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A health coaching self-management programme to improve physical activity, lung function and quality of life in patients with Chronic Obstructive Pulmonary Disease: a randomized controlled trial
Jönköping University, School of Health and Welfare, HHJ. ADULT.
Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science. Jönköping University, School of Health and Welfare, HHJ. ADULT.ORCID iD: 0000-0002-7406-8732
Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science. Jönköping University, School of Health and Welfare, HHJ. IMPROVE (Improvement, innovation, and leadership in health and welfare).
School of Nursing, Tianjin Medical University, China.
(English)Manuscript (preprint) (Other academic)
Abstract [en]

Background: Chronic obstructive pulmonary disease (COPD) is the fourth most prevalent cause of death in the world and contributes to higher economic and social burden. Health coaching, which is an approach to support self-management, has proven to be effective in health outcomes for patients with COPD in developed countries. However, no study has evaluated a systematic and structured health-coaching COPD programme to support self-management in China.

Objectives: To evaluate the effects of a health coaching self-management programme on lung function, physical activity and quality of life in patients with COPD

Design: A randomised controlled trial in patients with COPD

Methods: The participants were randomised to either an intervention group (n = 48) or a control group (n = 49) during hospitalisation. The intervention group received usual care combined with a health coaching self-management programme; the control group received only usual care. The intervention programme was performed for six months, and the effects of the intervention were assessed for FEV1%, FVC%, hand grip strength and 1-minute sit-to-stand (STS); and by the Global Physical Activity Questionnaire (GPAQ), Clinical COPD Questionnaire (CCQ) at baseline, 6th week, 6th month and 12th month follow-ups post-discharge.

Results: Of the 97 patients, 88% completed the 12-month follow-up (94% in the intervention group and 82% in the control group). The interaction effect between time and group (control or intervention) for lung function, physical activity and quality of life showed that the intervention group improved significantly compared to the control group in all measures: FEV1% (P =0.003), FVC% (P = 0.001), GPAQ (P = 0.001), 1-minute STS (P = 0.005) and Grip strength (P<0.001), as well as the CCQ-symptom (P <0.001), CCQ-emotion (P <0.001), CCQ-activity (P<0.001) and CCQ (P <0.001).

Conclusion: The health coaching self-management programme can improve lung function, physical activity and quality of life in patients with COPD.

Keywords [en]
Chronic obstructive pulmonary disease, Health coaching, lung function, physical activity, quality of life, self-management
National Category
Nursing
Identifiers
URN: urn:nbn:se:hj:diva-41177OAI: oai:DiVA.org:hj-41177DiVA, id: diva2:1240039
Note

Submitted to journal.

Available from: 2018-08-20 Created: 2018-08-20 Last updated: 2019-03-07
In thesis
1. A health coaching self-management programme for patients with Chronic Obstructive Pulmonary Disease: An explorative and interventional study
Open this publication in new window or tab >>A health coaching self-management programme for patients with Chronic Obstructive Pulmonary Disease: An explorative and interventional study
2018 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Background: Chronic Obstructive Pulmonary Disease (COPD) is a primary cause of chronic morbidity and mortality and contributes to an increased economic and social burden on patients and families. Self-management education as one non-pharmacological treatment approach is highlighted in guidelines. Although self-management programmes have shown positive effects for COPD, lack of disease-specific self-management skills, high dropout rates, and poor attendance of participants are problems which should be taken under consideration. One way to cope with the problems is to use amore motivational approach which focuses on patients’ health decisions in cooperation with healthcare practitioners, combined with systematic and structured health coaching. However, there is a lack of such studies, which are needed to explore the effects of self-management on patients with COPD by health coaching, not least in China.

Aims: The overall aim of this thesis was to explore sociodemographic and clinical factors influencing self-management and to test and evaluate a health coaching self-management programme for patients with COPD in China.

Methods: The study’s design was explorative, prospective, and longitudinal, with both quantitative and qualitative approaches. Specifically, a quantitative method with a cross-sectional approach was used to explore the self-management status of patients with COPD and examine the associations with socio-demographic and clinical variables (I). Furthermore, a prospective randomized controlled trial was conducted to study the longitudinal effects of the health coaching self-management programme using a repeated-measures analysis of variance model of patients with COPD (II & III). A qualitative study implementing inductive content analysis was used to describe and explore participants’ experiences of the health coaching self-management programme of patients with COPD (IV).

Results: High physical activity, high salary, and low age affected the self-management of patients with COPD most positively (I). The health coaching programme improved lung function, physical activity, quality of life, and self-management skills, as well as psychological status in both the short and long term (II & III). Participants expressed their experiences of the health coaching self-management programme as making them more aware of the importance of knowledge of the disease and their own responsibilities, taking action to maintain a healthy lifestyle, feeling supported by the programme, and being hindered by individual and programme limitations (IV).

Conclusions: This thesis contributes to knowledge about the self-management skills of patients with COPD, which is low in China. A health coaching self-management programme with iterative interactions between patients and healthcare professionals represented a valuable and effective intervention designed to improve health-related outcomes. Moreover, low literacy, poor physical condition, and family and economic burdens should be taken into account in the development of future self-management programmes in China.

Place, publisher, year, edition, pages
Jönköping: Jönköping University, School of Health and Welfare, 2018. p. 80
Series
Hälsohögskolans avhandlingsserie, ISSN 1654-3602 ; 092
Keywords
Chronic Obstructive Pulmonary Disease, Self-management, Health coaching
National Category
Nursing
Identifiers
urn:nbn:se:hj:diva-41179 (URN)978-91-85835-91-1 (ISBN)
Public defence
2018-09-13, Forum Humanum, School of Health and Welfare, Jönköping, 13:00 (English)
Opponent
Supervisors
Available from: 2018-08-20 Created: 2018-08-20 Last updated: 2019-03-07Bibliographically approved

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Wang, LanMårtensson, JanNygårdh, Annette

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