Construção, evidências de validade e normatização de uma escala de competências socioemocionais / Construction, evidence of validity and standardization of a scale of socio-emotional competences

As competências socioemocionais têm despertado a atenção de pesquisadores pela sua relevância teórica e aplicabilidade. O objetivo principal desta pesquisa foi a construção, busca de evidências de validade eprodução de normas para uma escala de competências socioemocionais. Foram realizados dois estudos com um total de 696 participantes. O primeiro estudo consistiu na elaboração de itens, análise de juízes e análise fatorial exploratória do instrumento. O segundo estudo consistiu na realização da análise fatorial confirmatória e produção de normas para fins de diagnóstico. Os resultados exploratórios apresentaram um instrumento inicial com 28 itens. Esta análise revelou cinco fatores que apresentaram agrupamentos de itens teoricamente consistentes com as definições do modelo hipotético utilizado. A análise fatorial confirmatória apresentou um modelo com bons índices de ajustes e com os mesmos fatorese itens encontrados na análise exploratória. Concluiu-se que a escala apresentou boas propriedades psicométricas(AU)

The socio-emotional competencies have attracted the attention of researchers due to their theoretical relevance and applicability. The main objective of this research was to build, search for evidence of validity and production of norms for a scale of socio-emotional competencies. Foram carried out two studies with atotal of 696 subjects. The first study consisted of the elaboration of items, analysis by judges and exploratory factor analysis of the instrument. The second study consisted of carrying out confirmatory factor analysis and producing norms for diagnostic purposes. The exploratory results presented an initial instrument with 28 items. This analysis revealed five factors that presented clusters of items theoretically consistent with the definitions of the hypothetical model used. A confirmatory factor analysis revealed a model with good fit indices and the same factors and items found in the exploratory analysis. It was concluded that the scale presented good psychometric properties(AU)

Construction and validity evidence of a Socioemotional Skills Scale for University Students / Construção e evidências de validade de uma Escala de Competências Socioemocionais para Universitários / Construcción y evidencias de validez de una Escala de Habilidades Socioemocionales para Estudiantes Universitarios

The aim of this study was to construct and investigate validity evidence for a measure of socioemotional skills for university students. Of the 60 items initially designed to represent six factors of the construct, 42 of them showed theoretical consistency. To analyze the structure of the instrument, exploratory factor analysis was carried out, based on the application of the instrument with 365 students. The analysis revealed six factors that presented groupings of items theoretically consistent with the definitions of the proposed hypothetical model: Self-Management of Emotions, Social Awareness, Responsible Decision-Making, Perseverance, Emotional Self-Awareness and Relationship Skills. The final structure, with 35 items, was able to explain 45.16% of the total variance. Confirmatory factor analysis was performed, based on the application of the instrument with 712 undergraduate students. The proposed structural model was confirmed, with adequate fit indices. Precision indices varied between .69 and .78. It is suggested that further studies investigate other types of validity evidence. (AU)

O objetivo deste estudo foi construir e buscar evidências de validade de uma medida de competências socioemocionais para estudantes universitários. Dentre 60 itens inicialmente elaborados para representar seis fatores do construto, 42 deles apresentaram consistência teórica. Para análise da estrutura fatorial do instrumento, realizou-se uma análise fatorial exploratória, a partir da aplicação do instrumento em 365 estudantes universitários. A análise revelou seis fatores que apresentaram agrupamentos de itens teoricamente consistentes com as definições do modelo hipotético proposto: Autogerenciamento das Emoções, Consciência Social, Tomada de Decisão Responsável, Perseverança, Autoconsciência Emocional e Habilidades de Relacionamento. A estrutura final foi capaz de explicar 45,16% da variância total, a partir de 35 itens. Posteriormente, procedeu-se a uma análise fatorial confirmatória, a partir da aplicação do instrumento em 712 estudantes de graduação. O modelo estrutural proposto foi confirmado, apresentando índices de ajuste adequados. Os índices de precisão variaram entre 0,69 e 0,78. Sugere-se que novos estudos busquem outros tipos de evidências de validade. (AU)

El objetivo de este estudio fue construir y buscar evidencias validez de una medida de habilidades socioemocionales para estudiantes universitarios. Entre los 60 ítems inicialmente desarrollados para representar seis factores del constructo, 42 de ellos mostraron consistencia teórica. Para analizar la estructura factorial del instrumento, se realizó un análisis factorial exploratorio, basado en la aplicación del instrumento a 365 estudiantes. El análisis reveló seis factores que presentaron agrupaciones de ítems teóricamente consistentes con las definiciones del modelo propuesto: Autogestión de las Emociones, Conciencia Social, Toma Responsable de Decisiones, Perseverancia, Autoconciencia Emocional y Habilidades de Relación. La estructura final fue capaz de explicar el 45,16% de la varianza total, basada en 35 ítems. Posteriormente, se realizó un análisis factorial confirmatorio, basado en la aplicación del instrumento a 712 estudiantes de grado. Los índices de precisión variaron entre 0,69 y 0,78. Se confirmó el modelo estructural, con índices de ajuste adecuados. Se sugiere que los estudios adicionales busquen otros tipos de evidencias de validez. (AU)

Patients' perceptions of self-management of high blood pressure in three low- and middle-income countries: findings from the BPMONITOR study.

Hypertension is the leading risk factor for global disease burden. Self-management of high blood pressure (BP) through self-monitoring and self-titration of medications, has proved to be one successful and cost-effective tool to achieve better BP control in many high-income countries but not much is known about its potential in low- and middle-income countries (LMICs). We used semi-structured questionnaires and focus groups in three LMICs; Peru, Cameroon and Malawi to examine perceptions and attitudes of patients diagnosed with essential hypertension towards living with hypertension, BP measurement and treatment, patient-physician relationship and opinions about self-management of high blood pressure. Results in all three countries were comparable. Patients showed varied levels of health literacy related to hypertension. BP measurement habits were mostly affected by resources available and caregiver support. Treatment and adherence to it were primarily affected by cost. Most patients were welcoming of the idea of self-management but skeptical about the ability to do self-monitoring accurately and the safety involving self-titration of medications.

Medical discernment and dialogical praxis: treatment as healing oneself.

This essay investigates the hermeneutic idea of health and the resulting formative notion of treatment. In its first part, the essay diagnoses, based on some texts of the German philosopher Hans-Georg Gadamer, the increasing technologization of contemporary professions and, specifically in the case of medicine, the risk of disappearance of self-treatment that this technologization causes. In addition to medicine, it also briefly takes psychoanalysis and pedagogy to exemplify the risk of over-specialized professionalization. In the second part, the essay seeks to doubly ground the hermeneutical idea of health: on the one hand, in the heritage of Hippocratic medicine that supports Gadamer's point of view and, on the other hand, in dialogical praxis, considering it the core of philosophical hermeneutics itself. Still in its second part, the essay interprets three aspects of the Gadamerian dialogue, translating them into medical professional practice. Finally, in the third and last part, the essay shows that hermeneutically-understood medical treatment leads to self-treatment, which is an indispensable, but not sufficient, condition of the patient's cure. In summary, when patients are mobilized by the dialogical praxis of medical discernment, they are more able to understand the importance of their taking treatment as self-treatment.

Self-Management of Type 2 Diabetes in Adult Haitian Immigrants: A Qualitative Study.

Introduction: A large body of literature exists on self-management of type 2 diabetes (T2D) in a variety of populations. However, research is limited on how Haitian immigrants self-manage their T2D despite a prevalence of 6.9% in Haiti. The purpose of this study was to explore and describe the lived experience of adult Haitian immigrants managing T2D living in the United States. Methodology: Moustakas's phenomenological approach guided this qualitative study. Adult Haitian immigrants diagnosed with T2D for at least 1 year were interviewed. Individual interviews were audio-recorded, transcribed verbatim, uploaded into NVivo, and analyzed using Moustakas's existential data analysis process. Results: We interviewed 16 participants (mean age 56;12 females; an average of 11 years living in the United States; mean hemoglobin A1c 8.1%). Four themes emerged: self-reliance, spirituality, nostalgia for home, and a desire for positive patient-provider relationships. Cultural influences and health beliefs may affect individual self-management of T2D in this population. Conclusions: These results may assist clinicians in identifying factors that contribute to suboptimal self-management in Haitian immigrants and help patients reach glycemic control. Culturally competent assessment and interventions for Haitian immigrants with T2D may not be provided without considering these four themes.

Predicting intention to participate in self-management behaviors in patients with Familial Hypercholesterolemia: A cross-national study.

RATIONALE: Familial Hypercholesterolemia (FH) is a genetic condition that predisposes patients to substantially increased risk of early-onset atherosclerotic cardiovascular disease. FH risks can be minimized through regular participation in three self-management. BEHAVIORS: physical activity, healthy eating, and taking cholesterol lowering medication. OBJECTIVE: The present study tested the effectiveness of an integrated social cognition model in predicting intention to participate in the self-management behaviors in FH patients from seven countries. METHOD: Consecutive patients in FH clinics from Australia, Hong Kong, Brazil, Malaysia, Taiwan, China, and UK (total N = 726) completed measures of social cognitive beliefs about illness from the common sense model of self-regulation, beliefs about behaviors from the theory of planned behavior, and past behavior for the three self-management behaviors. RESULTS: Structural equation models indicated that beliefs about behaviors from the theory of planned behavior, namely, attitudes, subjective norms, and perceived behavioral control, were consistent predictors of intention across samples and behaviors. By comparison, effects of beliefs about illness from the common sense model were smaller and trivial in size. Beliefs partially mediated past behavior effects on intention, although indirect effects of past behavior on intention were larger for physical activity relative to taking medication and healthy eating. Model constructs did not fully account for past behavior effects on intentions. Variability in the strength of the beliefs about behaviors was observed across samples and behaviors. CONCLUSION: Current findings outline the importance of beliefs about behaviors as predictors of FH self-management behaviors. Variability in the relative contribution of the beliefs across samples and behaviors highlights the imperative of identifying sample- and behavior-specific correlates of FH self-management behaviors.

Private self-consciousness, self-reflection, insight and alcohol consumption among young people and adults / Autoconsciência privada, autorreflexão, insight e consumo de álcool entre jovens e adultos / Autoconciencia privada, autorreflexión, insight y consumo de alcohol entre jóvenes y adultos

Private self-consciousness is a relevant metacognitive capacity in the self-regulation process, with possible implications in alcohol consumption. This research verified the influence of self-reflection and insight, dimensions of private self-consciousness, on drinking behavior. A total of 523 Brazilians, aged from 20 to 39 years old, participated in a survey by answering the Self-Reflection and Insight Scale and the AUDIT test. The results showed that women have higher levels of self-reflection, whereas men have higher levels of insight. With regard to alcohol consumption, young people drink at higher risk levels than adults. Self-reflection and insight were negatively correlated with alcohol consumption. Age and gender differences in the intensity of the correlation between variables and the influence of environmental factors on the regulation of drinking behavior are discussed. (AU)

A autoconsciência privada é uma capacidade metacognitiva relevante no processo de autorregulação, com possível implicação no consumo de álcool. Esta pesquisa objetivou verificar a relação da autorreflexão e do insight, dimensões da autoconsciência privada, no comportamento de beber. Participaram 523 brasileiros, de 20 a 39 anos que responderam à Escala de Autorreflexão e Insight e ao teste AUDIT. Os resultados indicaram que mulheres apresentam níveis mais elevados de autorreflexão, enquanto homens, de insight. Quanto ao consumo de álcool, jovens bebem em níveis considerados mais arriscados do que adultos. A autorreflexão e o insight correlacionaram negativamente com o consumo de álcool. Diferenças etárias e de gênero na intensidade da correlação entre variáveis e a influência de fatores ambientais na regulação do beber são discutidas. (AU)

La autoconciencia privada es una capacidad metacognitiva relevante en el proceso de autorregulación, con posibles implicaciones en el consumo de alcohol. Esta investigación verificó la relación entre autorreflexión e Insight, dimensiones de la autoconciencia privada, en el comportamiento de beber. Participaron 523 brasileños (20 a 39 años) que respondieron la Escala de Autorreflexión e Insight y el test AUDIT. Los resultados estadísticos mostraron que las mujeres tienen mayores niveles de autorreflexión, mientras que los hombres de Insight. En cuanto a consumo de alcohol, los jóvenes beben en niveles considerados más arriesgados que los adultos. Autorreflexión e Insight se correlacionaron negativamente con el consumo de alcohol. Se discuten las diferencias de edad y género con relación a la intensidad de correlación entre las variables y la influencia de factores ambientales en la regulación de beber. (AU)

Bifactor invariance analysis of student conceptions of assessment inventory / Análise da invariância bifatorial do inventário de concepções de avaliação de estudantes / Análisis de la invarianza bifactorial del inventario de concepciones de evaluación de estudiantes

Student conceptions of the purposes of assessment are an important aspect of self-regulated learning. This study advances our understanding of the Student Conceptions of Assessment Inventory (SCoA) by examining the generalizability of the factorial structure of the SCoA using bifactor analysis and conducting cross-cultural invariance testing between Brazil and New Zealand. Eight different models were specified and evaluated, with the best model being adopted for invariance testing. This research adds to our understanding of the cross-cultural properties of the SCoA because the introduction of the bifactor model resulted in metric equivalence between countries, which had previously had only partial metric equivalence. Future studies should attempt to create more items around several SCoA constructs. (AU)

As concepções de estudantes dos propósitos da avaliação são um aspecto importante da aprendizagem autorregulada. Este estudo avança nossa compreensão do Inventário de Concepções de Avaliação de Estudantes (CAE), pelo exame da generalização da estrutura fatorial do CAE usando análise bifatorial e realizando testes de invariância transcultural entre o Brasil e a Nova Zelândia. Oito modelos diferentes foram especificados e avaliados, com o melhor modelo adotado para o teste de invariância. Esta pesquisa acrescenta à nossa compreensão das propriedades transculturais do CAE porque a introdução do modelo bifatorial resultou em equivalência métrica entre países, que anteriormente tinham apenas equivalência métrica parcial. Estudos futuros devem tentar criar mais itens em torno de vários construtos do CAE. (AU)

Las concepciones de los estudiantes sobre los própositos de evaluación, son un aspecto importante del aprendizaje autorregulado. Este estudio amplía nuestra comprensión sobre el Inventario de Concepciones de Evaluación de Estudiantes (CEE), mediante la investigación de la generalización de la estructura factorial del CEE utilizando análisis bifactorial y realizando tests de invariancia transcultural entre Brasil y Nueva Zelanda. Se especificaron y evaluaron ocho modelos diferentes,con el mejor modelo adoptado para el test de invariancia. Esta investigación aumenta nuestra comprensión de las propiedades transculturales del CEE, ya que la introducción del modelo bifactorial resultó con equivalencia métrica entre países, que anteriormente tenían sólo equivalencia métrica parcial. En el futuro, otros estudios posiblemente tratarán de crear más ítems sobre varios constructos del CEE. (AU)

Dutch translation and adaptation of the Barkley Deficits in Executive Functioning Scale (BDEFS)

Abstract Background Based on his model of self-regulation and executive functions, Barkley developed a self- and other-report questionnaire (the Barkley Deficits in Executive Functioning Scale - BDEFS). The BDEFS measures deficits in executive functions as expressed in daily life activities like self-management of time, self-organization, self-restraint, self-motivation, and self-regulation of emotion. Objectives This study created and analyzed a Dutch translation and adaptation in conformance with official guidelines. Methods The Dutch and English BDEFS were completed by 25 bilingual Dutch adults to evaluate semantic correspondence. Consequently, 60 Dutch participants completed the Dutch BDEFS, Barratt Impulsiveness Scale-Eleventh edition (BIS-11) and the Dysexecutive Questionnaire (DEX) to evaluate concurrent validity and internal consistency. Results The versions demonstrated sufficient semantic equivalence and Spearman's rho of total scores was high; items mostly showed moderate-to-high correlations. Regression analysis showed no proportional bias. Internal consistency was also high. Correlations between BDEFS, BIS-11 and DEX supported concurrent validity. Discussion We conclude that a successful BDEFS translation and adaptation was created with satisfactory reliability and validity. Further research should assess the utility of the BDEFS in Dutch clinical practice.

Transition Readiness in Adolescents and Young Adults with Heart Disease: Can We Improve Quality of Life?

OBJECTIVES: We previously reported common knowledge deficits and lack of transition readiness in 13- 25-year-olds with congenital or acquired heart disease. The aims of this study were to re-evaluate transition readiness in this cohort at follow-up and to examine the relationship between changes in transition readiness and quality of life (QOL). STUDY DESIGN: In this prospective cohort study, patients completed the Transition Readiness Assessment and the Pediatric Quality of Life Inventory using an e-tablet, web-based format at a routine follow-up visit. Changes from initial to follow-up scores were evaluated. RESULTS: Sixty-five percent of patients (106 of 164) completed follow-up assessments at a median age of 18.7 years (IQR, 16.5-21.2 years) at a median follow-up of 1 year. The average perceived knowledge deficit score (percent of items with no knowledge) at follow-up was 18.0 ± 15.2%, which decreased from 24.7 ± 16.5% (P < .0001). On a 100-point scale, the mean score for self-efficacy increased from 71.4 ± 17.0 to 76.7 ± 18.2 (P = .0004) and for self-management increased from 47.9 ± 18.4 to 52.0 ± 20.7 (P = .004). Although physical QOL did not change, the mean psychosocial QOL score increased significantly (P = .02). A decrease in the knowledge deficit score at follow-up was significantly associated with an increased psychosocial QOL score (P = .03). An increase in the self-efficacy score was associated with an increase in psychosocial QOL score (P = .04), especially social QOL (P = .02). CONCLUSIONS: Although deficits in knowledge and self-management skills persist, transition readiness assessment and recognition of deficits can improve transition readiness with improved psychosocial QOL.

MyDiaText™: Feasibililty and Functionality of a Text Messaging System for Youth With Type 1 Diabetes.

PURPOSE: The purpose of this study was to determine the feasibility and functionality of MyDiaText™, a website and text messaging platform created to support behavior change in adolescents with type 1 diabetes (T1DM) and to evaluate user satisfaction of the application. METHODS: This study was a nonrandomized, prospective, pilot trial to test the feasibility and user interface with MyDiaText, a text message system for 10- to 17-year-old youths with newly diagnosed T1DM. Feasibility was evaluated by assessing for the user's ability to create a profile on the website. Functionality was defined by assessing whether a subject responded to at least 2 text messages per week and by their accumulating points on the website. User satisfaction of the text messaging system was assessed using an electronic survey. The 4 phases of this study were community engagement-advisory sessions, screening and enrollment, intervention, and follow-up. RESULTS: Twenty subjects (14 male, 6 female) were enrolled. All subjects were able to create a profile, and of these, 86% responded to at least 2 text messages per week. A survey administered during follow-up showed that users enjoyed reading text messages, found them useful, and thought the frequency of messages was appropriate. CONCLUSION: MyDiaText is a feasible, functional behavioral support tool for youth with T1DM. Users of the application reported high satisfaction with text messages and the reward system.

Living under treatment for Systemic Hypertension and Diabetes Mellitus: Feelings and behaviors.

OBJECTIVE: To understand the feelings and behaviors of people being treated for Systemic Hypertension (SH) and Diabetes Mellitus (DM). METHOD: A qualitative study based on Grounded Theory and Symbolic Interactionism, with 27 participants in treatment for SH and DM followed up by the Family Health Strategy team. Open, axial and selective coding was performed, giving rise to three theoretical categories and the central category. RESULTS: The daily life is explicit in the (lack of)care of the self with the chronic disease and feelings of sadness and anxiety are expressed as reasons for the lack of control of the disease. It points out that people take care of themselves because of fear of complications, reinforced the need for guidance on the use of medication and the empowerment of the chronic patient for self-care and care for the other. FINAL CONSIDERATIONS: Knowing behaviors and feelings of people with SH and/or DM allows a professional performance beyond the chronic condition.

Living under treatment for Systemic Hypertension and Diabetes Mellitus: Feelings and behaviors / Vidas en Tratamiento de la Hipertensión Arterial Sistémica y Diabetes Mellitus: sentimientos, comportamientos / Vidas em tratamento para Hipertensão Arterial Sistêmica e Diabetes Mellitus: sentimentos e comportamentos

ABSTRACT Objective: To understand the feelings and behaviors of people being treated for Systemic Hypertension (SH) and Diabetes Mellitus (DM). Method: A qualitative study based on Grounded Theory and Symbolic Interactionism, with 27 participants in treatment for SH and DM followed up by the Family Health Strategy team. Open, axial and selective coding was performed, giving rise to three theoretical categories and the central category. Results: The daily life is explicit in the (lack of)care of the self with the chronic disease and feelings of sadness and anxiety are expressed as reasons for the lack of control of the disease. It points out that people take care of themselves because of fear of complications, reinforced the need for guidance on the use of medication and the empowerment of the chronic patient for self-care and care for the other. Final considerations: Knowing behaviors and feelings of people with SH and/or DM allows a professional performance beyond the chronic condition.

RESUMEN Objetivo: Comprender los sentimientos y comportamientos de personas en tratamiento de la hipertensión arterial sistémica (HAS) y la diabetes mellitus (DM). Método: Estudio cualitativo basado en la Teoría Fundamentada en los Datos y en el Interaccionismo Simbólico, con 27 participantes en tratamiento de la HAS y DM, y acompañados por el equipo Estrategia Salud de la Familia. Se procedió a la codificación abierta, axial y selectiva que originó las tres categorías teóricas y la categoría central. Resultados: El cotidiano de la vida está explícito en el (des) cuidado de sí con una enfermedad crónica. Los sentimientos de tristeza y ansiedad se expresan como motivos condicionantes para el descontrol de la enfermedad. Se señala que las personas se cuidan movidas por el miedo a las complicaciones. Se reforzó la necesidad de orientación sobre el uso de la medicación y del empoderamiento del paciente crónico para el autocuidado y cuidado del otro. Consideraciones finales: Conocer los comportamientos y sentimientos de las personas con HAS y/o DM permite una actuación profesional más allá de la condición crónica.

RESUMO Objetivo: Compreender os sentimentos e comportamentos de pessoas em tratamento para a Hipertensão Arterial Sistêmica (HAS) e Diabetes Mellitus (DM). Método: Estudo qualitativo embasado na Teoria Fundamentada nos Dados e no Interacionismo Simbólico, com 27 participantes em tratamento para HAS e DM acompanhados pela equipe Estratégia Saúde da Família. Procedeu-se a codificação aberta, axial e seletiva que originaram três categorias teóricas e a categoria central. Resultados: O cotidiano de vida está explícito no (des)cuidado de si com a doença crônica e sentimentos de tristeza e ansiedade são expressos como motivos condicionantes para o descontrole da doença. Aponta que as pessoas se cuidam movidas pelo medo das complicações, reforçou a necessidade de orientação sobre o uso da medicação e do empoderamento do doente crônico para o autocuidado e cuidado do outro. Considerações finais: Conhecer comportamentos e sentimentos das pessoas com HAS e/ou DM permite uma atuação profissional além da condição crônica.

Type 1 diabetes mellitus: can coaching improve health outcomes?

OBJECTIVE: To evaluate the introduction of coaching in the interdisciplinary care of individuals with type 1 diabetes mellitus in the public health care system. SUBJECTS AND METHODS: Ten patients routinely attending a public health care service and with a glycated hemoglobin (HbA1c) level above 75% participated in eight coaching sessions. This study evaluated the patients' self-management of the disease and personal behavior. The participants were assessed at the beginning of the program and on two occasions after the intervention, with evaluation of biochemical and anthropometric data, and frequency of self-monitoring of blood glucose (SMBG). Questionnaires were applied during these evaluations to analyze emotional burden (B-PAID), medication adherence (Morisky Adherence Scale), and self-efficacy (IMDSES). RESULTS: HbA1c had a median level of 8.0% (range 76-10.3%) at the beginning of the study and reduced significantly 3 months after initiation of the intervention (7.78% [6.5-10%], p = 0.028), with no significant increase at 6 months (8.3% [713-9.27%], p = 0.386). SMBG improved significantly from the beginning to the end of the study, with the median number of glucose tests per week varying from 16.5 (range 0-42) at baseline to 29.0 (7-42) at 3 months and 27.5 (10-48) at 6 months (p = 0.047). No significant differences were observed in anthropometric parameters or in the scores of the instruments between the three measurements. CONCLUSION: A coaching intervention focused on patients' values and sense of purpose may provide added benefit to traditional diabetes education programs and could be an auxiliary method to help individuals with type 1 diabetes achieve their treatment goals.

Family Support and Diabetes: Patient's Experiences From a Public Hospital in Peru.

Family support is crucial for managing chronic conditions but it is often overlooked when designing behavioral interventions in type 2 diabetes mellitus (T2DM). As part of the formative phase of a feasibility randomized control trial (RCT), we conducted 20 semistructured interviews with people with T2DM from Lima, Peru. Based on such results, we describe the support people with T2DM receive from their families and the role that such support has in their efforts to implement diabetes management practices. We learned that participants receive support from family members, but mostly from their spouses and children. Their relatives encourage them and motivate them to fight for their health, they also provide instrumental support by preparing healthy meals, reminding them to take medications, and sharing physical activity. Participants also reported controlling actions which were not always "well received." Thus, any intervention supporting self-management practices need to work with key family members. We support the literature that suggests that interventions should target family members to ensure improved T2DM self-management practices.

Type 1 diabetes mellitus: can coaching improve health outcomes?

ABSTRACT Objective: To evaluate the introduction of coaching in the interdisciplinary care of individuals with type 1 diabetes mellitus in the public health care system. Subjects and methods: Ten patients routinely attending a public health care service and with a glycated hemoglobin (HbA1c) level above 75% participated in eight coaching sessions. This study evaluated the patients' self-management of the disease and personal behavior. The participants were assessed at the beginning of the program and on two occasions after the intervention, with evaluation of biochemical and anthropometric data, and frequency of self-monitoring of blood glucose (SMBG). Questionnaires were applied during these evaluations to analyze emotional burden (B-PAID), medication adherence (Morisky Adherence Scale), and self-efficacy (IMDSES). Results HbA1c had a median level of 8.0% (range 76-10.3%) at the beginning of the study and reduced significantly 3 months after initiation of the intervention (7.78% [6.5-10%], p = 0.028), with no significant increase at 6 months (8.3% [713-9.27%], p = 0.386). SMBG improved significantly from the beginning to the end of the study, with the median number of glucose tests per week varying from 16.5 (range 0-42) at baseline to 29.0 (7-42) at 3 months and 27.5 (10-48) at 6 months (p = 0.047). No significant differences were observed in anthropometric parameters or in the scores of the instruments between the three measurements. Conclusion: A coaching intervention focused on patients' values and sense of purpose may provide added benefit to traditional diabetes education programs and could be an auxiliary method to help individuals with type 1 diabetes achieve their treatment goals.

How do old men take care of their own health in Primary Care?

OBJECTIVE: To understand the care of elderly men with their own health. METHOD: A qualitative study with the participation of ten elderly men, through responses to the semi-structured interview guided by the "Tell me about your experiences of care with your health", carried out in a basic health unit, during the period of October-December 2014. The speeches, after being transcribed were submitted to content analysis. RESULTS: The ten interviewees were retired and had an average age of 67.3 years. From the analysis of the data, two categories have emerged: Elderly health care ways and health service as a supporter in the care (less) of the elderly, which revealed the restriction of health care to the triad: medicines, consultation to professionals and exams. FINAL CONSIDERATIONS: Institutional and sociocultural barriers that need to be overcome so that the male population can be consolidated, guaranteeing care of their peculiarities, encouraging active behaviors for self-care.

Self-Management Decision Making of Cuban Americans With Type 2 Diabetes.

PURPOSE: Although researchers have studied how individuals manage type 2 diabetes, none have examined how Cuban Americans do so. This article explores how Cuban Americans make self-management choices and examines whether an empowerment framework is viable for informing interventions. DESIGN: A qualitative descriptive study was conducted ( n = 20) with Cuban Americans with type 2 diabetes. Individual interviews were analyzed with content analysis. RESULTS: Motivation and temporal factors, such as knowledge of symptoms and the ability to plan ahead, positively affect self-management. Cultural factors, such as access to cultural foods, negatively affect self-management. Empowerment formed a comprehensive lens through which self-management decisions were acted on. CONCLUSION: Given the cultural context, empowerment and unique barriers and facilitators can affect diabetes self-management in this population. Strategies to promote healthy decisions must take into account the strengths of this community as well as its challenges.

How do old men take care of their own health in Primary Care? / ¿Cómo los ancianos cuidan de su propia salud en la atención básica? / Como homens idosos cuidam de sua própria saúde na atenção básica?

ABSTRACT Objective: To understand the care of elderly men with their own health. Method: A qualitative study with the participation of ten elderly men, through responses to the semi-structured interview guided by the "Tell me about your experiences of care with your health", carried out in a basic health unit, during the period of October-December 2014. The speeches, after being transcribed were submitted to content analysis. Results: The ten interviewees were retired and had an average age of 67.3 years. From the analysis of the data, two categories have emerged: Elderly health care ways and health service as a supporter in the care (less) of the elderly, which revealed the restriction of health care to the triad: medicines, consultation to professionals and exams. Final considerations: Institutional and sociocultural barriers that need to be overcome so that the male population can be consolidated, guaranteeing care of their peculiarities, encouraging active behaviors for self-care.

RESUMEN Objetivo: Comprender el cuidado de los ancianos con la propia salud. Método: Estudio cualitativo con participación de diez hombres ancianos, por medio de respuestas a la entrevista semiestructurada orientada por la cuestión "Cuéntame sus experiencias de cuidados con su salud", realizada en unidad básica de salud, en el período de octubre-diciembre de 2014. Las palabras, después de transcritas, fueron sometidas al análisis de contenido. Resultados: Los diez entrevistados eran jubilados y tenían en promedio 67,3 años de edad. A partir del análisis de los datos, surgieron dos categorías: Formas de atención a la salud por el hombre mayor y el servicio de salud como apoyador en el cuidado del hombre mayor, que revelaron la restricción de los cuidados con la propia salud a la tríada: medicamentos, consulta a profesionales y exámenes. Consideraciones finales: Barreras institucionales y socioculturales que necesitan ser superadas para que se pueda consolidar acogida a la población masculina, garantizando atención de sus peculiaridades, con estímulo de comportamientos activos para el autocuidado.

RESUMO Objetivo: Compreender os cuidados de homens idosos com a própria saúde. Método: Estudo qualitativo com participação de dez homens idosos, por meio de respostas à entrevista semiestruturada norteada pela questão "Conte-me suas experiências de cuidados com sua saúde", realizada em unidade básica de saúde, no período de outubro-dezembro de 2014. As falas, depois de transcritas, foram submetidas à análise de conteúdo. Resultados: Os dez entrevistados eram aposentados e tinham em média 67,3 anos de idade. A partir da análise dos dados, emergiram duas categorias: Formas de cuidados à saúde pelo homem idoso e serviço de saúde como apoiador no (des) cuidado do homem idoso, que revelaram a restrição dos cuidados com a própria saúde à tríade: medicamentos, consulta a profissionais e exames. Considerações finais: Barreiras institucionais e socioculturais que necessitam ser superadas para que se possa consolidar acolhimento à população masculina, garantindo atendimento de suas peculiaridades, com estímulo de comportamentos ativos para o autocuidado.