Diabetes is a highly prevalent chronic disease that requires good adherence to medical recommendation, and with a complex daily management in case of insulin-dependent diabetes. It is a very important societal issue, not only for reasons of personal health and well-being but also for economic reasons because poor therapeutic adherence affects the use and optimization of health system resources. The main goal of this communication is to present a research project that grasp the phenomenon of therapeutic adherence, and all that it implicates, in a complete and precise manner, based on a qualitative approach, namely in deep interviews and content analysis. The study focuses on adults. It approaches the question of how persons manage diabetes through an analysis of the socio-demographic profile, the economic situation, the dietary perceptions and practices, the perceptions of illness and health, the health literacy, the sources of motivation for care, the health care practices, the therapeutic adherence, the therapeutic itineraries within health care processes, the patient-doctor relationship, the care-giving practices of relatives, friends or private health workers, and the social support net. Diabetes involves some degree of disability and suffering, it requires self-care, including proper dietry, which requires a certain level of health literacy, particularly with regard to nutrition, as well as some economic capital. To understand that phenomenon we have to take into account the social, environmental and personal factors that interact in the disease. The therapeutic activity, taking into account the whole patient as a subject, looks for his independence towards the control of disease-related complications, and it is therefore important to its adherence to medical recommendations and requirements. In this context, we analyzed therapeutic adherence's determinants by taking into account the elements that influence it: gender (differences between men and women in illness perceptions and management), patient-health professional relationship, functioning health institutions, illness perception by the patients and their families, the therapeutic education practices, its impact on the daily management of diabetes, and the assessment of the knowledge and attitudes towards daily health care.
Maria Manuel Quintela
Governance, Policies and Livelihoods