Relación entre autoeficacia, apoyo social, adherencia al tratamiento y HbA1C por nivel de percepción de amenaza en pacientes con DM2

Abstract

Introduction: The main problem presented by patients with DM2 is the lack of adherence to medical treatments (WHO, 2004) since it is complex and requires changes in lifestyle and health habits. Objective: analyze the relationship between self-efficacy, social support, and threat perception to treatment adherence.Method: The design was transectional correlational with a non-probabilistic convenience sampling of 166 participants with DM2 who attended for medical attention at the Ministry of Health and ISSSTE of Michoacán. Instruments were administered to evaluate Self-efficacy to Treatment in DM2, Social Support in DM2, the subscales of severity and perceived susceptibility of the ECS-DM2 / PG and the adherence scale to the treatment of DM2.Results: By dividing the sample by levels of threat perception, a clear mediating role of perception of susceptibility and severity can be observed in the rest of the variables under study. Maintaining treatment adherence and glycosylated hemoglobin as dependent variables, multiple linear regression analyzes were performed using the stepwise method to identify the joint effect of the independent variables. The highest levels of prediction, both for treatment adherence and for glycosylated hemoglobin levels, are in the group with medium levels of susceptibility, where 46 % of the variance of treatment adherence is explained based on the sole independent variable of perceived social support. For glycosylated hemoglobin levels, the prediction of 33 % of the variance in the middle group is given by the factors of hygiene, self-care, and diet as components of treatment adherence. Discussion or Conclusion: According to the results obtained, it seems that the relationship between the perceived threat and adherence is not linear. It appears to be observed that perceived threat may produce a tendency to abandon by not following medical indications, when the patient perceives a very high level of susceptibility and severity, as well as when the levels are very low. It is also important to consider the perception of social support, the level of social support and self-efficacy to increase adherence to treatment in patients with T2DM.

Perception of Complementary Medicine and Treatment Adherence as Predictors of Self-Efficacy in Individuals with Chronic Conditions in Mexico

“…Moreover, the present study identifies a positive correlation between treatment adherence and self-efficacy, indicating that those who more faithfully follow their treatments tend to have greater confidence in their ability to do so. Like that reported by a study [25] of chronic patients in Michoacán, Mexico, which analyzed the relationship between self-efficacy, perceived social support, and adherence to treatment The results showed that self-efficacy was directly related to lower levels of noncompliance and greater perceived social support. In addition, mediational analyses indicated that self-efficacy had a significant direct and indirect effect (through perceived social support and satisfaction with support) on patients' adherence, specifically in relation to diet and physical exercise.…”

Insulinoterapia en pacientes con diabetes mellitus tipo 2. Una revisión narrativa

“…No obstante, a pesar de estas limitaciones, algunas organizaciones como la IDF o la American Diabetes Association (ADA, 2021) han considerado tres criterios diagnósticos para la DM2: muestra de glucemia plasmática al azar (> 200 mg/dl) o dos muestras seguidas con cifras > 126 mg/dl en ayuno, sobrecarga oral de glucosa luego de 2 h (> 200 mg/dl) y hemoglobina glucosilada (HbA1c) < 7 7,8 . Estos criterios asociados al control glucémico permiten utilizar diversos modelos orientados a generar cambios sobre la adhesión de estilos de vida saludables, además de tratamientos que incluyan medicamentos hipoglucemiantes no insulínicos e insulinoterapia cuando los métodos anteriores no logran un control glucémico deseado 8,9 La insulinoterapia se ha utilizado ampliamente debido al aumento en la prevalencia de DM2, por lo que un adecuado manejo es un factor fundamental dentro de las pautas de tratamiento. Su uso cobra relevancia por la existencia de una relación entre un adecuado control glucémico y un bajo riesgo de complicaciones de salud como lo es la lipohipertrofia en pacientes con DM2.…”