Thaís Santos Guerra Stacciarini

Insulin self-administration technique with disposable syringe among patients with diabetes mellitus followed by the family health strategy

This cross-sectional study aimed to describe the most common correct and incorrect self-administration techniques for insulin using disposable syringes by patients cared for by the Family Health Strategy (FHS), relate the findings to sociodemographic variables and also identify the professional responsible for teaching this technique. A total of 169 patients were selected by simple random sampling in 37 FHS units in a city in the state of Minas Gerais, Brazil from August to October 2006. The results identified errors in all the steps recommended by the American Diabetes Association and Brazilian Diabetes Association for the safe administration of insulin, from hand washing to compression on the injection site. The FHS favors the development of interventions focused on the needs of the clientele registered at the unit, stimulating self-care. Results from this study can contribute to the planning of these interventions.3Estudo seccional que objetivou descrever os erros e os acertos mais comuns da tecnica de autoaplicacao de insulina, com seringas descartaveis, pelos usuarios, acompanhados pela Estrategia Saude da Familia (ESF), assim como relacionar esses achados as variaveis sociodemograficas e identificar o profissional responsavel pelas orientacoes. Participaram 169 usuarios selecionados por meio de amostragem aleatoria simples, em 37 unidades da ESF, de um municipio do Estado de Minas Gerais, entre agosto e outubro de 2006. Os resultados identificaram erros em todos os passos recomendados pela Associacao Americana de Diabetes e Sociedade Brasileira de Diabetes para a aplicacao segura da insulina, desde a lavagem das maos ate a compressao do local de aplicacao. A ESF favorece o desenvolvimento de intervencoes centradas nas necessidades da clientela adscrita, estimulando-a para o autocuidado, e os resultados do presente estudo poderao contribuir para o planejamento dessas intervencoes.

Tradução, adaptação e validação de uma escala para o autocuidado de portadores de diabetes mellitus tipo 2 em uso de insulina

Objective Translate, adapt and validate the Appraisal of Self-care Agency Scale-Revised (ASAS-R) for Brazil.Methods A descriptive method for adapting measurement instruments was used with 150 diabetes mellitus patients. The instrument underwent translation, synthesis of independent translations, evaluation by a committee of judges, back-translation and submittal of back-translation to original authors, semantic validation, submittal of the adapted version to original authors, and pretesting.Results The ASAS-R maintained semantic, cultural and conceptual equivalence. Cronbach’s alpha was 0.74; the intraclass correlation coefficient for test-retest reliability was 0.81; and interobserver agreement was 0.84.Conclusion The Brazilian-Portuguese version maintained conceptual, semantic and cultural validity, as compared to the original version. In the discriminant validity, there was correlation between capacity for self-care, depression and perceived health, but not social support. There were significant differences between groups regarding age, education levels and insulin self-application.

Dose de insulina prescrita versus dose de insulina aspirada

Objectives: To compare the dose of prepared insulin to the dosage prescribed among users who self-administer; the differences relate to sociodemographic and clinical variables and identify the difficulties related to the procedure. Methods: The study included 169 users of the Family Health Strategy (ESF) of a municipality in the state of Minas Gerais, between August and October 2006. Results: Among the users who administered different doses than were prescribed (36.1%), 77% identified difficulty viewing the graduated scale of the syringe and 29.5% had motor difficulties in handling the syringe pr ecisely. Sex (f emale), age (> 60 y ears) and education (<8 years) w ere sta tistically significant predictors. Conclusion: The data show the need for targeted interventions to develop skills for self-application of insulin, considering the limitations /capabilities of each user. The proposals of the ESF can support actions for health care focused on the needs of enrolled clients.

Técnica de autoaplicação de insulina com seringas descartáveis entre os usuários com diabetes mellitus, acompanhados pela estratégia saúde da família

This cross-sectional study aimed to describe the most common correct and incorrect self-administration techniques for insulin using disposable syringes by patients cared for by the Family Health Strategy (FHS), relate the findings to sociodemographic variables and also identify the professional responsible for teaching this technique. A total of 169 patients were selected by simple random sampling in 37 FHS units in a city in the state of Minas Gerais, Brazil from August to October 2006. The results identified errors in all the steps recommended by the American Diabetes Association and Brazilian Diabetes Association for the safe administration of insulin, from hand washing to compression on the injection site. The FHS favors the development of interventions focused on the needs of the clientele registered at the unit, stimulating self-care. Results from this study can contribute to the planning of these interventions.3Estudo seccional que objetivou descrever os erros e os acertos mais comuns da tecnica de autoaplicacao de insulina, com seringas descartaveis, pelos usuarios, acompanhados pela Estrategia Saude da Familia (ESF), assim como relacionar esses achados as variaveis sociodemograficas e identificar o profissional responsavel pelas orientacoes. Participaram 169 usuarios selecionados por meio de amostragem aleatoria simples, em 37 unidades da ESF, de um municipio do Estado de Minas Gerais, entre agosto e outubro de 2006. Os resultados identificaram erros em todos os passos recomendados pela Associacao Americana de Diabetes e Sociedade Brasileira de Diabetes para a aplicacao segura da insulina, desde a lavagem das maos ate a compressao do local de aplicacao. A ESF favorece o desenvolvimento de intervencoes centradas nas necessidades da clientela adscrita, estimulando-a para o autocuidado, e os resultados do presente estudo poderao contribuir para o planejamento dessas intervencoes.

Prescribed insulin dose versus prepared insulin dose

Objectives: To compare the dose of prepared insulin to the dosage prescribed among users who self-administer; the differences relate to sociodemographic and clinical variables and identify the difficulties related to the procedure. Methods: The study included 169 users of the Family Health Strategy (ESF) of a municipality in the state of Minas Gerais, between August and October 2006. Results: Among the users who administered different doses than were prescribed (36.1%), 77% identified difficulty viewing the graduated scale of the syringe and 29.5% had motor difficulties in handling the syringe pr ecisely. Sex (f emale), age (> 60 y ears) and education (<8 years) w ere sta tistically significant predictors. Conclusion: The data show the need for targeted interventions to develop skills for self-application of insulin, considering the limitations /capabilities of each user. The proposals of the ESF can support actions for health care focused on the needs of enrolled clients.

Análise fatorial confirmatória da escala Appraisal of Self Care Agency Scale - Revised

ABSTRACT Objective: to analyze the factor structure of the Appraisal of Self-Care Agency Scale-Revised (ASAS-R), adapted for Brazil. Method: methodological study conducted with 150 individuals with diabetes mellitus cared for by the Family Health Strategy, most of whom are elderly with low educational levels. The test of the hypothesis concerning the confirmatory factor composition of the ASAS-R was performed using latent variables structural equations. Results: the model’s goodness-of-fit indexes were satisfactory (χ2 = 259.19; χ2/g.l = 2.97, p < 0.001; GFI = 0.85; RMR = 0.07; RMSEA = 0.09); the factor loads were greater than 0.40; and most item-to-factor-correlations presented moderate to strong magnitude (0.34 to 0.58); total alpha value was 0.74, while the alpha of the three factors were 0.69, 0.38 and 0.69, respectively. Conclusion: the scale’s factor structure presented satisfactory validity and reliability results, with the exception of one factor. Application of this scale to samples of the general population is desirable in order to strengthen analyses of internal consistency and the dimensionality of the factor structure. This study is expected to contribute to further studies addressing the self-care agency construct and the development of the ASAS-R.ABSTRACT Objective: to analyze the factor structure of the Appraisal of Self-Care Agency Scale-Revised (ASAS-R), adapted for Brazil. Method: methodological study conducted with 150 individuals with diabetes mellitus cared for by the Family Health Strategy, most of whom are elderly with low educational levels. The test of the hypothesis concerning the confirmatory factor composition of the ASAS-R was performed using latent variables structural equations. Results: the model’s goodness-of-fit indexes were satisfactory (χ2 = 259.19; χ2/g.l = 2.97, p < 0.001; GFI = 0.85; RMR = 0.07; RMSEA = 0.09); the factor loads were greater than 0.40; and most item-to-factor-correlations presented moderate to strong magnitude (0.34 to 0.58); total alpha value was 0.74, while the alpha of the three factors were 0.69, 0.38 and 0.69, respectively. Conclusion: the scale’s factor structure presented satisfactory validity and reliability results, with the exception of one factor. Application of this scale to samples of the general population is desirable in order to strengthen analyses of internal consistency and the dimensionality of the factor structure. This study is expected to contribute to further studies addressing the self-care agency construct and the development of the ASAS-R.

Dosis de insulina prescrita versus dosis de insulina aspirada

Objectives: To compare the dose of prepared insulin to the dosage prescribed among users who self-administer; the differences relate to sociodemographic and clinical variables and identify the difficulties related to the procedure. Methods: The study included 169 users of the Family Health Strategy (ESF) of a municipality in the state of Minas Gerais, between August and October 2006. Results: Among the users who administered different doses than were prescribed (36.1%), 77% identified difficulty viewing the graduated scale of the syringe and 29.5% had motor difficulties in handling the syringe pr ecisely. Sex (f emale), age (> 60 y ears) and education (<8 years) w ere sta tistically significant predictors. Conclusion: The data show the need for targeted interventions to develop skills for self-application of insulin, considering the limitations /capabilities of each user. The proposals of the ESF can support actions for health care focused on the needs of enrolled clients.

Técnica de auto aplicación de insulina con jeringas desechables entre usuarios con diabetes mellitus acompañados por la estrategia salud de la familia

This cross-sectional study aimed to describe the most common correct and incorrect self-administration techniques for insulin using disposable syringes by patients cared for by the Family Health Strategy (FHS), relate the findings to sociodemographic variables and also identify the professional responsible for teaching this technique. A total of 169 patients were selected by simple random sampling in 37 FHS units in a city in the state of Minas Gerais, Brazil from August to October 2006. The results identified errors in all the steps recommended by the American Diabetes Association and Brazilian Diabetes Association for the safe administration of insulin, from hand washing to compression on the injection site. The FHS favors the development of interventions focused on the needs of the clientele registered at the unit, stimulating self-care. Results from this study can contribute to the planning of these interventions.3Estudo seccional que objetivou descrever os erros e os acertos mais comuns da tecnica de autoaplicacao de insulina, com seringas descartaveis, pelos usuarios, acompanhados pela Estrategia Saude da Familia (ESF), assim como relacionar esses achados as variaveis sociodemograficas e identificar o profissional responsavel pelas orientacoes. Participaram 169 usuarios selecionados por meio de amostragem aleatoria simples, em 37 unidades da ESF, de um municipio do Estado de Minas Gerais, entre agosto e outubro de 2006. Os resultados identificaram erros em todos os passos recomendados pela Associacao Americana de Diabetes e Sociedade Brasileira de Diabetes para a aplicacao segura da insulina, desde a lavagem das maos ate a compressao do local de aplicacao. A ESF favorece o desenvolvimento de intervencoes centradas nas necessidades da clientela adscrita, estimulando-a para o autocuidado, e os resultados do presente estudo poderao contribuir para o planejamento dessas intervencoes.