Avaliação de estresse emocional em pessoas idosas com Diabetes Mellitus 2

Abstract

Emotional stress linked to type 2 diabetes mellitus (DM2) is an emotional reaction associated with changes in habits, risks of complications, demands for self-care, and the anguish and anxiety caused by the diagnosis and living with the disease. This impact is particularly significant for DM2 sufferers, especially older adults. The aim of this study was to assess emotional stress and associated factors in older people with DM2, including glycemic control. This cross-sectional study was conducted from August 2023 to February 2024, involving 147 participants aged 60 years or older who use insulin and are treated at Primary Health Care in Vitória da Conquista-BA. Emotional stress was measured using the Diabetes Distress Scale, where a mean score of ≥3 indicates a high level of emotional stress. The Instrumental Activities of Daily Living and Mini-Mental State Examination instruments were used to assess functional capacity and cognitive function, respectively. Glycated hemoglobin measurements taken on the day of the interview, data obtained from a home capillary blood glucose recording system, and self-reported clinical symptoms of hypoglycemia in the last three months were used in the assessment. Additionally, body mass index, systolic blood pressure, and diastolic blood pressure were measured during the participant interview. Statistical analysis was performed using Stata version 16.1. The association between emotional stress and independent variables was examined using the Chi-square test and Fisher's exact test. Poisson regression with robust variances was used to identify factors associated with emotional stress. Results were expressed with a statistical significance level of α = 0.05 and a 95% confidence interval. The prevalence rate of high levels of emotional stress was 22.5%. Factors associated with stress included marital status, presence/number of complications, symptoms of hypoglycemia, and level of functional dependence. Specifically, being single (PR: 2.95; 95% CI: [1.43-6.07]), having complications (PR: 3.19; 95% CI: [1.62-6.26]), and experiencing episodes of hypoglycemia (PR: 2.17; 95% CI: [1.11-4.26]) were associated with a higher likelihood of developing stress. Conversely, lower levels of dependence on routine activities were identified as a protective factor against stress. These findings underscore the importance of holistic disease management, addressing both the medical and psychosocial needs of individuals with DM2.