Open Access Peer-Reviewed
Review Article

Educational practices in diabetic patient and perspective of health professional: a systematic review

Práticas educativas no paciente diabético e perspectiva do profissional de saúde: uma revisão sistemática

Roxana Claudia Condori Iquize; Fabrício Claudino Estrela Terra Theodoro; Karla Andréa Carvalho; Manuela de Almeida Oliveira; Jônatas de França Barros; André Ribeiro da Silva

DOI: 10.5935/0101-2800.20170034

ABSTRACT:

This systematic review has sought to identify the multidisciplinary scientific production, addressing factors for proper diabetes mellitus management focusing on health education, from the perspective of the patient and the professional. The goal was to synthesize the knowledge produced and point out its implications for the practice of patient care. A search was conducted in PubMed, Medline, SCOPUS, LILACS and BIREME. The intervention programs present methodologies and different structures, although the theoretical basis is education for self-management. The evaluation methodologies for effectiveness of educational programs focused on the number of subscriptions and stay in groups. Some studies also evaluated psychological, social and pathophysiological parameters. The results show qualitative improvements in self-care, humanization in care, and quality of life of patients. The evidence shows that there seems to be a positive response to the intervention programs whenever comparing the physiological, psychological, educational and social parameters, initial and final of the studies.

Keywords:
diabetes mellitus ; health education; knowledge; self care.

RESUMO:

Esta revisão sistemática procurou identificar a produção científica multiprofissional, que aborde fatores para o adequado manejo do diabetes mellitus com enfoque na educação em saúde, na perspectiva do paciente e do profissional. O objetivo foi sintetizar o conhecimento produzido e apontar suas implicações na prática do atendimento ao doente. Foi realizada uma busca nas bases de PubMed, Medline, SCOPUS, LILACS e BIREME. Os programas de intervenção apresentam metodologias e estruturas distintas, embora a base teórica seja a educação para autogestão. As metodologias de avaliação da eficácia dos programas educativos incidiram no número de adesões e permanência nos grupos. Alguns estudos também avaliaram parâmetros psicológicos, fisiopatológicos e sociais. Os resultados mostram ganhos qualitativos no autocuidado, na humanização do atendimento, e na qualidade de vida dos pacientes. As evidências apontam que parece haver uma resposta positiva aos programas de intervenção quando comparados os parâmetros fisiológicos, psicológicos, educativos e sociais, iniciais e finais dos estudos.

Palavras-chave:
diabetes mellitus ; educação em saúde; conhecimento; autocuidado.

Citation: Iquize RCC, Theodoro FCET, Carvalho KA, Oliveira MA, Barros JF, Silva AR. Educational practices in diabetic patient and perspective of health professional: a systematic review. J Bras Nefrol 39(02):196. doi:10.5935/0101-2800.20170034
Received: May 04 2016; Accepted: June 05 2016

INTRODUCTION

Diabetes mellitus (DM) is a chronic disease that manifests when the pancreas cannot produce enough insulin or the body is unable to effectively use the insulin synthesized in the pancreas. DM causes blood glucose levels to increase (hyperglycemia).1

Chronic hyperglycemia introduces macroangiopathic complications such as ischemic heart disease (IHD), peripheral vascular disease (PVD), and stroke. Microangiopathic complications such as diabetic retinopathy (DR), diabetic nephropathy (DN), and distal sensory neuropathy (DSN) may also occur. Higher death rates have been observed in diabetic patients presenting atherosclerotic involvement of the coronary arteries of the lower limbs and of the cerebral arteries.2

Published numbers have shown that diabetes mellitus has attained the status of an epidemic. At a global level, an estimated 30 million adults had DM in 1985; the number grew to 135 million in 1995 and to 173 million in 2002. Forecasts indicate that 300 million will have DM in 2030. This increase has occurred mainly as a consequence of population growth and aging, greater urbanization, higher incidences of obesity and sedentary lifestyles, and the longer survival of patients with DM.3,4

As in other diseases, education plays a key role in the treatment of DM and in the management of the condition by the patients themselves. Since DM is a chronic disease, treatment success relies heavily on patient accountability and awareness over the restrictions imposed by the condition, in addition to the need for patients to manage their glucose levels. A wide array of educational interventions has been tested in patients with DM. Nonetheless, a universally effective model for patients with the disease is yet to be developed.5

Self-management education should reach every individual with DM. With that in mind, the National Standards for Diabetes Self-Management Education (DSME) were published in 2006 to improve the quality of the education and provide patients with DM in different settings with evidence-based information.6

Health education is recognized as an effective self-management capacity building tool, in which patients are empowered to play an active role in the management of their conditions. Defined as a means to help individuals trust their own ability to care for themselves, this approach aims to maximize the resources available and the responsibility each individual has for changing his attitude toward promoting health status improvements. The four main pillars of Empow