Intervenções de enfermagem para o controle do diabetes : ensaio clínico randomizado
Autor(a) principal: | |
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Data de Publicação: | 2018 |
Tipo de documento: | Tese |
Idioma: | por |
Título da fonte: | Biblioteca Digital de Teses e Dissertações da PUC_RS |
Texto Completo: | http://tede2.pucrs.br/tede2/handle/tede/8517 |
Resumo: | Introduction: Diabetes mellitus (DM) is a very common pathology, which can lead to chronic kidney disease (CKD) and the need for renal replacement therapy. In people with CKD and DM, glycemic control is critical for the prevention of microvascular lesions. In this context, the Nursing Process (NP) is the instrument to guide care, contributing to the attention of the needs of individuals. Objective: To evaluate the Nursing Interventions Classification (NIC) impact to diabetes control, in people with diabetes on hemodialysis diagnosed with NANDA-I diagnosis Risk for Unstable blood glucose level, trough the results of Nursing Outcomes Classification (NOC). Method: Randomized clinical trial in three dialysis services in southern Brazil. Population: Diabetic patients on hemodialysis. Sample: More than 18 years old, literate. Exclusion criteria: severe uncorrected deficiency in hearing, speech, total amaurosis, degenerative neurological diseases or scoring less than 20 in the Mini Mental State Examination. The sample consisted of 56 participants, 27 in the control group and 29 in the intervention group. Randomization occurred in groups, considering dialysis shifts. The control group followed the routine treatment and guidelines, while the intervention group received nursing interventions from the NIC for 6 months. The clinical variables related to the NOC results and the knowledge, attitude and self-care tests for DM were applied before and after the intervention period. After the interventions, a washout period of 06 months occurred, after which the variables were collected. Results: There were no differences between the groups in relation to the sociodemographic or clinical variables at the beginning of the study. The measurement of glycated hemoglobin in the intervention group was 7.7 ± 1.8; 7.0 ± 1.4 and 7.5 ± 2.1 mg / dl and 7.9 ± 2.2; 8.3 ± 2.3 and 8.4 ± 1.9 mg / dl in the control group at time zero, 6 and 12 months, respectively. There was significant improvement in knowledge, coping with diabetes and self-care, as well as in the NOC score Self-control of diabetes, Knowledge: diabetes control and glycemic level. Although the remaining knowledge and coping were observed after the washout period, the results point to a decrease in metabolic control. Conclusion: Nursing interventions based on NIC, applied to people with diabetes on hemodialysis, with a nursing diagnosis Unstable Glycemia, were effective for the knowledge, coping and self-care in relation to diabetes, positively impacting NOC nursing results Self-control of diabetes, knowledge : control of diabetes and glycemic level. Even with the best knowledge and self-control of diabetes, the results point to the need for continuous interventions with the group, the focus of this study, to achieve adequate long-term control of diabetes. |
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Figueiredo, Ana Elizabeth Prado Limahttp://lattes.cnpq.br/1371008868231019http://lattes.cnpq.br/5548008403562583Capellari, Claudia2019-04-10T21:00:09Z2018-11-09http://tede2.pucrs.br/tede2/handle/tede/8517Introduction: Diabetes mellitus (DM) is a very common pathology, which can lead to chronic kidney disease (CKD) and the need for renal replacement therapy. In people with CKD and DM, glycemic control is critical for the prevention of microvascular lesions. In this context, the Nursing Process (NP) is the instrument to guide care, contributing to the attention of the needs of individuals. Objective: To evaluate the Nursing Interventions Classification (NIC) impact to diabetes control, in people with diabetes on hemodialysis diagnosed with NANDA-I diagnosis Risk for Unstable blood glucose level, trough the results of Nursing Outcomes Classification (NOC). Method: Randomized clinical trial in three dialysis services in southern Brazil. Population: Diabetic patients on hemodialysis. Sample: More than 18 years old, literate. Exclusion criteria: severe uncorrected deficiency in hearing, speech, total amaurosis, degenerative neurological diseases or scoring less than 20 in the Mini Mental State Examination. The sample consisted of 56 participants, 27 in the control group and 29 in the intervention group. Randomization occurred in groups, considering dialysis shifts. The control group followed the routine treatment and guidelines, while the intervention group received nursing interventions from the NIC for 6 months. The clinical variables related to the NOC results and the knowledge, attitude and self-care tests for DM were applied before and after the intervention period. After the interventions, a washout period of 06 months occurred, after which the variables were collected. Results: There were no differences between the groups in relation to the sociodemographic or clinical variables at the beginning of the study. The measurement of glycated hemoglobin in the intervention group was 7.7 ± 1.8; 7.0 ± 1.4 and 7.5 ± 2.1 mg / dl and 7.9 ± 2.2; 8.3 ± 2.3 and 8.4 ± 1.9 mg / dl in the control group at time zero, 6 and 12 months, respectively. There was significant improvement in knowledge, coping with diabetes and self-care, as well as in the NOC score Self-control of diabetes, Knowledge: diabetes control and glycemic level. Although the remaining knowledge and coping were observed after the washout period, the results point to a decrease in metabolic control. Conclusion: Nursing interventions based on NIC, applied to people with diabetes on hemodialysis, with a nursing diagnosis Unstable Glycemia, were effective for the knowledge, coping and self-care in relation to diabetes, positively impacting NOC nursing results Self-control of diabetes, knowledge : control of diabetes and glycemic level. Even with the best knowledge and self-control of diabetes, the results point to the need for continuous interventions with the group, the focus of this study, to achieve adequate long-term control of diabetes.Introdução: O diabetes mellitus (DM) é uma patologia muito frequente, podendo culminar em doença renal crônica (DRC) e a necessidade de terapia renal substitutiva. Em pessoas com DRC e DM, o controle glicêmico é fundamental para a prevenção de lesões microvasculares. Neste contexto, o Processo de Enfermagem (PE) é o instrumento para guiar a assistência, contribuindo na atenção das necessidades dos indivíduos. Objetivo: Avaliar o impacto das intervenções da Nursing Interventions Classification (NIC) para o controle do diabetes, em pessoas com diabetes em hemodiálise, com diagnóstico Risco de Glicemia Instável, da Nanda – International (NANDA – I), por meio dos resultados da Nursing Outcomes Classification (NOC). Método: Ensaio clínico randomizado, ocorrido em três serviços de diálise do sul do Brasil. População: Portadores de diabetes em hemodiálise. Amostra: Maiores de 18 anos, alfabetizados. Critérios de exclusão: deficiência grave não corrigida na audição, na fala, amaurose total, doenças neurológicas degenerativas, ou pontuação inferior a 20 no Mini Exame do Estado Mental. A amostra constituiu-se de 56 participantes, sendo 27 no grupo controle e 29 no grupo intervenção. A randomização ocorreu por clusters, considerando os turnos de diálise. O grupo controle seguiu tratamento e orientações de rotina, enquanto o grupo intervenção recebeu intervenções de enfermagem da NIC, durante 06 meses. Variáveis clínicas e relativas a resultados NOC e os testes de conhecimento, atitude e autocuidado frente ao DM foram aplicados antes e após o período de intervenção. Após as intervenções, ocorreu um período de washout de 06 meses, após o qual as variáveis foram recoletadas. Resultados: Não houve diferença entre os grupos em relação às variáveis sociodemográficas, tampouco nas variáveis clínicas no início do estudo. A mensuração da hemoglobina glicada, no grupo intervenção foi 7,7±1,8; 7,0±1,4 e 7,5±2,1 mg/dl e, no controle, 7,9±2,2; 8,3±2,3 e 8,4±1,9 mg/dl em tempo zero, 6 e 12 meses, respectivamente. Houve melhora significativa no conhecimento, enfrentamento do diabetes e autocuidado, bem como nos escores NOC Autocontrole do diabetes, Conhecimento: controle do diabetes e Nível de glicemia. Embora tenha se observado conhecimento e enfrentamento remanescentes após o período de washout, os resultados apontam para um decréscimo no controle metabólico. Conclusão: Intervenções de enfermagem baseadas na NIC, aplicadas a pessoas com diabetes em hemodiálise, com o diagnóstico Risco de Glicemia Instável, mostraram-se eficazes para o conhecimento, enfrentamento e autocuidado em relação ao diabetes, impactando positivamente nos resultados de enfermagem da NOC Autocontrole do diabetes, Conhecimento: controle do diabetes e Nível de glicemia. Mesmo com melhora no conhecimento e autocontrole do diabetes, os resultados apontam para a necessidade de intervenções contínuas junto ao grupo, foco deste estudo, para que se logre controle adequado do diabetes em longo prazo.Submitted by PPG Medicina e Ciências da Saúde (medicina-pg@pucrs.br) on 2019-04-01T13:22:41Z No. of bitstreams: 1 Claudia_Capellari.pdf: 10510937 bytes, checksum: fca8c095e7aa77e124603a5bfba91df5 (MD5)Approved for entry into archive by Sheila Dias (sheila.dias@pucrs.br) on 2019-04-10T20:54:57Z (GMT) No. of bitstreams: 1 Claudia_Capellari.pdf: 10510937 bytes, checksum: fca8c095e7aa77e124603a5bfba91df5 (MD5)Made available in DSpace on 2019-04-10T21:00:09Z (GMT). No. of bitstreams: 1 Claudia_Capellari.pdf: 10510937 bytes, checksum: fca8c095e7aa77e124603a5bfba91df5 (MD5) Previous issue date: 2018-11-09Coordenação de Aperfeiçoamento de Pessoal de Nível Superior - CAPESapplication/pdfhttp://tede2.pucrs.br:80/tede2/retrieve/174541/TES_CLAUDIA_CAPELLARI_CONFIDENCIAL.pdf.jpghttps://tede2.pucrs.br/tede2/retrieve/190181/TES_CLAUDIA_CAPELLARI_COMPLETO.pdf.jpgporPontifícia Universidade Católica do Rio Grande do SulPrograma de Pós-Graduação em Medicina e Ciências da SaúdePUCRSBrasilEscola de MedicinaDiabetes MellitusProcessos de EnfermagemEnfermagem em NefrologiaEducação para a SaúdeDiabetes MellitusNursing ProcessNephrology NursingEducation HealthCIENCIAS DA SAUDE::MEDICINAIntervenções de enfermagem para o controle do diabetes : ensaio clínico randomizadoinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/doctoralThesisTrabalho será publicado como artigo ou livro60 meses10/04/2024-721401722658532398500500500600-224747486637135387-9693694523087866273590462550136975366info:eu-repo/semantics/openAccessreponame:Biblioteca Digital de Teses e Dissertações da PUC_RSinstname:Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS)instacron:PUC_RSORIGINALTES_CLAUDIA_CAPELLARI_COMPLETO.pdfTES_CLAUDIA_CAPELLARI_COMPLETO.pdfapplication/pdf10510937https://tede2.pucrs.br/tede2/bitstream/tede/8517/5/TES_CLAUDIA_CAPELLARI_COMPLETO.pdffca8c095e7aa77e124603a5bfba91df5MD55THUMBNAILTES_CLAUDIA_CAPELLARI_CONFIDENCIAL.pdf.jpgTES_CLAUDIA_CAPELLARI_CONFIDENCIAL.pdf.jpgimage/jpeg4091https://tede2.pucrs.br/tede2/bitstream/tede/8517/4/TES_CLAUDIA_CAPELLARI_CONFIDENCIAL.pdf.jpg75d5f25a834bf319b5365ecca46925d9MD54TES_CLAUDIA_CAPELLARI_COMPLETO.pdf.jpgTES_CLAUDIA_CAPELLARI_COMPLETO.pdf.jpgimage/jpeg5484https://tede2.pucrs.br/tede2/bitstream/tede/8517/7/TES_CLAUDIA_CAPELLARI_COMPLETO.pdf.jpgbe69ea5897a38aac4a8aa3dbb549c23dMD57TEXTTES_CLAUDIA_CAPELLARI_CONFIDENCIAL.pdf.txtTES_CLAUDIA_CAPELLARI_CONFIDENCIAL.pdf.txttext/plain1644https://tede2.pucrs.br/tede2/bitstream/tede/8517/3/TES_CLAUDIA_CAPELLARI_CONFIDENCIAL.pdf.txt1e66a24e69d5787ce75a513a49aff2ceMD53TES_CLAUDIA_CAPELLARI_COMPLETO.pdf.txtTES_CLAUDIA_CAPELLARI_COMPLETO.pdf.txttext/plain239219https://tede2.pucrs.br/tede2/bitstream/tede/8517/6/TES_CLAUDIA_CAPELLARI_COMPLETO.pdf.txt2c8a75940b0551872a2523434de732f3MD56LICENSElicense.txtlicense.txttext/plain; charset=utf-8590https://tede2.pucrs.br/tede2/bitstream/tede/8517/1/license.txt220e11f2d3ba5354f917c7035aadef24MD51tede/85172024-04-12 12:00:17.966oai:tede2.pucrs.br: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Biblioteca Digital de Teses e Dissertaçõeshttp://tede2.pucrs.br/tede2/PRIhttps://tede2.pucrs.br/oai/requestbiblioteca.central@pucrs.br||opendoar:2024-04-12T15:00:17Biblioteca Digital de Teses e Dissertações da PUC_RS - Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS)false |
dc.title.por.fl_str_mv |
Intervenções de enfermagem para o controle do diabetes : ensaio clínico randomizado |
title |
Intervenções de enfermagem para o controle do diabetes : ensaio clínico randomizado |
spellingShingle |
Intervenções de enfermagem para o controle do diabetes : ensaio clínico randomizado Capellari, Claudia Diabetes Mellitus Processos de Enfermagem Enfermagem em Nefrologia Educação para a Saúde Diabetes Mellitus Nursing Process Nephrology Nursing Education Health CIENCIAS DA SAUDE::MEDICINA |
title_short |
Intervenções de enfermagem para o controle do diabetes : ensaio clínico randomizado |
title_full |
Intervenções de enfermagem para o controle do diabetes : ensaio clínico randomizado |
title_fullStr |
Intervenções de enfermagem para o controle do diabetes : ensaio clínico randomizado |
title_full_unstemmed |
Intervenções de enfermagem para o controle do diabetes : ensaio clínico randomizado |
title_sort |
Intervenções de enfermagem para o controle do diabetes : ensaio clínico randomizado |
author |
Capellari, Claudia |
author_facet |
Capellari, Claudia |
author_role |
author |
dc.contributor.advisor1.fl_str_mv |
Figueiredo, Ana Elizabeth Prado Lima |
dc.contributor.advisor1Lattes.fl_str_mv |
http://lattes.cnpq.br/1371008868231019 |
dc.contributor.authorLattes.fl_str_mv |
http://lattes.cnpq.br/5548008403562583 |
dc.contributor.author.fl_str_mv |
Capellari, Claudia |
contributor_str_mv |
Figueiredo, Ana Elizabeth Prado Lima |
dc.subject.por.fl_str_mv |
Diabetes Mellitus Processos de Enfermagem Enfermagem em Nefrologia Educação para a Saúde |
topic |
Diabetes Mellitus Processos de Enfermagem Enfermagem em Nefrologia Educação para a Saúde Diabetes Mellitus Nursing Process Nephrology Nursing Education Health CIENCIAS DA SAUDE::MEDICINA |
dc.subject.eng.fl_str_mv |
Diabetes Mellitus Nursing Process Nephrology Nursing Education Health |
dc.subject.cnpq.fl_str_mv |
CIENCIAS DA SAUDE::MEDICINA |
description |
Introduction: Diabetes mellitus (DM) is a very common pathology, which can lead to chronic kidney disease (CKD) and the need for renal replacement therapy. In people with CKD and DM, glycemic control is critical for the prevention of microvascular lesions. In this context, the Nursing Process (NP) is the instrument to guide care, contributing to the attention of the needs of individuals. Objective: To evaluate the Nursing Interventions Classification (NIC) impact to diabetes control, in people with diabetes on hemodialysis diagnosed with NANDA-I diagnosis Risk for Unstable blood glucose level, trough the results of Nursing Outcomes Classification (NOC). Method: Randomized clinical trial in three dialysis services in southern Brazil. Population: Diabetic patients on hemodialysis. Sample: More than 18 years old, literate. Exclusion criteria: severe uncorrected deficiency in hearing, speech, total amaurosis, degenerative neurological diseases or scoring less than 20 in the Mini Mental State Examination. The sample consisted of 56 participants, 27 in the control group and 29 in the intervention group. Randomization occurred in groups, considering dialysis shifts. The control group followed the routine treatment and guidelines, while the intervention group received nursing interventions from the NIC for 6 months. The clinical variables related to the NOC results and the knowledge, attitude and self-care tests for DM were applied before and after the intervention period. After the interventions, a washout period of 06 months occurred, after which the variables were collected. Results: There were no differences between the groups in relation to the sociodemographic or clinical variables at the beginning of the study. The measurement of glycated hemoglobin in the intervention group was 7.7 ± 1.8; 7.0 ± 1.4 and 7.5 ± 2.1 mg / dl and 7.9 ± 2.2; 8.3 ± 2.3 and 8.4 ± 1.9 mg / dl in the control group at time zero, 6 and 12 months, respectively. There was significant improvement in knowledge, coping with diabetes and self-care, as well as in the NOC score Self-control of diabetes, Knowledge: diabetes control and glycemic level. Although the remaining knowledge and coping were observed after the washout period, the results point to a decrease in metabolic control. Conclusion: Nursing interventions based on NIC, applied to people with diabetes on hemodialysis, with a nursing diagnosis Unstable Glycemia, were effective for the knowledge, coping and self-care in relation to diabetes, positively impacting NOC nursing results Self-control of diabetes, knowledge : control of diabetes and glycemic level. Even with the best knowledge and self-control of diabetes, the results point to the need for continuous interventions with the group, the focus of this study, to achieve adequate long-term control of diabetes. |
publishDate |
2018 |
dc.date.issued.fl_str_mv |
2018-11-09 |
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2019-04-10T21:00:09Z |
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Pontifícia Universidade Católica do Rio Grande do Sul |
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