Adherence to self-care in people with Diabetes Mellitus in Primary Care: a mixed-methods study

Abstract

Objective

to develop an interpretive model on the adherence to self-care of people with Diabetes Mellitus in Primary Health Care.

Method

a mixed-method study conducted in four Basic Health Units. The cross-sectional quantitative study was composed of 329 participants, sociodemographic and clinical variables and the questionnaire of self-care activities were chosen. In the qualitative study, with 31 participants, the constructivist strand of Grounded Theory was used. The data were analyzed using descriptive statistics and initial and focused coding.

Results

most participants are female, married, with one to five years of schooling, retired, and with an income of one to three minimum wages. Low adherence to healthy eating, physical activity, and glycemic monitoring was obtained. The desirable adherence was related to the use of medications and foot care. In the qualitative step, the phenomenon was: Facing the complexity of the treatment of Diabetes Mellitus and seeking self-care. This was supported by two categories: Encountering difficulties to follow the treatment and valuing the facilitating aspects of the treatment that provided subsidies for the development of the model.

Conclusions and implications for practice

an interpretative model was elaborated whose elements demonstrate the complexity of the phenomenon and contribute to the adherence to self-care in this population.

Keywords:
Self Care; Diabetes Mellitus; Primary Health Care; Treatment Adherence and Compliance; Grounded Theory