Qualidade de vida de crianças e adolescentes com diabetes mellitus tipo 1 / Quality of life of children and adolescents with type 1 diabetes mellitus

Introdução: O diabetes mellitus tipo 1 (DM1) é uma doença autoimune, poligênica, decorrente de destruição das células ß pancreáticas, ocasionando deficiência completa na produção de insulina. Objetivo: avaliar a qualidade de vida (QV) de crianças e adolescentes com diabetes mellitus tipo 1 (DM1), seu perfil clínico e epidemiológico. Métodos: Estudo transversal, que incluiu crianças e adolescentes com idade entre 2 e 18 anos, que frequentavam uma Associação de Diabéticos Infanto Juvenis de Santa Catarina. Para avaliação utilizou-se dados sociodemográficos, de caracterização da doença e seu controle e o Questionário de QV Pediátrico PedsQL 3.0 - Módulo Diabetes Mellitus. Resultados: Participaram do estudo 30 crianças e adolescentes, sendo a média de idade de 12,6 anos (DP±3,7 anos); 56,7% eram do sexo feminino, 70% com diagnóstico entre 5 e 7 anos de idade, e 96,6% frequentavam a ADIJT há menos de 5 anos. A minoria dos pacientes apresentou um bom controle de hemoglobina glicada (23,3%). Verificou-se uma correlação forte e significativa entre os pacientes e seus responsáveis nos escores de QV segundo sintomas (R2=0,701), barreiras no tratamento (R2=0,759) e preocupações (R2=0,811), e uma diferença significativa para o domínio comunicação na comparação das crianças de 5 a 7 anos com as de 8 a 12 anos (p=0,042). Conclusão: Um grande percentual de pacientes com DM1 apresentou controle inadequado da doença, apesar da adequada autoavaliação de QV.

Introduction: Type 1 diabetes mellitus (T1DM) is an autoimmune polygenic disease resulting from the destruction of pancreatic ß cells, causing a complete deficiency in insulin production. Objective: To evaluate the quality of life (QoL) of children and adolescents with type 1 diabetes mellitus (T1DM), their clinical and epidemiological profile. Methods: A cross-sectional study, which included children and adolescents aged between 2 and 18 years, who attended an Association of Diabetic Children and Youth (ADIJT) in Santa Catarina. For evaluation, we used sociodemographic data, characterization of the disease and its control, and the Pediatric QoL Inventory PedsQL 3.0 ­ Diabetes Mellitus Module. Results: Thirty children and adolescents participated in the study, with a mean age of 12.6 years (SD±3.7 years); 56.7% were female, 70% were diagnosed between 5 and 7 years of age, and 96.6% had attended ADIJT for less than 5 years. A minority of patients had a good control of glycated hemoglobin (23.3%). There was a strong and significant correlation between patients and their caregivers in QOL scores according to symptoms (R2=0.701), barriers to treatment (R2=0.759) and concerns (R2=0.811), and a significant difference for the communication domain in the comparison of 5-7-year-olds with 8-12-year-olds (p=0.042). Conclusion: A large percentage of patients with T1DM had inadequate disease control, despite adequate QOL self-assessment.

Calidad de vida en el adulto mayor con diabetes mellitus tipo II / Quality of life in the elderly with type II diabetes mellitus

RESUMEN Objetivo: Conocer la calidad de vida de una familia de dos adultos mayores que padecen diabetes mellitus tipo II. Material y método: Se realizó un estudio de caso con diseño cualitativo, se aplicó entrevista a profundidad utilizando como referencia los ejes, categorías y subcategorías del Modelo de Valoración Familiar de Calgary y un diario de campo. Los datos se analizaron a través de la técnica de análisis de contenido; se aplicó la estrategia de "triangulación de investigador". Resultados: Las principales categorías que emergieron fueron: la importancia del rol de los padres en la crianza de sus hijos, la educación como base de la superación personal, limitaciones de la edad y secuelas de una vida con diabetes, amor costumbre y dependencia y red de apoyo pilar fundamental para el desarrollo de los adultos mayores. Conclusiones: Las intervenciones del profesional de enfermería están orientadas a favorecer el autocuidado y enseñar a vivir con las nuevas características dadas por las secuelas de su edad y de las complicaciones de las patologías que los aquejan. En caso necesario, se debe fortalecer la red social, buscando recursos familiares y extrafamiliares que participen en la resolución de las crisis que se presenten. Las relaciones con amigos, vecinos y compañeros se consideran también importantes para ofrecer otros tipos de ayuda, estas se establecen a través de intereses comunes y actividades compartidas y son esenciales fuera del contexto del hogar.

ABSTRACT Objective: To know the quality of life of a family of two older adults suffering from Type II Diabetes Mellitus. Material and method: A case study with qualitative design was carried out, an in-depth interview was applied using as reference the axes, categories and subcategories of the Calgary Family Valuation Model and a field diary. The data was analyzed through the technique of content analysis, the strategy of "investigator triangulation" was applied. Results: The main categories that emerged were: the importance of the role of parents in the upbringing of their children, education as a basis for self-improvement, age limitations and sequelae of a life with diabetes, love, habits and dependency and support network, a fundamental support pillar for the development of the elderly. Conclusions: The interventions of the registered nurse are oriented to favor self-care and teach to live with the new characteristics given by the consequences of their age and the complications of the pathologies that afflict them. If necessary, the social network should be strengthened, seeking family and extra-family resources to participate in the resolution of the crises that arise. Relationships with friends, neighbors and colleagues are also considered important to offer other types of help. These are established through common interests and shared activities and are essential outside the home context.

Instrumentos de avaliação da qualidade de vida de indivíduos com diabetes mellitus / Evaluation instruments of the quality of life of individuals with diabetes mellitus

Introdução: Reconhece-se que o diabetes é uma doença que, independentemente da faixa etária e da etiologia, causa impac-to negativo que compromete a qualidade de vida. A avaliação da qualidade de vida de indivíduos com doenças crônicas tem sido objeto de investigação na área da saúde, sendo considerada importante indicador dos resultados terapêuticos em diferentes situações clínicas. Objetivo: Realizar uma revisão integrativa apresentando os instrumentos utilizados para a avaliação da qualidade de vida em indivíduos com diabetes mellitus. Ma-teriais e Métodos: Foi realizada revisão integrativa nas bases de dados MEDLINE, LILACS, SCIELO, relativo aos anos de 2009 a 2017, utilizando os descritores: Diabetes Mellitus, Qua-lidade de Vida e Avaliação. Resultados: Foram selecionados sete artigos que em suas metodologias apresentaram quatro instrumentos de avaliação da qualidade de vida. Conclusão: As evidências demonstram que não existe uma padronização dos instrumentos em relação a avaliação da qualidade de vida em indivíduos com diabetes mellitus

Introduction: It is recognized that diabetes is a disease that, despite of the age and etiology, causes a negative impact that impairs the quality of life. The evaluation of chronic patients' quality of life has been the object of health researches, being considered an important indicator of the therapeutic results in different clinical situations. Objective: Perform an integrative review of the literature, presenting the instruments used for the evaluation of the quality of life in patients with Diabetes Mel-litus. Materials andMethods: It was performed an integrative review on the MEDLINE, LILACS and SCIELO databases from 2009 to 2017, using the descriptors: "Diabetes Mellitus", "Quality of Life", and "Evaluation". Results: Seven articles were selected, which methodologies presented four quality of life assessment instruments. Conclusion: The evidences show that there is no standardization regarding to the evaluation of the quality of life in patients with Diabetes Mellitus.

Perception of quality of life among people with diabetes

Diabetes is a chronic disease that affects a patient’s quality of life. This cross-sectional study aimed to determine the socio-demographic and disease profile factors associated with poor quality of life among patients with diabetes. The study was conducted at a primary health care clinic in Kuching between August to November 2010. Short Form - 36 (SF - 36) questionnaire was used to assess the quality of life of diabetic patients aged ≥ 18. A total of 142 respondents participated in the survey. After adjusting for age, those with no education scored lower at vitality (p=0.043) and emotional health (p=0.033) compared with those who have tertiary education. Those working in the private sector scored better for physical functioning (p=0.042) compared with pensioners and the unemployed. Patients with uncontrolled diabetes scored lower in the role-emotional domain (p=0.003). Participants who were on <3 (p=0.014) and ≥3 (p=0.024) oral medications had better score for role-physical than those on insulin. Those on insulin had worse score for bodily pain than those on oral medication only (vs <3 oral drugs, p=0.026; vs ≥3 oral drugs, p=0.001). Various socio-demographic factors, uncontrolled diabetes and insulin usage were found to have negative impact on a diabetic patient’s quality of life. Programmes addressing the physical and emotional needs of diabetic patients at the primary health care setting are essential to help improve their quality of life.