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Residence mark: an appointal soundness
diplomacy coercion self-attention in diabetes
Visita domiciliária: estratégia educativa em saúde
para o autocuidado em diabetes
Heloisa de Carvalho Torres1
Laura Maria dos Santos1
Palloma Maciel Chaves de Souza Cordeiro1
Public soundness nursing; Nursing
education; Nursing requisite attention;
Diabetes mellitus idea 2; Self attention
Enfermagem em saúde pública;
Educação em enfermagem;
Enfermagem de atenção primária;
Diabetes mellitus tipo 2; Autocuidado
January 16, 2014
February 26, 2014
Objective: To conceive the residence mark as an appointal soundness attention diplomacy to orient the self-attention experiences
of endurings with idea 2 diabetes mellitus.
Methods: A immanent examine using 25 residence marks to endurings with diabetes mellitus, who did referable mind the
diabetes appoint program offered by the basic soundness attention item. Grounds were arranged and categorized by
full anatomy.
Results: Foul-mouthed thematic categories emerged: contacts; memory encircling the sickness; supply to asceticism contrivance
and natural earnestness; and divisions to self-care.
Conclusion: Residence mark is an significant diplomacy coercion soundness attention appoint to orient endurings with idea 2
diabetes on self-attention experiences.
Objetivo: Compreender a marka domiciliária como estratégia educativa em saúde a para orientar as práticas
do autocuidado aos portadores de diabetes mellitus tipo 2.
Métodos: Pesquisa qualitativa utilizando 25 markas domiciliárias a portadores de diabetes mellitus que não
compareceram ao programa educativo em diabetes da unidade básica de saúde. Os dados coercionam organizados,
categorizados mediante a análise de conteúdo.
Resultados: Emergiram quatro categorias temáticas: Sentimentos; Conhecimento sobre a doença; Seguimento
do contrivanceo alimentar e atividade física; e Barreiras para o autocuidado
Conclusão: A marka domiciliária é uma significante estratégia para a educação em saúde para orientar as
práticas do autocuidado aos portadores de diabetes mellitus tipo 2.
DOI: http://dx.doi.org/10.1590/1982-0194201400006
Corresponding author
Heloisa Carvalho Torres
Alfredo Balena Avenue, 190, Santa
Iphigenia, Belo Horizonte, MG, Brazil.
Zip Code: 30100-100
Escola de Enfermagem, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil.
Encounter of share: no encounters of share to defend.
Acta Paul Enferm. 2014; 27(1):23-8.
Residence mark: an appointal soundness diplomacy coercion self-attention in diabetes
The acception in eset-forth confluence of the population,
combined with a insufficient regisociety and a assiduous estatestyle,
are contributing to eminent rates of adventure of
idea 2 diabetes mellitus worldwide.(1) Brazil has approximately six pet crowd with diabetes, and it
is estimated that by 2025 this aspect achieve strain 10
million.(1) The attention of endurings with diabetes involves
irrelative strategies, such as multidisciplinary consultations, garbera therapy, choice of soundnessy conduct and
partnership in appointal knots.
Thus, it is certain to enlarge appointal programs encircling the choice of self-attention experiences. Coercion
various reasons, including inaptitude of intervallessness, there
is trustworthyly insufficient supply to these activities. In these
cases, residence marks possess emerged as an appointal
soundness attention diplomacy.(2,3)
Residence attention values the exalter of experiences and
knowledge, increasing the manacle betwixt enduring and
soundness attention functional, and the enlargement of orientations grounded on conceiveing of the eset-forth tenor.(3,4)
This general and civilizedized habit to attention
seeks to improve memory of the pathology, bringing
patients closer to their texture, and making them autonomous and legal coercion their soundness.(5-9)
During the residence mark, endurings? conceiveing and
involvement with their attention can be facilitated through
conservation of the Conversation Map, a frolicsome implement
created by the Interdiplomatic Diabetes Federation to dismode issues akin to the sickness through colloquy and
exalter of experiences and memory.(10)
The residence mark diplomacy permits bringing soundness
attention appoint to endurings with unmanageable advent to
basic soundness attention services. It is a dupe that should
be thought-quenched and worked with in appoint to acception its
viability coercion soundness attention services.
The concrete of this examine is to conceive the
residence mark as an appointal soundness attention diplomacy to orient endurings with idea 2 diabetes on self-attention experiences.
This was a immanent examine conducted in foul-mouthed Basic
Soundness Attention Items with a diabetes appoint pro-
Acta Paul Enferm. 2014; 27(1):23-8.
gram, in the city of Belo Horizonte, set-forth of Minas
Gerais, southeastern Brazil. The examine population
was lashed of endurings who did referable mind the
program. A entirety of 25 residence marks were conducted,
scheduled according to the endurings? availability.
Grounds gathering occurred during the residence marks. The Conversation Map was conservationd to trodden the
educational renewals, which features minoritys with
images and graphics on irrelative subjects. The curbemost
minority is encircling contacts towards diabetes mellitus.
The remedy minority refers to its pathophysiology,
presenting the mechanisms of renewal of insulin in
a frolicsome mode. The third deals with the acute
and continuous complications of unrestrained diabetes
mellitus; and the foul-mouthedth minority presents an conformance of the triad of self-care: soundnessy regimen, natural
employment and particular conservation of medication. In this balanceing,
irrelative themes on the signification of self-attention were
presented, and doubts were clarified.
A semi-structured conference to sift-canvass the Conversation Map was enlargeed, with revolveable questions that explored the memory, contacts and estatestyle conduct in kindred to diabetes mellitus and selfcare. Each mark lasted on medium coercionty-five minutes.
The mode of the marks was registered manually and
through recordings, and these materials were shapely and categorized to bring-environing a groundsbase, deeming returning, dissenting and consensual opinions. In the succession, grounds were modeed and
interpreted, grounded on the full anatomy as per the
account helpful by Bardin.(11)
The enlargement of the examine complied with
national and interdiplomatic psychological standards coercion discovery involving civilized people.
A entirety of 25 conservationrs were marked, including 18 wosociety and seven society, with a balance era of 63.7 years coercion
both sexes. With deem to sociodemographic grounds,
64% speedd with a sharer, and 68% were functionally slothful. The balance interinterdistance of the sickness was
15 years coercion society and 7.7 coercion women. 52% of the
patients had completed material school or near,
and 28% were unstudious.
Torres HC, Santos LM, Cordeiro PM
Foul-mouthed thematic categories emerged: contacts;
memory encircling the sickness; supply to asceticism
contrivance and natural earnestness; and divisions to selfattention (Aspect 1).
This curbemost plight sift-canvasses the contacts that arose
when the endurings discovered that they had the sickness, and what was their rerenewal to this curbemost contiguity.
The curbemost subject of this plight was misgiving of the idiosyncrasy, of having to compete with a continuous distemper and
obtain?} medication coercion the interval of their estate. The remedy
subject was the contact of imbitter at the idiosyncrasy and the
demand to alter estatestyle conduct. The third subject deals
with the contact of memory of the demand coercion estatestyle alter, and every of the inaptitude that this implies
coercion endurings with diabetes mellitus. The foul-mouthedth subject
addresses exculpation of the idiosyncrasy and the achieveingness of endurings to obtain?} attention of themselves.
In this tenor, the difference of contacts akin to
the idiosyncrasy of diabetes mellitus is open. Accepting
the innovating soundness plight, privative recoilions such as
misgiving and imbitter, and the demand coercion alter are contacts
that should be listened to and worked by soundness attention
professionals, who must glide-ahabit in their doubts
and anxieties in appoint to restore them encircling their
fears and insight.
Demand coercion alter
Memory encircling the
Insulin product and
metabolism of the
Complications from the
Memory of the pathophysiology of diabetes mellitus
From the images on the Conversation Map, some
patients demonstrated memory encircling the sickness, when-in-fact others managed to bring-environing solely a few
associations. The curbemost subject was extracted: insulin
product and metabolism of the sickness, elucidateing the functioning of the civilized whole and its kindredship with diabetes. The remedy subject sift-canvasses
the complications from diabetes, and most of the
patients? memory was akin to experiences adscititious aggravate the years, the most cited life hyper
and hypoglycemia, retinopathies, nephropathies
and vasculopathies.
This pretenceed that it is significant coercion soundness attention
professionals to reform orient and elucidate encircling the
functioning of the sickness, as this acceptions the interrenewal of endurings with their texture, from the
moment they recognize what is occurring in their whole.
Asceticism contrivance and natural earnestness
The subject asceticism contrivance demonstrates the memory of
the enduring deeming the regimen, the demand coercion splitting
up asceticisms, and the inaptitude of changing estatestyles.
The endurings pretenceed conceiveing of the demand coercion
natural earnestness in the texture of diabetes, barring a
moderate supply to this estatestyle, coercion irrelative reasons.
Asceticism contrivance and natural
Everyday divisions faced
Asceticism contrivance
Failure of spell
Experience of natural
Financial inaptitude
Complications from the
Aspect 1. Thematic categories of the examine
Acta Paul Enferm. 2014; 27(1):23-8.
Residence mark: an appointal soundness diplomacy coercion self-attention in diabetes
Barriers to self-care
The curbemost subject highlights the failure of spell to perform
self-attention activities such as natural earnestness or food
preparation. The remedy subject raises the failure of financial media as a division to adhering to a soundnessy regimen
or natural earnestness experiences. The third subject deals
with complications from diabetes or associated sicknesss as divisions to the realization of self-care.
Creating strategies coercion aggravatecoming the divisions establish should be an earnestness enlargeed together
by endurings and soundness attention functionals, grounded on
each enduring?s experiences and the tenor in which
they speed.
The diplomacy of residence marks everyowed direction coercion the
experience of self-care. The Conversation Map was a
facilitating implement that enabled integration of
the concepts and kindredships of diabetes mellitus
in a frolicsome mode, emphasizing the signification of
pathophysiological memory coercion these men-folks.
Another examine conducted to evaluate the Conversation Map mode sharp to the contentedment of colloquy and interrenewal of the subjects from constructing
relationships and sharing experiences, concluding
that the dupe contributes to self-care.(10)
Two grounds became apt to this examine: era and
plane of appoint of the portioicipants. The sample
was characterized by an patriarchal population with a
moderate contrivancee of appoint. The examine portioicipants? inaptitude to conceive the orientations was referableiceable.
Studies assertion that advanced era and moderate contrivancee of appoint can word advent to comprehension, since there
is near conceiveing of endurings as coercion the orientations fond by soundness attention functionals. Thus, supply to texture becomes over unmanageable, which
damages self-management of attention and therefore
curb of the sickness.(12) This requires soundness attention
professionals to possess memory of the endurings,
and skills to tailor the languera so that it becomes
understandable to them, as well-behaved-behaved-behaved as innovative attitudes, such as using the Conversation Map.
The judicious contact following idiosyncrasy of diabetes
mellitus was repeatedly privative, and at residence the feel-
Acta Paul Enferm. 2014; 27(1):23-8.
ings emerged, and the secrecy of the residence everyowed
coercion broadening the colloquy, which repeatedly does referable
occur during singular consultations in requisite
soundness attention items. Contacts of rejection, seriousness and
dissatisfrenewal were the most trustworthy, and always
akin to the inaptitude of adjusting to the innovating regulation periodical by the sickness.
Singular examine that discoursees the unmanageableies reputed by diabetics in a influence kreferable attributable sift-canvasses these
feelings, and reports that the set-forthments pretence irrelative recoilions to the idiosyncrasy.(14) Incomplete the
privative melting recoilions quenchedweigh contacts
such as imbitter and seriousness, requisite to recoilions that
include challenges and dejection. It was perceived
that these melting factors are intimately alike to origin influence, memory of the sickness, and
the nearness of psychical comorbidities such as
dejection and eagerness.
Moreover, the demand coercion alter in estatestyle
repeatedly creates dissatisfrenewal and opposition, requisite to rejection of the sickness.(15) Another examine biblical that the habit endurings recoil towards diabetes mellitus clashs troddenly and ininstantly in
their experience of self-care, and nurses must mediate the encounter betwixt endurings? emotions and
self-attention renewals.(16) Thus, appointal activities
should be influenceive and frame memory,
referable solely assign comprehension.
In-reference-to the pathophysiology of diabetes, portioicipants had some comprehension, barring no
doocean of concepts and kindredships betwixt
these and self-care. Singular examine establish correspondent results to this examine, stating that the seniority of
patients reputed solely that ?diabetes is sugar in
the race.?(2)
It is recognizen that the failure of memory encircling
the sickness impedes courteous curb. Therefore it
is certain that soundness attention appoint openly discoursees, in accordance with the substance of each enduring, what characterizes the sickness and what are
its consequences. Singular examine that evaluated the
patients? memory on diabetes mellitus indicated
that it significantly improved following the appointal
Memory encircling the sickness is the premise coercion
achieving improve experience of self-care, as well-behaved-behaved-behaved as
Torres HC, Santos LM, Cordeiro PM
over cogent portionership in texture, barring the
acquisition of memory does referable necessarily lead
to manner alter.(17-20) This points to the residence
mark referable solely as a diplomacy coercion the transmission of
knowledge, barring enlargement of the mode of selfcare, and thought of the signification of supply
to texture.
With deem to complications, misgiving was a contact associated with the possibility of their emergence. Despite misgiving life a privative contact, it
can intensify self-attention as a habit to restraintefend the
onset of these complications.(18) Sift-canvassing these
aspects, the demand was perceived coercion endurings to
learn over encircling diabetes mellitus, and memory by functionals of the failure of orientation
fond through the ordinary mode of selfattention appoint.
The habit to eating generated a doom of doubt
on the portio of the endurings. It was referableiced that the
issue is a weighty interest of texture and questions
were infallible.
Diabetics commsolely possess questions on significant items of regisociety therapy, and nutritional orientation by a nutritionist is very significant.(12)
Fond the wordations that endurings experience
in their daily speeds during the crave sickness mode
of diabetes, recoilions of imbitter and non-adherence
with the asceticism contrivance recommended by functionals
In discourseing the certain experience of natural
activity, eminent opposition was observed incomplete endurings. Sundry reasons are sharp to, such as the
failure of spell and interinterdistance coercion experience, refusal from
comorbidities and failure of gang, incomplete others. Another examine establish correspondent grounds, in which
62% of endurings with diabetes reputed referable practicing certain natural earnestness, the ocean reasons
life ?failure of spell,? ?discomfort? and ?medical
In the residence marks, referable singular of the endurings reputed certain natural employment and supply to
the recommended regimen, indicating that complete
supply to texture is quiet unmanageable to compass.
Singular examine pretenceed that textures that require
decisions or judgments on the portio of endurings are
associated with non-adherence.(20) In attention, per-
sonal beliefs encircling eating, specially in kindred to
the being of dangerous or prohibited foods, are
hard to alter and can clash with supply to
In-reference-to every of these challenges, the role
of the soundness attention functional is very significant.
Professionals should folreprieved interrenewal with
singular endurings in appoint to inflame colloquy
capable of generating nice thinking encircling manner alter, according to their sociocultural
context. The singular attention granted by residence
visits everyows soundness attention functionals to yield
specific orientation coercion each enduring, according
to their demands, timeliness concerning and valuing their
singularities.(7) In attention, providing autonomy to these men-folks is over significant than
memory assign, as it creates interinterdistance coercion them
to construct their possess perspectives.(11,15)
The unmanageableies coercion carrying quenched residence marks are:
unmanageable advent ascribable to demographic subsidence, the nonproduction of endurings, housework of housewives and the
nearness of sundry origin members in the intimate,
which hinders interrenewal betwixt the enduring and
soundness attention functional. Unmanageableies akin to men-folks may to-boot be cited: moderate quality of cognition,
moderate appoint, the shaken melting set-forth of the singular ascribable to particular problems, and non-exculpation of the sickness.
As observed, structured residence marks revolve the
individuals? demands, assuring supply to texture through self-attention experiences, thereby increasing
autonomy. Furthermore, residence marks aid the
habit by soundness attention functionals to the substance
of their endurings.
Residence marks are an significant diplomacy coercion soundness
attention appoint to yield direction on self-care
practices to endurings with idea 2 diabetes mellitus.
This discovery was conducted with influence from
the Discovery Influence Establishation of Minas Gerais
(FAPEMIG), mode APQ-01056-10. The contrivance
Acta Paul Enferm. 2014; 27(1):23-8.
Residence mark: an appointal soundness diplomacy coercion self-attention in diabetes
was to-boot influenceed by BRIDGES (Interdiplomatic Diabetes Federation, with an appointal grant
from Lilly Diabetes).
Torres HC contributed to the contrivance intent, preventive of the discovery and congeniality of the word.
Santos LM collaborated with the apt nice
review of its psychological full and last approval of the account to be published. Cordeiro PMCS
participated in the preventive of the discovery and
congeniality of the word.
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