Carla Regina de Souza Teixeira

O cuidado à pessoa diabética e as repercussões na família

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 cores support is fundamental in treatment adherence.La finalidad de este estudio fue comprender las repercusiones en la familia de la atencion ofrecida tras la implementacion de un programa educativo en diabetes. Entrevistamos a seis familiares de pacientes diabeticos de un centro universitario de Ribeirao Preto-SP, Brasil, en 2007. El analisis tematico de los datos posibilito identificar tres temas: familiares reconocen que el Centro constituye un diferencial para adhesion al plano alimentario, actividad fisica y medicamentos; el Centro es reconocido como espacio educativo para convivencia y control del diabetes; el paciente como elemento que multiplica y expande el conocimiento acerca del diabetes en la familia. Los resultados apuntan que el programa educativo repercutio favorablemente en la familia, ampliando su repertorio de conocimientos sobre el tratamiento, y que el apoyo del nucleo familiar es fundamental en la adhesion al tratamiento.

Relação entre conhecimento, atitude, escolaridade e tempo de doença em indivíduos com diabetes mellitus*

ABSTRACT 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 Ribeirao 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.OBJETIVOS: Relacionar el conocimiento y la actitud de usuarios con Diabetes mellitus tipo 2 (DM2), conforme la escolaridad y el tiempo de la enfermedad. METODOS: Estudio de abordaje cuantitativo, descriptivo transversal realizado en una Unidad Basica Distrital de Salud del municipio de Ribeirao Preto, SP, en el 2010. Fueron entrevistados 123 usuarios con DM2, que reunian los criterios de inclusion. Para la recoleccion de los datos, fueron utilizados: Cuestionario de Conocimiento (DKN-A) y Cuestionario de Actitudes Psicologicas de la Diabetes (ATT-19). Los datos fueron obtenidos por medio de entrevista dirigida. Para el analisis, se utilizo el test Exacto de Fisher. RESULTADOS: El promedio de edad fue de 63,87±9,09 anos, 4,54±3,66 anos de estudio, tiempo promedio de enfermedad 11,18±8,64 anos. La escolaridad y el tiempo de enfermedad se mostraron estadisticamente significativos (p<0,01 e 0,02, respectivamente) para la adquisicion del conocimiento y prontitud para el autocuidado en Diabetes. CONCLUSIONES: La escolaridad y el tiempo de enfermedad son variables que influyen en el conocimiento y actitud del paciente con DM2.

Sociodemographic and clinical characteristics of a diabetic population at a primary level health care center

Este estudio tiene como objetivo analizar las caracteristicas sociodemograficas, clinicas y los habitosde vida de una poblacion diabetica atendida en el nivel primario de atencion a la salud. Participaron 52 diabeticosregistrados en un Centro de Investigacion y Extension Universitaria en el interior del Estado de San Paulo, en2006. Los datos fueron recolectados mediante entrevista, utilizando-se dos formularios, despues delconsentimiento de los sujetos. Los resultados mostraron que los sujetos presentaban otras enfermedadesasociadas a la diabetes y controle metabolico insatisfactorio. Esos datos pueden subsidiar las acciones de losprofesionales de salud para la efectiva prevencion y el manejo de la diabetes en los servicios de atencionbasica de salud. Ante los resultados conseguidos, se concluye que es necesario incrementar cursos de calificacionen educacion en la diabetes para los profesionales de salud, con el objetivo de atender a la complejidad delcuidado y a la progresion de la enfermedad en esta poblacion.DESCRIPTORES: diabetes mellitus; educacion en salud; enfermedad cronicaEste estudo teve como objetivo analisar as caracteristicas sociodemograficas, clinicas e habitos de vida de uma populacao diabetica em nivel primario de atendimento a saude. Participaram 52 diabeticos cadastrados em um Centro de Pesquisa e Extensao Universitaria no interior do Estado de Sao Paulo, em 2006. Os dados foram obtidos mediante entrevista, utilizando-se dois formularios, apos o consentimento dos sujeitos. Os resultados mostraram que os sujeitos apresentaram co-morbidades e controle metabolico insatisfatorio. Esses dados podem subsidiar as acoes dos profissionais de saude para a efetiva prevencao e manejo do diabetes nos servicos de atencao basica de saude. Frente aos resultados obtidos, concluiu-se ser necessario incrementar cursos de capacitacao em educacao em diabetes para os profissionais de saude, com o objetivo de atender a complexidade do cuidado e a progressao da doenca nessa clientela.

Características sociodemográficas e clínicas de portadores de diabetes em um serviço de atenção básica à saúde

Este estudio tiene como objetivo analizar las caracteristicas sociodemograficas, clinicas y los habitosde vida de una poblacion diabetica atendida en el nivel primario de atencion a la salud. Participaron 52 diabeticosregistrados en un Centro de Investigacion y Extension Universitaria en el interior del Estado de San Paulo, en2006. Los datos fueron recolectados mediante entrevista, utilizando-se dos formularios, despues delconsentimiento de los sujetos. Los resultados mostraron que los sujetos presentaban otras enfermedadesasociadas a la diabetes y controle metabolico insatisfactorio. Esos datos pueden subsidiar las acciones de losprofesionales de salud para la efectiva prevencion y el manejo de la diabetes en los servicios de atencionbasica de salud. Ante los resultados conseguidos, se concluye que es necesario incrementar cursos de calificacionen educacion en la diabetes para los profesionales de salud, con el objetivo de atender a la complejidad delcuidado y a la progresion de la enfermedad en esta poblacion.DESCRIPTORES: diabetes mellitus; educacion en salud; enfermedad cronicaEste estudo teve como objetivo analisar as caracteristicas sociodemograficas, clinicas e habitos de vida de uma populacao diabetica em nivel primario de atendimento a saude. Participaram 52 diabeticos cadastrados em um Centro de Pesquisa e Extensao Universitaria no interior do Estado de Sao Paulo, em 2006. Os dados foram obtidos mediante entrevista, utilizando-se dois formularios, apos o consentimento dos sujeitos. Os resultados mostraram que os sujeitos apresentaram co-morbidades e controle metabolico insatisfatorio. Esses dados podem subsidiar as acoes dos profissionais de saude para a efetiva prevencao e manejo do diabetes nos servicos de atencao basica de saude. Frente aos resultados obtidos, concluiu-se ser necessario incrementar cursos de capacitacao em educacao em diabetes para os profissionais de saude, com o objetivo de atender a complexidade do cuidado e a progressao da doenca nessa clientela.

Adherence To Diabetes Mellitus Treatments In Family Health Strategy Units

Estudo transversal que teve como objetivo analisar a adesao ao tratamento medicamentoso e nao medicamentoso em 17 unidades da Estrategia Saude da Familia (ESF). Participaram 423 pacientes com diabetes mellitus tipo 2 selecionados por meio de amostragem aleatoria estratificada, nas unidades da ESF de um municipio do interior de Minas Gerais, em 2010. Os resultados mostraram que a adesao ao tratamento medicamentoso foi superior a 60% nas 17 unidades investigadas; em relacao a atividade fisica foi superior a 60% em 58,8% das unidades; entretanto, para o plano alimentar, foi nula em 52,9% das unidades. Conclui-se que a adesao ao tratamento medicamentoso foi alta na maioria das unidades; a pratica de atividade fisica foi heterogenea e, em relacao ao plano alimentar foi baixa em todas as unidades. Recomenda-se o fortalecimento das diretrizes institucionais e estrategias educativas, em consonância com as diretrizes do SUS, para o enfrentamento dos desafios impostos pela falta de adesao.This cross-sectional study aimed to analyze the adherence to drug and non-drug treatments in 17 Family Health Strategy units. A total of 423 patients with type 2 diabetes mellitus were selected through stratified random sampling in Family Health Strategy units of a city in the state of Minas Gerais, Brazil, in 2010. The results showed that the prevalence rate of adherence to drug therapy was higher than 60% in the 17 units investigated; in relation to physical activity, adherence was higher than 60% in 58.8% units; and for the diet plan, there was no adherence in 52.9% units. Therefore, we concluded that adherence to drug therapy in most units was high and the practice of physical activity was heterogeneous, and in relation to diet adherence, it was low in all units. We recommend strengthening of institutional guidelines and educational strategies, in line with SUS guidelines, so that, professionals may face the challenges imposed by the lack of adherence.

Relationship between knowledge, attitude, education and duration of disease in individuals with diabetes mellitus

ABSTRACT 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 Ribeirao 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.OBJETIVOS: Relacionar el conocimiento y la actitud de usuarios con Diabetes mellitus tipo 2 (DM2), conforme la escolaridad y el tiempo de la enfermedad. METODOS: Estudio de abordaje cuantitativo, descriptivo transversal realizado en una Unidad Basica Distrital de Salud del municipio de Ribeirao Preto, SP, en el 2010. Fueron entrevistados 123 usuarios con DM2, que reunian los criterios de inclusion. Para la recoleccion de los datos, fueron utilizados: Cuestionario de Conocimiento (DKN-A) y Cuestionario de Actitudes Psicologicas de la Diabetes (ATT-19). Los datos fueron obtenidos por medio de entrevista dirigida. Para el analisis, se utilizo el test Exacto de Fisher. RESULTADOS: El promedio de edad fue de 63,87±9,09 anos, 4,54±3,66 anos de estudio, tiempo promedio de enfermedad 11,18±8,64 anos. La escolaridad y el tiempo de enfermedad se mostraron estadisticamente significativos (p<0,01 e 0,02, respectivamente) para la adquisicion del conocimiento y prontitud para el autocuidado en Diabetes. CONCLUSIONES: La escolaridad y el tiempo de enfermedad son variables que influyen en el conocimiento y actitud del paciente con DM2.

Validação de intervenções de enfermagem em pessoas com diabetes mellitus

This descriptive, exploratory study aimed to validate nursing interventions proposed by the Nursing Interventions Classification for impaired skin integrity, deficient knowledge, ineffective therapeutic regimen management for predominant nursing diagnoses in people with diabetes. Participants were 21 specialist nurses in diabetes mellitus in Brazil, in 2007. Interventions were analyzed according to Fehrings evaluation model. The nursing interventions with the highest weighted average were care to injuries: closed drainage and circulatory precautions for the impaired skin integrity nursing diagnosis, teaching: disease process and teaching: prescribed medication for deficient knowledge and teaching: disease process and teaching: prescribed diet for ineffective therapeutic regimen management. Among the 1005 activities of nursing, 51% were validated as very characteristic by experts. Other studies should be carried out to expand the validation of the nursing interventions to people with diabetes mellitus in Brazil, searching for scientific evidences for care to these clients.Estudo descritivo e exploratorio que objetivou validar as intervencoes de enfermagem propostas pela Nursing Interventions Classification para os diagnosticos de enfermagem: Integridade da pele prejudicada, Conhecimento deficiente e Controle ineficaz do regime terapeutico predominantes em pessoas com diabetes. Participaram 21 enfermeiros especialistas em diabetes mellitus no Brasil, em 2007. As intervencoes de enfermagem que obtiveram a maior media ponderada foram cuidado com lesoes: drenagem fechada, precaucoes circulatorias para o diagnostico de enfermagem Integridade da pele prejudicada, ensino: processo de doenca, ensino: medicacao prescrita para o Conhecimento deficiente e ensino: processo de doenca e ensino: dieta prescrita para Controle ineficaz do regime terapeutico. Dentre as 1005 atividades de enfermagem, 51% foram validadas como muitissimo caracteristicas pelos especialistas. Acredita-se que outros estudos devam ser conduzidos para ampliar a validacao das intervencoes de enfermagem em pessoas com diabetes mellitus no Brasil, buscando evidencias cientificas para o cuidado dessa clientela.

O trabalho multiprofissional com grupo de diabéticos

This single case study aims to reflect on group work in diabetes mellitus, carried out by a multiprofessional team in the education program implemented by a Preventive Medicine Service - SEMPRE. Data were collected from SEMPRE’s internal documentation and through direct and participant observation by the researcher during the activities were adults and children with diabetes. These reflections occur in line with the initial formation of a group,: referral, selection and grouping. This way of working allowed for greater efficiency and lower cost-effectiveness in the education programs, requiring investments in continuous education for the multiprofessional team. Thus, there is a need to unchain a process of internal cooperation. Moreover, each health team member’s knowledge needs to be made available. Descriptors: Diabetes mellitus; Interdisciplinary health team; Health education.This single case study aims to reflect on group work in diabetes mellitus, carried out by a multiprofessional team in the education program implemented by a Preventive Medicine Service--SEMPRE. Data were collected from SEMPREs internal documentation and through direct and participant observation by the researcher during the activities were adults and children with diabetes. These reflections occur in line with the initial formation of a group,: referral, selection and grouping. This way of working allowed for greater efficiency and lower cost-effectiveness in the education programs, requiring investments in continuous education for the multiprofessional team. Thus, there is a need to unchain a process of internal cooperation. Moreover, each health team members knowledge needs to be made available.

Avaliação da atenção em diabetes mellitus em uma unidade básica distrital de saúde

The objective of this cross-sectional quantitative study is to evaluate the structure and process components in Diabetes Mellitus user care given in a Basic Health District of Ribeirao Preto, SP, Brazil. We analyzed 138 medical records from users with Diabetes Mellitus in 2008. As a methodological reference, we used the Health Care Assessment using structure and process as the cut. A questionnaire containing 24 closed questions was used to collect data. Concerning the structure, the results showed that physical and material resources were adequate. As for the process, the actions implemented in assisting users with Diabetes Mellitus were fragmented. It follows that we must rethink the way such work is organized, helping health actions become committed to a fair quality practice, which promotes communication among the various professionals involved in Diabetes care and full compliance with their duties and responsibilitiesThe objective of this cross-sectional quantitative study is to evaluate the structure and process components in Diabetes Mellitus user care given in a Basic Health District of Ribeirao Preto, SP, Brazil. We analyzed 138 medical records from users with Diabetes Mellitus in 2008. As a methodological reference, we used the Health Care Assessment using structure and process as the cut. A questionnaire containing 24 closed questions was used to collect data. Concerning the structure, the results showed that physical and material resources were adequate. As for the process, the actions implemented in assisting users with Diabetes Mellitus were fragmented. It follows that we must rethink the way such work is organized, helping health actions become committed to a fair quality practice, which promotes communication among the various professionals involved in Diabetes care and full compliance with their duties and responsibilities DESCRIPTORS: Health evaluation. Diabetes mellitus. Nursing. Human resources.

Diagnósticos de enfermagem em pacientes diabéticos em uso de insulina

Trata-se de um estudo descritivo exploratorio que tem como objetivo identificar os diagnosticos de enfermagem em pacientes diabeticos em uso de insulina, atraves de estudo de casos multiplos. Os dados foram obtidos pelo pesquisador por meio de exame fisico e a tecnica de entrevista dirigida baseada na Teoria de Autocuidado de Orem. Apos a coleta de dados, procedeu-se a identificacao dos diagnosticos de enfermagem nomeados de acordo com a Taxonomia II da NANDA, utilizando o processo de raciocinio diagnostico de Risner. Identificou-se seis diagnosticos com frequencia superior a 50%: integridade da pele prejudicada (100%), risco para infeccao (100%), comportamento de busca de saude (57,2%), padrao do sono perturbado (57,2%), dor cronica (57,2%) e risco para disfuncao neurovascular periferica (57,2%). Destaca-se a pertinencia da aplicabilidade do processo de enfermagem baseado em Orem para identificacao dos requisitos de autocuidado com maior demanda e a importância do planejamento do cuiadado de enfermagem prestado a essa clientela.This is a descriptive study with a qualitative approach that has as objective to identify the nursing diagnoses of diabetic patients using insulin, having as inquiry method the study of multiple cases. The data were obtained by the researcher by means of physical examination and the technique of interview directed in the instrument based on the Orems Self-Care Theory. After data collection, the diagnostic indentification was proceeded from the nominated nursing diagnoses of NANDA Taxonomy II, using Risners reasoning diagnostic process. The identified nursing diagnoses with a higher frequency than 50% were six: impaired skin integrity (100%), risk for infection (100%), behavior of health search (57,2%), disturbed sleep (57,2%), chronic pain (57,2%) and risk for peripheral neurovascular dysfunction (57,2%). The application of the nursing process based in Orem and the importance of the identified diagnostic for clients nursing care were evidenced.