Avaliação de um programa educativo sobre adesão ao tratamento do diabetes mellitus tipo 1 em crianças, adolescentes e seus responsáveis

Abstract

Diabetes mellitus type 1 (DM1) is a chronic disease that requires medication, education about the disease and its management. It also requires a close relationship between patients, family and health care team. Objective: To evaluate an educational program on the treatment compliance of diabetes mellitus type 1 by children, adolescents and their caregivers. Patients and Method: After the Research Ethics Committee approved the project, children and adolescents (aged 6 to 18, both genders) diagnosed with DM1 and treated at the Pediatric Endocrinology outpatient clinics, Hospital de Base, a public hospital in São José do Rio Preto, SP. All of them agreed with their parents or responsible to participate in the study. Patients, who met the criteria according to the study, received a structured educational program (5 sessions) and the regular treatment offered by the medical institution (intervention group/IG) or received only the regular treatment offered by the medical institution (controlled group/CG). The following procedures and forms were used: Identification form and medical evaluation of the disease; Child Depression Inventory (CDI); Parental Bonding Instrument (PBI);Diabetes impact on the family; Measurement of emotional adjustment on patients with diabetes; Inventory of Stress Symptoms on Adults of LIPP (ISSL); Inventory of Beck Depression – (BDI-II); The Zarit Burden Interview; Survey of abilities not related to diabetes (parents´ form); Inventory of behavior to children and teenagers (CBCL6/18); Inventory of behavior to children and teenagers between 6 to 18 years old – Teacher´s form (TRF). Results: After the participation in the program, the IG presented an improvement on glycated hemoglobin as compared to CG and IG before intervention. The children and the adolescents, after intervention had some improvement on parental style evaluation, the diabetes impact and on the measurement of emotional adjustment. There were no depression symptoms even before they took part in the IG. The caregivers after GI, had better results on the symptoms of depression; stress; disease impact; on the evaluation of their children's skills not-related to diabetes as well as on the burden of the disease. Some improvement on children's behavior as well as on the results of teachers´ evaluation could be observed. Conclusion: The educational program was associated with treatment compliance of Diabetes mellitus type 1 in children, adolescents and their legal responsible. The results pointed out the need of educational groups to cope with patients and their caregivers for a better way to deal with DM1 and the compliance to the treatment.