Percepções sobre barreiras e facilitadores para adesão de hábitos saudáveis por amazônidas com Diabetes Mellitus Tipo 2

Abstract

Introduction: The growing prevalence of Type 2 Diabetes Mellitus (T2DM) represents a global challenge, especially in regions like the Amazon, where access to healthcare and sociocultural particularities directly influence health behaviors. The quality of life of individuals living with T2DM is an increasing concern, both regarding their personal experiences and the essential daily needs. Thus, understanding the elements that hinder adherence to healthy habits becomes crucial for developing more effective strategies capable of improving both the well-being and health outcomes of these individuals. Objective: To analyze the perceptions of T2DM users and Community Health Agents regarding barriers and facilitators that influence adherence to healthy habits among T2DM patients residing in Amazonas. Methodological Procedures: This is a qualitative study with a participatory interface and is part of a matrix project entitled “Community Health Agent-led intervention for the management of Type 2 diabetes in the interior of Amazonas.” This study was conducted in two stages, involving Community Health Agents (CHAs) and T2DM users: the first stage utilized the World Café group technique with CHAs and T2DM users, and the second stage involved semi-structured interviews with T2DM users who did not participate in the previous stage. The content from the World Café sessions and the semi-structured interviews was fully transcribed and processed using Atlas.ti24 software and analyzed through Thematic Network Analysis. For this dissertation, only two main themes derived from the research data were considered: dietary habits and physical activity. Results: The study involved 17 CHAs and 47 T2DM users, whose reports generated basic themes organized into intrapersonal, interpersonal, and environmental factors. For the findings on healthy dietary habits, the manuscript “Barriers and facilitators to adherence to healthy eating habits in people with Type 2 Diabetes Mellitus (T2DM)” was produced. Through the participants' accounts, it was possible to understand that the main barriers were financial difficulties, lack of family support, and the absence of qualified professionals, while the main facilitators were awareness of healthy eating, adequate financial conditions, and family support. For the findings on physical activity, the manuscript “Barriers and facilitators to adherence to physical activity in people with Type 2 diabetes” was produced, where the significant statements from participants revealed that the main barriers were physical limitations, lack of motivation, financial difficulties, lack of knowledge, lack of qualified professionals, and distance from physical activity locations. In contrast, the main facilitators were the presence of an appropriate location within the coverage area of the Basic Health Unit (UBS), professional guidance, the presence of qualified professionals, personal motivation, family support, and adequate financial conditions. Conclusion: It was clear and evident that intrapersonal factors significantly influence both barriers and facilitators in adhering to healthy eating habits and regular physical activity among T2DM users attended by primary care in the Amazon context.