Heloisa Turcatto Gimenes Faria

Fatores associados à adesão ao tratamento de pacientes com diabetes mellitus

OBJECTIVE: Investigating the association between adherence to treatment of type 2 diabetes mellitus and socio-demographic, clinical and metabolic control variables. METHODS: Cross-sectional study with 423 patients with diabetes mellitus. The Fishers exact test and logistic regression models were used to investigate the association between adherence to treatment and the studied variables. RESULTS: There was no association between adherence to treatment of T2DM and socio-demographic and clinical variables. It was found that total cholesterol and HbA1c were significantly associated with adherence to diet (p = 0,036) and exercise (p = 0,006). CONCLUSION: The chance of a patient with cholesterol within the recommended level adhering to diet is almost five times the chance of the patient in poor lipid control. The chance of patients with poor glycemic control adhering to exercise is almost twice the chance of those who keep adequate glycemic control.

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.

Quality of life in patients with diabetes mellitus before and after their participation in an educational program

This quasi-experimental study aimed to evaluate the health-related quality of life in individuals with diabetes mellitus before and after their participation in a five-month educational program in a primary care service in Brazil in 2008. The sample consisted of 51 individuals, 56.9% female and 43.1% male, who had a mean age of 57.65 ± 11.44 years. Data were collected using the Portuguese version of the SF-36 questionnaire. The instrument had adequate reliability estimates for the study sample. Cronbachs alpha for the two components of the instrument, physical and mental, were 0.83 and 0.89, respectively. The findings suggested improvements in all the domain components; however, only the general health domain, before (63.96 ± 19.03) and after (70.59 ± 17.82) the educational program, presented statistically significant mean differences, t(50) = 2.16, p<0.05. Participation in the educational program also contributed to improvements in the perceptions of the individuals regarding their general health status.This quasi-experimental study aimed to evaluate the health-related quality of life in individuals with diabetes mellitus before and after their participation in a five-month educational program in a primary care service in Brazil in 2008. The sample consisted of 51 individuals, 56.9% female and 43.1% male, who had a mean age of 57.65 ± 11.44 years. Data were collected using the Portuguese version of the SF-36 questionnaire. The instrument had adequate reliability estimates for the study sample. Cronbachs alpha for the two components of the instrument, physical and mental, were 0.83 and 0.89, respectively. The findings suggested improvements in all the domain components; however, only the general health domain, before (63.96 ± 19.03) and after (70.59 ± 17.82) the educational program, presented statistically significant mean differences, t(50) = 2.16, p<0.05. Participation in the educational program also contributed to improvements in the perceptions of the individuals regarding their general health status.

Conhecimento sobre terapêutica medicamentosa em diabetes: um desafio na atenção à saúde

Objective: To assess and describe patients’ knowledge regarding medication therapy to treat diabetes mellitus. Methods: This descriptive cross-sectional study was conducted in 2007 at a university center in the interior of Sao Paulo State, Brazil. Forty-six patients with diabetes were interviewed using a structured questionnaire to gather sociodemographic, clinical, and medication information. Data analysis consisted of univariate statistics and measures of central tendency. Results: The majority of participants (89.1%) used oral hypoglycemic agents, 41.3% used insulin injections, and 30.4% used a combination therapy oral hypoglycemic agents and insulin injections. A large number of participants (56.5%) had knowledge deficit regarding their medication regimen. Conclusion: The findings suggest the need to develop a more effective patient orientation process in the health care services. It is not enough to offer the medication; one must also comprehensively assess patients’ knowledge and use of the medication.

Adherence to nutritional recommendations and sociodemographic variables in patients with diabetes mellitus

OBJECTIVE To determine if there is a relationship between adherence to nutritional recommendations and sociodemographic variables in Brazilian patients with type 2 diabetes mellitus. METHODS Cross-sectional observational study using a stratified random sample of 423 individuals. The Food Frequency Questionnaire (FFQ) was used, and the Fishers exact test was applied with 95% confidence interval (p<0.05). RESULTS Of the 423 subjects, 66.7% were women, mean age of 62.4 years (SD = 11.8), 4.3 years of schooling on average (SD = 3.6) and family income of less than two minimum wages. There was association between the female gender and adherence to diet with adequate cholesterol content (OR: 2.03; CI: 1.23; 3.34), between four and more years of education and adherence to fractionation of meals (OR: 1 92 CI: 1.19; 3.10), and income of less than two minimum wages and adherence to diet with adequate cholesterol content (OR: 1.74; CI: 1.03, 2.95). CONCLUSION Adherence to nutritional recommendations was associated with the female gender, more than four years of education and family income of less than two minimum wages.OBJETIVO: Verificar si hay relacion entre la adhesion a las recomendaciones de nutricion y las variables sociodemograficas de pacientes brasilenos con diabetes mellitus tipo 2. METODOS: Estudio observacional seccional, con muestra aleatoria estratificada constituida de 423 individuos. Se utilizo el Cuestionario de Frecuencia de Consumo Alimentario. Se aplico el Test Exacto de Fisher con intervalo de confianza del 95% (p-valor<0,05). RESULTADOS: De los 423 sujetos, el 66,7% eran mujeres, promedio de edad de 62,4 (DP=11,8) anos, promedio de anos de estudio de 4,3 (DP=3,6) y renta familiar inferior a dos sueldos minimos. Se encontro asociacion entre sexo femenino y adhesion a la dieta con adecuado contenido de colesterol (OR:2,03; IC:1,23;3,34), entre cuatro anos y mas de estudio y adhesion al fraccionamiento de las comidas (OR:1,92; IC:1,19;3,10), renta inferior a dos sueldos minimos y adhesion a la dieta con adecuado contenido de colesterol (OR:1,74; IC:1,03;2,95). CONCLUSION: La adhesion a las recomendaciones de nutricion estuvo asociada con el sexo femenino, escolaridad superior a cuatro anos y renta familiar inferior a dos sueldos minimos.

Adesão ao tratamento do diabetes mellitus e variáveis sociodemográficas, clinicas e de controle metabólico

Objective To investigate the association between adherence to type 2 diabetes mellitus treatment and sociodemographic, clinical and metabolic control variables. Methods Cross-sectional study that included 417 diabetes mellitus patients. The research instrument was a questionnaire with the study variables; Treatment Adherence Measure; Food Consumption Frequency Questionnaire and International Physical Exercise Questionnaire. Fisher’s Exact Test was used to analyze the data. Results About 98.3% showed non adherence to the diet, 41.9% to physical exercise and 15.8% to the medication treatment. Conclusion No association was found between adherence to type 2 diabetes mellitus treatment and sex, age, years of education, length of diagnosis and metabolic control variables.

Qualidade de vida de pacientes com diabetes mellitus antes e após participação em programa educativo

This quasi-experimental study aimed to evaluate the health-related quality of life in individuals with diabetes mellitus before and after their participation in a five-month educational program in a primary care service in Brazil in 2008. The sample consisted of 51 individuals, 56.9% female and 43.1% male, who had a mean age of 57.65 ± 11.44 years. Data were collected using the Portuguese version of the SF-36 questionnaire. The instrument had adequate reliability estimates for the study sample. Cronbachs alpha for the two components of the instrument, physical and mental, were 0.83 and 0.89, respectively. The findings suggested improvements in all the domain components; however, only the general health domain, before (63.96 ± 19.03) and after (70.59 ± 17.82) the educational program, presented statistically significant mean differences, t(50) = 2.16, p<0.05. Participation in the educational program also contributed to improvements in the perceptions of the individuals regarding their general health status.This quasi-experimental study aimed to evaluate the health-related quality of life in individuals with diabetes mellitus before and after their participation in a five-month educational program in a primary care service in Brazil in 2008. The sample consisted of 51 individuals, 56.9% female and 43.1% male, who had a mean age of 57.65 ± 11.44 years. Data were collected using the Portuguese version of the SF-36 questionnaire. The instrument had adequate reliability estimates for the study sample. Cronbachs alpha for the two components of the instrument, physical and mental, were 0.83 and 0.89, respectively. The findings suggested improvements in all the domain components; however, only the general health domain, before (63.96 ± 19.03) and after (70.59 ± 17.82) the educational program, presented statistically significant mean differences, t(50) = 2.16, p<0.05. Participation in the educational program also contributed to improvements in the perceptions of the individuals regarding their general health status.

Patients' knowledge regarding medication therapy to treat diabetes: a challenge for health care services

Objective: To assess and describe patients’ knowledge regarding medication therapy to treat diabetes mellitus. Methods: This descriptive cross-sectional study was conducted in 2007 at a university center in the interior of Sao Paulo State, Brazil. Forty-six patients with diabetes were interviewed using a structured questionnaire to gather sociodemographic, clinical, and medication information. Data analysis consisted of univariate statistics and measures of central tendency. Results: The majority of participants (89.1%) used oral hypoglycemic agents, 41.3% used insulin injections, and 30.4% used a combination therapy oral hypoglycemic agents and insulin injections. A large number of participants (56.5%) had knowledge deficit regarding their medication regimen. Conclusion: The findings suggest the need to develop a more effective patient orientation process in the health care services. It is not enough to offer the medication; one must also comprehensively assess patients’ knowledge and use of the medication.

Adhesión a las recomendaciones de nutrición y variables sociodemográficas en pacientes con diabetes mellitus

OBJECTIVE To determine if there is a relationship between adherence to nutritional recommendations and sociodemographic variables in Brazilian patients with type 2 diabetes mellitus. METHODS Cross-sectional observational study using a stratified random sample of 423 individuals. The Food Frequency Questionnaire (FFQ) was used, and the Fishers exact test was applied with 95% confidence interval (p<0.05). RESULTS Of the 423 subjects, 66.7% were women, mean age of 62.4 years (SD = 11.8), 4.3 years of schooling on average (SD = 3.6) and family income of less than two minimum wages. There was association between the female gender and adherence to diet with adequate cholesterol content (OR: 2.03; CI: 1.23; 3.34), between four and more years of education and adherence to fractionation of meals (OR: 1 92 CI: 1.19; 3.10), and income of less than two minimum wages and adherence to diet with adequate cholesterol content (OR: 1.74; CI: 1.03, 2.95). CONCLUSION Adherence to nutritional recommendations was associated with the female gender, more than four years of education and family income of less than two minimum wages.OBJETIVO: Verificar si hay relacion entre la adhesion a las recomendaciones de nutricion y las variables sociodemograficas de pacientes brasilenos con diabetes mellitus tipo 2. METODOS: Estudio observacional seccional, con muestra aleatoria estratificada constituida de 423 individuos. Se utilizo el Cuestionario de Frecuencia de Consumo Alimentario. Se aplico el Test Exacto de Fisher con intervalo de confianza del 95% (p-valor<0,05). RESULTADOS: De los 423 sujetos, el 66,7% eran mujeres, promedio de edad de 62,4 (DP=11,8) anos, promedio de anos de estudio de 4,3 (DP=3,6) y renta familiar inferior a dos sueldos minimos. Se encontro asociacion entre sexo femenino y adhesion a la dieta con adecuado contenido de colesterol (OR:2,03; IC:1,23;3,34), entre cuatro anos y mas de estudio y adhesion al fraccionamiento de las comidas (OR:1,92; IC:1,19;3,10), renta inferior a dos sueldos minimos y adhesion a la dieta con adecuado contenido de colesterol (OR:1,74; IC:1,03;2,95). CONCLUSION: La adhesion a las recomendaciones de nutricion estuvo asociada con el sexo femenino, escolaridad superior a cuatro anos y renta familiar inferior a dos sueldos minimos.

Adesão ao tratamento em diabetes mellitus em unidades da Estratégia Saúde da Família

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.