Effectiveness of Motivational Enhancement Therapy Plus Cognitive Behavior Therapy on Glycerol Control, Depressive Symptoms, and Health Related Quality of Life in Diabetic Patients: A Randomized Controlled Trial

Saturday, 26 July 2014

Chiung-Yu Huang, PhD
Nursing Department, I-Shou University, Kaohsiung, Taiwan
Hui-Ling Lai, PhD, RN
Nursing, Tzu Chi University/ Buddhist Tzu Chi General Hospital, Hualien, Taiwan
Wen-Kuei Chen, PhD
management of college, I-Shou University, Kaohsiung, Taiwan


When patients with diabetes have proper glycerol control, negative emotional responses usually occur and their health related quality of life is consequently under threats. The objective of this study was to determine the effectiveness of motivational enhancement therapy (MET) plus cognitive behavioral therapy (CBT) on depressive symptoms, HbA1C, fasting sugar, BMI, and health related quality of life in type II diabetic patients.

Methods: There was an experimental design, a repeated measurement analysis. Data were collected in diabetic outpatient department. In the outpatients department of a general hospital, 241 diabetes patients had been approached in a managed diabetes care system, and 61 of them were recruited for the intervention clinical trial, who were screened by using Radloff CESD for depressive symptoms with score above 16. The MET plus CBT intervention consisted of twelve weekly 80 minute-sessions. At this purpose, six scales were repeated measured before and after the intervention, and there month follow-up.


Sixty-one patients completed the study. There were statistically significant improvements for outcome variables in the MET plus CBT experimental group (n = 31) (p < 0.01). In comparison the outcomes to experiment and control group (n = 30), there were statistically significant decreasing in HbA1C and fasting sugar three months after intervention (p = 0.0009, p = 0.0144), and significant decreasing in depressive symptoms after and three month later of intervention (p = 0.0000).


Cognitive behavioral therapy improves self control skills and thus strengthens diabetes control skills, which results into the changes in fasting sugar, HbA1C, and depressive symptoms, and enhance health related quality of life. The intervention results 1-month improvement in HbA1C, fasting sugar and post and 3-month decreasing depressive symptoms compared with usual medical care. Nurse and psychiatrist delivered MET plus CBT as feasible for adults with depressive symptoms of type II diabetes. Nursing professional can consider using MET plus CBT besides usual care for improving psychological adjustment to their situation and thus lower the complications and cost of diabetic consequences.