RESUMO
Introdução: As úlceras em membros inferiores representam uma das complicações mais devastadoras do Diabetes Mellitus (DM), devido à elevada mortalidade, alterações na qualidade de vida e prolongamento do tratamento hospitalar ou ambulatorial. Objetivo: Avaliar o conhecimento e as atitudes de portadores de DM tipo II com relação aos autocuidados com os pés. Métodos: Trata-se de um estudo transversal descritivo realizado em pacientes diabéticos frequentadores do Centro Integrado de Diabetes e Hipertensão (CIDH). Avaliou-se a condição dermatológica, estrutural, circulatória, neuropática motora e neuropático-sensitiva mediante a realização do exame físico dos pés e posterior anamnese clínica. Resultados: Dos 235 pacientes entrevistados, 83,8% tiveram a sensibilidade vibratória dorsal presente e 58,3% tiveram a sensibilidade protetora plantar preservada. Quanto à estratificação do risco para desenvolvimento do pé diabético, verificou-se predominância do grau 0 (57,9%), seguido pelo grau 1 (23%) e 3 (10,6%). Observou-se um número expressivo de pacientes com conhecimento insuficiente (49,8%) em relação aos autocuidados para prevenção do pé diabético. No momento da aplicação do instrumento, constatou-se um significativo índice de desconhecimento dos diabéticos com relação ao tipo, formato e material dos calçados adequados, bem como em relação à maneira correta de cortar as unhas. Conclusão: Este estudo permitiu avaliar o conhecimento, as atitudes e a prática do paciente diabético em relação à execução de medidas de autocuidado com os pés, considerando-se os parâmetros essenciais para a ponderação do diagnóstico educacional da amostra estudada.
Introduction: Ulcers in lower limbs represent one of the most devastating complications of Diabetes Mellitus (DM) due to high mortality, changes in quality of life and extension of hospital or outpatient treatment. Objective: Evaluate the knowledge and attitudes of patients with DM type II in relation to self-care with the feet. Materials and methods: This is a cross-sectional study conducted in diabetic patients attended at the Integrated Center for Diabetes and Hypertension. We evaluated the dermatological, the structural, the circulatory, the motor and the sensitive condition by means of the physical examination of the foot and subsequent clinical history. Results: Of 235 interviewed patients, 83.8% had the dorsal vibratory sensitivity preserved and 58.3% had protective sensation plant preserved. As for the stratification of risk for development of diabetic foot, there was a predominance of grade 0 (57.9%), followed by grade 1 (23%) and 3 (10.6%). There were a significant number of patients with insufficient knowledge (49.8%) in relation to self-care for the prevention of diabetic foot. At the time of application of the instrument, a significant unawareness of the type, shape and materials of appropriate footwear, and of the proper way to cut the nails was found. Conclusion: This study allowed us to evaluate the knowledge, attitudes and practice of diabetic patients regarding the implementation of self-care measures with their feet, considering the essential parameters for consideration of the sample's educational diagnosis.
Assuntos
Diabetes Mellitus , Autocuidado , Pé DiabéticoRESUMO
La diabetes mellitus constituye un problema global de salud. Ha sido estimada la existencia de 120 millones de diabéticos. Una de las principales complicaciones de la diabetes mellitus, la retinopatía diabética se sitúa entre las más importantes causas de ceguera en Cuba. Se realizó un estudio longitudinal prospectivo para aplicar por primera vez una estrategia terapéutica en adultos mayores con retinopatía diabética y así mejorar su calidad visual; en la consulta de retina del servicio de oftalmología del hospital provincial general Docente Dr Antonio Luaces Iraola de Ciego de Ávila. La muestra fue de 180 pacientes. Se utilizaron variables de interés que se vertieron en una historia clínica previamente confeccionada al efecto. El grupo de edad más afectado fue el de 60-69 años y el sexo predominante fue el femenino. La hipertensión arterial fue el antecedente patológico personal más referido y la catarata como antecedente ocular. La gravedad de la retinopatía fue incrementándose con la edad de los pacientes. Se aplicó a todos los ojos triamcinolona subtenoniana, Grid macular y Panfotocoagulación con láser, lográndose mejorar considerablemente la agudeza visual de los mismos. Se evaluó el grado de satisfacción según escala, los pacientes refirieron estar satisfechos con el tratamiento
Diabetes mellitus is a global health problem. It has been estimated that there are 120 million diabetics. One of the main complications of diabetes mellitus, diabetic retinopathy is among the leading causes of blindness in Cuba. A prospective longitudinal study was carried out to apply for the first time a therapeutic strategy in elderly with diabetic retinopathy and improve visual quality, in the retina consultation of Ophthalmology service of Provincial General Teaching Hospital Dr Antonio Luaces Iraola Ciego Avila. The sample consisted of 180 patients. Variables of interest were used that poured into a clinical history previously drawn up. The age group most affected was 60-69 years and female was the predominant sex. Hypertension was the antecedent personal medical history most referred and eye cataracts as ocular history. The severity of retinopathy was increasing with age of the patients. It was applied to all eyes Tenon triamcinolone, macular grid and laser photocoagulation, achieving significant improvement in visual acuity of them. It assessed satisfaction degree by scale, patients reported being satisfied