Nurse-led psychological interventions to improve diabetes control: Assessing competencies

Maissi, Esther; Ridge, Katie; Treasure, Janet; Chalder, Trudie; Roche, Suzanne; Bartlett, Jonathan; Schmidt, Ulrike; Thomas, Stephen; Ismail, Khalida

doi:10.1016/j.pec.2010.07.036

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Volume 84, Issue 2 , Pages e37-e43, August 2011

Nurse-led psychological interventions to improve diabetes control: Assessing competencies

Esther Maissi
- Department of Psychological Medicine, Institute of Psychiatry, King's College London, UK
Katie Ridge
- Department of Psychological Medicine, Institute of Psychiatry, King's College London, UK
Janet Treasure
- Department of Psychological Medicine, Institute of Psychiatry, King's College London, UK
Trudie Chalder
- Department of Psychological Medicine, Institute of Psychiatry, King's College London, UK
Suzanne Roche
- South London and Maudsley NHS Foundation Trust, London, UK
Jonathan Bartlett
- Medical Statistics Unit, London School of Hygiene and Tropical Medicine, London, UK
Ulrike Schmidt
- Department of Psychological Medicine, Institute of Psychiatry, King's College London, UK
Stephen Thomas
- Diabetes and Endocrinology, Guy's and St. Thomas’ NHS Foundation Trust, London, UK
Khalida Ismail
- Department of Psychological Medicine, Institute of Psychiatry, King's College London, UK
- Corresponding author at: Institute of Psychiatry, Psychological Medicine, King's College London, 10 Cutcombe Road, London SE5 9RJ, UK. Tel.: +44 0207 848 0778; fax: +44 0207 848 5408.

Received 16 February 2010; received in revised form 17 June 2010; accepted 21 July 2010. published online 01 September 2010.

Abstract

Objective

To assess whether medical nurses can deliver motivational enhancement therapy (MET) and cognitive behavioural therapy (CBT) to a competent level and whether treatment fidelity is maintained.

Methods

Training consisted of classroom teaching, written materials, a training caseload, and audio-visual feedback. We used the Motivational Interviewing Treatment Integrity (MITI), the Revised 12-item Cognitive Therapy Scale (CTS-R), and components of the Motivational Interviewing Skill Code (MISC) to assess competency and treatment fidelity. Two independent clinical psychologists who were blind to the allocation rated a random selection of 40 sessions.

Results

Six nurses were trained in both interventions. For the MET the mean (SD) scores for empathy and spirit on the MITI scale were 5.1 (0.7) and 4.6 (1.0) respectively and for CBT the total mean (SD) CTS-R score was 52.1 (7.5), which was acceptable competency in both treatments. The two interventions were distinguishable.

Conclusion

Results suggest that nurses can be trained to deliver diabetes-specific MET and CBT competently and maintain treatment fidelity.

Practice implications

Findings of this study provide preliminary evidence to suggest that nurse-led psychological interventions could be incorporated into the traditional diabetes setting.

Keywords: Motivational enhancement therapy, Cognitive behaviour therapy, Diabetes, Randomised controlled trial