Intervenção telefônica na prática de autocuidado com os pés em diabéticos: ensaio clínico randomizado

Abstract

RESUMO Objetivo: Avaliar o efeito de uma intervenção telefônica para a prática de autocuidado com os pés em pessoas com diabetes mellitus tipo 2. Método: Ensaio clínico randomizado com dois grupos, controle e intervenção, realizado com 102 usuários com diabetes mellitus tipo 2, vinculados a quatro Unidades Básicas de Saúde de um município do Piauí. Para o grupo intervenção, foram realizadas seis intervenções telefônicas em três meses, e o grupo controle recebeu somente o acompanhamento convencional. Para a avaliação, aplicou-se um formulário antes e após o período das intervenções. Resultados: Na análise intragrupo, ao comparar a prática de autocuidado com os pés no grupo controle, no pré e pós-teste, não houve diferença significativa (p > 0,05); já no grupo intervenção, houve aumento da prática de autocuidado em 70% dos itens, obtendo-se p < 0,001 a 0,03. Ao analisar a prática de autocuidado intergrupal após a intervenção telefônica, evidenciou-se o efeito positivo da intervenção, obtendo diferenças estatisticamente significativas em 60% dos itens, com valor de p < 0,001 a 0,031. Conclusão: A intervenção telefônica promoveu maior adesão à prática de autocuidado com os pés dos pacientes com diabetes mellitus tipo 2. Registro Brasileiro de Ensaios Clínicos: RBR-3pq5th.

A Scoping Review of Footwear Worn by People With Diabetes in Low- and Middle-Income Countries: Implications for Ulcer Prevention Programs

“…Additionally, several other studies from LMICs classifying footwear of people with diabetes as appropriate or inappropriate but that do not define these terms or classify more than half of their sample (and hence, were not eligible for inclusion in our study) corroborate the low rates of appropriate footwear use found in included studies. [65][66][67][68][69][70][71][72][73][74] More studies are warranted, particularly in Latin America, sub-Saharan Africa, the Middle East, Central Asia, and Eastern Europe. Little is reported in the literature about the footwear practices of people with diabetes in these regions.…”

Relax to Heal? Perspectives of Patients with Diabetic Foot Ulcers and Health Professionals on Relaxation Sessions for Wound Healing

“…Some studies found that telephone interventions are effective in promoting foot care adherence because they offer flexibility with patients' schedules and are inexpensive. 43,44 This treatment option could be tested in a future pilot study.…”

“…This option may also be implemented to overcome patient difficulties in traveling to the hospital and the noisy hospital conditions, which both patients and HPs reported being a barrier to relaxation. Some studies found that telephone interventions are effective in promoting foot care adherence because they offer flexibility with patients’ schedules and are inexpensive 43,44 . This treatment option could be tested in a future pilot study.…”

Effectiveness of educational interventions for diabetes‐related foot disease: A systematic review and meta‐analysis

“…Overall, 14 trials were deemed to be at high risk of bias, 23,24,26,29,30,32,34,36,37,42,45,[47][48][49] 14 as having some risk of bias, 21,22,25,27,28,31,33,[38][39][40][41]43,44,46 and only one as low risk of bias (Figure 2). 35 A high risk of bias was commonly identified with the methods of randomisation, lack of allocation concealment, inappropriate analyses, missing data, and uncertainty on the integrity of DROVANDI ET AL.…”

“…Nineteen of 20 trials reported the education programs significantly increased participant DFD self-care behaviours but metaanalysis was not possible due to heterogeneity in measurement tools used (for example the Foot Self-Care Behaviour Scale and the Foot Care Practices Questionnaire). 21,22,24,[27][28][29][31][32][33][34][35]38,39,41,42,[44][45][46][47]49 F I G U R E 2 Risk of bias outcomes for each randomised controlled trial included.…”