Avaliação e relevância do perfil de religiosidade/espiritualidade dos cuidadores de crianças e adolescentes com diabetes mellitus tipo I no enfrentamento da doença e sua relação com o controle metabólico

Abstract

INTRODUCTION: Diabetes Mellitus (DM) is a chronic metabolic condition in which there is an increase in blood glucose levels due to failure in secretion or insulin action, or both. The discovery of Diabetes in a child raises doubts, uncertainties, revolt and despair in the family. The search for information is necessary to clarify the disease, in order to mitigate the strong impact that the diagnosis of DM causes and, the search for support in religion, through prayers and support in the Divine faith to lessen suffering. Caregivers report symptoms of depression, stress and anxiety, which may interfere with glycemic control of children and adolescents with DM1. Therefore, religiosity constitutes an important tool for understanding the situation, obtaining resources and strengthening to deal with the weaknesses imposed by DM. OBJECTIVE: The level of religiosity and spirituality was Verified, its use as a Coping strategy and, symptoms of depression, stress and anxiety in caregivers of children and adolescents with diabetes type1; and its interference in glycemic control. METHODS: Socio-economic and demographic data Were collected from caregivers of 59 children and adolescents with Diabetes and obtained dosages of Fasting Glucose (FG); Postprandial Glycemia (PPG); Fructosamine (FRUTO), HbA1c, calculated the glycemic variability-Δ HbA1c, total cholesterol (TC) and fractions: high-density lipoprotein (HDL-C); Low-density lipoprotein (LDL-C); Non-high-density lipoprotein (non-HDL-c) and triglycerides (TG). Levels of religiosity were obtained by the DUREL scale; the use of religious/spiritual coping was verified by the SRCOPE scale. The DASS21 scale analyzed symptoms of depression, anxiety and stress. Descriptive statistical analyses were performed. The Student's T-Test was used for the independent groups or ANOVA followed by the Tukey Test of multiple comparisons for 2 or more independent groups. Pearson's coefficient was used to verify the correlation between the variables. In all tests, a significance level of 5% was considered, and the data were analyzed with the aid of Statistica V10 and SPSS version 23 software. RESULTS: Among The 59 participants, 54.2% (n = 32) were less than 40 years old and the majority consisted of female caregivers 93.2% (n = 55). Regarding children and adolescents with diabetes 30 (50.8%) were male, 46 (78.0%) Older than 10 years and 38 (64.4%) Time of diagnosis exceeding 5 years. In assessing the religiosity of caregivers, high religiosity averages were observed in the three dimensions evaluated: ORA, NORA and IR. Regarding the use of religiosity in coping with DM1 by caregivers, scores of use considered high of the Total SRCOPE (3.7 ± 0.3) and the average use of the CRP score (3.3 ± 0.6) were observed. The NSRCOPE/PSRCOPE ratio was (0.5 ± 0.2), demonstrating that the use of PSRCOPE was 50% higher in relation to the use of NSRCOPE The severity of symptoms of depression, stress and anxiety was identified as severe in 22.0% (n = 13), 44.1% (n = 26) and 42.1% (n = 25) of caregivers respectively. Regarding glycemic control and lipid profile, it was observed that the mean GJ, GPP, HbA1c and Fructosamine were above the reference values for glycemic control goals for children and adolescents with DM1. The values of TC, HDL-C and LDL-C were in conformity with the referential values. There was an inverse and moderate association between Δ HbA1c and RI; Strong and inverse between FRUTO and ORA and, positive and moderate between TC and NORA. Positive and strong associations were observed between the factor N4 – Dissatisfaction with the other institutional - with anxiety and moderate with stress. Moderate and positive Correlations were identified between N1 – Negative Revaluation of God - with depression; Between N3-negative Revaluation of meaning - with depression; with stress and anxiety, and between N4 - Dissatisfaction with the other institutional - with depression. CONCLUSION: High levels of religiosity were observed in the three dimensions evaluated, as well as their use by caregivers of children and adolescents with T1D. It was also Observed that the use of negative religious-spiritual coping in coping with the situation is positively associated with the severity of symptoms of depression, stress and anxiety, implying the need to assess the emotional health of Caregivers, as well as offering support by health professionals to help relieve these symptoms.