Self-care activities, sociodemographic variables, treatment and depressive symptoms among older adults with Diabetes Mellitus

Trevizani, Fernanda Auxiliadora; Doreto, Daniella Tech; Lima, Gabriella Santos; Marques, Sueli

doi:10.1590/0034-7167-2017-0579

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ORIGINAL ARTICLE • Rev. Bras. Enferm. 72 (suppl 2) • Nov 2019 • https://doi.org/10.1590/0034-7167-2017-0579 copy

Self-care activities, sociodemographic variables, treatment and depressive symptoms among older adults with Diabetes Mellitus

Actividades de autocuidado, variables sociodemográficas, tratamiento y síntomas depresivos entre adultos mayores con Diabetes Mellitus

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

Objective:

to analyze the association between self-care activities of older adults with Type 2 Diabetes Mellitus (DM) and sociodemographic variables, type of treatment and depressive symptoms.

Method:

inferential and cross-sectional study, with 121 older adults with Type 2 DM in ambulatory care. We used a questionnaire for characterization of sociodemographic and health, questionnaire self-care activities with DM, Mini Mental State Examination and Geriatric Depression Scale. The association of variables was used (Fisher’s exact test) and for comparing the means (Student’s t-test and analysis of variance).

Results:

The mean age was 68.1 years, the majority were women (57.2%), retired (71.9%) and married (65.3%). The highest averages were for the activities: “to dry the spaces between the toes, after washing them” and smaller averages for “exercise”.

Conclusion:

In spite of high average for self-care activities, there is a need for enhanced performance and compliance to them.

Descriptors:
Aged; Self Care; Diabetes Mellitus; Aging; Nursing

Variables	n	%	Minimum	Maximum	Mean (SD)*
Age			60	86	68.1 (6.2)
60 to 69	80	66.1
70 to 79	33	27.2
80 and +	8	6.6
Gender
Female	69	57.2
Male	52	42.9
Marital status
Single	6	5.0
Married/live companion	79	65.3
Widow	29	24.0
Divorced/separated	7	5.8
Education			0.0	20.0	3.9 (4.3)
Illiterate	39	32.2
Read and write informally	8	6.6
Incomplete first degree	32	26.5
Complete first degree	22	18.2
Incomplete second degree	6	5.0
Complete second degree	0	0.0
Complete third degree	5	4.1
Others	9	7.4
Profession / Occupation
Retired	87	71.9
Pensioner	16	13.2
Unemployed	0	0
Home	7	5.8
Self Employed	4	3.3
Others	7	5.8
Family income			700.00	6,000.00	1,855.38 (1,034.72)
Total	121	100

SDSCA Items	Mean	SD (DP)
1. Follow a healthy diet	4.9	2.5
2. Follow the food orientation given by a professional	3.4	3.1
3. Ingest five or more fruit and/or vegetable	4.6	2.6
4. Eat red meat and/or whole milk products.	4.9	2.6
5. Ingestion of sweets	0.8	1.5
6. Exercising for at least 30 minutes	1.6	2.6
7. Specific exercise (swimming, walking)	1.6	2.5
8. Blood sugar testing	5.4	2.5
9. Evaluate blood sugar the recommended number of times	5.5	2.5
10. Foot care	4.8	3.0
11. Examine inside the shoes before putting them on.	4.2	3.2
12. Dry the spaces between the toes, after washing them	6.4	1.8
13. Take insulin injections as recommended	6.1	2.3
14. Take the indicated number of diabetes pills	4.5	3.3

Variable	Dimensions of the Diabetes Self-Care Activities Questionnaire
	General diet		Specific diet		Exercise		Blood sugar testing		Foot care		Medication
	Mean (SD)	p value	Mean (SD)	p value	Mean (SD)	p value	Mean (SD)	p value	Mean (SD)	p value	Mean (SD)	p value
Marital status^* * Test of comparison of means by analysis of variance, significance value p <0.05.
Single	4.6 (3.1)		4.0 (1.0)		1.1 (2.8)		3.3 (3.3)		4.6 (2.0)		5.8 (1.2)
Married	4.3 (2.4)	0.22	4.2 (1.3)	0.84	1.5 (2.4)	0.42	5.5 (2.3)	0.03	5.4 (1.9)	0.23	5.9 (1.9)	0.70
Widow	3.3 (2.5)		4.4 (1.5)		1.4 (2.5)		5.9 (2.1)		4.6 (2.2)		5.6 (1.1)
Divorced/Separated	4.7 (2.4)		4.3 (1.4)		3.0 (2.8)		4.0 (2.4)		5.2 (2.1)		6.0 (1.2)
Years of study
None	4.2 (2.5)		4.2 (1.3)		1.9 (2.8)		5.3 (2.4)		5.0 (2.2)		5.6 (1.1)
1 to 4 years	3.9 (2.5)	0.51	4.1 (1.4)	0.82	1.0 (2.1)	0.37	5.6 (2.4)	0.74	5.2 (1.9)	0.59	5.9 (1.2)	0.47
5 to 8 years	4.7 (2.5)		4.4 (1.6)		2.1 (2.8)		4.9 (2.2)		5.0 (1.7)		6.1 (1.1)
9 to 11 years	2.9 (2.5)		4.5 (1.5)		1.8 (3.1)		5.0 (3.4)		4.3 (2.8)		5.3 (1.1)
12 and over	4.6 (1.9)		4.6 (1.0)		1.0 (1.5)		6.1 (1.4)		6.0 (2.2)		5.9 (1.2)
Income (tercile)^* * Test of comparison of means by analysis of variance, significance value p <0.05.
1 to R$ 1,399.99	4.1 (2.4)		3.8 (1.4)		1.1 (2.2)		5.7 (2.3)		4.9 (2.1)		5.7 (1.1)
R$ 1,400.00 to 2,099.99	4.2 (2.4)	0.94	4.0 (1.3)	0.00	2.0 (2.7)	0.26	5.4 (2.5)	0.66	5.3 (1.9)	0.74	5.9 (1.2)	0.77
R$ 2,100.00	4.0 (2.6)		4.9 (1.2)		1.4 (2.4)		5.2 (5.3)		5.1 (2.2)		5.8 (1.1)

Variable		Dimensions of the Diabetes Self-Care Activities Questionnaire
Variable		General diet		Specific diet		Exercise		Blood sugar testing		Foot care		Medication
Type of treatment	n	Mean (SD)	p value	Mean (SD)	p value	Mean (SD)	p value	Mean (SD)	p value	Mean (SD)	pvalue	Mean (SD)	p value
Diet
No	(25)	0.7(1.0)	1.00	4.2(1.2)	0.48	1.8(2.6)	0.29	4.8(2.8)	0.06	4.4(2.3)	0.03	5.7(1.1)	0.37
Yes	(96)	5.0(1.9)		4.2(1.4)		1.4(2.5)		5.6(2.2)		5.3(1.9)		5.8(1.1)
Insulin
No	(80)	4.1(2.5)	0.49	4.2(1.4)	0.43	1.7(2.5)	0.18	5.1(2.5)	0.01	5.2(2.0)	0.20	6.4(0.9)	0.00
Yes	(41)	4.1(2.0)		4.3(1.3)		1.2(2.4)		6.1(1.7)		5.0(2.4)		4.6(0.1)
Association (OAD+insulin)
No	(54)	3.7(2.4)	0.09	4.2(1.3)	0.47	1.5(2.6)	0.46	4.8(2.7)	0.01	4.9(2.2)	0.20	4.6(0.1)	0.00
Yes	(67)	4.3(2.4)		4.2(1.4)		1.5(2.4)		5.9(1.9)		5.2(1.9)		6.8(0.6)
Oral anti-diabets
No	(108)	4.2(2.4)	0.01	4.2(1.4)	0.44	1.4(2.4)	0.10	6.0(1.8)	0.00	5.1 (2.0)	0.32	5.9(1.1)	0.00
Yes	(13)	2.6(2.7)		4.2(1.2)		2.3(3.1)		1(1.5)		4.8(2.4)		4.6(0.0)
Exercise
No	(82)	3.9(2.4)	0.06	4.3(1.4)	0.49	0.1(0.9)	0.00	5.3(2.4)	0.35	4.9(2.1)	0.06	5.7(1.1)	0.20
Yes	(39)	4.5(2.4)		4.3(1.4)		4.3(2.2)		5.6(2.1)		5.5(1.9)		5.9 (1.1)

Dimensions - SDSCA	With depressive symptoms Mean (SD)	Without depressive symptoms Mean (SD)	p value
General diet	4.1(2.4)	4.0(2.5)	0.43
Specific diet	4.3(1.4)	4.2(1.3)	0.26
Exercise	2.0(2.8)	1.1(2.1)	0.96
Blood sugar testing	5.2(2.4)	5.6(2.3)	0.20
Foot care	4.9(2.3)	5.3(1.8)	0.16
Medication	5.7(1.1)	5.9(1.1)	0.10

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[1] Corresponding Author: Fernanda Auxiliadora Trevizani. E-mail: fernanda_trevizani@hotmail.com