Programa Diabetes em Dia: aceptabilidad y viabilidad de la propuesta
DOI:
https://doi.org/10.15649/cuidarte.4268Palabras clave:
Diabetes Mellitus, Autogestión, Educación para la Salud, Salud Complementaria, Estudios de FactibilidadResumen
Introducción: El enfoque contemporáneo del cuidado de la diabetes guía la educación para el automanejo. Objetivo: Evaluar la aceptabilidad y viabilidad de la propuesta de un programa educativo para el automanejo de la diabetes tipo 2 (Programa Diabetes em Día), adaptado a los usuarios de un servicio ambulatorio de un hospital privado de la ciudad de São Paulo, Brasil. Materiales y Métodos: Estudio de evaluación de la propuesta preliminar de una intervención compleja, realizada por profesionales de la salud miembros del Grupo de Estudio de la Diabetes del hospital. Tras conocer la propuesta, se invitó a los profesionales a evaluarla mediante una escala diferencial semántica con criterios de aceptabilidad y viabilidad. Se consideraron los porcentajes de acuerdo para la evaluación, y se alcanzó el consenso cuando el acuerdo fue ≥ 89%. Resultados: Hubo consenso en que el programa era adecuado para el manejo de la diabetes tipo 2; comprensible, aceptable y eficaz; no presentaba riesgos para la persona ni para el profesional de la salud; y requería pocos recursos materiales adicionales y supervisión constante. No hubo consenso sobre la evaluación general del programa; el esfuerzo y el tiempo requeridos para su implementación; la facilidad/dificultad de implementación; la necesidad de recursos humanos adicionales; y la rentabilidad de la propuesta. Discusión: Los profesionales demostraron ser conscientes de la importancia e idoneidad del programa, reconociendo su valor y sus efectos positivos. Sin embargo, reconocieron que su implementación efectiva requeriría cambios significativos en los procesos de trabajo. Conclusión: Si bien el programa recibió una evaluación favorable en muchos criterios de aceptabilidad, presenta barreras para su implementación.
Como citar este artículo: Brevidelli, Maria Meimei; De Domenico, Edvane Birelo Lopes; Rodrigues, Gilcelli Vascom Girotto; Moura, Veronica Paula Torel de. Programa Diabetes em Dia: aceitabilidade e viabilidade da proposta. Revista Cuidarte. 2025;16(2):e4268. https://doi.org/10.15649/cuidarte.4268
Referencias
Powers MA, Bardsley J, Cypress M, Funnell MM, Harms D, Helms-Fischl A et al. Diabetes self-management education and support in type 2 diabetes: A Consensus Report of the American Diabetes Association, the Association of Diabetes Care & Education Specialists, the Academy of Nutrition and Dietetics, the American Academy of Family, Physicians, the American Academy of PAs, the American Association of Nurse Practitioners, and the American Pharmacists Association. Diabetes Educ. Aug 2020;46(4):350-369. https://doi.org/10.2337/dci20-0023
Lambrinou E, Hansen TB, Beulens JW. Lifestyle factors, self-management and patient empowerment in diabetes care. Eur J Prev Cardiol. 2019;26(2):55-63. http://doi.org/10.1177/2047487319885455
Davis J, Fischl AH, Beck J, Browning L, Carter A, Condon JE, et al. 2022 National Standards for Diabetes Self-Management Education and Support. Diabetes Care. 2022; 45(2):484–94. https://doi.org/10.2337/dc21-2396
Hermanns N, Ehrmann D, Finke‐Groene K, Kulzer B. Trends in diabetes self‐management education: where are we coming from and where are we going? A narrative review. Diabet Med. 2020;37(3):436-447. https://doi.org./10.1111/dme.14256
Siegel KR, Ali MK, Zhou X, Ng BP, Jawanda S, Proia K, et al. Cost-effectiveness of interventions to manage diabetes: has the evidence changed since 2008? Diabetes Care. 2020;43(7):1557-1592. https://doi.org/10.2337/dci20-0017
Whitehouse CR, Haydon-Greatting S, Srivastava SB, Brady VJ, Blanchette JE, Smith T, et al. Economic impact and health care utilization outcomes of diabetes self-management education and support interventions for persons with diabetes: a systematic review and recommendations for future research. J Diabetes Sci Technol. 2021;15(3):470-487. https://doi.org/10.1177/26350106211047565
Jiang X, Jiang H, Tao L, Li M. The cost-effectiveness analysis of self-efficacy-focused structured education program for patients with type 2 diabetes mellitus in Mainland China setting. Front Public Health. 202;9:767123. https://doi.org/10.3389/fpubh.2021.767123
American Diabetes Association. Facilitating behavior change and well-being to improve health outcomes: Standards of Medical Care in Diabetes - 2024. Diabetes Care 2024;47(1):S77–S110. https://doi.org/10.2337/dc24-S005
National Institute for Health and Care Excellence - NICE. Type 2 diabetes in adults. Quality Standards (QS209). NICE [Internet] 2025 [Cited 2023 March 02] Available from: www.nice.org.uk/guidance/qs209
Hadjiconstantinou M, Quinn LM, Tippins F, Schreder S, Khunti K, Davies MJ. A perspective piece on Diabetes Self-Management Education and Support (DSMES) programmes for under-represented groups with T2DM in the UK. Br J Diabetes. 2021; 21:3-10. https://doi.org/10.15277/bjd.2021.278
Sherifali D, Berard LD, Gucciardi E, MacDonald B, MacNeill G. Clinical practice guidelines self-management education and support. Diabetes Canada Clinical Practice Guidelines Expert Committee 2018. Can J Diabetes. 2018;42(1):S36–S41. https://doi.org/10.1016/j.jcjd.2017.10.006
Wheatley SD, Arjomandkhah NC, Murdoch C, Whitaker MJG, Evans NM, Hollinrake PB, et al. Improved blood glucose control, cardiovascular health and empowerment in people attending X-PERT structured diabetes education. Pract Diabetes. 2021; 38(6):31-35. https://doi.org/10.1002/pdi.2368
Lamptey R, Robben MP, Amoakoh‐Coleman M, Boateng D, Grobbee DE, Davies MJ, et al. Structured diabetes self‐management education and glycaemic control in low‐and middle‐income countries: a systematic review. Diabetic Med. 2022;39(8):e14812. https://doi.org/10.1111/dme.14812
Brevidelli MM, Bergerot CD, DeDomenico EBL. Programa Dia-D: ensaio propositivo de intervenção educativa para autogerenciamento em diabetes tipo 2. Rev Anna Nery. 2023;27:e20220291. https://doi.org/10.1590/2177-9465-EAN-2022-0291pt
Agência Nacional de Saúde Suplementar. Boletim Panorama: Saúde Suplementar [. 2 (2), 2º trimestre de 2023. Rio de Janeiro: ANS, 2023. Consulta: março 02, 2023 Disponível em: https://www.gov.br/ans/pt-br/arquivos/assuntos/noticias/copy2_of_PanoramaSaudeSuplementar_dezembro_2023.pdf
Ministério da Saúde. Vigitel Brasil 2018: Saúde Suplementar: vigilância de fatores de risco e proteção para doenças crônicas por inquérito telefônico: estimativas sobre frequência e distribuição sociodemográfica de fatores de risco e proteção para doenças crônicas para beneficiários de planos de saúde nas capitais dos 26 estados brasileiros e no Distrito Federal em 2018. Agência Nacional de Saúde Suplementar. – Brasília: 2020. Consulta: março 02, 2023. Disponível em: https://www.gov.br/ans/pt-br/arquivos/acesso-a-informacao/perfil-do-setor/dados-e-indicadores-do-setor/dados-assistenciais-e-publicacoes-relacionadas/vigitel_brasil_2018_saude_suplementar.pdf
Malta DC, Bernal RTI, Vieira Neto E, Curci KA, Pasinato MT de M, Lisbôa RM et al. Doenças Crônicas Não Transmissíveis e fatores de risco e proteção em adultos com ou sem plano de saúde. Cien Saude Colet. 2020;5(8):2973-2983. https://doi.org/10.1590/1413-81232020258.32762018
Brevidelli MM, Oliveira AB de; Rodrigues GVG, Gamba MA, De Domenico EBL. Fatores sociodemográficos, clínicos e psicossociais correlacionados ao autocuidado em diabetes. Rev Cuid. 2021;12(2):e2057. http://dx.doi.org/10.15649/cuidarte.2057
Skivington K, Matthews L, Simpson SA, Craig P, Baird J, Blazeby JM, et al. A new framework for developing and evaluating complex interventions: update of Medical Research Council guidance. BMJ. 2021;374:n2061. https://dx.doi.org/10.1136/bmj.n2061
O’Cathain A, Hoddinott P, Lewin S, Thomas KJ, Young B, Adamson J, et al. Maximising the impact of qualitative research in feasibility studies for randomised controlled trials: guidance for researchers. Pilot Feasibility Stud. 2015;1:1-13. https://doi.org/10.1186/s40814-015-0026-y
O’Cathain A, Croot L, Duncan E, Rousseau N, Sworn K, Turner KM, et al. Guidance on how to develop complex interventions to improve health and healthcare. BMJ Open. 2019;9(8):e029954. https://doi.org/10.1136/bmjopen-2019-029954
Vaughn LM, Jacquez F. Participatory Research Methods – Choice Points in the Research Process. J Particip Res Methods. 2020;1(1). https://doi.org/10.35844/001c.13244
Hoffmann TC, Glasziou PP, Boutron I, Milne R, Perera R, Moher D et al. Better reporting of interventions: template for intervention description and replication (TIDieR) checklist and guide. BMJ 2014;348:g1687. https://doi.org/10.1136/bmj.g1687
Kolb L. An Effective Model of Diabetes Care and Education: The ADCES7 Self-Care BehaviorsTM. Sci Diabetes Self Manag Care. 2021;47(1):30–53. https://doi.org/10.1177/0145721720978154
Michie S, Atkins L, West R. The behaviour change wheel: a guide to designing interventions. London: Silverback Publishing; 2014.
American Diabetes Association. Facilitating behavior change and well-being to improve health outcomes: standards of medical care in diabetes - 2022. Diabetes Care 2022;45(1):S60–S80. https://doi.org/10.2337/dc22-S005
Hildebrand JA, Billimek J, Lee J-A, Sorkin DH, Olshansky EF, Clancy SL, et al. Effect of diabetes self-management education on glycemic control in Latino adults with type 2 diabetes: A systematic review and meta-analysis. Patient Educ Couns. 2019; 103(2):266-275. https://doi.org/10.1016/j.pec.2019.09.009
Blasco-Blasco M, Puig-Garcia M, Piay N, Lumbreras B, Hernández-Aguado I, Parker LA. Barriers, and facilitators to successful management of type 2 diabetes mellitus in Latin America and the Caribbean: A systematic review. PLoS ONE. 2020; 15(9):e0237542. https://doi.org/10.1371/journal.pone.0237542
Sekhon M, Cartwright M, Francis JJ. Acceptability of healthcare interventions: an overview of reviews and development of a theoretical framework. BMC Health Serv Res. 2017;17:1-13. https://doi.org/10.1186/s12913-017-2031-8
Sekhon M, Cartwright M, Francis JJ. Development of a theory-informed questionnaire to assess the acceptability of healthcare interventions. BMC Health Serv Res. 2022;22(1):279. https://doi.org/10.1186/s12913-022-07577-3
van der Krieke L, Bird V, Leamy M, Bacon F, Dunn R, Pesola F, et al. The feasibility of implementing recovery, psychosocial and pharmacological interventions for psychosis: comparison study. Implementation Science. 2015;10:1-7. https://doi.org/10.1186/s13012-015-0262-9
Brevidelli MM. Arquivo de dados, Mendeley Data V1, 2024. doi: http://doi.org/10.17632/r4x3n68cw8.1
Taylor E. We Agree, Don’t We? The Delphi Method for Health Environments Research. HERD. 2020; 13(1):11–23. https://doi.org/10.1177/1937586719887709
Silva JAM, Mininel VA, Fernandes Agreli H, Peduzzi M, Harrison R, Xyrichis A. Collective leadership to improve professional practice, healthcare outcomes and staff well-being. Cochrane Database Syst Rev. 2022;10(10):CD013850. https://doi.org/10.1002/14651858.CD013850.pub2
Goff LM, Rivas C, Moore A, Beckley-Hoelscher N, Reid F, Harding S, et al. Healthy Eating and Active Lifestyles for Diabetes (HEAL-D), a culturally tailored self-management education and support program for type 2 diabetes in black-British adults: a randomized controlled feasibility trial. BMJ Open Diab Res Care 2021; 9:e002438. https://doi.org/10.1136/bmjdrc-2021-002438
Brady EM, Bamuya C, Beran D, Correia J, Crampin A, Damasceno A, et al. EXTending availability of self-management structured EducatioN programmes for people with type 2 Diabetes in low-to-middle income countries (EXTEND)—a feasibility study in Mozambique and Malawi. BMJ Open 2021;11:e047425. http://doi.org/10.1136/bmjopen-2020-047425
Hurley L, O’Donnell M, O’Hara MC, Carey ME, Willaing I, Daly H, et al. Is diabetes self-management education still the Cinderella of diabetes care? Patient Educ Couns. 2017;100(10):1957-1960 http://dx.doi.org/10.1016/j.pec.2017.05.026
Harrison R, Fischer S, Walpola RL, Chauhan A, Babalola T, Mears S, et al. Where Do Models for Change Management, Improvement and Implementation Meet? A Systematic Review of the Applications of Change Management Models in Healthcare. J Healthc Leadersh. 2021;13:85-108. https://doi.org/10.2147/JHL.S289176
De Paula EA, Schwartz E, Nunes BP, dos Santos BP dos, Barceló A. Análise da estrutura de serviços de saúde para o cuidado às pessoas com diabetes. R Enferm Cent O Min. 2021;11:e4400. http://doi.org/10.19175/recom.v11i0.4400
Coates V, Slevin M, Carey M, Slater P, Davies Ml. Declining structured diabetes education in those with type 2 diabetes: A plethora of individual and organizational reasons. Patient Educ Couns. 2018;101(4):696-702. https://doi.org/10.1016/j.pec.2017.10.013
Bastable SB, Gonzales KM. Overview of education in health care. In: Bastable SB, (ed.) Essentials of patient education. 5nd edition. Burlington (MA): Jones & Bartlett Learning; 2019. p. 3-33.
Ryan D, Burke SD, Litchman ML, Bronich-Hall L, Kolb L, Rinker J, et al. Competencies for diabetes care and education specialists. The Diabetes Educator 2020;46(4),384-397. https://doi.org/10.1177/0145721720931092
Conselho Federal de Enfermagem. Resolução COFEN No 734/2023. Normatiza a atividade do Enfermeiro em cuidados e educação às pessoas com Diabetes Mellitus e dá outras providências. Dec 21, 2023. SEI/COFEN - 0199930 – Resolução. Consulta: março 02, 2023. Disponível em: https://www.cofen.gov.br/wp-content/uploads/2023/12/Resolucao-Cofen-no-734-2023-NORMATIZA-A-ATIVIDADE-DO-ENFERMEIRO-EM-CUIDADOS-E-EDUCACAO.pdf
Publicado
Cómo citar
Descargas
Número
Sección
Categorías
Licencia
Derechos de autor 2025 Revista Cuidarte
Esta obra está bajo una licencia internacional Creative Commons Atribución 4.0.
Journal Cuidarte, scientific publication of open access, is licensed under a Creative Commons Attribution (CC BY-NC), which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.
Any other form of use such as reproduction, transformation, public communication or distribution, for profit, requires the prior authorization of the University of Santander UDES.
The names and e-mail addresses entered in the Journal Cuidarte will be used exclusively for the purposes stated by this magazine and will not be available for any other purpose or other person.
The articles published in the Journal Cuidarte represent the criteria of their authors and do not necessarily constitute the official opinion of the University of Santander UDES.
