Adherence to self-care practices and empowerment of people with diabetes mellitus: a randomized clinical trial

Macedo, Maísa Mara Lopes; Cortez, Daniel Nogueira; Santos, Jéssica Caroline dos; Reis, Ilka Afonso; Torres, Heloísa de Carvalho

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Original Article • Rev. esc. enferm. USP 51 • 2017 • https://doi.org/10.1590/S1980-220X2016050303278 copy

Adherence to self-care practices and empowerment of people with diabetes mellitus: a randomized clinical trial^* Apoio Financeiro Fundação de Amparo à Pesquisa de Minas Gerais (FAPEMIG). Processo APQ-00896-13/Edital Programa HIPERDIA Minas.

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

Objective:

To evaluate adherence to self-care and glycemic control and empowerment of people with diabetes mellitus in group education.

Method:

Cluster-randomized clinical trial, with participants with type 2 diabetes mellitus. All people in the sample were linked to Family Health Strategy Units from Divinópolis, state of Minas Gerais, Brazil, during 2014 and 2015. Data regarding adherence to self-care practices, empowerment and glycated hemoglobin were collected for comparison of groups in the baseline and of intergroup results before and after interventions. The chosen level of significance was 0.05.

Results:

The sample had 183 people, with 72 in the intervention group and 111 in the control group. A statistically significant decrease (< 0.001) in the value of glycated hemoglobin and an increase in the scores of adherence to self-care and empowerment scales were found for participants in the intervention group (< 0.001).

Conclusion:

Group education caused an increase in the scores of the scales of adherence to self-care practices and empowerment, in addition to an improvement in glycemic levels, as shown by glycated hemoglobin results. Brazilian Registry of Clinical Trials: RBR-92j38t.

DESCRIPTORS
Diabetes Mellitus; Self Care; Health Education; Public Health Nursing

Variable		Mean ± SD or Median (min. - max.)		p ^* * Student's t-test or chi-square test.
Variable		IG (n=72)	CG (n=111)	p ^* * Student's t-test or chi-square test.
Age (mean ± SD)		60.4 ± 8.0	57.5 ± 9.7	0.033
Gender (N(%))
	Male	27 (37.5)	38 (34.2)	0.652
	Female	45 (62.5)	73 (65.8)
Level of education (N(%))
	Up to incomplete elementary school	52 (72.02)	73 (65.8)	0.359
	Complete elementary school to graduate course	20 (27.8)	38 (34.2)
Marital status (N(%))
	No partner	53 (73.6)	87 (78.4)	0.457
	Has a partner	19 (26.4)	24 (21.6)
Occupation (N(%))
	Active	26 (36.1)	55 (49.6)	0.074
	Inactive	46 (63.9)	56 (50.5)
Diabetes time (N(%))
	≤ 5 years	28 (38.9)	21 (18.9)	0.003
	> 5 years	44 (61.1)	90 (81.1)
HbA1c		8.3 (5.7-13.1)	7.9 (5.0-14.4)	0.083
MHN		3.5 (1.2-7.5)	3.3 (1.0-6.8)	0.158
DES-SF		3.7 (2.7-4.7)	3.6 (2.7-4.7)	0.903

Variable	IG			CG		p ^* * Wilcoxon test for intragroup comparison (before and after period of study).
Variable	Ti Median (min. and max.)	Tf Median (min. and max.)	p ^* * Wilcoxon test for intragroup comparison (before and after period of study).	Ti Median (min. and max.)	Tf Median (min. and max.)
HbA1c	8.3 (5.7-13.1)	7.4 (5.2-11.9)	<0.001	7.9 (5.0-14.4)	8.1 (4.9-13.9)	0.296
MHN	3.5 (1.2-7.5)	4.1 (1.7-6.2)	<0.001	3.3 (1.0-6.8)	3.3 (1.2-6.1)	0.970
DES-SF	3.7 (2.7-4.7)	4.1 (2.7-4.9)	<0.001	3.6 (2.7-4.7)	3.9 (2.5-4.9)	<0.001

Variables	IG	CG	IG – CG
Variables	Median Δ (min.; max.)	Median Δ (min.; max.)	p^* * Mann-Whitney test for intergroup comparison.
HbA1c	-6.36 (-40; 32.94)	0 (-45.87; 90.42)	<0.001
MHN	17.92 (-57.01; 284.48)	0 (-61.54; 435)	0.026
DES-SF	11.62 (-21.43; 44.08)	9.27 (-42.66; 59.09)	0.159

Universidade de São Paulo, Escola de Enfermagem Av. Dr. Enéas de Carvalho Aguiar, 419 , 05403-000 São Paulo - SP/ Brasil, Tel./Fax: (55 11) 3061-7553, - São Paulo - SP - Brazil
E-mail: reeusp@usp.br

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[1] Corresponding author: Heloisa de Carvalho Torres, Universidade Federal de Minas Gerais, Escola de Enfermagem Av. Prof. Alfredo Balena, 190, room 520 – Santa Efigênia 30130-100 – Belo Horizonte, MG, Brazil heloisa@enf.ufmg.com

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Adherence to self-care practices and empowerment of people with diabetes mellitus: a randomized clinical trial* Apoio Financeiro Fundação de Amparo à Pesquisa de Minas Gerais (FAPEMIG). Processo APQ-00896-13/Edital Programa HIPERDIA Minas.

ABSTRACT

Objective:

Method:

Results:

Conclusion:

Adherence to self-care practices and empowerment of people with diabetes mellitus: a randomized clinical trial^* Apoio Financeiro Fundação de Amparo à Pesquisa de Minas Gerais (FAPEMIG). Processo APQ-00896-13/Edital Programa HIPERDIA Minas.