas de saúde da regional leste do município de Belo Horizonte, Minas Gerais (Brasil). Para a coleta de dados, utilizou-se a entrevista semiestruturada guiada pelas seguintes questões: "quais as práticas educativas que vêm sendo utilizadas na atenção primária?"; "de que modo vêm sendo utilizadas?"; e "quais os seus fundamentos?" Em seguida, foram realizados grupos focais por meio das questões norteadoras: "como você acha que é ter o diagnóstico de diabetes?"; "como você acha que é ter que seguir um plano de cuidados diários para a saúde?"; e "qual é a sua visão do Mapa de Conversação em Diabetes?" Os dados foram analisados com base no referencial de análise de conteúdo de Bardin, do qual emergiram duas categorias: a) o Mapa de Conversação como uma estratégia de aprendizagem participativa; b) fatores que interferem na prática educativa para o autocuidado. A utilização do Mapa de Conversação em Diabetes permitiu verificar a visão dos profissionais sobre uma nova estratégia para a construção do autocuidado em diabetes, reconhecendo-o, assim, como uma ferramenta apropriada para a condução das práticas educativas. Palavras-chave: Diabetes Mellitus; Autocuidado; Educação em Saúde; Pessoal de Saúde. ABSTR ACT
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