Indicadores emocionais, qualidade de vida e adesão ao tratamento em adultos com diabetes tipo 2

Abstract

Diabetes treatment involves changes in the patients’ life style. Caution with glycemic self-monitoring, regular physical activity, medicine/ insulin administration and use of a healthy nutrition program are important to stabilize the body insulin levels and prevent against chronic complications. Due to the treatment complexity, emotional indicators such as stress, anxiety and depression have been pointed out by many researchers as difficulties related to patients’ adherence, which would lead to further complications, substantiating studies in this area. This study compared the effects of three procedures: self-monitoring with feedback, a 24-hour reminder and treatment routine on emotional indicators, quality of life and treatment adherence. It was verified that the relation among these variables before and after the patients had been subjected to the medical procedures. An experimental design was used, with the participation of nine adults selected from a previous study (Study 1: Relation between emotional states and adherence to treatment before and after the participants were subjected to medical procedures in adults with Type 2 diabetes). The selected participants showed presence of stress, anxiety and/or depression associated to low adherence to Type 2 diabetes. The participants were distributed into three conditions: (A) Self-monitoring, (B) 24-hour reminder and (C) Routine. Under condition A, the three participants were subjected to a self-monitoring training, with feedback for contingency analysis related to resolution of problems in the adherence to treatment. Under condition B, three participants were subjected to the use of 24-hour reminder to enable them to describe the adherence behaviors recorded the day before the interview. Under Condition C, three participants were subjected to the treatment routine in a healthcare center. All of them were evaluated on emotional indicators (ISSL, BDI and BAI), quality of life (SF-36) and adherence to treatment (A1C) when the research began, and again in the end. The results of this study showed that the participants high levels of stress (n=6) depression (n=6) anxiety (n=4), negative perception of their quality of life in baseline (n=6) and low level of adherence to diet (M=47,45). Throughout the study, it was observed a drop in the glycated hemoglobin values from three participants of Condition A (A1, A2, and A3) and in the emotional indicators (A1 and A3). The other conditions showed a drop in the values of the glycated hemoglobin in B1 and change in the perception of quality of life of B1, B2 and C3. It was observed that no changes occurred in adherence to diet and physical activity (except for participant B2), regardless of the condition to which the participant was subjected. These data suggested that the procedure of self-monitoring with feedback favored changes in emotional indicators, A1C values and quality of life perception, but had no effect on the adherence to diet and regular physical activity.