Uso dos serviços de saúde segundo determinantes sociais, comportamentos em saúde e qualidade de vida entre diabéticos

Demographic, Clinical, and Quality of Life Profiles of Older People With Diabetes During the COVID-19 Pandemic: Cross-Sectional Study

BACKGROUND

Diabetes mellitus, one of the main diseases that affects the Brazilian population older than 60 years, is defined as a divergent group of metabolic disorders that present a high level of glycemia (hyperglycemia), causing damage to various organs and systems of the body, including the heart, kidneys, eyes, and nervous system. It is believed that in 2025, in Brazil alone, there will be more than 18.5 million individuals diagnosed with diabetes mellitus. Therefore, it is important to know the individuals' quality of life in the context of life and culture.

OBJECTIVE

This study aimed to assess the demographic, clinical, and quality of life profiles of older adults with diabetes during the COVID-19 pandemic in a university hospital complex in the northern Amazon region.

METHODS

We conducted a cross-sectional, exploratory, noninterventional, descriptive, and analytical study using a nonrandom sample of 54 older people diagnosed with diabetes mellitus at the geriatrics outpatient clinic of the medium and high complexity university hospital in the western Brazilian Amazon between 2020 and 2022. We used 3 instruments, namely, a sociodemographic questionnaire, a clinical conditions questionnaire, and Diabetes-39. Qualitative data were described using absolute and relative frequencies. The Kolmogorov-Smirnov normality test was applied, and the z test was used for inferential analysis. SPSS software (version 27) was used for data analysis, and the significance level was 5%.

RESULTS

Of the 54 interviewees, the majority were women, married, retired, and had a good quality of life. Of these, 48.1% (n=26) were infected by COVID-19, 61.5% (n=16) of whom progressed to long COVID, presenting with fatigue or muscle weakness. As for the quality of life, the "social overload" (P<.001) and "sexual functioning" (P<.001) dimensions had with low scores compared to the "energy and mobility" (P=.005), "diabetes control" (P<.001), and "anxiety and worry" (P<.001) dimensions. Quality of life was negatively impacted in the "anxiety and worry" dimension. Among those affected by COVID-19, most progressed to long COVID; however, there was a lack of data on this theme in the population of older people with diabetes.

CONCLUSIONS

The majority of interviewees progressed to long COVID, with their quality of life negatively impacted in the "anxiety and worry" dimension, reflecting that health actions prioritizing mental health should be implemented by health professionals.

Análise das manifestações à Ouvidoria-Geral do SUS, no período de 2014 a 2018: evidências para a tomada de decisões

Resumo O objetivo deste artigo é analisar as manifestações dos cidadãos à Ouvidoria-Geral do Sistema Único de Saúde (SUS), no período de 2014-2018, discutindo-as e compreendendo-as como evidências capazes de orientar a tomada de decisões dos gestores do SUS. Para isso, foi extraído o banco de dados do sistema informatizado OuvidorSUS, a partir de 16 variáveis referentes ao conteúdo das manifestações, à sua categorização e ao perfil do cidadão. Foram registradas 216.832 manifestações e 114.618 perfis dos cidadãos que entraram em contato com a Ouvidoria-Geral do SUS nesse período, sendo o principal canal o Disque Saúde 136. Os grupos que mais acessaram a Ouvidoria e responderam ao perfil do cidadão foram mulheres, brancos, heterossexuais, com idade entre 31 e 40 anos, nível superior completo ou incompleto, trabalhadores do setor privado e com renda entre 1 e 2 salários mínimos. As demandas, principalmente relacionadas a solicitações, reclamações e denúncias, tiveram como assuntos mais frequentes a gestão do sistema, a assistência à saúde e a assistência farmacêutica. Os registros apontam a importância da consolidação de variáveis estratégicas da Ouvidoria para a qualificação da gestão do sistema.