Fatores relacionados aos estágios de mudança de comportamento em saúde de adolescentes com diabetes tipo 1

Abstract

The study aimed to investigate the factors related to the stages of behavioral change in health of adolescents with Type 1 Diabetes users from a Diabetes outpatient clinic. Observational, descriptive, cross-sectional research performed in a pediatric outpatient clinic of a reference hospital in the city of Fortaleza. Adolescents aged 10 to 19 years were followed up for at least 1 month. An individual interview was carried out using an instrument, previously validated for collection, considering sociodemographic, clinical data, health self-care activities and stages of behavior change and social support. The study had as theoretical support the transtheoric model. The research was approved by the Research Ethics Committee under opinion 2.266777. 97 adolescents participated in the study, in which the prevalent age range was from 13 to 15 years. The mean time to diagnosis of diabetes was over 1.1 to 3 years, with income from 1501 to 2500 reais. Regarding health aspects, almost 80% of the participants already had a history of previous hospitalization. Less than half of adolescents attended diabetes education groups. The mean value of glycated hemoglobin was 7.22%. On glycemic monitoring, the vast majority reported doing 4 to 7 days a week, similar data when questioned about insulin application. Concerning the stages of behavior change (EMC), there was predominance, with more than 50% of the adolescents, in the maintenance phase, with the exception of self-care physical activity, in which this phase corresponded to 37%. When correlating the socio-demographic data with CMEs to identify factors that could influence them, it was obtained that for self-care healthy eating, the factors that presented statistical significance were age, diagnosis time and family income, factors significant for self-care physical activity, but for this was added the factor years of study. Regarding glycemic monitoring, the factors were age, diagnosis time and years of study, the same for insulin therapy with the exception of income. When correlating the value of glycated hemoglobin (HB1Ac) with self-care activities and stages of behavior change in the transtheoric model, it was found that young people who said they had healthy eating had lower HB1Ac levels than those who said they did not have the practice of healthy eating, a similar result for those who practice physical activity that have lower glycation rates. With regard to social support, for all self-care activities, the results show that adolescents in the maintenance phase have the highest average family support and friends. The study revealed that there are several factors that can interfere in the individual's behavior change for a given self-care, with emphasis on the importance of personalizing educational interventions with the goal of achieving greater effectiveness in behavior change awareness or strategies for maintaining this behavior.