Influencia de las variables neuropsicológicas y psicológicas en la adherencia al tratamiento en la DM2
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Fecha
2017-03
Autores
Benítez-Agudelo, Juan Camilo
Barceló-Martínez, Ernesto
Gelves-Ospina, Melissa
Díaz-Bernier, Alejandro
Orozco-Acosta, Erick
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Editor
Academia Mexicana de Neurología A.C.
Resumen
Introducción: La diabetes mellitus es la patología metabólica
más prevalente a nivel mundial. La “adherencia al tratamiento” es
determinante en el control metabólico de la misma y se describe
como la acción de involucrarse activa y voluntariamente en el manejo
de la enfermedad.
Objetivos: Determinar la influencia de variables neuropsicológicas
y psicológicas en la adherencia al tratamiento de pacientes con
diabetes tipo 2.
Métodos: Se evaluaron 60 sujetos: 30 con diabetes controlada
(DC) y 30 con diabetes no controlada (DNC), remitidos por centros
diabetologícos en la ciudad de Barranquilla, entre julio y noviembre
de 2015, a los cuales se les realizó evaluación neuropsicológica, de
percepción de salud (cuestionario de salud general de goldberg,
GHQ-28) y de adherencia al tratamiento (escala de adherencia al
tratamiento en diabetes mellitus tipo II: EATDM-III). El abordaje
metodológico fue descriptivo transversal, con análisis de casos y
controles, la selección de la muestra fue intencional no probabilística.
Se utilizó la prueba de U de mann-whitney y el modelo de regresión
lineal para realizar el análisis.
Resultados: observamos compromiso significativo de la
atención, memoria y funciones ejecutivas en los pacientes con
DNC. Encontramos diferencia significativa entre ambos grupos en
los puntajes de la escala (EATDM-III), en: ejercicio físico, higiene y
autocuidado, dieta y valoración de la condición física. Se identificó que
la variable ansiedad-insomnio tienen un riesgo de 0.771 (p=0.035),
que puede influir en la adherencia al tratamiento.
Conclusiones: Factores como: ejercicio físico,
higiene y autocuidado, dieta y valoración de la
condición física son fundamentales en el control
metabólico estos pacientes. De igual manera,
variables psicológicas (ansiedad-insomnio) son
determinantes en la adherencia al tratamiento
en este grupo de pacientes, los cuales; al
ser potencialmente modificables deben ser
considerados y controlados tempranamente en
cualquier esquema terapéutico.
Introduction: Diabetes mellitus is the most prevalent metabolic disease worldwide. “Adherence to treatment” is critical in the metabolic control of it and described as the action actively and voluntarily engages in the management of the disease. Objective: To determine the influence of neuropsychological and psychological variables in adherence to treatment of patients with type 2 diabetes. Methods: 60 subjects were evaluated: 30 with controlled diabetes (DC) and 30 with uncontrolled diabetes (DNC), submitted by centers-diabetes in the city of Barranquilla, between July and November 2015, to which underwent neuropsychological assessment, perception of health (general health questionnaire Goldberg, GHQ-28) and adherence to treatment (scale adherence treatment of type II Diabetes Mellitus: EATDMIII). The methodological approach was transversal descriptive, casecontrol analysis, selection of the sample was not probabilistic intentional. U test of Mann-Whitney and linear regression model was used to perform the analysis. Results: We observed significant commitment of attention, memory and executive functions in patients with DNC. We found a significant difference between the two groups in scores on the scale (EATDMIII), in: exercise, hygiene and selfcare, diet and fitness assessment. It was identified that anxiety-insomnia variable has a risk of 0.771 (p=0.035), which may influence adherence to treatment. Conclusions: Factors such as physical exercise, hygiene and self-care, diet and fitness assessment are fundamental in metabolic control these patients. Similarly, psychological variables (anxiety-insomnia) are determining adherence to treatment in this group of patients, which; being potentially modifiable they must be considered and controlled early in any therapeutic regimen.
Introduction: Diabetes mellitus is the most prevalent metabolic disease worldwide. “Adherence to treatment” is critical in the metabolic control of it and described as the action actively and voluntarily engages in the management of the disease. Objective: To determine the influence of neuropsychological and psychological variables in adherence to treatment of patients with type 2 diabetes. Methods: 60 subjects were evaluated: 30 with controlled diabetes (DC) and 30 with uncontrolled diabetes (DNC), submitted by centers-diabetes in the city of Barranquilla, between July and November 2015, to which underwent neuropsychological assessment, perception of health (general health questionnaire Goldberg, GHQ-28) and adherence to treatment (scale adherence treatment of type II Diabetes Mellitus: EATDMIII). The methodological approach was transversal descriptive, casecontrol analysis, selection of the sample was not probabilistic intentional. U test of Mann-Whitney and linear regression model was used to perform the analysis. Results: We observed significant commitment of attention, memory and executive functions in patients with DNC. We found a significant difference between the two groups in scores on the scale (EATDMIII), in: exercise, hygiene and selfcare, diet and fitness assessment. It was identified that anxiety-insomnia variable has a risk of 0.771 (p=0.035), which may influence adherence to treatment. Conclusions: Factors such as physical exercise, hygiene and self-care, diet and fitness assessment are fundamental in metabolic control these patients. Similarly, psychological variables (anxiety-insomnia) are determining adherence to treatment in this group of patients, which; being potentially modifiable they must be considered and controlled early in any therapeutic regimen.
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Palabras clave
Adherencia al tratamiento, Diabetes, Hemoglobina glicosilada, Adherence, Glycated hemoglobin