Empoderamento na educação em grupo de diabetes na atenção primária à saúde

Abstract

Chronic Diabetes feature requires that group education targeted users with diabetes, consider the complexity of the illness and living with the disease and seek to meet their real needs, which involves the identification and recognition of the importance of sociodemographic factors (age, sex, level of education) or clinical (exchange glycohemoglobin) that can influence the education and empowerment process. From the identification of these factors will be possible to better understand the users that will be involved in the education group and then plan activities and its development in context. The empowerment approach in diabetes is based on the principles of Paulo Freire, for whom learning occurs through questioning of everyday life and considers education with a transformative and liberating action. In group education for diabetes self-care empowerment is defined as a process by which health professionals assist the user in the discovery and development of their ability to take responsibility for self-care with diabetes as well as collaborate in building knowledge necessary for making informed daily also related to self-care decisions. This approach has proven effective in supporting users with diabetes to take responsibility for the care of their health, in partnership with professionals. This study aimed to determine the effects of group education on the level of empowerment in diabetes association and empowerment with glycohemoglobin and sociodemographic variables, and describe the group education as an educational practice for empowerment in diabetes. This is kind of the cluster randomized study conducted in eight Basic Health Units in Belo Horizonte, Minas Gerais. Participated in the study 77 users with the Diabetes Intervention group and 113 in the control group. In the Intervention Group, group education included four meetings , with the participation of 10 users on average each lasting approximately 90 minutes . The contents discussed in each group were approached through games, play and interactive and dynamic approach based on empowerment . Users in the control group was given the educational booklet about diabetes: Knowing Diabetes Mellitus, but the playbook has not been discussed. To collect data on diabetes two instruments were used, Diabetes Empowerment Scale with 28 questions and Self-Management of Diabetes Care with eight issues, including a semi-structured script with information about sociodemographic data. Whereas the sociodemographic and clinical characteristics in both intervention and control groups, it was found that most users were female, and 72.7 % and 66.7 %, respectively, lived with a partner, duration of disease above ten years or more, was elderly and inactive in relation to occupation. Users of the intervention group participated in four meetings in the education group based in empowerment approach. Observed in group education users were shared the experiences of attempting to put into practice the goals set for self-care, discussed the barriers and alternatives to overcome them. Users of the intervention group showed higher scores of empowerment and self-care compared to the control group. Within the Intervention Group users Female sex, inactive and literate are more empowered, with p<0.05. Recognizing the benefits of empowerment approach, it is essential to consider the factors that affect this process and then develop effective interventions to cooperate to empower users with diabetes to enable them to actively participate in managing their health.