EVALUATION OF THE EMOTIONAL ASPECTS AND SELF-CARE OF ELDERLY PEOPLE WITH DIABETES MELLITUS

Bendelaque, Dandara de Fátima Ribeiro; Carvalho, Dayara de Nazaré Rosa de; Silveira, Stelacelly Coelho Toscano; Sousa, Fabianne de Jesus Dias de; Andrade, Mariseth Carvalho de; Aguiar, Viviane Ferraz Ferreira de

doi:10.1590/ce.v29i0.94954

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ORIGINAL ARTICLE • Cogitare Enferm. 29 • 2024 • https://doi.org/10.1590/ce.v29i0.94954 copy

EVALUATION OF THE EMOTIONAL ASPECTS AND SELF-CARE OF ELDERLY PEOPLE WITH DIABETES MELLITUS

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

Objective:

To evaluate the emotional aspects and self-care of elderly people with Diabetes Mellitus.

Method:

a descriptive, exploratory, and quantitative study with 105 elderly people from an outpatient clinic in a hospital located in the city of Belém-Pará, Brazil, carried out between July and September 2022. The following questionnaires were used: sociodemographic, economic, and clinical data; problem areas in Diabetes; and Diabetes self-care activities. The data was analyzed using descriptive statistics (frequency and percentage) and inferential analysis using the following tests: Chi-square, and the G-adherence test.

Results:

low emotional distress was found in items: nine (p = 0.0001), ten to twenty (p<0.0001), and good adherence to self-care in the domains of general nutrition (p<0.0001), specific nutrition (p<0.0001), foot care and medication (p<0.0001).

Conclusion:

The findings can be linked to adequate guidance on daily care, contributing to the perception of the emotional condition and its relationship with self-care.

KEYWORDS:
Elderly; Diabetes Mellitus; Surveys and Questionnaires; Self-care; Mental Health.

HIGHLIGHTS

1. They have a clinical profile prone to complications associated with diabetes.

2. The majority had a low level of emotional distress.

3. Self-care evaluation was considered desirable.

4. Emotional condition is a determining factor for the self-care.

Variables	n	%	p-value
Gender			0, 2046
Female	46	43,8
Male	59	56,2
Age group^* * Chi-Square Adherence Test.			0,0116^* * Chi-Square Adherence Test.
60 to 69^* * Chi-Square Adherence Test.	45	42,9
70 to 79	39	37,1
80 to 89	16	15,2
90 and over	5	4,8
Race			< 0,0001^* * Chi-Square Adherence Test.
White	11	10,5
Brown^* * Chi-Square Adherence Test.	69	65,7
Black	19	18,1
Yellow	6	5,7
Education			< 0,0001^**
Incomplete elementary school	16	15,2
Complete elementary school^**	42	40,0
High school incomplete	12	11,4
High school complete	33	31,4
Other	2	1,9
Marital status			< 0,0001^* * Chi-Square Adherence Test.
Single	8	7,6
Married^* * Chi-Square Adherence Test.	57	54,3
Widowed	34	32,4
Other	6	5,7
Family income (MW)			< 0,0001^* * Chi-Square Adherence Test.
< 01	7	6,7
01 to < 02^* * Chi-Square Adherence Test.	64	61,0
02 to 03	34	32,4

Variables	n	%	p-value
Comorbidities			< 0,0001^* * Chi-Square Adherence Test.
SAH^* * Chi-Square Adherence Test.	88	83,8
Dyslipidemia	53	50,5
Heart Disease	26	24,8
EVA or hemorrhagic CVA	3	2,9
Heart failure	1	1,0
Others	3	2,9
Risk factors for comorbidities			0,0001^* * Chi-Square Adherence Test.
Sedentary lifestyle^* * Chi-Square Adherence Test.	72	68,6
Family history of DM	53	50,5
Alcohol consumption	19	18,1
Tobacco use	12	11,4
Complicações			0,0002^* * Chi-Square Adherence Test.
Diabetic foot^* * Chi-Square Adherence Test.	27	25,7
Amputation	15	14,3
Diabetic neuropathy	13	12,4
Diabetic retinopathy	3	2,9
Time since DM diagnosis (years)			0,0039^* * Chi-Square Adherence Test.
Up to 10	11	10,5
11 to 15	27	25,7
16 to 20^* * Chi-Square Adherence Test.	36	34,3
Over 20	31	29,5
Type of treatment			< 0,0001^* * Chi-Square Adherence Test.
1 drug	15	14,3
2 medications	37	35,2
Medication + Insulin therapy^* * Chi-Square Adherence Test.	40	38,1
Insulin therapy	13	12,4
Hospitalization due to DM complications			< 0,0001^* * Chi-Square Adherence Test.
None^* * Chi-Square Adherence Test.	62	59,0
1 in the last 6 months	35	33,3
2 or more in the last 6 months	8	7,6
COVID-19 infection			0,2831
Yes	47	44,8
No	58	55,2
Vaccination against COVID-19^* * Chi-Square Adherence Test.			< 0,0001^* * Chi-Square Adherence Test.
02 doses	9	8,6
03 doses	50	47,6
04 doses	46	43,8
Hospitalized due to COVID-19^* * Chi-Square Adherence Test.			0,0051^* * Chi-Square Adherence Test.
Yes	17	36,2
No	30	63,8

Problems related to treatment.	Score achieved				p-value
	0 to 2 pts		3 to 4 pts
	n	%	n	%
1. Worrying about low glucose episodes.	30	28,6	75	71,4	< 0,0001^*
2. Worrying about the future and the possibility of serious complications.	31	29,5	74	70,5	< 0,0001^*
3. Worrying about food and what to eat.	35	33,3	70	66,7	0,0006^*
4. Dealing with the complications of diabetes.	39	37,1	66	62,9	0,0084^*
5. Having feelings of deprivation about food and meals.	44	41,9	61	58,1	0,0971
6. Feeling fear when thinking about living with diabetes.	45	42,9	60	57,1	0,1432
7. Facing uncomfortable social situations related to care.	47	44,8	58	55,2	0,2831
8. Feeling that diabetes is taking up too much of your mental and physical energy.	50	47,6	55	52,4	0,6256
9. Feeling exhausted by the effort it takes to care for diabetes.	72	68,6	33	31,4	0,0001^**
10. Getting angry at the thought of living with diabetes.	78	74,3	27	25,7	< 0,0001^**
11. Feeling that your diabetes is a burden to you.	79	75,2	26	24,8	< 0,0001^**
12. Feeling alone with your diabetes.	83	79,0	22	21,0	< 0,0001^**
13. Feeling that your friends and family don’t support you in dealing with your diabetes.	85	81,0	20	19,0	< 0,0001^**
14. Feeling dissatisfied with the doctor who looks after your diabetes.	88	83,8	17	16,2	< 0,0001^**
15. Not accepting your diabetes.	90	85,7	15	14,3	< 0,0001^**
16. Feeling guilty or anxious when you fail to take care of your diabetes.	91	86,7	14	13,3	< 0,0001^**
17. Getting depressed when you think about having to live with diabetes.	92	87,6	13	12,4	< 0,0001^**
18. Feeling discouraged about your diabetes treatment.	95	90,5	10	9,5	< 0,0001^**
19. Not knowing if your mood/feeling is related to diabetes.	97	92,4	8	7,6	< 0,0001^**
20. The lack of clear and concrete goals in your diabetes care.	99	94,3	6	5,7	< 0,0001^**

QAD instrument	Time in days								p-value
	0 to 1 day		2 to 3 days		4 to 5 days		6 to 7 days
	n	%	n	%	n	%	n	%
1. General diet
Followed a healthy diet.	4	3,8	4	3,8	58	55,2	39	37,1	< 0,0001^* * G Test Adherence.
Followed dietary guidelines.	5	4,8	4	3,8	58	55,2	38	36,2	< 0,0001^* * G Test Adherence.
2. Specific diet
Ate five or more portions of fruit and/or vegetables.	4	3,8	9	8,6	52	49,5	40	38,1	< 0,0001^* * G Test Adherence.
Ate sweets.	30	28,6	10	9,5	40	38,1	25	23,8	0,0005^* * G Test Adherence.
Ate foods high in fat.	33	31,4	13	12,4	30	28,6	29	27,6	0,0262^* * G Test Adherence.
3. Physical activity
Performed physical activity for at least thirty minutes.	91	86,7	5	4,8	3	2,9	6	5,7	< 0,0001^* * G Test Adherence.
Performed specific physical exercises.	91	86,7	5	4,8	3	2,9	6	5,7	< 0,0001^* * G Test Adherence.
4. Blood sugar monitoring
Assessed blood sugar.	36	34,3	44	41,9	14	13,3	11	10,5	< 0,0001^* * G Test Adherence.
Assessed blood sugar at the recommended level.	35	33,3	46	43,8	14	13,3	10	9,5	< 0,0001^* * G Test Adherence.
5. Foot care
Have examined your feet.	3	2,9	5	4,8	20	19,0	77	73,3	< 0,0001^* * G Test Adherence.
Have examined the inside of your shoes before putting them on.	3	2,9	5	4,8	20	19,0	77	73,3	< 0,0001^* * G Test Adherence.
Dried the inter-digital spaces after washing the feet.	3	2,9	5	4,8	15	14,3	82	78,1	< 0,0001^* * G Test Adherence.
6. Medication						0,0
Took medication as recommended.	0	0,0	1	1,0	2	1,9	102	97,1	< 0,0001^* * G Test Adherence.
Taken insulin injections as recommended.	0	0,0	1	3,0	1	3,0	31	93,9	< 0,0001^* * G Test Adherence.
Took the indicated number of diabetes tablets.	0	0,0	2	2,9	14	20,0	54	77,1	< 0,0001^* * G Test Adherence.

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E-mail: cogitare@ufpr.br

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[1] Associate editor: Dra. Luciana Nogueira