Denise Siqueira Péres

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.

Comportamento alimentar em mulheres portadoras de diabetes tipo 2

OBJECTIVE To explore type 2 diabetes womens thoughts, feelings and behaviors concerning diet. METHODS A descriptive, exploratory qualitative study was carried out among eight type 2 diabetes women from a primary health care unit in Southeastern Brazil in January 2003. A semi-structured interview was applied for data collection. The theoretical reference was the theory of social representations. The interviews were recorded, transcribed and then their thematic content was analyzed. RESULTS The study results showed womens difficulty in following the prescribed diet due to several associated meanings, such as loss of eating and drinking pleasure and loss of eating autonomy and free choice. Following the diet elicits an extremely aversive and restrictive attitude, and complying with it is associated to damage to health. The frequent absence of symptoms was mentioned as one reason that prevents compliance to the diet. Other difficulties reported were touching, looking at, and handling foods during their preparation but not being allowed to eat them. Sweet foods revealed to be extremely desired. Transgression and food desire are equally present in their life. Following the recommended diet brings sadness and the act of eating is frequently accompanied by fear, guilt and anger. CONCLUSIONS Type 2 diabetes womens eating behavior is very complex and needs to be understood from its psychological, biological, social, cultural and economic aspects for promoting more effective educational interventions.

Dificuldades dos pacientes diabéticos para o controle da doença: sentimentos e comportamentos

This study aimed to identify difficulties diabetic patients face during treatment in controlling the disease. A total of 24 diabetic patients, attended in the Nurse Educational Center for Adults and Elders in 2003, participated in the study. The data was collected individually, through a written report guided by a question previously elaborated, on a pre-scheduled date. The Content Analysis technique was used in the data analysis. The results showed several difficulties related to the treatment follow up: rejection and denial of the patients condition, suffering and revolt due to restrictions imposed by the diet, physical activity and medication. It is possible to infer that the focus of the education approach should not be restricted to the transmission of knowledge; it should also include emotional, social and cultural aspects that also influence in the treatment follow up.Este estudio tuvo como objetivo identificar las dificultades de los pacientes diabeticos en relacion altratamiento para el control de la enfermedad. Participaron 24 diabeticos acompanados en el Centro Educativo deEnfermeria para Adultos y Ancianos en 2003. Para obtener los datos, se utilizo un relato escrito, de forma individual,en dia predeterminado, a partir de una pregunta orientadora previamente elaborada. En el analisis de los datos seutilizo la tecnica de Analisis de Contenido. Los resultados mostraron que son innumeras las dificultades relacionadasal seguimiento del tratamiento: rechazo y negacion de la condicion de enfermo, sufrimiento y revuelta debido a lasrestricciones impuestas por la alimentacion, actividad fisica y medicamentos. Es posible inferir que el enfoque de laaproximacion educativa no debe restringirse apenas a la transmision de conocimientos; tambien es importante queenglobe aspectos emocionales, sociales y culturales que influencian en el seguimiento del tratamiento.DESCRIPTORES: diabetes mellitus; educacion en salud; enfermedad cronica

Difficulties of diabetic patients in the illness control: feelings and behaviors

This study aimed to identify difficulties diabetic patients face during treatment in controlling the disease. A total of 24 diabetic patients, attended in the Nurse Educational Center for Adults and Elders in 2003, participated in the study. The data was collected individually, through a written report guided by a question previously elaborated, on a pre-scheduled date. The Content Analysis technique was used in the data analysis. The results showed several difficulties related to the treatment follow up: rejection and denial of the patients condition, suffering and revolt due to restrictions imposed by the diet, physical activity and medication. It is possible to infer that the focus of the education approach should not be restricted to the transmission of knowledge; it should also include emotional, social and cultural aspects that also influence in the treatment follow up.Este estudio tuvo como objetivo identificar las dificultades de los pacientes diabeticos en relacion altratamiento para el control de la enfermedad. Participaron 24 diabeticos acompanados en el Centro Educativo deEnfermeria para Adultos y Ancianos en 2003. Para obtener los datos, se utilizo un relato escrito, de forma individual,en dia predeterminado, a partir de una pregunta orientadora previamente elaborada. En el analisis de los datos seutilizo la tecnica de Analisis de Contenido. Los resultados mostraron que son innumeras las dificultades relacionadasal seguimiento del tratamiento: rechazo y negacion de la condicion de enfermo, sufrimiento y revuelta debido a lasrestricciones impuestas por la alimentacion, actividad fisica y medicamentos. Es posible inferir que el enfoque de laaproximacion educativa no debe restringirse apenas a la transmision de conocimientos; tambien es importante queenglobe aspectos emocionales, sociales y culturales que influencian en el seguimiento del tratamiento.DESCRIPTORES: diabetes mellitus; educacion en salud; enfermedad cronica

Progress of the patients with diabetes mellitus who were managed with the staged diabetes management framework

Objective: To describe the progress of patients with diabetes mellitus seen by health care team members who followed the Staged Diabetes Management framework. Methods: This descriptive, prospective, and longitudinal study was conducted in a period of 12 months. The sample consisted of 54 patients with diabetes mellitus. Data were collected in three occasions through interviews: P0 Рat beginning of the study; P6 Рin six months; and, P12 Рat the end of the study. Results: There was an increase in adherence to diet from 61.1% in the P0 to 92.6% in the P12, in adherence to physical activities from 57.4% in the P0 to 66,7% in the P12, and in the use of medication. Conclusion: The use of the SDM framework among this sample of patients with diabetes promoted better adherence to diet, physical activities, and the use of medication.ABSTRACTObjective: To describe the progress of patients with diabetes mellitus seen by health care team members who followed the Staged DiabetesManagement framework. Methods: This descriptive, prospective, and longitudinal study was conducted in a period of 12 months. Thesample consisted of 54 patients with diabetes mellitus. Data were collected in three occasions through interviews: P0 Πat beginning of thestudy; P6 Πin six months; and, P12 Πat the end of the study. Results: There was an increase in adherence to diet from 61.1% in the P0 to92.6% in the P12, in adherence to physical activities from 57.4% in the P0 to 66,7% in the P12, and in the use of medication. Conclusion: The use of the SDM framework among this sample of patients with diabetes promoted better adherence to diet, physical activities, and theuse of medication. Keywords: Diabetes mellitus; Clinical protocols; Patient compliance; Nursing RESUMOObjetivo: Descrever a evolucao do tratamento de pacientes diabOticos por equipe multiprofissional utilizando o Protocolo Staged DiabetesManagement.

Satisfaction of diabetes patients under follow-up in a diabetes education program

This study aimed to describe the satisfaction of diabetes patients, using the information received and the care offered after the implementation of the health educational program called Staged Diabetes Management (SDM), in April 2005, at a University Research and Extension Center in Ribeirao Preto - SP. Patient satisfaction was assessed through a satisfaction questionnaire, applied to 54 diabetes patients who participated in the program during 12 months. The patients reported that the information received during the program attended their needs; of the 54 patients, 59.3% mentioned information related to nutrition; 33.3% mentioned medicines and 31.5% glucose control. Related to the assessment of care, 81.5% of the patients considered it excellent. We concluded that the patient satisfaction evaluation was a valuable feedback to evaluate the program implemented by the multiprofessional team.

Feelings of women after the diagnosis of type 2 diabetes

Descriptive and exploratory study with the objective of knowing feelings and emotional reactions of women after the diagnosis of diabetes. Data were collected at a primary health care unit in Ribeirão Preto-SP, Brazil, through a semi-structured interview. Thematic content analysis was used for interpreting the data. The results showed that womens behavior after the diagnosis of diabetes was associated with feelings and emotional reactions that interfere with treatment adherence and which the health team needs to understand. In an educational process, it is not enough to offer information. Human behavior is extremely complex, going beyond the cognitive aspects, and is rooted in affective-emotional dispositions.Descriptive and exploratory study with the objective of knowing feelings and emotional reactions of women after the diagnosis of diabetes. Data were collected at a primary health care unit in Ribeirao Preto - SP, Brazil, through a semi-structured interview. Thematic content analysis was used for interpreting the data. The results showed that womens behavior after the diagnosis of diabetes was associated with feelings and emotional reactions that interfere with treatment adherence and which the health team needs to understand. In an educational process, it is not enough to offer information. Human behavior is extremely complex, going beyond the cognitive aspects, and is rooted in affective-emotional dispositions.

Sentimentos de mulheres após o diagnóstico de diabetes tipo 2

Descriptive and exploratory study with the objective of knowing feelings and emotional reactions of women after the diagnosis of diabetes. Data were collected at a primary health care unit in Ribeirão Preto-SP, Brazil, through a semi-structured interview. Thematic content analysis was used for interpreting the data. The results showed that womens behavior after the diagnosis of diabetes was associated with feelings and emotional reactions that interfere with treatment adherence and which the health team needs to understand. In an educational process, it is not enough to offer information. Human behavior is extremely complex, going beyond the cognitive aspects, and is rooted in affective-emotional dispositions.Descriptive and exploratory study with the objective of knowing feelings and emotional reactions of women after the diagnosis of diabetes. Data were collected at a primary health care unit in Ribeirao Preto - SP, Brazil, through a semi-structured interview. Thematic content analysis was used for interpreting the data. The results showed that womens behavior after the diagnosis of diabetes was associated with feelings and emotional reactions that interfere with treatment adherence and which the health team needs to understand. In an educational process, it is not enough to offer information. Human behavior is extremely complex, going beyond the cognitive aspects, and is rooted in affective-emotional dispositions.

Social representations of low-income diabetic women according to the health-disease process

Este trabalho tem como objetivo identificar as representacoes sociais de mulheres diabeticas das camadas populares em relacao ao processo saude-doenca. Trata-se de estudo descritivo e exploratorio. Foram entrevistadas oito participantes, atendidas numa unidade basica de saude do municipio de Ribeirao Preto, SP, em 2003. Os dados foram organizados mediante analise tematica de conteudo e analisados segundo a teoria das representacoes sociais. O diabetes esta relacionado a sentimentos negativos como choque, revolta e tristeza, o plano alimentar aparece vinculado a perda do prazer e prejuizos a saude. As mulheres diabeticas mostraram relacao ambivalente com o uso da medicacao, percebido como cansativo e como recurso que promove o bem-estar e melhoria da qualidade de vida. A representacao negativa dos servicos de saude parece interferir no comportamento de adesao ao tratamento medicamentoso. Compreender as representacoes de mulheres com diabetes contribui para a integralidade do cuidado ao diabetico.The purpose of this article is to identify the social representations of low-income diabetic women according to the health-disease process. This is a descriptive, exploratory study. Eight participants, all of them patients at a basic health unit in Ribeirão Preto, were interviewed in 2003. The data were organized according to thematic content analysis and analyzed according to theory of social representations. Diabetes is related to negative feelings, such as shock, anger and sadness; the diet plan is linked to the loss of pleasure, and also to health risks. The diabetic women showed an ambivalent relation to medication, perceived it as both tiring and as a resource that promotes well-being and improvements in quality of life. The negative representation of health services seems to interfere with the behavior of adherence to pharmacological treatment. Understanding the representations of women with diabetes contributes to integral healthcare for diabetic patients.Este trabajo tiene como objetivo identificar las representaciones sociales de mujeres diabeticas de clases populares en relacion al proceso salud-enfermedad. Se trata de un estudio descriptivo y exploratorio. Fueron entrevistadas ocho participantes, atendidas en una unidad basica de salud del municipio de Ribeirao Preto, en 2003. Los datos fueron organizados mediante un analisis tematico de contenido y analizados segun la teoria de las representaciones sociales. La diabetes esta relacionada a sentimientos negativos, como choque, rabia y tristeza; el plano alimentario aparece vinculado a la perdida del placer y de danos a la salud. Las mujeres diabeticas mostraron una relacion ambivalente con el uso de los medicamentos, percibido como productor de cansancio y como un recurso que promueve el bienestar y mejora la calidad de vida. La representacion negativa de los servicios de salud parece interferir en el comportamiento de adherencia al tratamiento con medicamentos. Comprender las representaciones de mujeres con diabetes contribuye a la prestacion de servicios del cuidado al diabetico.

DIFICULTADES DE LOS PACIENTES DIABÉTICOS PARA EL CONTROL DE LA ENFERMEDAD: SENTIMIENTOS Y COMPORTAMIENTOS

This study aimed to identify difficulties diabetic patients face during treatment in controlling the disease. A total of 24 diabetic patients, attended in the Nurse Educational Center for Adults and Elders in 2003, participated in the study. The data was collected individually, through a written report guided by a question previously elaborated, on a pre-scheduled date. The Content Analysis technique was used in the data analysis. The results showed several difficulties related to the treatment follow up: rejection and denial of the patients condition, suffering and revolt due to restrictions imposed by the diet, physical activity and medication. It is possible to infer that the focus of the education approach should not be restricted to the transmission of knowledge; it should also include emotional, social and cultural aspects that also influence in the treatment follow up.Este estudio tuvo como objetivo identificar las dificultades de los pacientes diabeticos en relacion altratamiento para el control de la enfermedad. Participaron 24 diabeticos acompanados en el Centro Educativo deEnfermeria para Adultos y Ancianos en 2003. Para obtener los datos, se utilizo un relato escrito, de forma individual,en dia predeterminado, a partir de una pregunta orientadora previamente elaborada. En el analisis de los datos seutilizo la tecnica de Analisis de Contenido. Los resultados mostraron que son innumeras las dificultades relacionadasal seguimiento del tratamiento: rechazo y negacion de la condicion de enfermo, sufrimiento y revuelta debido a lasrestricciones impuestas por la alimentacion, actividad fisica y medicamentos. Es posible inferir que el enfoque de laaproximacion educativa no debe restringirse apenas a la transmision de conocimientos; tambien es importante queenglobe aspectos emocionales, sociales y culturales que influencian en el seguimiento del tratamiento.DESCRIPTORES: diabetes mellitus; educacion en salud; enfermedad cronica