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Perceção de Funcionalidade Familiar, Conhecimento e Atividades de Autocuidado em Utentes com Diagnóstico de Diabetes Mellitus
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Abstract(s)
O presente relatório descreve o Estágio de Natureza Profissional, realizado entre 1 de outubro de 2024 e 31 de março de 2025, na USF Santa Clara, com o propósito de analisar o desenvolvimento de competências especializadas em enfermagem comunitária na área de enfermagem de saúde familiar. Como parte integrante deste percurso, é apresentado o estudo de investigação, intitulado "Perceção de Funcionalidade Familiar, conhecimento e atividades de autocuidado em utentes com diagnóstico de Diabetes Mellitus". O estudo, de natureza quantitativa, observacional, descritivo- correlacional e transversal, teve como objetivo analisar a relação entre variáveis sociodemográficas, clínicas e a perceção de funcionalidade familiar, o conhecimento e o autocuidado em 210 utentes das USF Santa Clara e Aqueduto. Os dados foram recolhidos entre 14 de fevereiro e 14 de março de 2025, através de um formulário que incluiu o questionário sociodemográfico e clínico e três escalas validadas: APGAR Familiar (Agostinho & Rebelo, 1998), a Escala de Atividade de Autocuidado com a Diabetes (Bastos, 2004) e o Questionário de Conhecimentos sobre a Diabetes (Bastos et al., 2007). Os dados foram analisados com o software R (versão 4.4.2). Os resultados revelaram uma amostra predominantemente masculina e envelhecida, com baixa escolaridade, casados ou em união de facto e com várias patologias além da DM. A maioria dos participantes (77,1%) percecionou alta funcionalidade familiar. A nível de conhecimentos, apresentaram um total de respostas corretas de 57,9%. Nas atividades de autocuidado, demonstraram uma elevada frequência de lavagem com os pés, com média de 6,55 dias/semana e adesão à medicação alta, com média de 6,66 dias/semana. Os principais resultados indicaram que o estado civil (p=0,036) e o nível de escolaridade (p=0,037) se associaram estatisticamente com a perceção de funcionalidade familiar. A presença de múltiplas patologias também se correlacionou com uma maior perceção de funcionalidade (p<0,001). Em relação ao autocuidado, verificaram-se associações estatisticamente significativas com o sexo feminino (U=6494,50 p=0,02) e o nível de escolaridade em dimensões específicas como a alimentação geral (H= 11,98 p=0,01), a atividade física (H=9,06 p=0,03) e a adesão à medicação (H=8,23 p=0,04). O número de patologias diagnosticadas associou- se de forma inversa ao autocuidado total (H=10,64 p=0,01) e à atividade física (H=18,65 p<0,001). Foi identificada uma relação estatisticamente significativa entre o conhecimento sobre a DM e o autocuidado (r=0,28 p<0,001). Embora a funcionalidade familiar não se tenha associado ao autocuidado total (U=4517,5 p=0,0888), revelou uma correlação negativa estatisticamente significativa com a monitorização da glicemia (r=-0,15; p=0,029) e uma correlação positiva estatisticamente significativa com os cuidados com os pés (r=0,19; p=0,0067). A realização deste estudo, em estreita articulação com a prática clínica, contribuiu de forma indissociável para o desenvolvimento de competências fundamentais para o enfermeiro mestre e especialista em enfermagem comunitária na área de enfermagem de saúde familiar. Através de uma abordagem guiada pelo referencial teórico MDAIF, a autora consolidou a sua capacidade de avaliar a família como unidade de cuidados, de forma ética e holística, e de liderar processos de intervenção centrados na pessoa e na família. Esta experiência reforçou a importância da prática baseada na evidência, da gestão dos cuidados e da colaboração interprofissional para a prestação de cuidados de qualidade, personalizados e eficazes. Os resultados reforçam, assim, a necessidade de intervenções ajustadas ao contexto familiar para capacitar os utentes na gestão da DM, o que se alinha diretamente com as competências da especialidade.
This report describes the Professional Internship, undertaken between October 1, 2024, and March 31, 2025, at the Santa Clara Family Health Unit, to analyze the development of specialized competencies in community nursing within the scope of family health nursing. As part of this pathway, the research study entitled "Perception of Family Functioning, Knowledge, and Self-Care Activities in Patients Diagnosed with Diabetes Mellitus" is presented. This was a quantitative, observational, descriptive-correlational, and cross-sectional study aimed to analyze the relationship between sociodemographic and clinical variables and the perception of family functioning, knowledge, and self-care activities in 210 patients from the Santa Clara and Aqueduto Family Health Units. Data were collected between February 14 and March 14, 2025, using a questionnaire that included the Family APGAR, the Diabetes Knowledge Questionnaire-24, and the Summary of Diabetes Self-Care Activities. Statistical analyses were performed using R software (version 4.4.2).The sample was predominantly male, older, with low educational attainment, most were married or in common-law partnerships, and presented multiple chronic conditions in addition to diabetes mellitus. Most participants (77.1%) perceived high family functionality. The mean percentage of correct answers in diabetes knowledge was 57.9%. For self-care, participants reported a high frequency of foot care (mean 6.55 days/week) and medication adherence (mean 6.66 days/week). The main results showed statistically significant associations between marital status (p=0.036), education level (p=0.037), and perceived family functionality. The presence of multiple comorbidities was also correlated with higher family functionality (p<0.001). Regarding self-care, significant associations were observed with female sex (p=0.02) and education level, particularly in the domains of general diet (p=0.01), physical activity (p=0.03), and medication adherence (p=0.04). The number of comorbidities was inversely associated with overall self-care (p=0.01) and physical activity (p<0.001). A strong positive association was identified between diabetes knowledge and self-care (p<0.001). Although family functionality was not associated with overall self-care (p=0.0888), it demonstrated a negative Spearman correlation with blood glucose monitoring (r = -0.15; p=0.029) and a positive Spearman correlation with foot care (r = 0.19; p=0.0067). This study, closely linked to clinical practice, contributed to the development of essential competencies for advanced practice nurses specializing in community and family health nursing. Guided by the MDAIF theoretical framework, the author strengthened the ability to assess the family as a unit of care, ethically and holistically, and to lead person-and family-centered interventions. The findings highlight the importance of evidence-based practice, care management, and interprofessional collaboration in delivering high-quality, tailored, and effective care. They also reinforce the need for family-centered nursing interventions to empower patients in the management of diabetes, directly aligning with the competencies of the specialty.
This report describes the Professional Internship, undertaken between October 1, 2024, and March 31, 2025, at the Santa Clara Family Health Unit, to analyze the development of specialized competencies in community nursing within the scope of family health nursing. As part of this pathway, the research study entitled "Perception of Family Functioning, Knowledge, and Self-Care Activities in Patients Diagnosed with Diabetes Mellitus" is presented. This was a quantitative, observational, descriptive-correlational, and cross-sectional study aimed to analyze the relationship between sociodemographic and clinical variables and the perception of family functioning, knowledge, and self-care activities in 210 patients from the Santa Clara and Aqueduto Family Health Units. Data were collected between February 14 and March 14, 2025, using a questionnaire that included the Family APGAR, the Diabetes Knowledge Questionnaire-24, and the Summary of Diabetes Self-Care Activities. Statistical analyses were performed using R software (version 4.4.2).The sample was predominantly male, older, with low educational attainment, most were married or in common-law partnerships, and presented multiple chronic conditions in addition to diabetes mellitus. Most participants (77.1%) perceived high family functionality. The mean percentage of correct answers in diabetes knowledge was 57.9%. For self-care, participants reported a high frequency of foot care (mean 6.55 days/week) and medication adherence (mean 6.66 days/week). The main results showed statistically significant associations between marital status (p=0.036), education level (p=0.037), and perceived family functionality. The presence of multiple comorbidities was also correlated with higher family functionality (p<0.001). Regarding self-care, significant associations were observed with female sex (p=0.02) and education level, particularly in the domains of general diet (p=0.01), physical activity (p=0.03), and medication adherence (p=0.04). The number of comorbidities was inversely associated with overall self-care (p=0.01) and physical activity (p<0.001). A strong positive association was identified between diabetes knowledge and self-care (p<0.001). Although family functionality was not associated with overall self-care (p=0.0888), it demonstrated a negative Spearman correlation with blood glucose monitoring (r = -0.15; p=0.029) and a positive Spearman correlation with foot care (r = 0.19; p=0.0067). This study, closely linked to clinical practice, contributed to the development of essential competencies for advanced practice nurses specializing in community and family health nursing. Guided by the MDAIF theoretical framework, the author strengthened the ability to assess the family as a unit of care, ethically and holistically, and to lead person-and family-centered interventions. The findings highlight the importance of evidence-based practice, care management, and interprofessional collaboration in delivering high-quality, tailored, and effective care. They also reinforce the need for family-centered nursing interventions to empower patients in the management of diabetes, directly aligning with the competencies of the specialty.
Description
Keywords
Diabetes Mellitus Funcionalidade familiar Enfermagem de saúde familiar Health literacy