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1601Rev Bras Enferm. 2019;72(6):1601-8. http://dx.doi.org/10.1590/0034-7167-2018-0731

ABSTRACT Objective: to evaluate the contributions of an educational program for capillary blood glucose self-monitoring. Method: a quasi-experimental study performed in an outpatient unit of a tertiary health care service in a sample of 25 people with Type 2 Diabetes Mellitus, from July 2016 to December 2017, developed through interactive tools for care with capillary blood glucose self-monitoring. Results: among the items of capillary blood glucose self-monitoring that showed improvement after participation in the educational program, the most noteworthy are the “postprandial blood glucose values” (p=0.0039), “Interpretation of capillary blood glucose results with meals and medications” (p=0.0156), “recognition of the ‘weakness’ symptom for hyperglycemia” (p=0.0386) and “administration of medications correctly” for hyperglycemia prevention (p=0.0063). Conclusion: the study made it possible to recognize the main characteristics of blood glucose self-monitoring that may contribute to the care for the person with diabetes. Descriptors: Diabetes Mellitus; Health Education; Blood Glucose Self-Monitoring; Self- Care; Nursing Care.

RESUMO Objetivo: avaliar as contribuições de um programa educativo para a automonitorização da glicemia capilar. Método: estudo quase-experimental, realizado em unidade ambulatorial de um serviço de atenção terciária à saúde, em amostra de 25 pessoas com Diabetes Mellitus tipo 2, no período de julho de 2016 a dezembro de 2017, desenvolvido por meio de ferramentas interativas para o cuidado com a automonitorização da glicemia capilar. Resultados: entre os itens da automonitorização da glicemia capilar que apresentaram melhora após a participação no programa educativo, destacam-se os “valores da glicemia pós-prandial” (p=0,0039), “interpretação dos resultados de glicemia capilar com as refeições e medicamentos” (p=0,0156), “reconhecimento do sintoma ‘fraqueza’ para a hiperglicemia” (p=0,0386) e “administração de medicamentos corretamente” para prevenção da hiperglicemia (p=0,0063). Conclusão: o estudo possibilitou reconhecer as principais características da automonitorização da glicemia que poderão contribuir para o cuidado à pessoa portadora da doença. Descritores: Diabetes Mellitus; Educação em Saúde; Automonitorização da Glicemia; Autocuidado; Cuidados de Enfermagem.

RESUMEN Objetivo: evaluar las contribuciones de un programa educativo para la automonitorización de la glucemia capilar. Método: el estudio cuasi-experimental, realizado en unidad ambulatoria de un servicio de atención terciaria a la salud, en muestra de 25 personas con Diabetes Mellitus tipo 2, en el período de julio de 2016 a diciembre de 2017, desarrollado por medio de herramientas interactivas para el cuidado con la automonitorización de la glucemia capilar. Resultados: entre los ítems de la automonitorización de la glucemia capilar que presentaron mejoría después de la participación en el programa educativo, se destacan los “valores de la glucemia postprandial” (p=0,0039), “Interpretación de los resultados de glucemia capilar con las comidas y medicamentos” (p=0,0156), “reconocimiento del síntoma” debilidad “para la hiperglicemia” (p=0,0386) y “administración de medicamentos correctamente” para prevenir la hiperglucemia (p=0,0063). Conclusión: el estudio posibilitó reconocer las principales características de la automonitorización de la glucemia que pueden contribuir para el cuidado a la persona portadora de la enfermedad. Descriptores: Diabetes Mellitus; Educación en Salud; Automonitorización de la Glucosa Sanguínea; Autocuidado; Atención de Enfermería.

Education in Diabetes Mellitus for blood glucose self-monitoring: a quasi-experimental study

Educação em Diabetes Mellitus para automonitorização da glicemia: estudo quase-experimental

Educación en Diabetes Mellitus para automonitorización de la glucemia: estudio cuasi-experimental

ORIGINAL ARTICLE

Marcelo Henrique Barbosa BaptistaI

ORCID: 0000-0002-4864-9170

Fernanda Cristina DouradoI

ORCID: 0000-0003-1719-8116

Danielle dos Santos GomidesI

ORCID: 0000-0003-2870-2525

Carla Regina de Souza TeixeiraI

ORCID: 0000-0002-8887-5439

Maria Cristina Foss de FreitasI

ORCID: 0000-0002-1350-1125

Ana Emilia PaceI

ORCID: 0000-0002-0079-6913

I Universidade de São Paulo. Ribeirão Preto, São Paulo, Brazil.

How to cite this article: Baptista MHB, Dourado FC, Gomides DS, Teixeira CRS,

Freitas MCF, Pace AE. Education in Diabetes Mellitus for blood glucose self-monitoring: a quasi-

experimental study. Rev Bras Enferm. 2019;72(6):1601-8. doi: http://dx.doi.org/10.1590/0034-7167-2018-0731

Corresponding Author: Ana Emilia Pace

E-mail: aepace@eerp.usp.br

Submission: 12-02-2018 Approval: 04-09-2019

1602Rev Bras Enferm. 2019;72(6):1601-8.

Education in Diabetes Mellitus for blood glucose self-monitoring: a quasi-experimental study Baptista MHB, Dourado FC, Gomides DS, Teixeira CRS, Freitas MCF, Pace AE.

INTRODUCTION

Chronic hyperglycemia of diabetes mellitus (DM) is the main cause of the development of microvascular and macrovascular complications, with involvement in several organs and systems(1-2). Therefore, the treatment consists in the control of blood glucose for the prevention and/or delay of these chronic complications(3-4).

Through the importance of glycemic control, strategies that support behaviors favorable to its reach and maintenance should be a priority in care for the person with DM. In this perspective, DM education can be a fundamental strategy to promote knowledge and the development of self-care skills(2,5-6).

When considering education as the basis for managing disease care, its development should address the person’s current needs. In this context, the theoretical assumptions of Self-Efficacy (SE), one of the elements of the Cognitive Social Theory (CST), were used, which includes the relation between personal belief and its influence in the adoption and maintenance of a new behavior(7-8). Personal beliefs are the basis of human motivation, so the educational process can positively influence acquiring and maintaining new behavioral prac- tices, as well as influencing perseverance to overcome difficulties(8).

Among the essential care activities in the present study, we will highlight those related to capillary blood glucose self-monitoring (CBGFM). CBGFM is considered an essential care activity to evalu- ate the efficacy of drug and non-drug treatment, mainly because it includes elements that may influence glycemic control such as diet, physical exercises, medications, emotions, presence of infections, and contribute to the development of care skills and promote the person’s involvement in their self-care(1).

A review of the literature in the last five years in the main databases has shown the scarcity of studies that address CBGFM care education, especially through interactive and easy-to-use tertiary care health. Therefore, the present study was proposed on the basis of this need for research expansion.

OBJECTIVE

To evaluate the contributions of an educational program for capillary blood glucose self-monitoring.

METHOD

Ethical aspects

The study was approved by the Research Ethics Committee (REC) from Escola de Enfermagem de Ribeirão Preto – USP and REC from Hos- pital das Clínicas of the Faculdade de Medicina de Ribeirão Preto – USP.

Design, place of study and period

This is a quasi-experimental study, with assessment before (T0) and after educational interventions (T12) developed in an outpa- tient unit of a municipal tertiary health service in the countryside of São Paulo State, from July 2016 to December 2017.

The present study is part of the matrix project called “Interven- ções educativas em DM: estudo quase-experimental”, composed of two quasi-experimental studies, whose samples came from the same base population.

Sample, inclusion and exclusion criteria

The sample consisted of people with Type 2 Diabetes Mellitus (2DM) of both genders, with a minimum diagnosis time of one year, minimum age of 40 years, who were able to respond verbally to the questionnaires, whose drug treatment was with insulin, associated with or not to the oral antidiabetic drug, in medical follow-up and that they had a glucose meter.

As exclusion criteria, people who participated in another educa- tional program were undergoing hemodialysis, had a wheelchair and/or stretcher for locomotion, had amaurosis, disabling sequels of stroke/heart failure, previous amputations and/or active ulcer in lower limbs, severe psychiatric disorders, as well as impairment in cognitive processes as assessed by the Mini Mental State Examina- tion (MMSE), were included(9).

In order to carry out the selection of possible participants, it was verified in the electronic system of the health service visits during the period that included the study development study. Among the 7,402 visits, duplicate records and those who did not meet the established inclusion criteria were excluded, resulting in 210 people who could participate in the present study.

Study protocol

Sociodemographic characterization of the sample was performed using the following variables: gender, age, schooling, and family monthly income. For clinical variables: time of diagnosis of 2DM and glycated hemoglobin (HbA1c). Finally, for the drug treatment vari- able: type of medication used and treatment time, in complete years.

The results of HbA1c used to evaluate glycemic control were obtained in the electronic system of the health service and were considered on average three months prior to the interview date for T0 and three months after T12 for collection post-interventions.

Sociodemographic,…

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