O cuidado ao paciente diabético na atenção primária: o papel das práticas de colaboração interprofissional em saúde

Abstract

Introduction: Care for the patient with diabetes in primary health care (PHC) needs to be constantly improved, with interprofessional practices and continuing education in health indicated for this purpose. Objectives: To evaluate the practices of interprofessional collaboration in the care of patients with diabetes mellitus 2 (DM2) in PHC. To share with family health strategy team, educational support in assisting diabetic patients. To determine the variation of the competences in the care to the diabetic user and the satisfaction of the health professionals with the intervention. Material and Methods: This is a quantitative, prospective and interventional study in diabetes lasting six months. The intervention was in a family health unit (FHU) of Votuporanga (SP), Brazil. Clinical data were obtained from the patients and questionnaires were used to assess attitudes and adherence to the treatment of patients, knowledge (DKN-A) and psychological parameters (ATT-19). The institutional capacity for DM2 care was assessed by ACIC. The perception of health professionals about the effect of the process applied in their practice of diabetes care was verified by a questionnaire developed for this research, characterized as retrospective pre-pos intervention and applied after the end of the intervention. For the comparison of the before and after results the t or Wilcoxon test was used. Results: The samples had 39 diabetic patients and 17 health professionals. The mean age of the patients was 66,7±11,1 years. The DKN-A score increased from 7,3±4,0 to 9,0±2,2 (p = 0,008); in ATT-19 the score ranged from 56,3±8,4 to 54,5± 6,5 (p = 0,53); and in the SCSCA of 2,8±2,6 to 3,3±2,3 (p = 0,004). The estimated glycated hemoglobin increased from 7,5%±1,9 to 6,8±1,5 (p = 0,007). The health institution under intervention went from 2,6 in the ACIC to 7,2 (on a scale of zero to 11, p = 0,00). The scores reported retrospectively by professionals as initial and final were, respectively, 25,2±5,5, and 36,1±4,8 (p = 0,001). Discussion / Conclusion: When interpreting the binomial institution / health professionals - patients with diabetes, users improved their understanding of the disease, self - care actions and metabolic control, without improving their acceptance and psychological adjustment of their disease. There was an improvement in the capacity perceived by the USF as a health institution and by its professionals, who appropriated the proposed work process