Thom David H, Wolf Jessica, Gardner Heather, DeVore Denise, Lin Michael, Ma Andy, Ibarra-Castro Ana, Saba George
Center for Excellence in Primary Care, Department of Family and Community Medicine, University of California, San Francisco School of Medicine, San Francisco, California
Center for Excellence in Primary Care, Department of Family and Community Medicine, University of California, San Francisco School of Medicine, San Francisco, California.
Ann Fam Med. 2016 Nov;14(6):509-516. doi: 10.1370/afm.1988.
Although health coaches are a growing resource for supporting patients in making health decisions, we know very little about the experience of health. We undertook a qualitative study of how health coaches support patients in making decisions and implementing changes to improve their health.
We conducted 6 focus groups (3 in Spanish and 3 in English) with 25 patients and 5 friends or family members, followed by individual interviews with 42 patients, 17 family members, 17 health coaches, and 20 clinicians. Audio recordings were transcribed and analyzed by at least 2 members of the study team in ATLAS.ti using principles of grounded theory to identify themes and the relationship between them.
We identified 7 major themes that were related to each other in the final conceptual model. Similarities between health coaches and patients and the time health coaches spent with patients helped establish the health coach-patient relationship. The coach-patient relationship allowed for, and was further strengthened by, 4 themes of key coaching activities: education, personal support, practical support, and acting as a bridge between patients and clinicians.
We identified a conceptual model that supports the development of a strong relationship, which in turn provides the basis for effective coaching. These results can be used to design health coach training curricula and to support health coaches in practice.
尽管健康教练作为一种资源,在帮助患者做出健康决策方面正日益增加,但我们对健康体验却知之甚少。我们开展了一项定性研究,以了解健康教练如何帮助患者做出决策并实施改善健康的改变。
我们组织了6个焦点小组(3个用西班牙语,3个用英语),参与者包括25名患者以及5名朋友或家庭成员,随后对42名患者、17名家庭成员、17名健康教练和20名临床医生进行了个人访谈。研究团队的至少两名成员在ATLAS.ti中对录音进行转录和分析,运用扎根理论的原则来确定主题以及它们之间的关系。
我们在最终的概念模型中确定了7个相互关联的主要主题。健康教练与患者之间的相似性以及健康教练与患者相处的时间有助于建立健康教练 - 患者关系。教练 - 患者关系促成了4个关键指导活动主题,并因之得到进一步加强:教育、个人支持、实际支持以及充当患者与临床医生之间的桥梁。
我们确定了一个支持建立牢固关系的概念模型,这反过来又为有效的指导提供了基础。这些结果可用于设计健康教练培训课程,并在实践中为健康教练提供支持。