Informação e educação estruturada em saúde como ferramentas fundamentais para o autocuidado de indivíduos com diabetes mellitus tipo 1

Abstract

Abstract : Introduction: In 2012 Brazil ranked fourth in the world ranking with 7.6 million cases of diabetes. Given this high prevalence of the disease in the country, this project was proposed to address the importance of a structured education program for self-care of patients with Type 1 Diabetes Mellitus (T1DM). The ideas were based on the DAFNE Programme "Dose Adjustment for Normal Eating, developed in Germany in 1980 and having a worldwide impact. DAFNE has provided satisfactory results in treatment and self-care of diabetic individuals from their educational methodology quality. Objectives: The objective of the study is to observe whether this Structured Education Program, based in DAFNE, has some positive effect in the treatment of individuals with T1DM, if it can help them to have more knowledge about their health-disease situation by providing more ability to control it. To observe if well-directed individual manages to fit diabetes into their lifestyle, rather than changing their lifestyle to fit diabetes, giving them more flexibility in daily activities and quality of life. Methods: Study in the same line of the DAFNE methodology, adapted to the needs of Brazil according to their culture and society. Had the participation of 47 T1DM, mean age 26 ± 6.7 (male) and 28 ± 8.7 (females) years. Were followed for 20 months and analyzed the value of Glycated Hemoglobin (HbA1c) before and after the DAFNE Program, recent HbA1c and daily glycemic profile. This consisted of applying Questionnaire for analyzing knowledge pre and post this Program; workshops with educational activities, individual care, monitoring by phone and internet, and semi-structured interview as a form of feedback. Results: The mean HbA1c of individuals decreased by about 1.9 % in one year and plus 0.9 % in a consecutive period of 8 months compared to baseline. In the evaluation of the Information/Knowledge, in the category "Total scores", there was an increase of 37 % on average when comparing the pre and post DAFNE. The feedback shows that individuals who participated in the Education Program, 87.5 % consider currently have much insight into T1DM; 81.25% are very satisfied with the current quality of life in relation to diabetes, 93.75% are very pleased with the flexibility of the diet; 100 % are very satisfied with the support for questions and 90.6 % are highly motivated to continue treatment appropriately. Statistical outcomes showed significance values of p < 0.005. Conclusion: The study showed significant and beneficial results to the participants. The decrease in HbA1c average, the increase of the index in the evaluation of knowledge and reports of improved quality of life, confirms the importance and necessity of a Structured Education Program as a means of prevention and continuous health promotion to individuals with this chronic disease, which requires attention to complex daily care.