Linden Consulting Group, Portland, OR, USA.
J Eval Clin Pract. 2010 Feb;16(1):166-74. doi: 10.1111/j.1365-2753.2009.01300.x.
To evaluate the impact of motivational interviewing-based health coaching on a chronically ill group of participants compared with non-participants. Specifically, measures that could be directly attributed to a health coaching intervention on chronic illness were assessed.
Quasi-experimental study design.
A large medical university in the north-west United States.
One hundred and six chronically ill programme participants completed a health risk survey instrument prior to enrolment and again at approximately 8 months. Outcomes were compared with 230 chronically ill non-participants who completed the survey twice over a similar time frame. Inverse probability of treatment weights were used in conjunction with the propensity score to correct for selection bias.
Compared with non-participants, programme participants improved their self-efficacy (P = 0.01), patient activation (P = 0.02), lifestyle change score (P = 0.01) and perceived health status (P = 0.03). Fewer participants increased their stages of change risk over time than non-participants (P < 0.01), and more participants decreased their stages of change risk over time than non-participants (P = 0.03).
These results support motivational interviewing-based health coaching as an effective chronic care management intervention in impacting outcome measures that could also serve well as a proxy in the absence of other clinical or cost indices.
评估基于动机访谈的健康辅导对慢性病患者群体与非参与者的影响。具体而言，评估了可直接归因于慢性病健康辅导干预的措施。
准实验研究设计。
美国西北部的一所大型医科大学。
106 名慢性病项目参与者在入组前和大约 8 个月后完成了一项健康风险调查工具。结果与在相似时间框架内完成两次调查的 230 名慢性病非参与者进行了比较。采用逆概率治疗权重与倾向评分相结合的方法纠正选择偏差。
与非参与者相比，项目参与者提高了自我效能感（P = 0.01）、患者激活度（P = 0.02）、生活方式改变得分（P = 0.01）和感知健康状况（P = 0.03）。随着时间的推移，参与者增加风险阶段的人数少于非参与者（P < 0.01），而参与者减少风险阶段的人数多于非参与者（P = 0.03）。
这些结果支持基于动机访谈的健康辅导作为一种有效的慢性病管理干预措施，对可能作为其他临床或成本指标替代的结果测量指标产生影响。
