Avaliação da Percepção de Conhecimento, das Atitudes e da Presença de Sintomas para Episódios de Depressão em Pessoas com Diabetes Mellitus

Abstract

Worldwide evidence shows that diabetes mellitus is a widespread problem in our society and that depression is one of its most frequent and underdiagnosed problems. This study sought to analyze the perception of people with diabetes mellitus with knowledge, attitude, and the presence of symptoms for episodes of depression treated in outpatient services at public institutions. In addition to characterizing people with diabetes mellitus with sociodemographic and clinical data, to evaluate the degree of knowledge about the disease in people with diabetes mellitus to describe the attitudes towards the disease of people with diabetes mellitus and identify the attitudes of people with diabetes mellitus to symptoms for episodes of depression. This cross-sectional, descriptive, and exploratory study uses a quantitative approach. The study took place in two public endocrinology centers in southern Brazil. Seven hundred and sixty-one people aged ≥ 18 years with type 1 or type 2 diabetes and scheduled appointments with specialists took part. The study was approved by the Ethics Committee under opinion 6.179.589/70415423.9.0000.5316. A sociodemographic and clinical questionnaire and three instruments, the Diabetes Knowledge Questionnaire, the Diabetes Attitude Questionnaire, and the Patient Health Questionnaire, were applied between July 2023 and April 2024 through face to-face interviews using the Research Electronic Data Capture digital platform. This cross-sectional, descriptive, and exploratory study uses a quantitative approach. The study took place in two public endocrinology centers in southern Brazil. Seven hundred and sixty-one people aged ≥ 18 years with type 1 or type 2 diabetes and scheduled appointments with specialists took part. The study was approved by the Ethics Committee under opinion 6.179.589 / 70415423.9.0000.5316. A sociodemographic and clinical questionnaire and three instruments, the Diabetes Knowledge Questionnaire, the Diabetes Attitude Questionnaire, and the Patient Health Questionnaire, were applied between July 2023 and April 2024 through face to-face interviews using the Research Electronic Data Capture digital platform. Wilcoxon-Mann-Whitney, Kruskal-Wallis and Dunn's tests were conducted, all considering a 95% confidence level (α = 0.05). The average age was 60, 68.9% were female, 68.9% had a maximum of 8 years of schooling, 61.9% had a partner, 80.3% were white, 57.3% were retired, and 56.3% earned between two and five minimum wages. An endocrinologist treated 58.1%, and 68.1% had been diagnosed more than 10 years ago. 91.7% had type 2 diabetes, 83.3% had uncontrolled diabetes, 91.0% used four or more medications, and 74.9% had hypertension associated with diabetes. Of those interviewed, 85.7% had satisfactory knowledge, 90.3% had a negative attitude, and 54.2% had some degree of symptoms of an episode of depression. Younger people (p= 0.0001) and those with a higher level of education had more knowledge about diabetes, and those with less education had more positive attitudes towards stress (p=0.0157), confidence (p= 0.0061), and acceptance (p= 0.0001). Women had higher mean scores (p= 0.0001) for symptoms of depressive episodes. An increase in the amount of medication worsened (p= 0.0001) the state of symptoms for depressive episodes. The study may alert us to the need to use effective instruments that can provide resolutive health/care actions and contribute to behavioral change with positive attitudes and the absence of depressive symptoms in people with diabetes mellitus.