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Previous issue date: 2014 / Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP) / Introdução - A necessidade do controle adequado da diabetes e um consenso global. O controle inadequado da Diabetes Melittus Tipo 1 (DM1) se relaciona com varias complicacoes clinicas. Ha evidencias de que fatores como a depressao e a resiliencia desempenhem um papel significativo no controle glicemico de pacientes com DM1. Nestes pacientes, intervencoes educacionais podem facilitar o controle adequado e reduzir o surgimento das complicacoes clinicas. Objetivos u Investigar a associacao do controle glicemico (hemoglobina glicada u HbA1c) aos seguintes fatores: conhecimento sobre diabetes, ansiedade, depressao, resiliencia e esperanca. E tambem investigar a incorporacao desses fatores em duas modalidades de intervencoes educacionais online. Metodos - Foram incluidos no estudo 114 adolescentes diagnosticados com DM1, atendidos no Centro de Diabetes do Hospital São Paulo, UNIFESP. Foram colhidos os valores dos exames da HbA1c e aplicados os seguintes questionarios: DKNA (conhecimento sobre diabetes); HADS (ansiedade e depressao; RS (resiliencia); e HHI (esperanca). Os sujeitos incluidos foram randomizados em 3 grupos: grupo controle (38 pacientes); grupo intervencao na plataforma Moodle (38 pacientes); e grupo intervencao em uma rede social online (38 pacientes). Resultados u O presente estudo nao encontrou correlacao significativa entre o questionario de conhecimento sobre diabetes (DKNA) e os valores da HbA1c. Em um modelo de regressao linear multipla, as seguintes variaveis apresentaram uma associacao significativa com a HbA1c: depressao (p = 0,007); resiliencia (p = 0,007); e esperanca (p = 0,018). A intervencao baseada na rede social online teve um numero de acessos significativamente maior em relacao ao Moodle (p=0,002). Conclusao - A depressao esta associada a um controle glicemico inadequado (altos valores da HbA1c). Os resultados fornecem evidencias de que niveis elevados de esperanca e de resiliencia estao associados com um melhor controle glicemico (baixos valores de HbA1c) e sugerem que as abordagens sobre resiliencia e esperanca devam ser consideradas em intervencoes voltadas para o adequado controle glicemico de jovens com DM1. As redes sociais online podem ser ferramentas uteis e promissoras para veiculacao dessas intervencoes. / INTRODUCTION: The need for an adequate diabetes control is a global consensus. Inadequate control of Diabetes Mellitus type 1 (DM1) is related to several medical complications. Evidence suggests that factors such as depression and resilience play a significant role in the glycemic control of DM1 patients, and that efficient intervention may reduce the incidence of clinical complications. OBJECTIVES: To investigate the relations between glycemic control (Glycated Hemoglobin –HbA1c) and the following: knowledge about diabetes, anxiety,
resilience and hope; also to investigate the adding of these factors to two different kinds of online educational interventions. METHODS: 114 adolescents diagnosed with DM1 and followed by the Diabetes Center at Hospital São Paulo, UNIFESP, were included in this study. Results of HbA1c exams were collected and applied to the following questionnaires: DKNA (knowledge about diabetes); RS (resilience); HHI (hope) and HADS (anxiety and depression). The subjects included were randomly distributed in three group: A control group (38 patients); a Moodle intervention platform group (38 patients); and a Social Network intervention group (38 patients)
RESULTS: the present study found no significant correlation between the diabetes knowledge questionnaire (DKNA) and HbA1c values. In a multiple linear regression model, the following variables presented significant
association with HbA1 results: depression (p = 0.007); resilience (p = 0.007); and hope (p = 0,018). The online social network–based intervention had a significantly higher number of accesses, when compared to Moodle (p =
0,002). CONCLUSION: Depression is associated with an inadequate glycemic control. The results provide evidence to support that high levels of resilience and hope are associated with a better glycemic control (low HbA1c values), and to suggest that approaches involving resilience and hope must be considered when setting up interventions aimed at adequate glycemic control by young subjects with DM1. Online social networks seem to be useful and promising tools to convey these interventions. / FAPESP: 2010 / 51872-0 / BV UNIFESP: Teses e dissertações
| Identifer | oai:union.ndltd.org:IBICT/oai:repositorio.unifesp.br:11600/23075 |
| Date | January 2014 |
| Creators | Santos, Fábio Roberto Munhoz dos [UNIFESP] |
| Contributors | Universidade Federal de São Paulo (UNIFESP), Sigulem, Daniel [UNIFESP] |
| Publisher | Universidade Federal de São Paulo (UNIFESP) |
| Source Sets | IBICT Brazilian ETDs |
| Language | Portuguese |
| Detected Language | English |
| Type | info:eu-repo/semantics/publishedVersion, info:eu-repo/semantics/doctoralThesis |
| Format | 105 f. |
| Source | reponame:Repositório Institucional da UNIFESP, instname:Universidade Federal de São Paulo, instacron:UNIFESP |
| Rights | info:eu-repo/semantics/openAccess |
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