Motivational Interviewing and Nurse Practitioner-Implemented Lifestyle Inverventions for the Prevention and Management of Type 2 Diabetes

Abstract

The purpose of this thesis was to develop recommendations for best practice in the management of type 2 diabetes patients by advanced practice nurses trained in motivational interviewing. The focus of the project was to provide a healthy lifestyle program for adults diagnosed with or at risk for type 2 diabetes. Type 2 diabetes accounts for 95% of diagnosed cases (CDC, 2012) and is the 7th leading cause of death (American Diabetes Association, 2014). In 2012, 29 million Americans had diabetes and 86 million had prediabetes, trending up from 2010 (American Diabetes Association, 2014). A literature review was conducted using keywords "type 2 diabetes", "lifestyle interventions" and "motivational interviewing" in PubMed, CINAHL and Cochrane databases. Results indicated that motivational interviewing and lifestyle interventions were associated with increased metabolic control for overweight and obese patients, including those with type 2 diabetes. Nurse practitioner understanding of nutrition and motivational interviewing techniques was often insufficient. The proposed intervention includes a comprehensive training program for primary care nurse practitioners including focus groups and evaluation. Motivational interviewing is utilized to deliver dietary counseling to patients with prediabetes and type 2 diabetes.