Adherence to diabetes mellitus care at three levels of health care

Abstract

Adherence to diabetes mellitus care at three levels of health careAdesão ao cuidado em diabetes mellitus nos três níveis de atenção à saúde La adhesión a la atención en la diabetes mellitus en tres niveles de atención de la salud AbstrActObjective: To evaluate adherence to self-care among people with diabetes mellitus cared for at the three levels of health care.Method: Quantitative, descriptive, cross-sectional study addressing a sample of 143 people from a city in the interior of São Paulo, Brazil from primary (45), secondary (48) and tertiary (50) units. Adherence to self-care was assessed using the "The Summary of Diabetes Self-Care Activities Measure" and "Measurement of Treatment Adherence". Results: Adherence to exercises, blood glucose monitoring, shoe inspection, and the use of insulin differed between units; better results were obtained for those in resumen Objetivo: Evaluar la adherencia al cuidado de personas con diabetes mellitus asistidas en tres niveles de atención a la salud.Método: Estudio cuantitativo, descriptivo, transversal, muestra de 143 personas de un municipio de São Paulo, provenientes de unidad atención primaria (45), secundaria (48) y terciaria (50). Se evaluó la adherencia utilizando el "Cuestionario de Actividades de Autocuidado con la Diabetes" y la "Prueba de Medición de Adherencia al Tratamiento". Resultados: La adherencia a la actividad física, monitoreo de la glucosa capilar, inspección del calzado y uso de insulina difirieron entre las unidades; mejores resultados en la atención terciaria. Conclusión: Se necesita una mayor inversión en el tratamiento precoz para mejorar la adherencia a los cuidados personales. Implicaciones para la práctica: Fue posible identificar el perfil de la adhesión al cuidado a la enfermedad, y subsidiar la planificación de las intervenciones de enfermería en la atención en diabetes mellitus.

Educational program to promote the self-care of people with diabetes mellitus

“…It was observed that in our study, gender does not corroborate other similar studies that obtained a larger number of women in their samples. The type of occupation performed by this group in the telephony field can explain this fact, and it is observed that data related to age is corroborated by other analyzed studies, due to the populational aging and higher morbidity of dm type 2 in this age group (1,14,17).…”

Literacy in health and self-care in people with type 2 diabetes mellitus

“…Given that patients have to cope with the disease and participate in self-care activities, they must be health literate, since individuals with limited training and insufficient health literacy tend to have more difficulties during therapy (4,5) , presenting low adherence to the therapeutic regimen, poor understanding of health problems, lack of self-care knowledge, low use of preventive services, poor general health and morbidity (6,7) .…”

Atividades de autocuidado em pessoas com diabetes mellitus tipo 2

“…1,2,13 However, it is cautioned that this self-care was unsatisfactory both in this research and in several other. 6,20 In a study conducted with 225 patients with DM, 62% with DM2 reported that they did not exercise regularly and, when evaluating the report of the reasons for non-adherence to this self-care activity, stated: "because of discomfort", "because of medical restriction" and "for not liking". 21 These results are confirmed by the study that presents the frequencies for the Brazilian capitals of lifestyle indicators: high consumption of meat with excess fat; recommended low consumption of fruits and vegetables; practice of physical activity in free time below the recommended.…”

“…Moreover, these participants also obtained low scores for the items to eat five or more portions of fruits and/or vegetables, to eat foods rich in fat and in the physical activity domain. 20 It leads to poor glycemic control due to non-adherence to physical activity, as well as drug treatment and eating plan. 7,24 Hyperglycemia, if left unchecked over time, can cause damage to various organs of the body, leading to the development of life-threatening health disabilities and complications such as cardiovascular disease, neuropathy, nephropathy and eye disease, leading to retinopathy and blindness.…”