Intenção de uso de antidiabético oral e insulina em pessoas com diabetes mellitus tipo 2

Detalhes bibliográficos
Autor(a) principal: Gouveia, Bernadete de Lourdes André
Data de Publicação: 2019
Tipo de documento: Tese
Idioma: por
Título da fonte: Biblioteca Digital de Teses e Dissertações da UFPB
Texto Completo: https://repositorio.ufpb.br/jspui/handle/123456789/19132
Resumo: Introduction: Non-adherence to diabetes treatment, with failures or noncompliance with the proposed therapeutic scheme, results in decreased glycemic control, early onset of neuropathic complications and worsening in quality of life. The study of behaviors with interest in taking medications may result in contributions to therapeutic adherence and prevention of negative outcomes with improved health. Objective: To evaluate the psychosocial factors that explain behavioral intention of people with 2 diabetes mellitus to use oral antidiabetic drugs and insulin. Method: The research was developed in two stages: the first stage comprised a methodological study with a survey of beliefs about the use of oral antidiabetic drugs and insulin and the validation of the contente of these instruments by experts. The second stage consisted of a quantitative cross-sectional study, identifying the predictors of intention to use oral antidiabetic drugs and insulin. The two stages were performed from January to October 2018, at the outpatient clinic of a public hospital. The population comprised all people with type 2 diabetes mellitus attending the outpatient service surveyed. The sample of the first stage consisted of 64 participants using oral medication and insulin, and 425 participants, in the second stage, in identifying the factors determining behavioral intention. The legal opinion No. 2.446.500 was issued by the Research Ethics Committee (CAAE 80456917.9.00005183). Results: The main advantage in using oral antidiabetic drugs was to keep diabetes under control and the disadvantages were pain and gastric discomfort, nausea and diarrhea. Among the positive referents was indicated the family (children, mother, brothers); how facility, take the pills with water; how difficult, the size of the pills. In the use of insulin, as na advantage, keep diabetes controlled and disadvantage, pain with insulin application; among the referents, the children presented higher representation, as easiness, the application of insulin and as barrier, difficulty in the application of insulin. The instrument aimed at the use of oral antidiabetic drugs decreased from 34 to 26 items and the insulin from 45 to 40 items, with CVI between 0.80 and 1.0 for clarity and relevance. Behavioral beliefs are the psychosocial determinants that best explain the variability of intention to take oral antidiabetic drugs, while normative beliefs explain the intention to take insulin. Conclusion: The variable that explains the intention to take oral antidiabetic drugs comes from the beliefs of keeping diabetes under control, easiness of treatment, improved health and not having to take insulin. The intention to take insulin is explained by the socio-family referrals who support the treatment. Not only the indication of the factors that influence the researched behaviors are the product of the research, but also adjusted instruments capable of measuring the effect of interventions aimed directly at these factors, with greater potential to influence the use of oral antidiabetic drugs and insulin, applied by a multidisciplinar team and, particularly, by nursing, in health education actions and other intervention modalities.
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spelling Intenção de uso de antidiabético oral e insulina em pessoas com diabetes mellitus tipo 2CrençasIntençãoControle comportamentalAntidiabéticos/hipoglicemiantesEnfermagemBeliefsIntentionBehavioral controlAntidiabetic/hypoglycemic agentesNursingCreenciasIntencionControl de comportamientoAgentes antidiabéticos/hipoglucémicosEnfermeríaCNPQ::CIENCIAS DA SAUDE::ENFERMAGEMIntroduction: Non-adherence to diabetes treatment, with failures or noncompliance with the proposed therapeutic scheme, results in decreased glycemic control, early onset of neuropathic complications and worsening in quality of life. The study of behaviors with interest in taking medications may result in contributions to therapeutic adherence and prevention of negative outcomes with improved health. Objective: To evaluate the psychosocial factors that explain behavioral intention of people with 2 diabetes mellitus to use oral antidiabetic drugs and insulin. Method: The research was developed in two stages: the first stage comprised a methodological study with a survey of beliefs about the use of oral antidiabetic drugs and insulin and the validation of the contente of these instruments by experts. The second stage consisted of a quantitative cross-sectional study, identifying the predictors of intention to use oral antidiabetic drugs and insulin. The two stages were performed from January to October 2018, at the outpatient clinic of a public hospital. The population comprised all people with type 2 diabetes mellitus attending the outpatient service surveyed. The sample of the first stage consisted of 64 participants using oral medication and insulin, and 425 participants, in the second stage, in identifying the factors determining behavioral intention. The legal opinion No. 2.446.500 was issued by the Research Ethics Committee (CAAE 80456917.9.00005183). Results: The main advantage in using oral antidiabetic drugs was to keep diabetes under control and the disadvantages were pain and gastric discomfort, nausea and diarrhea. Among the positive referents was indicated the family (children, mother, brothers); how facility, take the pills with water; how difficult, the size of the pills. In the use of insulin, as na advantage, keep diabetes controlled and disadvantage, pain with insulin application; among the referents, the children presented higher representation, as easiness, the application of insulin and as barrier, difficulty in the application of insulin. The instrument aimed at the use of oral antidiabetic drugs decreased from 34 to 26 items and the insulin from 45 to 40 items, with CVI between 0.80 and 1.0 for clarity and relevance. Behavioral beliefs are the psychosocial determinants that best explain the variability of intention to take oral antidiabetic drugs, while normative beliefs explain the intention to take insulin. Conclusion: The variable that explains the intention to take oral antidiabetic drugs comes from the beliefs of keeping diabetes under control, easiness of treatment, improved health and not having to take insulin. The intention to take insulin is explained by the socio-family referrals who support the treatment. Not only the indication of the factors that influence the researched behaviors are the product of the research, but also adjusted instruments capable of measuring the effect of interventions aimed directly at these factors, with greater potential to influence the use of oral antidiabetic drugs and insulin, applied by a multidisciplinar team and, particularly, by nursing, in health education actions and other intervention modalities.RESUMEN. Introducción: la falta de adherencia al tratamiento de la diabetes, con fallas o incumplimiento del esquema terapéutico propuesto, disminución del control glucémico, aparición temprana de complicaciones neuropáticas y empeoramiento de la calidad de vida. El estudio de comportamientos con interés en tomar medicamentos puede contribuir a la adherencia terapéutica y la prevención de resultados negativos con una mejor salud. Objetivo: evaluar los factores psicosociales que explican la intención conductual de las personas con diabetes mellitus tipo 2 de usar medicamentos antidiabéticos orales e insulina. Método: La investigación se desarrolló en dos etapas: la primera etapa incluyó un estudio metodológico con una encuesta de creencias sobre el uso de medicamentos antidiabéticos orales e insulina en personas con diabetes mellitus tipo 2, seguido de la construcción de instrumentos para medir la intención de comportamiento para tomar fármacos antidiabéticos orales e insulina y la validación del contenido de estos instrumentos por parte de expertos; La segunda etapa consistió en un estudio transversal cuantitativo, que identificó los predictores de la intención de usar medicamentos antidiabéticos orales e insulina. Las dos etapas se realizaron de enero a octubre de 2018, en la clínica ambulatoria de un hospital público. La población estaba compuesta por todas las personas con diabetes mellitus tipo 2 que asistían al servicio ambulatorio encuestado. La muestra de la primera etapa consistió en 64 participantes que usaron medicación oral e insulina y la segunda etapa, 425 participantes en la identificación de los factores que determinan la intención de comportamiento. Opinión legal no. 2.446.500 fue emitido por el Comité de Ética en Investigación (CAAE 80456917.9.00005183). Resultados: La principal ventaja en el uso de medicamentos antidiabéticos orales fue mantener la diabetes bajo control y las desventajas fueron dolor e incomodidad gástrica, náuseas y diarrea. Entre los referentes positivos se indicó la familia (hijos, madres, hermanos); con qué facilidad, tome las tabletas con agua y cuán difícil sea el tamaño de las tabletas. En el uso de insulina, como ventaja, mantenga la diabetes controlada y la desventaja, el dolor con la aplicación de insulina; entre los referentes, los niños presentaron mayor representación; como facilidad, la aplicación de insulina y como barrera, dificultad en la aplicación de insulina. El instrumento destinado al uso de fármacos antidiabéticos orales disminuyó de 34 a 26 ítems y la insulina de 45 a 40 ítems, con CVI entre 0,80 a 1,0 para mayor claridad y relevancia. Las creencias conductuales son los determinantes psicosociales que mejor explican la variabilidad de la intención de tomar medicamentos antidiabéticos orales, mientras que las creencias normativas explican la intención de tomar insulina. Conclusión: La variable que explica la intención de tomar medicamentos antidiabéticos orales proviene de la creencia de mantener la diabetes bajo control, facilidad de tratamiento, mejor salud y no tener que tomar insulina. La intención de tomar insulina se explica por las referencias sociofamiliares que respaldan el tratamiento. No solo son los produtos de investigación la indicación de los factores que influyen en los comportamientos investigados, sino también instrumentos ajustados capaces de medir el efecto de las intervenciones dirigidas directamente a estos factores, con un mayor potencial para influir en el uso de medicamentos antidiabéticos orales e insulina. aplicado por un equipo multidisciplinario y particularmente por enfermería, en acciones de educación en salud y otras modalidades de intervención.Pró-Reitoria de Pós-graduação da UFPB (PRPG/UFPB)Introdução: A não adesão ao tratamento do diabetes, com falhas ou descumprimento do esquema terapêutico proposto recaem em descontrole glicêmico, surgimento precoce das complicações neuropáticas e piora na qualidade de vida. O estudo de comportamentos com interesse na tomada dos medicamentos pode resultar em contribuições para a adesão terapêutica e prevenção de desfechos negativos com melhora da saúde. Objetivo: Avaliar os fatores psicossociais que explicam a intenção comportamental de pessoas com diabetes mellitus tipo 2 de usar antidiabético oral e insulina. Método: A pesquisa foi desenvolvida em duas etapas: a primeira etapa, compreendeu um estudo metodológico com levantamento das crenças sobre o uso dos antidiabéticos orais e insulina em pessoas com diabetes mellitus tipo 2, seguido da construção dos instrumentos de medida da intenção comportamental de tomar antidiabéticos orais e insulina e da validação de conteúdo destes instrumentos por expertises; a segunda etapa, consistiu em estudo transversal quantitativo, com identificação dos preditores da intenção de uso dos antidiabéticos orais e insulina. as duas etapas foram realizadas no período de janeiro a outubro de 2018, no ambulatório de um hospital público. A população compreendeu todas as pessoas com diabetes mellitus tipo 2 em atendimento no serviço ambulatorial pesquisado. A amostra da primeira etapa constou de 64 participantes em uso do medicamento oral e insulina e da segunda etapa, 425 participantes na identificação dos fatores determinantes da intenção comportamental. O Parecer nº. 2.446.500 foi emitido pelo Comitê de Ética em Pesquisa (CAAE 80456917.9.00005183). Resultados: A principal vantagem no uso dos antidiabéticos orais foi manter o diabetes controlado e as desvantagens foram, dor e desconforto gástrico, enjoo e diarreia. Entre os referentes positivos foi indicada a família (filhos, mãe irmãos); como facilidade, tomar os comprimidos com água e como dificuldade, o tamanho dos comprimidos. No uso de insulina, como vantagem, manter o diabetes controlado e desvantagem, dor com aplicação da insulina; entre os referentes, os filhos apresentaram maior representação; como facilidade, a aplicação da insulina e como barreira, dificuldade na aplicação da insulina. O instrumento voltado ao uso de antidiabéticos orais teve redução de 34 para 26 itens e o de insulina de 45 para 40 itens, com IVC entre 0,80 a 1,0 para clareza e pertinência. As crenças comportamentais são os determinantes psicossociais que melhor explicam a variabilidade da intenção de tomar os antidiabéticos orais, enquanto que as crenças normativas explicam a intenção de tomar insulina. Conclusão: A variável que explica a intenção de tomar os antidiabéticos orais advém das crenças de manter o diabetes controlado, da facilidade do tratamento, melhora da saúde e não precisar tomar insulina. A intenção de tomar insulina é explicada pelos referentes sócio-familiares que apoiam o tratamento. Têm-se como produtos não somente a indicação dos fatores que influenciam os comportamentos pesquisados, como também instrumentos ajustados e capazes de medir o efeito de intervenções voltadas diretamente a estes fatores, com maior potencial de influenciar o uso de antidiabéticos orais e insulina e podendo ser aplicadas por equipe multiprofissional e, particularmente, pela enfermagem, nas ações de educação em saúde e em outras modalidades de intervenção.Universidade Federal da ParaíbaBrasilEnfermagemPrograma de Pós-Graduação em EnfermagemUFPBOliveira, Simone Helena dos Santoshttp://lattes.cnpq.br/9917899598089580Gouveia, Bernadete de Lourdes André2021-01-04T18:44:39Z2019-10-172021-01-04T18:44:39Z2019-08-29info:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/doctoralThesishttps://repositorio.ufpb.br/jspui/handle/123456789/19132porAttribution-NoDerivs 3.0 Brazilhttp://creativecommons.org/licenses/by-nd/3.0/br/info:eu-repo/semantics/openAccessreponame:Biblioteca Digital de Teses e Dissertações da UFPBinstname:Universidade Federal da Paraíba (UFPB)instacron:UFPB2021-01-05T06:15:34Zoai:repositorio.ufpb.br:123456789/19132Biblioteca Digital de Teses e Dissertaçõeshttps://repositorio.ufpb.br/PUBhttp://tede.biblioteca.ufpb.br:8080/oai/requestdiretoria@ufpb.br|| diretoria@ufpb.bropendoar:2021-01-05T06:15:34Biblioteca Digital de Teses e Dissertações da UFPB - Universidade Federal da Paraíba (UFPB)false
dc.title.none.fl_str_mv Intenção de uso de antidiabético oral e insulina em pessoas com diabetes mellitus tipo 2
title Intenção de uso de antidiabético oral e insulina em pessoas com diabetes mellitus tipo 2
spellingShingle Intenção de uso de antidiabético oral e insulina em pessoas com diabetes mellitus tipo 2
Gouveia, Bernadete de Lourdes André
Crenças
Intenção
Controle comportamental
Antidiabéticos/hipoglicemiantes
Enfermagem
Beliefs
Intention
Behavioral control
Antidiabetic/hypoglycemic agentes
Nursing
Creencias
Intencion
Control de comportamiento
Agentes antidiabéticos/hipoglucémicos
Enfermería
CNPQ::CIENCIAS DA SAUDE::ENFERMAGEM
title_short Intenção de uso de antidiabético oral e insulina em pessoas com diabetes mellitus tipo 2
title_full Intenção de uso de antidiabético oral e insulina em pessoas com diabetes mellitus tipo 2
title_fullStr Intenção de uso de antidiabético oral e insulina em pessoas com diabetes mellitus tipo 2
title_full_unstemmed Intenção de uso de antidiabético oral e insulina em pessoas com diabetes mellitus tipo 2
title_sort Intenção de uso de antidiabético oral e insulina em pessoas com diabetes mellitus tipo 2
author Gouveia, Bernadete de Lourdes André
author_facet Gouveia, Bernadete de Lourdes André
author_role author
dc.contributor.none.fl_str_mv Oliveira, Simone Helena dos Santos
http://lattes.cnpq.br/9917899598089580
dc.contributor.author.fl_str_mv Gouveia, Bernadete de Lourdes André
dc.subject.por.fl_str_mv Crenças
Intenção
Controle comportamental
Antidiabéticos/hipoglicemiantes
Enfermagem
Beliefs
Intention
Behavioral control
Antidiabetic/hypoglycemic agentes
Nursing
Creencias
Intencion
Control de comportamiento
Agentes antidiabéticos/hipoglucémicos
Enfermería
CNPQ::CIENCIAS DA SAUDE::ENFERMAGEM
topic Crenças
Intenção
Controle comportamental
Antidiabéticos/hipoglicemiantes
Enfermagem
Beliefs
Intention
Behavioral control
Antidiabetic/hypoglycemic agentes
Nursing
Creencias
Intencion
Control de comportamiento
Agentes antidiabéticos/hipoglucémicos
Enfermería
CNPQ::CIENCIAS DA SAUDE::ENFERMAGEM
description Introduction: Non-adherence to diabetes treatment, with failures or noncompliance with the proposed therapeutic scheme, results in decreased glycemic control, early onset of neuropathic complications and worsening in quality of life. The study of behaviors with interest in taking medications may result in contributions to therapeutic adherence and prevention of negative outcomes with improved health. Objective: To evaluate the psychosocial factors that explain behavioral intention of people with 2 diabetes mellitus to use oral antidiabetic drugs and insulin. Method: The research was developed in two stages: the first stage comprised a methodological study with a survey of beliefs about the use of oral antidiabetic drugs and insulin and the validation of the contente of these instruments by experts. The second stage consisted of a quantitative cross-sectional study, identifying the predictors of intention to use oral antidiabetic drugs and insulin. The two stages were performed from January to October 2018, at the outpatient clinic of a public hospital. The population comprised all people with type 2 diabetes mellitus attending the outpatient service surveyed. The sample of the first stage consisted of 64 participants using oral medication and insulin, and 425 participants, in the second stage, in identifying the factors determining behavioral intention. The legal opinion No. 2.446.500 was issued by the Research Ethics Committee (CAAE 80456917.9.00005183). Results: The main advantage in using oral antidiabetic drugs was to keep diabetes under control and the disadvantages were pain and gastric discomfort, nausea and diarrhea. Among the positive referents was indicated the family (children, mother, brothers); how facility, take the pills with water; how difficult, the size of the pills. In the use of insulin, as na advantage, keep diabetes controlled and disadvantage, pain with insulin application; among the referents, the children presented higher representation, as easiness, the application of insulin and as barrier, difficulty in the application of insulin. The instrument aimed at the use of oral antidiabetic drugs decreased from 34 to 26 items and the insulin from 45 to 40 items, with CVI between 0.80 and 1.0 for clarity and relevance. Behavioral beliefs are the psychosocial determinants that best explain the variability of intention to take oral antidiabetic drugs, while normative beliefs explain the intention to take insulin. Conclusion: The variable that explains the intention to take oral antidiabetic drugs comes from the beliefs of keeping diabetes under control, easiness of treatment, improved health and not having to take insulin. The intention to take insulin is explained by the socio-family referrals who support the treatment. Not only the indication of the factors that influence the researched behaviors are the product of the research, but also adjusted instruments capable of measuring the effect of interventions aimed directly at these factors, with greater potential to influence the use of oral antidiabetic drugs and insulin, applied by a multidisciplinar team and, particularly, by nursing, in health education actions and other intervention modalities.
publishDate 2019
dc.date.none.fl_str_mv 2019-10-17
2019-08-29
2021-01-04T18:44:39Z
2021-01-04T18:44:39Z
dc.type.status.fl_str_mv info:eu-repo/semantics/publishedVersion
dc.type.driver.fl_str_mv info:eu-repo/semantics/doctoralThesis
format doctoralThesis
status_str publishedVersion
dc.identifier.uri.fl_str_mv https://repositorio.ufpb.br/jspui/handle/123456789/19132
url https://repositorio.ufpb.br/jspui/handle/123456789/19132
dc.language.iso.fl_str_mv por
language por
dc.rights.driver.fl_str_mv Attribution-NoDerivs 3.0 Brazil
http://creativecommons.org/licenses/by-nd/3.0/br/
info:eu-repo/semantics/openAccess
rights_invalid_str_mv Attribution-NoDerivs 3.0 Brazil
http://creativecommons.org/licenses/by-nd/3.0/br/
eu_rights_str_mv openAccess
dc.publisher.none.fl_str_mv Universidade Federal da Paraíba
Brasil
Enfermagem
Programa de Pós-Graduação em Enfermagem
UFPB
publisher.none.fl_str_mv Universidade Federal da Paraíba
Brasil
Enfermagem
Programa de Pós-Graduação em Enfermagem
UFPB
dc.source.none.fl_str_mv reponame:Biblioteca Digital de Teses e Dissertações da UFPB
instname:Universidade Federal da Paraíba (UFPB)
instacron:UFPB
instname_str Universidade Federal da Paraíba (UFPB)
instacron_str UFPB
institution UFPB
reponame_str Biblioteca Digital de Teses e Dissertações da UFPB
collection Biblioteca Digital de Teses e Dissertações da UFPB
repository.name.fl_str_mv Biblioteca Digital de Teses e Dissertações da UFPB - Universidade Federal da Paraíba (UFPB)
repository.mail.fl_str_mv diretoria@ufpb.br|| diretoria@ufpb.br
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