Self-care activities and their relationship to metabolic and clinical control of people with diabetes Mellitus

Coelho, Anna Claudia Martins; Boas, Lilian Cristiane Gomes Villas; Gomides, Daniele dos Santos; Foss-Freitas, Maria Cristina; Pace, Ana Emilia

doi:10.1590/0104-07072015000660014

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Original Article • Texto contexto - enferm. 24 (3) • July-Sep 2015 • https://doi.org/10.1590/0104-07072015000660014 copy

Self-care activities and their relationship to metabolic and clinical control of people with diabetes Mellitus¹ 1 Extract from the dissertation - Self-care in people with type 2 Diabetes mellitus outpatients, presented to the Escola de Enfermagem de Ribeirão Preto (EERP), Universidade de São Paulo (USP), and supported by the São Paulo Research Foundation (FAPESP), process no. 2011/09037-6 and CNPq 563598/2010-7, Request MCT/CNPq/CT-SAÚDE/MS/SCTIE/DECIT n. 42/2010 - Diabetes

Actividades de autocuidado y sus relaciones con control metabólico y clínico de las personas con diabetes Mellitus

Authorship SCIMAGO INSTITUTIONS RANKINGS

Cross-sectional study with the aim to evaluate self-care in people with type 2 diabetes mellitus and verify its relationship with sociodemographic and clinical characteristics. The sample included 218 patients under outpatient follow-up. Self-care activities were evaluated by means of a questionnaire that was previously translated and validated for Brazil. The questionnaire items that reached the highest means were related to drug therapy, whereas those with the lowest means were related to the practice of physical activity. Age correlated inversely with physical activity and foot care, and elapsed time since the disease diagnosis showed a direct correlation with blood glucose monitoring. Data showed that self-care activities related to behavioral changes are the ones that require greater investments to achieve its goals, and age and time since diagnosis should be considered in the planning of nursing care for people with diabetes mellitus.

Selfcare; Diabetes mellitus, type 2; Nursing care

SDSCA Items	Mean* (SD†)	1st Quartile	Median	3rd Quartile
1. Following a healthy diet.	5.0 (SD=2.5)	3.0	6.0	7.0
2. Following professional dietary guidelines.	3.7 (SD=2.8)	0.0	4.0	7.0
3. Eating five or more servings of fruits and/or vegetables.	4.1 (SD=2.8)	2.0	5.0	7.0
4. Ingesting meat and/or whole milk derivatives.	3.0 (SD=2.7)	0.0	3.5	7.0
5. Eating sweets.	6.0 (SD=1.2)	6.0	6.0	7.0
6. Performing physical activity for at least 30 minutes.	2.4 (SD=2.7)	0.0	2.0	5.0
7. Performing specific physical exercises (swimming, walking, etc.).	2.1 (SD=2.6)	-	-	4.0
8. Testing blood sugar.	4.5 (SD=2.8)	2.0	6.0	7.0
9. Testing blood sugar as often as recommended.	3.3 (SD=3.0)	0.0	3.0	7.0
10. Performing foot examination.	4.5 (SD=3.1)	1.0	7.0	7.0
11. Inspection of shoes before putting them on.	4.2 (SD=3.3)	-	7.0	7.0
12. Drying the spaces between the toes, after washing them.	6.2 (SD=2.2)	7.0	7.0	7.0
13. Taking insulin injections, as recommended.	6.8 (SD=1.0)	7.0	7.0	7.0
14. Taking the indicated number of diabetes pills.	6.6 (SD=1.4)	7.0	7.0	7.0

Scores of the variables	Self-care
	General nutrition		Specific nutrition		Physical activity		Monitoring of blood glucose		Foot care		Medication
	Statistics*	p-value^†	Statistics*	p-value^†	Statistics*	p-value^†	Statistics*	p-value^†	Statistics*	p-value^†	Statistics*	p-value^†
Age (full years)	0.03	0.61	-0.04	0.55	-0.13	0.04	-0.03	0.61	-0.15	0.01	-0.07	0.27
Schooling (total years of completed education)	0.07	0.27	0.07	0.24	0.11	0.07	-0.03	0.61	0.14	0.03	-0.05	0.43
Number of people in the household	-0.19	0.00	-0.05	0.41	-0.03	0.63	-0.04	0.55	-0.09	0.17	0.02	0.66
Monthly per capita income	-0.05	0.42	-0.03	0.61	0.02	0.74	0.00	0.96	-0.01	0.78	-0.08	0.23
Time since diagnosis (years)	0.09	0.18	0.06	0.36	-0.00	0.97	0.14	0.03	0.12	0.07	0.01	0.79
Time of insulin use (years)	-0.01	0.81	-0.04	0.54	-0.04	0.50	-0.06	0.34	0.12	0.08	0.01	0.88
Daily frequency of application	-0.06	0.34	0.05	0.41	0.05	0.44	0.05	0.45	0.02	0.76	0.07	0.28
OADs‡ time of use (years)	0.06	0.36	-0.03	0.63	-0.03	0.66	0.05	0.44	0.12	0.09	-0.02	0.78
Daily frequency of OAD ingestion	-0.10	0.19	0.13	0.06	0.15	0.03	-0.02	0.70	0.17	0.02	0.01	0.83

Self-care
Scores of the variables	General nutrition		Specific nutrition		Physical activity		Monitoring of blood glucose		Foot care		Medication
Scores of the variables	Mean (SD)*	p-value^†	Mean (SD)*	p-value^†	Mean (SD)*	p-value^†	Mean (SD)*	p-value^†	Mean (SD)*	p-value^†	Mean (SD)*	p-value^†
Gender
Male	4.5 (2.2)	0.36	4.4 (1.4)	0.97	2.9 (2.5)	<0.00	3.9 (2.8)	1.00	5.2 (1.8)	0.08	6.7 (1.0)	0.94
Female	4.3 (2.2)		4.2 (1.3)		1.7 (2.3)		3.9 (2.5)		4.7 (2.1)		6.8 (0.8)
Occupation
Active	4.5 (2.1)	0.84	4.5 (1.3)	0.60	2.1 (2.1)	0.01	3.6 (2.9)	0.35	5.3 (1.8)	0.40	6.8 (0.8)	0.76
Inactive	4.4 (2.2)		4.1 (1.4)		2.6 (2.6)		3.9 (2.7)		4.8 (2.2)		6.7 (1.0)
At home	4.2 (2.4)		4.3 (1.2)		1.5 (2.4)		4.4 (2.5)		5.1 (1.8)		6.8 (0.8)
Drug treatment
Associations	4.3 (2.2)	0.25	4.4 (1.3)	0.64	2.1 (2.5)	0.25	4.2 (2.6)	<0.00	5.0 (2.9)	0.25	6.8 (0.9)	0.79
OAD‡	3.9 (2.5)		4.1 (1.4)		2.4 (5.6)		1.1 (1.9)		4.4 (2.1)		6.7 (1.0)
Insulin	4.8 (2.0)		4.1 (1.4)		2.7 (2.3)		4.7 (2.3)		5.0 (1.7)		6.8 (0.9)

Universidade Federal de Santa Catarina, Programa de Pós Graduação em Enfermagem Campus Universitário Trindade, 88040-970 Florianópolis - Santa Catarina - Brasil, Tel.: (55 48) 3721-4915 / (55 48) 3721-9043 - Florianópolis - SC - Brazil
E-mail: textoecontexto@contato.ufsc.br

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[1] Correspondence: Ana Emilia Pace Universidade de São Paulo. Escola de Enfermagem de Ribeirão Preto Departamento de Enfermagem Geral e Especializada Avenida dos Bandeirantes, 3900 14040-902 - Monte Alegre, Ribeirão Preto, SP, Brasil E-mail: aepace@eerp.usp.br