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Pensar Enfermagem / v.28 n.sup / October 2024
DOI: 10.71861/pensarenf.v28iSup.355
Abstract
Introduction
Due to its complexity, type 2 diabetes mellitus (T2DM) requires people to adopt different
self-care behaviors. The domains of self-care: medication adherence, blood glucose testing,
diet, physical activity, and self-monitoring are essential in its management.1 Identifying
barriers to self-care is crucial to controlling T2DM2.²
Objective
Identify the main barriers to self-care for people with T2DM.
Methods
A cross-sectional descriptive study was conducted between September 2022 and March
2023 in a primary healthcare setting, involving 365 people with T2DM. Data was collected
using a questionnaire, categorized based on the COM-B model of behavior (B) change
(capability (C), opportunity (O), and motivation (M))³, and analyzed using descriptive
statistics.
Results
Of the sample, 66.9% (n=244) reported barriers in at least one of the self-care domains.
Diet (58.5%) and physical activity (47.2%) were the most reported barriers. For diet,
psychological capability (lack of knowledge) accounted for 12.3%, and automatic motivation (lack
of will) for 22.7%. For physical activity, physical capability (pain, age) was the most frequently
mentioned barrier (21.4%), followed by the category of automatic motivation (lack of will) with
14.5%. In medication management (6.9%), psychological capability (forgetfulness) was reported
by 5.9%, and physical opportunity (access to the prescription) by 1.1%. In the self-monitoring
domain, psychological capability (lack of knowledge) was the most common barrier (3.9%), and
in blood glucose testing, automatic motivation (fear) was 6.3%.
Conclusion
Knowledge of the barriers to self-care in T2DM enables the development of targeted
interventions by health professionals and informed health policies. This study provides a
substantial, person-centered contribution to positively impacting the management and
metabolic control of T2DM.
Keywords
Self-care; Type II Diabetes Mellitus; Barriers; Cross-Sectional Study; Behavior Change
Techniques.
References
1. Protheroe J, Rowlands G, Bartlam B, Levin-Zamir D. Health literacy, diabetes
prevention, and self-management. J Diabetes Res [Internet] 2017 [cited 2024 07 26];
2017:1298315. Available from: https://doi.org/10.1155/2017/1298315
2. Rushforth B, McCrorie C, Glidewell L, Midgley E, Foy R. Barriers to effective
management of type 2 diabetes in primary care: qualitative systematic review. Br J Gen
Pract. [Internet] 2016 Feb [cited 2024 07 27]; 66(643):e114-27. Available from:
https://doi.org/10.3399/bjgp16X683509
3. Michie S, van Stralen MM, West R. The behaviour change wheel: a new method for
characterising and designing behaviour change interventions. Implementation S
[Internet] 2011 Apr 23 [cited 2024 07 27];6(42). Available from:
https://doi.org/10.1186/1748-5908-6-42
Barriers to Self-care for People with Type 2 Diabetes
Mellitus: a Descriptive Cross-sectional Study
Dulce Oliveira1
orcid.org/0000-0003-4685-3458
Maria Adriana Henriques2
orcid.org/0000-0003-0288-6653
Paulo Nogueira3
orcid.org/0000-0001-8316-5035
Andreia Costa4
orcid.org/0000-0002-2727-4402
1 Doutoranda no Programa de Doutoramento em
Enfermagem, Escola Superior de Enfermagem de
Lisboa (ESEL)/Universidade de Lisboa (UL), Lisboa;
Centro de Investigação, Inovação e Desenvolvimento
em Enfermagem (CIDNUR), Lisboa; Instituto de
Saúde Ambiental (ISAMB), Faculdade de Medicina de
Lisboa (FMUL), Lisboa; Cuidados de Saúde Primários
(UCSP Brandoa), Unidade Local de Saúde
Amadora/Sinta, Amadora, Portugal.
2 Departamento de Saúde Comunitária, Escola
Superior de Enfermagem de Lisboa (ESEL), Lisboa;
Instituto de Saúde Ambiental (ISAMB), Faculdade de
Medicina de Lisboa (FMUL), Lisboa; TERRA
Laboratório para a Sustentabilidade do Uso da Terra e
dos Serviços de Ecossistemas, Departamento
Sociedade e Saúde Ambiental, Lisboa, Portugal.
3 Instituto de Saúde Ambiental (ISAMB), Faculdade de
Medicina de Lisboa (FMUL), Lisboa; TERRA
Laboratório para a Sustentabilidade do Uso da Terra e
dos Serviços de Ecossistemas, Departamento
Sociedade e Saúde Ambiental, Lisboa, Portugal.
4 Departamento de Saúde Comunitária, Escola
Superior de Enfermagem de Lisboa (ESEL), Lisboa;
Instituto de Saúde Ambiental (ISAMB), Faculdade de
Medicina de Lisboa (FMUL), Lisboa; TERRA
Laboratório para a Sustentabilidade do Uso da Terra e
dos Serviços de Ecossistemas, Departamento
Sociedade e Saúde Ambiental, Lisboa, Portugal.
Corresponding author:
Dulce Oliveira
E-mail: dulce.oliveira@campus.esel.com