Danilo Donizetti Trevisan

Clinical and sociodemographic variables associated with diabetes-related distress in patients with type 2 diabetes mellitus

ABSTRACT Objective: To evaluate the relation between diabetes-related distress and the clinical and sociodemographic characteristics of type 2 diabetes mellitus patients. Methods: A cross-sectional study based on a secondary analysis of data collected at a specialized care outpatient center in Brazil. Participants completed a questionnaire on sociodemographic and clinical characteristics and the Brazilian version of the Diabetes Distress Scale (B-DDS). Results: About 31% of the 130 eligible patients reported diabetes distress, and the mean B-DDS score was 2.6. Multiple regression analysis showed the B-DDS score was positively correlated with marital status (p=0.0230), use of diet and physical activities for diabetes management (p=0.0180), and use of insulin therapy (p=0.0030). The “emotional burden”, “regimen-related distress”, and “interpersonal distress” domains from B-DDS were associated with the use of insulin therapy (p=0.0010), marital status (p=0.0110), and the presence of three or more comorbidities (p=0.0175). Conclusion: These findings suggest the clinical and sociodemographic variables are relatively weak predictors of diabetes-related distress. The highest scores in the B-DDS were observed in the emotional burden domain, indicating the presence of diabetes distress among the participants of the study.

Saúde, dor e atividades de vida diária entre idosos praticantes de Lian Gong e sedentários

It is a well-known fact that the practice of physical activity on a regular basis among elderly people contributes to the prevention and reduction of pain, as well as promote active ageing. Based on this premise, the scope of this study was to evaluate the presence of chronic pain among elderly people attended in a primary health care unit in a city in the interior of Sao Paulo State, Brazil, by comparing those who practice Chinese gymnastics (Lian Gong) and the sedentary. Sixty elderly people were divided between 30 sedentary and 30 who participate in a group practicing Lian Gong. The presence of pain was assessed through the Nordic Questionnaire on Musculoskeletal Symptoms, already adapted and validated for Brazilian culture. When questioned about pain in the last seven days, the Lian Gong group showed a higher presence (62,3%) of pain when compared to the sedentary group, although they had fewer difficulties in performing daily activities (55,5%). Among the active elderly the presence of lower back pain was statistically inferior (p < 0.05) when comparing the groups. The practice of Lian Gong was associated to a more positive perception of ones health, less use of medicines, as well as the adopting of self-care practices and the feeling of fewer impairments in performing daily activities.

ESTILO DE VIDA ATIVO PREGRESSO E SUA RELAÇÃO COM MARCADORES BIOQUÍMICOS DE LESÃO CARDÍACA E CATETERISMO CARDÍACO NA SÍNDROME CORONARIANA AGUDA

Resumo Este estudo teve como objetivo avaliar a relação entre a atividade física de lazer (AFTL), a aptidão cardiorrespiratória, o desempenho das enzimas cardíacas e o desfecho obtido por meio do cateterismo cardíaco em pacientes com doença arterial coronária (DAC). Trata-se de estudo exploratório e transversal. A AF foi avaliada por meio do Godin-Shephard Leisure-Time Physical Activity Questionnaire (GSLTPAQ) e pelo Questionário de Atividade Física Habitual de Baecke (AFH-Baecke); e a aptidão cardiorrespiratória pelo Veterans Specific Activity Questionnaire (VSAQ). Foram avaliados a Troponina ultrassensível I; a isoenzima MB da creatinoquinase massa e resultados do cateterismo cardíaco. A amostra (n=68) foi composta por homens, com idade entre 50 e 60 anos, brancos, que viviam com companheiro, ativos, com baixas renda e escolaridade; com precordialgia, hipertensão arterial (HAS) e dislipidemia (DLP), pouco ativos quanto à AFTL. A presença de dispneia, precordialgia, palpitação, fadiga e lipotimia evidenciou pior aptidão cardiorrespiratória entre aqueles com história de IAM prévio. Pacientes com DAC e diabetes mellitus (DM) apresentaram menor aptidão cardiorrespiratória, maior elevação da CKMB e maior número de artérias coronárias comprometidas. Quanto à coronariografia, sujeitos com menor número de artérias comprometidas apresentaram maior escore do GSLTPAQ e da dimensão EFL e maiores médias de idade e escolaridade. Foram constatadas correlações positivas entre o GSLTPAQ e a escolaridade; entre o VSAQ e a escolaridade e a renda, entre EFL e a escolaridade; e correlação negativa entre o VSAQ e a idade; e entre EFL e a idade.

A randomized controlled trial on the effect of behavioral strategies for adherence to oral antidiabetic drugs: study protocol

Background: Non-adherence to oral antidiabetics drugs (OADs) has been a common problem and may contribute to poor glycemic control. Aim: To describe an experimental study protocol that aims at implementing and evaluating the effect of the “action planning and coping planning” interventions on medication adherence to OADs in patients with type 2 diabetes mellitus (T2DM) in follow-up at primary care services. Design: A randomized controlled trial. Methods: Two groups (intervention and control) will be followed over a period of 105 days. The intervention group will receive a combination of the “action planning” and “coping planning” intervention strategies. There will be in-person meetings and phone calls to reinforce the intervention. The control group will receive the usual care from the health unit. Conclusions: It is hoped that this study will help health professionals to improve their approach with patients who have T2DM in relation to medication adherence.

Instrumentos para avaliação da qualidade de vida em crianças e adolescentes com diabetes mellitus

Objective: to review the literature on existing instruments to evaluate the quality of life in children and adolescents with diabetes mellitus, adapted and validated for use in Brazil. Methodology: this was an integrative review study with the guiding question: “what are the existing instruments in the national literature that can be used to evaluate the quality of life in diabetic children and adolescents?” The PICO strategy was used: “patient, intervention, comparison, and outcomes.” The analysis of the instruments found was performed using the JBI QARI instrument (Joanna Briggs Institute – Qualitative Assesment and Review Instrument) for the evaluation of systematic reviews. Scientific publications indexed in databases were evaluated. Results: four instruments were identified. They are: Quality of Life Instrument for Young People with Diabetes (IQVJD), DISABKIDS Generic Module, Pediatric Quality of Life InventoryTM version 4.0 (PedsQLTM 4.0), and KIDSCREEN-52. The classification, according to the JBI QARI instrument, showed positive results for eight out of 10 items evaluated in all analyzed studies. The dissemination and incorporation of these instruments in the clinical practice can help the development of care plans tailored to each patient.