Objectives: To relate the knowledge and attitudes of users with type 2 diabetes mellitus (DM2), according to educational level and duration of disease. Methods: This was a quantitative, descriptive transversal study conducted in a Basic Health District Unit in the municipality of Ribeirão Preto, SP, in 2010. We interviewed 123 users with DM2, who met the inclusion criteria. For data collection we used: Knowledge Questionnaire (DKN-A) and Questionnaire of Psychological Attitudes about Diabetes (TA-19). Data were collected through direct interviews. For the analysis, we used the Fisher exact test. Results: The mean age was 63.87 ± 9.09 years, 4.54 ± 3.66 years of study, mean disease duration 11.18 ± 8.64 years. The education and disease duration were statistically signifi cant (p <0.01 and 0.02, respectively) for the acquisition of knowledge and readiness for self-care in diabetes. Conclusions: education and disease duration are variables that infl uence the knowledge and attitude of patients with DM2. RESUMENObjetivos: Relacionar el conocimiento y la actitud de usuarios con Diabetes mellitus tipo 2 (DM2), conforme la escolaridad y el tiempo de la enfermedad. Métodos: Estudio de abordaje cuantitativo, descriptivo transversal realizado en una Unidad Básica Distrital de Salud del municipio de Ribeirão Preto, SP, en el 2010. Fueron entrevistados 123 usuarios con DM2, que reunían los criterios de inclusión. Para la recolección de los datos, fueron utilizados: Cuestionario de Conocimiento (DKN-A) y Cuestionario de Actitudes Psicológicas de la Diabetes (ATT-19). Los datos fueron obtenidos por medio de entrevista dirigida. Para el análisis, se utilizo el test Exacto de Fisher. Resultados: El promedio de edad fue de 63,87±9,09 años, 4,54±3,66 años de estudio, tiempo promedio de enfermedad 11,18±8,64 años. La escolaridad y el tiempo de enfermedad se mostraron estadísticamente signifi cativos (p<0,01 e 0,02, respectivamente) para la adquisición del conocimiento y prontitud para el autocuidado en Diabetes. Conclusiones: La escolaridad y el tiempo de enfermedad son variables que infl uyen en el conocimiento y actitud del paciente con DM2. Descriptores: Diabetes mellitus tipo 2; Conocimiento; Actitud; Escolaridad

The objective of the present study was to assess patient adherence to antidiabetic drug therapy and its association with factors related to the patient, patient-provider relationship, therapeutic regimen and the disease itself. The study comprised 46 diabetic patients enrolled in a research and extension education center in the State of Sao Paulo, southeastern Brazil, in 2007. Data was collected through interviews using a questionnaire and the Treatment Adherence Measure (TAM). The patient adherence level to antidiabetic drug therapy was 78.3%. In conclusion, since prevalence of adherence is below that recommended in the literature, and in the light of poor blood glucose control and alleged failure of therapeutic regimen, health providers are urged to measure diabetic patient treatment adherence, because it is key to adequate diabetes management with drugs.

Objective: Investigating the association between adherence to treatment of type 2 diabetes mellitus and sociodemographic, clinical and metabolic control variables. Methods: Cross-sectional study with 423 patients with diabetes mellitus. The Fisher's exact test and logistic regression models were used to investigate the association between adherence to treatment and the studied variables.Results: There was no association between adherence to treatment of T2DM and socio-demographic and clinical variables. It was found that total cholesterol and HbA1c were significantly associated with adherence to diet (p = 0.036) and exercise (p = 0.006). Conclusion: The chance of a patient with cholesterol within the recommended level adhering to diet is almost five times the chance of the patient in poor lipid control. The chance of patients with poor glycemic control adhering to exercise is almost twice the chance of those who keep adequate glycemic control. ResumoObjetivo: Investigar associação entre adesão ao tratamento do diabetes mellitus tipo 2 e variáveis sociodemográficas, clínicas e controle metabólico. Métodos: Desenho cross seccional com 423 portadores de diabetes mellitus. Para verificar a associação entre adesão ao tratamento e as variáveis estudadas, utilizou-se teste exato de Fisher e modelos de regressão logística. Resultados: Não houve associação entre adesão ao tratamento do DM2 e variáveis sociodemográficas e clínicas. Verificou-se que o colesterol total e a HbA1c apresentaram associação estatisticamente significativa com a adesão ao plano alimentar (p = 0.036) e de exercício físico (p = 0.006). Conclusão: A chance do paciente com colesterol dentro do valor recomendado apresentar adesão ao plano alimentar é quase cinco vezes a chance do paciente em mau controle lipídico. A chance dos pacientes com mau controle glicêmico apresentarem adesão ao exercício físico é quase duas vezes a chance daquele sem controle adequado da glicemia.

Middle-income countries are facing a growing challenge of adequate health care provision for people with multimorbidity. The objectives of this study were to explore the distribution of multimorbidity and to identify patterns of multimorbidity in the Brazilian general adult population. Data from 60202 adults, aged ≥18 years that completed the individual questionnaire of the National Health Survey 2013 (Portuguese: “Pesquisa Nacional de Saúde”–“PNS”) was used. We defined multimorbidity as the presence of two or more chronic conditions, including self-reported diagnoses and responses to the 9-item Patient Health Questionnaire for depression. Multivariate Poisson regression analyses were used to explore relationship between multimorbidity and demographic factors. Exploratory tetrachoric factor analysis was performed to identify multimorbidity patterns. 24.2% (95% CI 23.5–24.9) of the study population were multimorbid, with prevalence rate ratios being significantly higher in women, older people and those with lowest educational level. Multimorbidity occurred earlier in women than in men, with half of the women and men aged 55–59 years and 65–69 years, respectively, were multimorbid. The absolute number of people with multimorbidity was approximately 2.5-fold higher in people younger than 65 years than older counterparts (9920 vs 3945). Prevalence rate ratios of any mental health disorder significantly increased with the number of physical conditions. 46.7% of the persons were assigned to at least one of three identified patterns of multimorbidity, including: “cardio-metabolic”, “musculoskeletal-mental” and “respiratory” disorders. Multimorbidity in Brazil is as common as in more affluent countries. Women in Brazil develop diseases at younger ages than men. Our findings can inform a national action plan to prevent multimorbidity, reduce its burden and align health-care services more closely with patients’ needs.

This study aimed to understand the repercussions in the family of the care offered after the implementation of a diabetes education program. We interviewed six relatives of diabetes patients from a university center in Ribeirão Preto-SP, Brazil, in 2007. Thematic data analysis made it possible to identify three themes: relatives recognize that the Center constitutes a differential for adherence to the food plan, physical activity and medication; the Center is acknowledged as an educative space to get together and control diabetes; the patient as an element that multiplies and expands the knowledge about diabetes in the family. The results indicate that the education program favorably affected the family, expanding its knowledge repertoire about treatment, and that the family core's support is fundamental in treatment adherence.

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Objective:To describe the knowledge and behaviors of patients with diabetes towards foot care. Methods: A cross-sectional descriptive study was conducted at a university research and intervention center in the interior of the state of São Paulo. Data were collected through interviews, two specific questionnaires, and physical examination of the foot in 55 patients in 2005. Results: The participants did not recognize the dimension of the true risks regarding lack of foot care. The participant knowledge of diabetes did not translate into actions to prevent foot problems. These results suggest the need to take into consideration specific individual characteristics and the individual's interactions with the environment in designing educational interventions. Conclusions: Health care professionals need to understand that discrepancy between knowledge and behaviors of patients with diabetes is not an obstacle impossible to cross, but a challenging issue that needs to be addressed. Keywords: Diabetes mellitus; Primary prevention; Diabetic foot/prevention & control; Health behavior; Health knowledge, attitudes, practice RESUMO Objetivo: Identificar o conhecimento e comportamento de pessoas diabéticas em relação aos cuidados com os pés. Métodos: Estudo descritivo e transversal realizado em um centro de pesquisa e extensão universitária do interior paulista, em 2005. Foram entrevistados 55 pacientes diabéticos. Para a obtenção dos dados utilizamos um formulário, dois questionários e exame físico dos pés. Resultados: As pessoas diabéticas não reconhecem a dimensão do risco real com relação aos pés. O conhecimento referido nem sempre se traduz na adoção de ações de autocuidado para a prevenção de problemas relacionados aos pés. Esta realidade aponta para a necessidade de considerarmos as particularidades de cada sujeito e sua interação com o ambiente, para delineamento das intervenções educativas. Conclusões: É preciso que os profissionais de saúde compreendam que o descompasso entre conhecimento e comportamento dos diabéticos não deve ser interpretado como um obstáculo intransponível, mas como um dos desafios fundamentais que precisam ser enfrentados. Descritores: Diabetes mellitus; Prevenção primária; Pé diabético/prevenção & controle; Conduta de saúde; Conhecimentos, atitudes e prática em saúde RESUMEN Objetivo: Identificar el conocimiento y comportamiento de personas diabéticas en relación a los cuidados de los piés. Métodos: Estudio descriptivo y transversal realizado en un centro de investigación y extensión universitaria del interior paulista, en el 2005. Fueron entrevistados 55 pacientes diabéticos. Para la obtención de los datos utilizamos un formulario, dos cuestionarios y examen físico de los piés. Resultados: Las personas diabéticas no reconocen la dimensión del riesgo real en relación a los piés. El conocimiento referido no siempre se traduce en la adopción de acciones de autocuidado para la prevención de problemas relacionados a los piés. Esta realidad apunta hacia la necesidad de considerar las parti...

RESUmoEstudo quase-experimental com objetivo de avaliar a qualidade de vida relacionada à saúde de pessoas com diabetes mellitus, antes e após participação em um programa educativo de cinco meses. Participaram 51 sujeitos, com predomínio do sexo feminino (56,9%), média e desvio-padrão de 57,65 ± 11,44 anos de idade, em um serviço de atenção primária no interior paulista, em 2008. Para obtenção dos dados utilizou-se o questionário SF-36. O instrumento mostrou-se confiável para a população estudada, sendo os valores de alpha de Cronbach para os componentes físico e mental 0,83 e 0,89, respectivamente. Os resultados mostraram melhora discreta em quase todos os domínios, embora apenas o estado geral de saúde antes (63,96 ± 19,03) e após (70,59 ± 17,82) o programa educativo tenha apresentado diferença estatisticamente significativa t(50) = -2,16, p < 0,05. A participação dos sujeitos no programa educativo em diabetes mellitus também contribuiu para a melhoria da percepção acerca de seu estado geral de saúde.