Educational intervention to promote self-care in older adults with diabetes mellitus

Marques, Marilia Braga; Coutinho, Janaína Fonseca Victor; Martins, Mariana Cavalcante; Lopes, Marcos Venícios de Oliveira; Maia, Juliana Cunha; Silva, Maria Josefina da

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Original Article • Rev. esc. enferm. USP 53 • 2019 • https://doi.org/10.1590/S1980-220X2018026703517 copy

Educational intervention to promote self-care in older adults with diabetes mellitus^* * Extracted from the thesis: “Intervenção educativa para o autocuidado com os pés de idosos com diabetes mellitus”, Programa de Pós-Graduação em Enfermagem, Universidade Federal do Ceará, 2015.

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

Objective:

To evaluate the efficacy of an educational nursing intervention in self-care for older adults who have Diabetes Mellitus.

Method:

A quasi-experimental study with control and intervention two groups conducted with older adults living with Diabetes Mellitus, attended at Primary Health Care Units of Fortaleza/Ceará. The intervention was a group educational approach with guidelines on diabetes treatment and foot care. The Brazilian adapted version of the Summary of Diabetes Self-Care Activities Questionnaire (SDSCA) was used for evaluating before-and-after self-care. A significance level of 0.05 was considered.

Results:

103 older adults participated in the study. There was an increase in self-care for diabetes after the educational intervention related to the aspects: healthy diet (p = 0.027), dietary instruction (p = 0.013) and foot examination (p = 0.012).

Conclusion:

The performed intervention promoted positive behavioral changes, favoring the adoption of healthy habits and the promotion of self-care in older adult patients with Diabetes Mellitus.

DESCRIPTORS
Diabetes Mellitus; Aged; Self Care; Diabetic Foot; Nursing Care; Health Education

Variables	IG (n = 53)			CG (n = 50)
Variables	Before Mean (±SD)	After Mean (±SD)	p^* * Wilcoxon Test.	Before Mean (±SD)	After Mean(±SD)	p^* * Wilcoxon Test.
Glycemia (mg/dl)	187.30 (73.93)	171.06 (87.83)	0.135	175.04 (79.0)	171.74 (70.34)	0.966
SBP (mmHg)	131.36 (15.17)	129.68 (15.38)	0.364	130.40 (13.24)	132.44 (18.67)	0.412
DBP (mmHg)	78.49 (7.65)	75.16 (11.79)	0.147	76.68 (10.0)	79.06 (16.97)	0.719
BMI (Kg/cm²)	27.26 (5.12)	27.12 (4.5)	0.915	28.22 (5.18)	28.01 (5.23)	0.555

QAD^* * All questions from the QAD concerned the last 7 days; Items	Intervention Group (IG)			Control Group (CG)
	Before Mean (±SD)	After Mean (±SD)	p^ c2/Fisher test. a) Marginal Homogeneity Test. b) Wilcoxon Test.	Before Mean (±SD)	After Mean (±SD)	p^ c2/Fisher test. a) Marginal Homogeneity Test. b) Wilcoxon Test.
Follow a healthy diet	4.58(2.91)	5.74(2.17)	0.027	4.80(2.68)	4.90(2.55)	0.922
Follow food instructions	4.32(2.88)	5.58(2.19)	0.013	4.58(2.80)	4.72(2.66)	0.818
Eat five or more servings of fruits and/or vegetables.	5.53(2.35)	5.85(2.18)	0.358	4.94(2.59)	5.40(2.17)	0.337
Eat high fat foods	2.83(2.82)	3.06(2.76)	0.685	2.78(2.95)	2.24(2.38)	0.333
Eat candy/sweets	1.42(2.23)	1.04(2.05)	0.258	1.20(2.33)	0.84(1.78)	0.354
Practice physical activity for at least 30 minutes daily	2.36(2.94)	2.98(2.82)	0.174	1.86(2.70)	2.18(2.67)	0.245
Perform specific exercise	1.87(2.84)	2.26(2.69)	0.271	1.30(2.29)	1.46(2.28)	0.361
Evaluate glycemia	2.42(2.81)	2.21(2.83)	0.400	1.40(2.22)	1.42(2.25)	0.930
Evaluate glycemia as recommended	2.32(3.02)	2.15(2.93)	0.618	1.10(1.91)	1.34(2.40)	0.727
Examine feet	4.94(2.95)	6.06(2.31)	0.012	3.62(3.33)	4.40(3.05)	0.620
Examine inside shoes before putting them on	4.77(3.18)	5.53(2.79)	0.172	4.50(3.37)	5.04(3.01)	0.145
Dry the intertoe spaces of the feet after washing them	5.85(2.45)	6.30(2.01)	0.199	3.74(3.45)	4.08(3.27)	0.270
Take DM medications as recommended	6.38(1.73)	6.58(1.63)	0.513	6.52(1.68)	6.60(1.37)	0.888
Take insulin injections as recommended	2.85(3.43)	2.91(3.38)	0.865	1.38(2.79)	1.10(2.55)	0.157
Take the indicated number of diabetes pills	6.21(2.09)	6.06(2.38)	0.715	6.52(1.68)	6.26(1.95)	0.473

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: Marília Braga Marques, Universidade Federal do Ceará, Departamento de Enfermagem Rua Alexandre Baraúna, 1115, Rodolfo Teófilo CEP: 60430-160 – Fortaleza, CE, Brazil mariliabm1@hotmail.com

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Educational intervention to promote self-care in older adults with diabetes mellitus* * Extracted from the thesis: “Intervenção educativa para o autocuidado com os pés de idosos com diabetes mellitus”, Programa de Pós-Graduação em Enfermagem, Universidade Federal do Ceará, 2015.

ABSTRACT

Objective:

Method:

Results:

Conclusion:

Educational intervention to promote self-care in older adults with diabetes mellitus^* * Extracted from the thesis: “Intervenção educativa para o autocuidado com os pés de idosos com diabetes mellitus”, Programa de Pós-Graduação em Enfermagem, Universidade Federal do Ceará, 2015.