Sofrimento emocional em adultos com diabetes assistidos na Atenção Primária

Abstract

Diabetes mellitus (DM) is a chronic disease characterized by insufficient insulin production or impaired insulin utilization. Adherence to treatment may be hindered by psychosocial factors, particularly emotional distress, making it essential to understand these aspects in order to develop interventions that help patients overcome barriers and improve treatment adherence. This study aimed to assess emotional distress among adults with diabetes receiving care in primary healthcare settings. A descriptive, cross-sectional study with a quantitative approach was conducted. Data were collected using a questionnaire consisting of two sections: sociodemographic and clinical information. In addition, the Depression, Anxiety, and Stress Scale (DASS-21), a validated instrument for assessing psychological distress, was administered. Statistical analyses were performed using the Mann– Whitney U test. Data were organized in electronic spreadsheets and analyzed using descriptive statistics, as well as association, comparison, and correlation tests, adopting a significance level of 5%. For categorical variables with three or more categories, the Kruskal–Wallis test was applied. Effect sizes for the Mann– Whitney U tests were estimated using the correlation coefficient r (r = Z/√N), whereas epsilon-squared (ε²) was calculated for Kruskal–Wallis analyses. The sample consisted of 194 participants assisted by the Family Health Strategy in the municipality of São Gonçalo do Amarante, Ceará, Brazil. The findings demonstrated that emotional distress among individuals with diabetes was primarily associated with hypertension and poor glycemic control, while weaker associations were observed with socioeconomic factors and excess body weight. In contrast, sex, age, educational level, insulin therapy, physical activity, oral antidiabetic medication use, and the presence of comorbidities showed no significant association with the psychological outcomes investigated. These results suggest that specific clinical factors exert a greater influence on emotional distress than isolated sociodemographic characteristics.