Abstract
Diabetes mellitus treatment is complex and involves several activities. Its goal is to control the disease and prevent complications. The success of this treatment includes adherence to self-care. This study aimed at identifying factors related to self-care activities adherence in community older adults with diabetes. Cross-sectional, observational and analytical study with a quantitative approach to data, conducted with 140 older people. We used the following instruments: Mini-Mental State Examination for cognitive assessment, socio-demographic and clinical characterization instrument, Brazilian Functional and Multidimensional Assessment Questionnaire to verify the self-reported morbidities, Abbreviated Geriatric Depression Scale to investigate the presence of depressive symptoms and Diabetes Self-Care Activities Questionnaire to assess activities adherence related to self-management of people with diabetes. The results of this study indicated that self-care activities with higher adherence were: “taking the indicated number of diabetes pills” (6.6 ± 1.2), “taking insulin injections as recommended” (6.2 ± 2.0), “drying the spaces between the toes after wash them” (4.6 ± 3.2) and “following a healthy diet” (4.5 ± 2.7). The self-care activities with smallest adherence were: “performing specific physical activities (walking, swimming, etc.)” (0.9 ± 1.9), “performing physical activities for at least 30 minutes” (1.2 ± 2.2), “evaluation of blood sugar as times as recommended” (1.2 ± 2.3), “sweets intake” (1.3 ± 1.7) and “evaluation of blood sugar” (1.4 ± 2.3). Regarding smoking, 88.6% were not smokers. Factors related to self-care measures were: gender, indicating greater adherence of women, education level, and number of morbidities, suggesting that adherence to the feet care domain is directly proportional to education and number of morbidities. However, this same domain was inversely proportional to depression, indicating that there was greater adherence in those people without depressive symptoms. The factors associated with the adherence to self-care activities observed in this research contributed to the planning of strategies to prevent diabetes mellitus complications and promote improvements in the life and health of the older adults in the community.
Highlights
Diabetes mellitus (DM) is a multifactorial disease of high incidence and prevalence worldwide, characterizing this clinical condition as a worldwide epidemic
Similar to other findings in the literature, the distribution according to gender may be justified by the higher life expectancy compared to men, showing an increase in this population (ROSSET et al, 2011)
They are more assiduous to health services because they are more attentive to health issues and aware of the importance of monitoring with health professionals, favoring early diagnosis (MEDEIROS; MORAIS, 2015), contributing to the fact that women have a higher proportion of diabetes diagnosis reports than men (INSTITUTO BRASILEIRO DE GEOGRAFIA ESTATÍSTICA, 2014a)
Summary
Diabetes mellitus (DM) is a multifactorial disease of high incidence and prevalence worldwide, characterizing this clinical condition as a worldwide epidemic It is a major challenge for public health and health professionals and for society The adoption of balanced eating habits, regular physical activity, foot care, disease monitoring, and compliance with the routine care provided by the health service are some of the non-medication measures related to the DM treatment (AMERICAN DIABETES ASSOCIATION, 2015; BRAZILIAN SOCIETY DE DIABETES, 2016). These activities are related to the skills developed during the disease evolution (BUB et al, 2006; WEINGER, BEVERLY, SMALDONE, 2014)
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