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Effects of a health coaching self-management programme in patients with Chronic Obstructive Pulmonary Disease on self-management skills and psychological status: 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. IMPROVE (Improvement, innovation, and leadership in health and welfare).
School of Nursing, Tianjin Medical University, China.
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
(English)Manuscript (preprint) (Other academic)
Abstract [en]

Objectives: To evaluate the effects of a health coaching self-management programme intended to improve self-management skills and psychological status for patients with Chronic Obstructive Pulmonary Disease.

Design: Randomized controlled trial.

Methods: A randomized controlled study was conducted among patients with COPD. The participants who met the inclusion criteria were randomized to either an intervention group (n=48) or a control group (n=49). The intervention group received the health coaching self-management programme, while the control group received usual care. The programme were performed during six months, and the effects of the intervention were assessed by the COPD Self-management Scale (CSMS) and Hospital anxiety and depression scale (HADS) at baseline, 6th week, 6th month and 12th month post discharge.

Results: Of the 97 patients, 45 (94%) in the intervention group and 40 (82%) in control group, completed 12-month follow-up. The interaction effect between time and group (control or intervention) showed that the intervention group improved significantly compared to the control group for all five dimensions in self management skills, Symptom management (P<0.001), Daily life management (P<0.001), Emotion management (P<0.001), Information management (P<0.001) and Self-efficacy (P<0.001), as well as psychological status with anxiety (P<0.001) and depression (P<0.001).

Conclusion: This trial shows that a nurse-led Health Coaching Self-management Programme has the potential to significantly improve the effects on the self management skills, as well as reducing anxiety and depression for patients with COPD.

Keywords [en]
Health Coaching, Self-management, Chronic Obstructive Pulmonary Disease, Anxiety, Depression
National Category
Nursing
Identifiers
URN: urn:nbn:se:hj:diva-41178OAI: oai:DiVA.org:hj-41178DiVA, id: diva2:1240042
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, LanNygårdh, AnnetteMårtensson, Jan

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