Desarrollo de un Modelo de Atención Nutricional para la Adherencia al Tratamiento Basado en Entrevista Motivacional y Educación Interactiva en un Grupo de Mujeres Adultas con Prediabetes de un Consultorio Privado de Santo Domingo de Heredia. Primer Semestre del 2018
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Fecha
2023
Tipo
tesis de maestría
Autores
Prendas Espinoza, Magaly
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Resumen
Introducción: La prediabetes es una condición que se caracteriza por
niveles de glucosa en sangre más altos que lo normal pero por debajo del umbral
de corte para diagnosticar diabetes. Las personas con esta condición tienen un
mayor riesgo de desarrollar DM2 y de sufrir complicaciones cardiovasculares ya que
la prediabetes genera alteraciones metabólicas que propician el proceso de estrés
oxidativo e inflamación. La investigación científica ha demostrado que esta
condición puede ser revertida hasta en un 58% de los casos, mediante
intervenciones que permitan la pérdida de peso a través de cambios en los estilos
de vida, principalmente en la alimentación y la actividad física.
Objetivo: Diseñar, implementar y evaluar un modelo de atención nutricional
para la adherencia al tratamiento basado en entrevista motivacional y educación
interactiva en un grupo de mujeres adultas con prediabetes.
Metodología: Intervención de 4 meses en un grupo de 15 mujeres con
diagnóstico de prediabetes. Se analizaron datos sociodemográficos, clínicos,
antropométricos, dietéticos, actividad física, glicemia en ayunas, etapa de cambio y
conocimientos de autocuidado. Se diseñó y aplicó un modelo de atención nutricional
fundamentado en 3 ejes: eje dietoterapéutico para la consulta individual que incluyó
plan de alimentación individualizado, capacitación sobre el tamaño de las porciones
y consejo dietético sobre hábitos de alimentación y de actividad física, herramienta
de entrevista motivacional como eje trasversal de la consulta individual para generar
discusión empática según la etapa de cambio en que se encontraba la participante
y el eje de educación interactiva grupal.
Resultados: Se obtuvo una reducción promedio de 12 mg/dL de la glicemia
en ayunas y la reversión de la prediabetes en el 40% del grupo intervenido, con una
pérdida promedio de 5.6% de peso corporal y 9.6 cm en la circunferencia abdominal.
Se observó una modificación positiva en los estilos de vida y un aumento de los
conocimientos de autocuidado para la prevención de la DM2.
Conclusión: La dietoterapia individual con entrevista motivacional y
educación interactiva grupal como parte de una intervención intensiva, permite
frenar el aumento de la obesidad, capacita para el autocuidado y produce cambios
significativos en el estilo de vida y en los marcadores de la prediabetes.
Introduction: Prediabetes is a condition characterized by blood glucose levels higher than normal but below the cut-off threshold for diagnosing diabetes. People with this condition have a higher risk of developing DM2 and of suffering cardiovascular complications since prediabetes generates metabolic alterations that favor the process of oxidative stress and inflammation. Scientific research has shown that this condition can be reversed in up to 58% of cases, through interventions that allow weight loss through changes in lifestyles, mainly in diet and physical activity. Objective: Design, implement and evaluate a nutritional care model for adherence to treatment based on motivational interviewing and interactive education in a group of adult women with prediabetes. Methodology: 4-month intervention in a group of 15 women diagnosed with prediabetes. Sociodemographic, clinical, anthropometric, dietary, physical activity, fasting blood glucose, stage of change, and knowledge of self-care data were analyzed. A nutritional care model based on 3 axes was designed and applied: diet therapeutic axis for individual consultation that included an individualized eating plan, training on portion sizes and dietary advice on eating habits and physical activity, motivational interview tool as a transversal axis of the individual consultation to generate empathic discussion according to the stage of change in which the participant was and the group interactive education axis. Results: An average reduction of 12 mg/dL in fasting blood glucose and reversal of prediabetes was obtained in 40% of the intervened group, with an average loss of 5.6% of body weight and 9.6 cm in abdominal circumference. A positive change in lifestyles and an increase in knowledge of self-care for the prevention of DM2 were observed. Conclusion: Individual diet therapy with motivational interviewing and group interactive education as part of an intensive intervention, allows to stop the increase in obesity, enables self-care and produces significant changes in lifestyle and in the prediabetes markers.
Introduction: Prediabetes is a condition characterized by blood glucose levels higher than normal but below the cut-off threshold for diagnosing diabetes. People with this condition have a higher risk of developing DM2 and of suffering cardiovascular complications since prediabetes generates metabolic alterations that favor the process of oxidative stress and inflammation. Scientific research has shown that this condition can be reversed in up to 58% of cases, through interventions that allow weight loss through changes in lifestyles, mainly in diet and physical activity. Objective: Design, implement and evaluate a nutritional care model for adherence to treatment based on motivational interviewing and interactive education in a group of adult women with prediabetes. Methodology: 4-month intervention in a group of 15 women diagnosed with prediabetes. Sociodemographic, clinical, anthropometric, dietary, physical activity, fasting blood glucose, stage of change, and knowledge of self-care data were analyzed. A nutritional care model based on 3 axes was designed and applied: diet therapeutic axis for individual consultation that included an individualized eating plan, training on portion sizes and dietary advice on eating habits and physical activity, motivational interview tool as a transversal axis of the individual consultation to generate empathic discussion according to the stage of change in which the participant was and the group interactive education axis. Results: An average reduction of 12 mg/dL in fasting blood glucose and reversal of prediabetes was obtained in 40% of the intervened group, with an average loss of 5.6% of body weight and 9.6 cm in abdominal circumference. A positive change in lifestyles and an increase in knowledge of self-care for the prevention of DM2 were observed. Conclusion: Individual diet therapy with motivational interviewing and group interactive education as part of an intensive intervention, allows to stop the increase in obesity, enables self-care and produces significant changes in lifestyle and in the prediabetes markers.
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Palabras clave
Prediabetes, Glucosa en sangre, ESTILO DE VIDA, SANTO DOMINGO (SANTO DOMINGO, HEREDIA, COSTA RICA)