Patient-Centered Medicine and Self-Care of Patients with Type 2 Diabetes: A Cross-Sectional Study
Autor(a) principal: | |
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Data de Publicação: | 2023 |
Outros Autores: | , |
Tipo de documento: | Artigo |
Idioma: | por |
Título da fonte: | Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
Texto Completo: | https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/18584 |
Resumo: | Introduction: Even though the prevalence rate of diabetes in Portugal is one of the highest in Europe, no studies on the association between patient centered medicine, diabetes self-care, and glycemic control have been published. Assuming that patient centered medicine increases adherence to treatment through the improvement of the doctor-patient relationship, the aim of this study was to assess the influence of patient-centered medicine on the self-care of patients with type 2 diabetes patients’ (T2DM) in two Family Health Units in Central Portugal, according to gender and age.Material and Methods: A cross-sectional study was conducted in two Family Health Units in Central Portugal between the 25th November 2021 and the 15th January 2022. Patients with type 2 diabetes were invited to fill in the Patient-Centered Medicine questionnaire, for patients (PCM-p) (where higher values represent worse results) and the Summary of Diabetes Self-Care Activities Measure (SDSCAM), (where higher values represent better results), while healthcare professionals filled in the epidemiologic variables on pre-defined days.Results: A sample of 298 patients with type 2 diabetes was studied. Linear regressions for the association between SDSCAM scale factors and PCM-p showed significant associations for general diet (β = -0.07, p < 0.001), specific diet (β = -0.10, p < 0.001), exercise (β = -0.03, p = 0.008), foot care (β = -0.11, p < 0.001) and medication adherence in general (β = -0.06, p = 0.001). Multiple linear regression including the association between glycated hemoglobin (HbA1c) and the SDSCAM scale dimensions showed that specific diet was associated with lower HbA1c levels (β = -0.01, p = 0.007) and blood sugar testing (β = 0.01, p < 0.001) and that a higher score in PCMp was associated with higher HbA1c levels (β = 0.06, p < 0.001). Male patients (β = -6.93, p = 0.007) and older patients (β = -0.42, p = 0.001) were associated with lower scores in the specific diet. The male gender was associated with higher scores in exercise (β = 7.62, p = 0.029), lower scores in foot care (β = -6.06, p = 0.029) and lower scores in medication adherence to injectable medicines/6.2 (β = -0.73, p = 0.018). Age was associated with a lower score in medication (β = -0.03, p = 0.045) and a higher PCMp total score (β = 0.07, p = 0.030).Conclusion: Patient-centered medicine in type 2 diabetics is associated with better self-care behaviors in patients with type 2 diabetes. Gender and age differences were observed in self-care behaviors and age differences were observed in Patient Centered Medicine. |
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Patient-Centered Medicine and Self-Care of Patients with Type 2 Diabetes: A Cross-Sectional StudyA Medicina Centrada no Paciente e os Autocuidados dos Doentes com Diabetes Tipo 2: Um Estudo TransversalBlood Glucose Self-MonitoringDiabetes Mellitus, Type 2Family PracticePatient-Centered CarePortugalSelf CareAutocuidadoAutomonitorização da GlicemiaDiabetes Mellitus Tipo 2Medicina Centrada no PacienteMedicina FamiliarPortugalIntroduction: Even though the prevalence rate of diabetes in Portugal is one of the highest in Europe, no studies on the association between patient centered medicine, diabetes self-care, and glycemic control have been published. Assuming that patient centered medicine increases adherence to treatment through the improvement of the doctor-patient relationship, the aim of this study was to assess the influence of patient-centered medicine on the self-care of patients with type 2 diabetes patients’ (T2DM) in two Family Health Units in Central Portugal, according to gender and age.Material and Methods: A cross-sectional study was conducted in two Family Health Units in Central Portugal between the 25th November 2021 and the 15th January 2022. Patients with type 2 diabetes were invited to fill in the Patient-Centered Medicine questionnaire, for patients (PCM-p) (where higher values represent worse results) and the Summary of Diabetes Self-Care Activities Measure (SDSCAM), (where higher values represent better results), while healthcare professionals filled in the epidemiologic variables on pre-defined days.Results: A sample of 298 patients with type 2 diabetes was studied. Linear regressions for the association between SDSCAM scale factors and PCM-p showed significant associations for general diet (β = -0.07, p < 0.001), specific diet (β = -0.10, p < 0.001), exercise (β = -0.03, p = 0.008), foot care (β = -0.11, p < 0.001) and medication adherence in general (β = -0.06, p = 0.001). Multiple linear regression including the association between glycated hemoglobin (HbA1c) and the SDSCAM scale dimensions showed that specific diet was associated with lower HbA1c levels (β = -0.01, p = 0.007) and blood sugar testing (β = 0.01, p < 0.001) and that a higher score in PCMp was associated with higher HbA1c levels (β = 0.06, p < 0.001). Male patients (β = -6.93, p = 0.007) and older patients (β = -0.42, p = 0.001) were associated with lower scores in the specific diet. The male gender was associated with higher scores in exercise (β = 7.62, p = 0.029), lower scores in foot care (β = -6.06, p = 0.029) and lower scores in medication adherence to injectable medicines/6.2 (β = -0.73, p = 0.018). Age was associated with a lower score in medication (β = -0.03, p = 0.045) and a higher PCMp total score (β = 0.07, p = 0.030).Conclusion: Patient-centered medicine in type 2 diabetics is associated with better self-care behaviors in patients with type 2 diabetes. Gender and age differences were observed in self-care behaviors and age differences were observed in Patient Centered Medicine.Introdução: Apesar de Portugal ser um dos países com maior prevalência de diabetes, não existem estudos que relacionem a medicina centrada no paciente com autocuidados e controlo glicémico. Partindo do pressuposto de que a medicina centrada no doente aumenta a adesão terapêutica em resultado da melhoria da relação médico-doente, pretendeu-se verificar com este estudo a influência deste modelo de Medicina nos autocuidados da diabetes tipo 2, em duas unidades de Saúde Familiar do Centro de Portugal, segundo o sexo e a idade.Material e Métodos: Estudo transversal em duas unidades de Saúde Familiar da região Centro, entre 25 de novembro de 2021 e 15 de janeiro de 2022. Os doentes com diabetes tipo 2 preencheram os questionários Summary of Diabetes Self-care Activities e Patient Perception of Patient Centeredness, e a equipa de saúde preencheu as variáveis epidemiológicas em dias pré-definidos.Resultados: Reuniu-se uma amostra de 298 diabéticos tipo 2. As regressões lineares para a associação entre as dimensões da escala Summary of Diabetes Self-care Activities e as da Patient Perception of Patient Centeredness mostraram associações significativas relativamente à dieta geral (β = -0,07, p < 0,001), à dieta específica (β = -0,10, p < 0,001), ao exercício, (β = -0,03, p = 0,008), aos cuidados dos pés (β = -0,11, p < 0,001) e à adesão à medicação em geral (β = -0,06, p = 0,001). A regressão linear múltipla para a hemoglobina glicada com as dimensões significativas da Summary of Diabetes Self-care Activities mostrou uma associação entre a dieta específica e menor valor de hemoglobina glicada (β = -0,01, p = 0,007), e que valores superiores de glicémia capilar (β = 0,01, p < 0,001) e maior pontuação na Patient Perception of Patient Centeredness estavam associados a uma maior hemoglobina glicada (β = 0,06, p < 0,001). O sexo masculino (β = -6,93, p = 0,007) e idosos (β = -0,42, p = 0,001) foi associado a menor pontuação na dieta específica. O sexo masculino foi associado a maiores níveis de exercício (β = 7,62, p = 0,029), menores cuidados dos pés (β = -6,06, p = 0,029) e menor pontuação na adesão a medicação injetável (β = -0,73, p = 0,018). A idade avançada foi associada a menor pontuação na medicação 6.2 (β = -0,03, p = 0,045) e maior pontuação no Patient Perception of Patient Centeredness (β = 0,07, p = 0,030).Conclusão: A medicina centrada associou-se a melhores comportamentos de autocuidado em doentes com diabetes tipo 2. Foram observadas diferenças nos autocuidados relativamente ao género e à idade e na medicina centrada no doente relativamente à idade.Ordem dos Médicos2023-03-31info:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleapplication/pdfhttps://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/18584Acta Médica Portuguesa; Vol. 37 No. 1 (2024): January; 3-9Acta Médica Portuguesa; Vol. 37 N.º 1 (2024): Janeiro; 3-91646-07580870-399Xreponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãoinstacron:RCAAPporhttps://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/18584https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/18584/15288Direitos de Autor (c) 2022 Acta Médica Portuguesainfo:eu-repo/semantics/openAccessSousa, SolangePereira, Albino MiguelSantiago, Luiz Miguel2024-01-07T03:00:29Zoai:ojs.www.actamedicaportuguesa.com:article/18584Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireopendoar:71602024-03-19T17:48:25.365306Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãofalse |
dc.title.none.fl_str_mv |
Patient-Centered Medicine and Self-Care of Patients with Type 2 Diabetes: A Cross-Sectional Study A Medicina Centrada no Paciente e os Autocuidados dos Doentes com Diabetes Tipo 2: Um Estudo Transversal |
title |
Patient-Centered Medicine and Self-Care of Patients with Type 2 Diabetes: A Cross-Sectional Study |
spellingShingle |
Patient-Centered Medicine and Self-Care of Patients with Type 2 Diabetes: A Cross-Sectional Study Sousa, Solange Blood Glucose Self-Monitoring Diabetes Mellitus, Type 2 Family Practice Patient-Centered Care Portugal Self Care Autocuidado Automonitorização da Glicemia Diabetes Mellitus Tipo 2 Medicina Centrada no Paciente Medicina Familiar Portugal |
title_short |
Patient-Centered Medicine and Self-Care of Patients with Type 2 Diabetes: A Cross-Sectional Study |
title_full |
Patient-Centered Medicine and Self-Care of Patients with Type 2 Diabetes: A Cross-Sectional Study |
title_fullStr |
Patient-Centered Medicine and Self-Care of Patients with Type 2 Diabetes: A Cross-Sectional Study |
title_full_unstemmed |
Patient-Centered Medicine and Self-Care of Patients with Type 2 Diabetes: A Cross-Sectional Study |
title_sort |
Patient-Centered Medicine and Self-Care of Patients with Type 2 Diabetes: A Cross-Sectional Study |
author |
Sousa, Solange |
author_facet |
Sousa, Solange Pereira, Albino Miguel Santiago, Luiz Miguel |
author_role |
author |
author2 |
Pereira, Albino Miguel Santiago, Luiz Miguel |
author2_role |
author author |
dc.contributor.author.fl_str_mv |
Sousa, Solange Pereira, Albino Miguel Santiago, Luiz Miguel |
dc.subject.por.fl_str_mv |
Blood Glucose Self-Monitoring Diabetes Mellitus, Type 2 Family Practice Patient-Centered Care Portugal Self Care Autocuidado Automonitorização da Glicemia Diabetes Mellitus Tipo 2 Medicina Centrada no Paciente Medicina Familiar Portugal |
topic |
Blood Glucose Self-Monitoring Diabetes Mellitus, Type 2 Family Practice Patient-Centered Care Portugal Self Care Autocuidado Automonitorização da Glicemia Diabetes Mellitus Tipo 2 Medicina Centrada no Paciente Medicina Familiar Portugal |
description |
Introduction: Even though the prevalence rate of diabetes in Portugal is one of the highest in Europe, no studies on the association between patient centered medicine, diabetes self-care, and glycemic control have been published. Assuming that patient centered medicine increases adherence to treatment through the improvement of the doctor-patient relationship, the aim of this study was to assess the influence of patient-centered medicine on the self-care of patients with type 2 diabetes patients’ (T2DM) in two Family Health Units in Central Portugal, according to gender and age.Material and Methods: A cross-sectional study was conducted in two Family Health Units in Central Portugal between the 25th November 2021 and the 15th January 2022. Patients with type 2 diabetes were invited to fill in the Patient-Centered Medicine questionnaire, for patients (PCM-p) (where higher values represent worse results) and the Summary of Diabetes Self-Care Activities Measure (SDSCAM), (where higher values represent better results), while healthcare professionals filled in the epidemiologic variables on pre-defined days.Results: A sample of 298 patients with type 2 diabetes was studied. Linear regressions for the association between SDSCAM scale factors and PCM-p showed significant associations for general diet (β = -0.07, p < 0.001), specific diet (β = -0.10, p < 0.001), exercise (β = -0.03, p = 0.008), foot care (β = -0.11, p < 0.001) and medication adherence in general (β = -0.06, p = 0.001). Multiple linear regression including the association between glycated hemoglobin (HbA1c) and the SDSCAM scale dimensions showed that specific diet was associated with lower HbA1c levels (β = -0.01, p = 0.007) and blood sugar testing (β = 0.01, p < 0.001) and that a higher score in PCMp was associated with higher HbA1c levels (β = 0.06, p < 0.001). Male patients (β = -6.93, p = 0.007) and older patients (β = -0.42, p = 0.001) were associated with lower scores in the specific diet. The male gender was associated with higher scores in exercise (β = 7.62, p = 0.029), lower scores in foot care (β = -6.06, p = 0.029) and lower scores in medication adherence to injectable medicines/6.2 (β = -0.73, p = 0.018). Age was associated with a lower score in medication (β = -0.03, p = 0.045) and a higher PCMp total score (β = 0.07, p = 0.030).Conclusion: Patient-centered medicine in type 2 diabetics is associated with better self-care behaviors in patients with type 2 diabetes. Gender and age differences were observed in self-care behaviors and age differences were observed in Patient Centered Medicine. |
publishDate |
2023 |
dc.date.none.fl_str_mv |
2023-03-31 |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article |
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article |
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publishedVersion |
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https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/18584 |
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https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/18584 |
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por |
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por |
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https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/18584 https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/18584/15288 |
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Direitos de Autor (c) 2022 Acta Médica Portuguesa info:eu-repo/semantics/openAccess |
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Direitos de Autor (c) 2022 Acta Médica Portuguesa |
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openAccess |
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application/pdf |
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Ordem dos Médicos |
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Ordem dos Médicos |
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Acta Médica Portuguesa; Vol. 37 No. 1 (2024): January; 3-9 Acta Médica Portuguesa; Vol. 37 N.º 1 (2024): Janeiro; 3-9 1646-0758 0870-399X reponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação instacron:RCAAP |
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Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
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RCAAP |
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RCAAP |
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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
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