Date of Award

Spring 5-27-2023

Document Type

Doctor of Nursing Practice Final Manuscript

Degree Name

Doctor of Nursing Practice



First Advisor



Major depressive disorder is one of the most common mental health conditions. In the United States, 8.1% of the population have symptoms of depression. Patients with diabetes are 2–3 times more likely to experience symptoms of depression compared to the general population. Having these chronic conditions simultaneously can cause complications in both. The purpose of this study was to improve depression scores for patients who have comorbid type II diabetes. This project took place in a rural community with the Latino population. The nurse practitioner led an evidence-based practice project implementing treatment of depression with medication management, individual psychotherapy, and increase in physical activity. Patient Health Questionnaire 9 (PHQ-9) scores and hemoglobin A1c results were collected at the start of treatment and were monitored for improvement. After 3 months, results showed 80% improvement in PHQ-9 scores and 55% improvement in hemoglobin A1c levels with the treatment of depression and encouragement of self-care activities. Empowering patients with self-care activities to improve their mental health should be included in the plan of care for patients with depression and diabetes. Health care providers must educate how mental health can also affect physical health. We all need to work cohesively towards removing the stigma of mental health.

Keywords: Depression, diabetes, stigma, treatment, rural, PHQ9, HgbA1c, major depression, type II diabetes

Included in

Nursing Commons