Calidad de vida de las personas con diabetes mellitus

Tonetto, Isabela Fernandes de Aguiar; Baptista, Marcelo Henrique Barbosa; Gomides, Danielle dos Santos; Pace, Ana Emilia

doi:10.1590/S1980-220X2018002803424

Brasil

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ORIGINAL ARTICLE • Rev. esc. enferm. USP 53 • 2019 • https://doi.org/10.1590/S1980-220X2018002803424 linkcopiar

Calidad de vida de las personas con diabetes mellitus

Autoría SCIMAGO INSTITUTIONS RANKINGS

RESUMEN

Objetivo: Analizar la calidad de vida de personas con diabetes mellitus tipo 2, en los tres niveles de atención sanitaria.

Método: Estudio cuantitativo, transversal y descriptivo, realizado en unidades de atención primaria, secundaria y terciaria de salud con personas en atención ambulatoria. Se utilizó el instrumento validado Diabetes-39 para evaluar la calidad de vida.

Resultados: La muestra estuvo constituida de 53 personas. Se observó tendencia creciente en el compromiso de la calidad de vida del nivel de atención primaria a terciaria. En la muestra total, hubo diferencias entre dominios de la calidad de vida con las variables sexo, uso de insulina y ocupación, mayor decepción del compromiso con la calidad de vida y severidad de la enfermedad en la personas con mayores tasas de hemoglobina glicada.

Conclusión: La calidad de vida tiende a empeorar a medida que se agrava la enfermedad. Los resultados sugieren que la calidad de vida se relaciona con la variables sociodemográficas y clínicas, por lo tanto, esas deben considerarse en el cuidado.

DESCRIPTORES: Diabetes Mellitus Tipo 2; Calidad de Vida; Atención de Enfermería; Atención Primaria de Salud; Estado de Salud

Variables		Frequency (%)/Mean (standard deviation)			*p-value
Variables		UAPS	UASS	UATS
Gender
	Male	10 (52.6%)	07 (46.7%)	06 (31.6%)	**1.805
	Female	09 (47.4%)	08 (53.3%)	13 (68.4%)	**1.805
	Age (complete years)	57.37 (15.81)	63.95 (7.96)	59.36 (9.11)	*0.259
Marital status
	Without a partner	06 (31.6%)	09 (60.0%)	07 (36.8%)	**3.055
	With a partner	13 (68.4)	06 (40.0%)	12 (63.2%)	**3.055
	Education level	6.0 (3.66)	5.80 (3.98)	6.21 (4.75)	*0.872
Occupation
	Active	07 (36.8%)	03 (20.0%)	04 (21.0%)	**7.029
	Retired with paid activity	00 (0.0%)	03 (20.0%)	01 (5.3%)
	Retired/Pensioner	09 (47.4%)	08 (53.3%)	11 (57.9%)
	Works at home, without pay	01 (5.3%)	00 (0.0%)	01 (5.3%)
	Unemployed/On leave	02 (10.5%)	01 (6.7)	02 (10.5%)
BMI		32.21 (8.22)	27.17 (4.98)	29.95 (4.64)	*0.133
SBP		122.10 (12.39)	136.00 (25.01)	135.68 (21.55)	*0.046
DBP		81.36 (23.18)	84.66 (9.15)	78.52 (10.07)	*0.088
FG		165.05 (99.34)	146.66 (73.91)	169.61 (81.52)	*0.495
HbA1c		13.37 (19.54)	8.14 (1.94)	8.77 (1.95)	*0.561

Variables	Mean (standard deviation)			P-value*
D-39 Domains	UAPS (n= 19)	UASS (n= 15)	UATS (n=19)
Energy and Mobility	35.14 (29.64)	41.40 (21.28)	48.12 (26.69)	0.220
Diabetes Control	30.62 (25.59)	32.03 (22.36)	36.47 (22.99)	0.659
Anxiety and Worry	44.07 (29.50)	43.33 (26.80)	47.58 (30.91)	0.782
Social Burden	23.15 (30.27)	14.66 (14.29)	24.21 (29.60)	0.857
Sexual Functioning	30.70 (37.33)	35.92 (40.32)	34.50 (29.25)	0.734
Total classification	32.79 (25.26)	34.87 (18.66)	40.37 (22.44)	0.465
Overall perceived QoL	67.54 (28.58)	65.55 (31.15)	68.42 (26.58)	0.954
Severity of perceived DM	47.36 (32.51)	50.0 (38.31)	76.31 (32.54)	0.024*

Variables	Quality of life (Diabetes-39)
Variables	Energy and Mobility	Diabetes Control	Anxiety and Worry	Social Burden	Sexual functioning	Total QoL	QoL Overall	Diabetes Severity
	Statistical value for the Spearman coefficient (p-value)
Age	-0.13 (0.35)	-0.32 (0.01)	-0.21 (0.11)	-0.25 (0.06)	-0.19 (0.16)	-0.23 (0.08)	-0.02 0.87)	-0.17 (0.21)
Duration of DM	0.12 (0.36)	- 0.02 (0.87)	0.11 (0.44)	-0.09 (0.48)	-0.12 (0.37)	0.04 (0.72)	0.04 (0.76)	0.22 (0.11)
Education level	0.04 (0.72)	0.05 (0.68)	0.06 (0.62)	-0.05 (0.67)	-0.04 (0.74)	0.02 (0.87)	-0.17 (0.19)	-0.06 (0.63)
BMI	0.14 (0.32)	0.04 (0.76)	0.08 (0.57)	0.00 (0.94)	-0.10 (0.47)	0.06 (0.66)	0.00 (0.99)	0.04 (0.74)
HbA1C	0.20 (0.16)	0.49 (0.00)	0.22 (0.13)	0.20 (0.16)	0.02 (0.88)	0.35 (0.01)	0.18 (0.21)	0.38 (0.00)

Variables		Quality of life (Diabetes - 39)
		Mean (SD)
		Energy Mobility	p- value	Diabetes control	p- value	Anxiety Worry	p- value	Social Burden	p- value	Sexual func.	p- value	Total QoL	p- value	Overall QoL	p- value	Diabetes Severity	p- value
Gender
	Male	30.77 (24.52)	0.0091	25.90 (23.39)	0.0281	32.60 (24.02)	0.0061	15.94 (15.69)	0.857	43.47 (36.53)	0.056	28.53 (21.10)	0.0241	74.63 (21.82)	0.157	47.10 (33.57)	0.0381
	Female	49.85 (25.34)	0.0091	38.65 (22.49)	0.0281	54.72 (28.79)	0.0061	25.11 (31.89)	0.857	25.92 (32.24)	0.056	41.89 (21.88)	0.0241	61.66 (31.30)	0.157	67.22 (36.22)	0.0381
Insulin
	Yes	49.79 (23.31)	0.0131	39.03 (21.17)	0.0271	48.45 (26.63)	0.269	22.59 (26.21)	0.356	36.62 (34.35)	0.428	41.92 (19.58)	0.0191	66.66 (29.59)	0.927	75.30 (31.47)	0.0011
	No	33.03 (26.11)	0.0131	26.70 (24.55)	0.0271	41.66 (31.02)	0.269	19.61 (26.85)	0.356	30.34 (35.94)	0.428	30.04 (23.80)	0.0191	67.94 (27.04)	0.927	41.02 (32.73)	0.0011
Marital status
	With a partner	45.98 (29.86)	0.190	35.30 (26.65)	0.626	45.02 (32.08)	0.942	25.80 (30.80)	0.643	39.96 (35.29)	0.106	39.55 (26.35)	0.343	72.04 (66.66)	0.127	60.21 (38.89)	0.519
	Without a partner	35.35 (19.97)	0.190	30.05 (18.45)	0.626	45.26 (24.13)	0.942	14.54 (16.79)	0.643	24.49 (33.14)	0.106	31.23 (14.27)	0.343	60.60 (29.79)	0.127	56.06 (32.75)	0.519
Occupation
	Active	37.61 (27.24)	0.353	32.14 (25.82)	0.0382	47.32 (29.71)	0.194	24.04 (25.18)	0.180	36.50 (39.02)	0.690	35.10 (25.11)	0.097	69.04 (26.84)	0.973	51.19 (37.81)	0.242
	Retired with paid activity	59.72 (22.32)		45.13 (17.58)		57.29 (34.42)		20.83 (13.70)		59.72 (41.91)		50.00 (17.18)		70.83 (34.35)		83.33 (19.24)
	Retired / Pensioner	38.29 (25.44)		25.79 (18.52)		37.79 (25.53)		13.80 (18.95)		27.38 (29.51)		30.41 (18.06)		66.66 (29.04)		53.58 (36.95)
	Works at home, without pay	61.11 (28.28)		63.88 (17.67)		81.25 (8.83)		60.00 (47.14)		36.11 (11.78)		61.96 (22.36)		58.33 (11.78)		83.33 (23.57)
	Unemployed / On leave	48.66 (32.84)		55.00 (28.60)		55.83 (35.55)		38.66 (47.70)		37.77 (51.87)		49.23 (30.51)		66.66 (35.35)		76.66 (32.48)
SBP
	Yes	40.35 (29.29)	0.627	31.69 (25.86)	0.538	45.23 (31.78)	0.927	23.69 (30.06)	0.775	41.46 (35.44)	0.111	36.14 (25.49)	0.920	72.02 (25.27)	0.289	63.09 (34.35)	0.373
	No	43.19 (24.03)		34.66 (21.51)		44.61 (26.16)		18.61 (22.02)		25.69 (33.12)		36.21 (19.16)		61.80 (31.26)		54.16 (38.77)	0.373
DBP
	Yes	46.17 (28.42)	0.392	37.26 (24.25)	0.322	47.91 (31.77)	0.550	26.11 (30.76)	0.328	30.86 (30.62)	0.761	39.86 (24.98)	0.447	62.96 (30.54)	0.383	76.85 (31.38)	0.0081
	No	39.28 (25.98)		30.84 (23.57)		43.38 (27.86)		18.82 (24.10)		35.94 (37.38)		34.22 (21.32)		69.60 (27.36)		40.50 (35.64)	0.0081
Other diseases
	Yes	44.08 (29.49)	0.450	33.46 (24.73)	0.985	47.04 (31.53)	0.525	23.87 (29.76)	0.750	35.66 (35.36)	0.561	37.88 (24.97)	0.595	70.96 (27.87)	0.269	63.97 (36.02)	0.205
	No	38.09 (22.37)		32.47 (22.85)		41.86 (25.36)		17.61 (21.00)		32.01 (35.13)		33.65 (18.68)		61.90 (28.93)		51.58 (36.47)	0.205
Complications from DM
	Yes	48.49 (24.91)	0.163	35.78 (21.54)	0.453	47.05 (30.46)	0.618	20.58 (86.67)	0.969	30.39 (29.60)	0.803	39.46 (20.58)	0.354	66.66 (28.25)	0.794	76.41 (33.08)	0.0031
	No	38.34 (27.36)		31.74 (24.97)		43.92 (28.73)		21.71 (27.21)		36.03 (37.56)		34.57 (23.60)		67.61 (28.85)		49.04 (34.04)	0.0031

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[TFN1] * Kruskal-Wallis test; ** Chi-square test.