Patient Preference and Adherence (Jul 2022)

Self-Care in Patients with Non-Optimal Diabetes Management in Brazilian Rural Areas: A Mixed-Methods Study

  • Macedo JCL,
  • Soares DA,
  • de Carvalho VCHS,
  • Cortes TBA,
  • Mistro S,
  • Kochergin CN,
  • Rumel D,
  • Oliveira MG

Journal volume & issue
Vol. Volume 16
pp. 1831 – 1842

Abstract

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Jessica Caline Lemos Macedo,1 Daniela Arruda Soares,1 Vivian Carla Honorato dos Santos de Carvalho,2 Taciana Borges Andrade Cortes,1 Sóstenes Mistro,1 Clavdia Nicolaevna Kochergin,2 Davi Rumel,3 Marcio Galvão Oliveira1 1Master’s Program in Collective Health, Multidisciplinary Health Institute, Federal University of Bahia, Vitória da Conquista, Bahia, Brazil; 2Multidisciplinary Health Institute, Federal University of Bahia, Vitória da Conquista, Bahia, Brazil; 3Department of Community Health, School of Medicine of the Municipal University of São Caetano do Sul, São Caetano do Sul, São Paulo, BrazilCorrespondence: Marcio Galvão Oliveira, Multidisciplinary Health Institute, Federal University of Bahia, Rua Hormindo Barros, 58 - Candeias, Vitória da Conquista - BA, Vitória da Conquista, Bahia, 45029-094, Brazil, Tel +55 77 988280954, Email [email protected]: This study aims to assess self-care in patients with non-optimal diabetes management (HbA1c > 7.0% for adults and > 8.0 for those aged 60 or over) and the positive and negative experiences associated with it in the rural communities of a Brazilian municipality.Patient and Methods: This is a cross-sectional mixed-methods study. The data were collected from participants with high HbA1c through focus group discussions, subsequently performing thematic analysis, and through structured questionnaires (socioeconomic characteristics and the Summary of Diabetes Self-Care Activities (SDSCA)).Results: The mean HbA1c of the 156 study participants was 9.94% (95% confidence interval: 9.70– 10.19%) and most participants (86.54%) had negative self-care behaviors, with an overall SDSCA mean score of 3.55. This mean was not positive for any of the socioeconomic characteristics. The self-care activities with the most satisfactory performance concerned non-smoking and the use of prescribed medications, and the poorest results were observed for the practice of specific physical activities. The qualitative data indicated that the study participants face many difficulties regarding self-care practices, especially those related to an adequate diet.Conclusion: The self-care assessment revealed unsatisfactory self-care behaviors as well as high HbA1c levels among the study participants and highlighted the various difficulties they encounter. This indicates the need for more attentive health teams to monitor patients, especially regarding actions focused on the non-pharmacological elements of self-care, such as lifestyle changes, which were found to be the dimensions with the most unsatisfactory results.Keywords: primary care, non-communicable diseases, behaviors, rural communities

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