Macedo Jessica Caline Lemos, Soares Daniela Arruda, de Carvalho Vivian Carla Honorato Dos Santos, Cortes Taciana Borges Andrade, Mistro Sóstenes, Kochergin Clavdia Nicolaevna, Rumel Davi, Oliveira Marcio Galvão
Master's Program in Collective Health, Multidisciplinary Health Institute, Federal University of Bahia, Vitória da Conquista, Bahia, Brazil.
Multidisciplinary Health Institute, Federal University of Bahia, Vitória da Conquista, Bahia, Brazil.
Patient Prefer Adherence. 2022 Jul 27;16:1831-1842. doi: 10.2147/PPA.S373302. eCollection 2022.
This study aims to assess self-care in patients with non-optimal diabetes management (HbA1c >7.0% for adults and >8.0 for those aged 60 or over) and the positive and negative experiences associated with it in the rural communities of a Brazilian municipality.
This is a cross-sectional mixed-methods study. The data were collected from participants with high HbA1c through focus group discussions, subsequently performing thematic analysis, and through structured questionnaires (socioeconomic characteristics and the Summary of Diabetes Self-Care Activities (SDSCA)).
The mean HbA1c of the 156 study participants was 9.94% (95% confidence interval: 9.70-10.19%) and most participants (86.54%) had negative self-care behaviors, with an overall SDSCA mean score of 3.55. This mean was not positive for any of the socioeconomic characteristics. The self-care activities with the most satisfactory performance concerned non-smoking and the use of prescribed medications, and the poorest results were observed for the practice of specific physical activities. The qualitative data indicated that the study participants face many difficulties regarding self-care practices, especially those related to an adequate diet.
The self-care assessment revealed unsatisfactory self-care behaviors as well as high HbA1c levels among the study participants and highlighted the various difficulties they encounter. This indicates the need for more attentive health teams to monitor patients, especially regarding actions focused on the non-pharmacological elements of self-care, such as lifestyle changes, which were found to be the dimensions with the most unsatisfactory results.
本研究旨在评估糖尿病管理不佳（成人糖化血红蛋白>7.0%，60岁及以上者>8.0%）患者的自我护理情况，以及巴西一个市镇农村社区中与之相关的积极和消极体验。
这是一项横断面混合方法研究。通过焦点小组讨论收集糖化血红蛋白水平高的参与者的数据，随后进行主题分析，并通过结构化问卷（社会经济特征和糖尿病自我护理活动总结（SDSCA））收集数据。
156名研究参与者的糖化血红蛋白平均水平为9.94%（95%置信区间：9.70 - 10.19%），大多数参与者（86.54%）有消极的自我护理行为，SDSCA总平均分为3.55。对于任何社会经济特征而言，该平均分都不理想。表现最令人满意的自我护理活动是不吸烟和使用处方药，而特定体育活动的执行情况结果最差。定性数据表明，研究参与者在自我护理实践方面面临许多困难，尤其是与合理饮食相关的困难。
自我护理评估显示，研究参与者的自我护理行为不尽人意，糖化血红蛋白水平较高，并突出了他们遇到的各种困难。这表明需要更细心的医疗团队来监测患者，特别是在关注自我护理的非药物因素的行动方面，如生活方式改变，这些方面被发现是结果最不理想的维度。
