Promoting self-care for the patient with diabetes and depression: an integrative literature review

Patients with diabetes are well known to be at risk of various complications, with depression being one of them. The aim of this integrative literature review is to explore the impact of depression on diabetes self-care activities and the role of the nurse practitioner (NP) in promoting diabetes self-care in this population. A comprehensive search and analysis of the literature was undertaken and a final cohort of 18 studies was included for this integrative literature review. The literature demonstrates a strong association between diabetes and depression, and the negative impact on diabetes self-care activities. Furthermore, the literature demonstrates the use of three types of interventions for this population in primary care including 1) enhanced depression treatment 2) integrated management of diabetes and depression, and 3) patient centred collaborative care. Key findings and recommendations include the need to identity and screen patients with diabetes for depression, provide on-going support in the management of both conditions and ensure a patient centred approach to treatment. Further research is needed to determine the uptake and screening of depression in primary care settings, the utilization of the collaborative care model for multiple chronic conditions and to examine the delivery of healthcare in British Columbia by NPs for patients with multiple chronic conditions. --Leaf ii.