Factors related to self-care activities of patients with type 2 diabetes mellitus

Eid, Letícia Palota; Leopoldino, Sílvia Aparecida Dourado; Oller, Graziella Allana Serra Alves de Oliveira; Pompeo, Daniele Alcalá; Martins, Marlene Andrade; Gueroni, Laís Palota Balderrama

doi:10.1590/2177-9465-EAN-2018-0046

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RESEARCH • Esc. Anna Nery 22 (4) • 2018 • https://doi.org/10.1590/2177-9465-EAN-2018-0046 copy

Factors related to self-care activities of patients with type 2 diabetes mellitus

Factores relacionados con las actividades de autocuidado de pacientes con diabetes mellitus tipo 2

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract

Objective:

To verify self-care activities of patients with type 2 diabetes mellitus and to analyze the relationship with sociodemographic and clinical variables.

Method:

A cross-sectional study was performed of 149 people using the Diabetes Self-Care Activities Questionnaire.

Results:

Of the 15 self-care activities analyzed, appropriate behavior was observed for aspects related to medication use and inadequate for fruit/vegetable consumption, blood sugar testing and physical exercise. The correct use of medications was correlated to marital status. Regarding inadequate behaviors, there were associations of fruit/vegetable consumption with skin color and place of residence and blood sugar testing with marital status and inverse correlations of physical exercise with systolic blood pressure, pulse pressure, waist circumference and postprandial glycemia.

Conclusion:

The results of this research contribute by strengthening the line of care in chronic diseases and assist in divulging the importance of supported self-care.

Implications for practice:

The findings of this research provided information relevant to the planning of care.

Keywords:
Diabetes Mellitus; Self Care; Nursing Care

Item	Frequency (days of week)				Mean^* * Average in days per week for self-care activities; SD: Standard deviation. (SD)
	0-4 days		5-7 days
	n	%	n	%
1. General diet
1.1 Followed a healthy diet	48	32.2	101	67.8	5.0 (2.2)
1.2 Followed diet guidance given by a professional	49	32.8	100	67.2	4.9 (2.2)
2. Specific diet
2.1 Ingested five or more servings of fruits and/or vegetables	127	85.2	22	14.8	1.3 (2.4)
2.2. Ate red meat and/or whole milk products	98	65.7	51	34.3	2.8 (2.4)
2.3. Ate sweets	22	14.7	127	85.3	5.5 (1.8)
3. Physical exercise
3.1 Performed physical exercise for at least 30 minutes	123	82.5	26	17.5	1.6 (2.5)
3.2 Performed specific physical exercise (swimming, walking, etc.)	125	83.8	24	16.2	1.5 (2.4)
4. Blood sugar testing
4.1. Evaluated blood sugar	127	85.2	22	14.8	1.3 (2.4)
4.2. Tested blood sugar the recommended number of times	127	85.2	22	14.8	1.3 (2.4)
5. Foot care
5.1. Checked the feet	35	23.4	114	76.6	5.5 (2.7)
5.2. Inspected the inside of the shoes before putting them on	38	25.5	111	74.5	5.3 (2.8)
5.3. Dried between the toes after washing them	19	12.7	130	87.3	6.1 (2.0)
6. Medications
6.1 Took medicines as recommended	5	3.3	144	96.7	6.7 (2.1)
6.2. Took insulin injections as recommended	0	0	38	100	6.9 (0.3)
6.3. Took the indicated number of diabetes pills	10	6.8	139	93.2	6.5 (1.6)

Item	General diet		Fruits or vegetables		Blood sugar testing
Variable	Mean (SD)	p^* * Statistical significance (p < 0.05);	Mean (SD)	p^* * Statistical significance (p < 0.05);	Mean (SD)	p^* * Statistical significance (p < 0.05);
Sex		0.76		0.15		0.29
Male	5.0 (2.3)		1.6 (2.5)		1.4 (2.4)
Female	5.0 (2.1)		0.9 (2.0)		1.2 (2.4)
Skin color		0.96		0.00		0.34
White	4.9 (2.2)		1.8 (2.6)		1.0 (2.1)
Non-white	5.0 (2.1)		0.8 (2.0)		1.6 (2.7)
Residence		0.47		0.00		0.66
Urban	5.0 (2.2)		1.2 (2.3)		1.3 (2.4)
Rural	5.3 (2.8)		3.5 (1.8)		1.5 (2.7)
Schooling		0.07		0.23		0.37
Illiterate	3.8 (3.1)		2.1 (2.8)		0.8 (1.7)
Up to 9 years	5.2 (2.0)		1.3 (2.3)		1.5 (2.5)
More than 9 years	4.0 (2.2)		0.7 (1.8)		0.7 (1.5)
Marital status
With partner	5.3 (2.0)	0.05	1.5 (2.6)	0.98	1.5 (2.5)	0.04
Without partner	4.4 (2.5)		1.0 (1.7)		0.9 (2.1)
Income		0.00		0.29		0.99
≤ 2 salaries	5.2 (2.1)		1.2 (2.3)		1.4 (2.5)
> 2 salaries	3.2 (2.5)		2.0 (2.8)		0.6 (0.8)

Item	Check feet		Dry between the toes		Take indicated number of tablets
Variable	Mean (SD)	p^* * Statistical significance (p <0.05);	Mean (SD)	p^* * Statistical significance (p <0.05);	Mean (SD)	p^* * Statistical significance (p <0.05);
Sex		0.52		0.16		0.84
Male	5.2 (2.9)		5.8 (2.5)		6.6 (1.5)
Female	5.6 (2.9)		6.4 (1.7)		6.5 (1.7)
Skin color		0.16		0.87		0.14
White	5.2 (2.9)		6.2 (1.9)		6.8 (1.1)
Non-white	5.8 (2.4)		6.1 (2.2)		6.2 (2.0)
Residence		0.09		0.97		0.49
Urban	5.5 (2.6)		6.1 (2.1)		6.5 (1.6)
Rural	3.5 (3.8)		6.6 (0.8)		6.8 (0.4)
Schooling		0.03		0.00		0.52
Illiterate	4.7 (3.1)		6.0 (2.3)		6.6 (1.6)
Up to 9 years	5.7 (2.6)		6.4 (1.8)		6.5 (1.7)
More than 9 years	4.2 (2.9)		4.0 (3.1)		7.0 (0.0)
Marital status		0.04		0.57		0.01
With partner	5.8 (2.4)		6.2 (2.0)		6.7 (1.3)
Without partner	4.8 (3.0)		6.0 (2.2)		6.1 (2.1)
Income		0.53		0.88		0.22
≤ 2 salaries	5.5 (2.7)		6.1 (2.1)		6.5 (1.7)
> 2 salaries	5.1 (2.9)		6.4 (1.8)		7.0 (0.0)

Item	General diet		Fruits and vegetables		Red meat/dairy products		Physical exercise
Variable	r^* * Statistical value corresponds to the Spearman correlation coefficient;	p^ Statistical significant (p < 0.05).	r^* * Statistical value corresponds to the Spearman correlation coefficient;	p^ Statistical significant (p < 0.05).	r^* * Statistical value corresponds to the Spearman correlation coefficient;	p^ Statistical significant (p < 0.05).	r^* * Statistical value corresponds to the Spearman correlation coefficient;	p^ Statistical significant (p < 0.05).
Age	0.14	0.74	-0.02	0.80	-0.08	0.29	-0.06	0.44
Fasting blood glucose	-0.18	0.02	0.21	0.00	0.18	0.02	0.08	0.30
Postprandial blood glucose	0.07	0.39	-0.25	0.00	-0.17	0.03	-0.17	0.03
Systolic blood pressure	0.05	0.54	-0.15	0.05	0.00	0.91	-0.19	0.01
Diastolic blood pressure	0.04	0.56	0.12	0.12	0.08	0.33	-0.05	0.48
Body mass index (BMI)	0.02	0.78	-0.05	0.52	-0.00	0.96	-0.08	0.34
Abdominal Circumference	-0.20	0.80	-0.11	0.16	-0.08	0.31	-0.17	0.03
Pulse pressure	-0.00	0.98	0.27	0.00	-0.06	0.42	-0.22	0.00
Time since diagnosis	0.14	0.07	0.02	0.80	0.22	0.00	0.02	0.78
Duration of insulin therapy	0.14	0.07	-0.03	0.64	0.08	0.29	-0.06	0.42
Duration of oral antidiabetic drug use	0.11	0.17	-0.06	0.44	0.12	0.13	0.08	0.32

Item	Blood sugar testing		Check feet		Insulin injections
Variable	r^* * Statistical value corresponds to the Spearman correlation coefficient;	p^ Statistical significant (p < 0.05).	r^* * Statistical value corresponds to the Spearman correlation coefficient;	p^ Statistical significant (p < 0.05).	r^* * Statistical value corresponds to the Spearman correlation coefficient;	p^ Statistical significant (p < 0.05).
Age	-0.06	0.44	-0.18	0.02	-0.0	0.97
Fasting blood glucose	0.08	0.28	0.14	0.08	0.23	0.00
Postprandial blood glucose	0.06	0.45	-0.04	0.59	-0.08	0.32
Systolic blood pressure	-0,09	0,06	0.01	0.86	0.06	0.44
Diastolic blood pressure	-0,07	0,39	0.00	0.92	0.06	0.41
Body mass index (BMI)	-0.04	0.55	0.08	0.31	0.13	0.10
Abdominal Circumference	-0.12	0.13	0.04	0.56	0.09	0.27
Pulse pressure	-0.10	0.20	0.03	0.71	0.05	0.52
Time since diagnosis	0.05	0.49	0.09	0.26	0.05	0.51
Duration of insulin therapy	0.38	0.00	0.19	0.01	0.07	0.35
Duration of oral antidiabetic drug use	0.01	0.86	0.11	0.15	0.19	0.01

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[1] Corresponding author: Letícia Palota Eid. E-mail: lpalota@usp.br