Collins David A, Thompson Kirsten, Atwood Katharine A, Abadi Melissa H, Rychener David L, Simmons Leigh Ann
1Pacific Institute for Research and Evaluation - Louisville Center, Louisville, KY.
2Duke University School of Nursing, Durham, NC.
Glob Adv Health Med. 2018 Feb 14;7:2164957X18757463. doi: 10.1177/2164957X18757463. eCollection 2018.
Although studies of health coaching for behavior change in chronic disease prevention and management are increasing, to date no studies have reported on what concepts and skills providers integrate into their clinical practice following participation in health coaching courses. The purpose of this qualitative study was to assess Veterans Health Administration (VHA) providers' perceptions of the individual-level and system-level changes they observed after participating with colleagues in a 6-day Whole Health Coaching course held in 8 VHA medical centers nationwide.
Data for this study were from the follow-up survey conducted with participants 2 to 3 months after completing the training. A total of 142 responses about individual-level changes and 99 responses about system-level changes were analyzed using content analysis.
Eight primary themes emerged regarding individual changes, including increased emphasis on Veterans' values, increased use of listening and other specific health coaching skills in their clinical role, and adding health coaching to their clinical practice.Four primary themes emerged regarding system-level changes, including leadership support, increased staff awareness/support/learning and sharing, increased use of health coaching skills or tools within the facility, and organizational changes demonstrating a more engaged workforce, such as new work groups being formed or existing groups becoming more active.
Findings suggest that VHA providers who participate in health coaching trainings do perceive positive changes within themselves and their organizations. Health coaching courses that emphasize patient-centered care and promote patient-provider partnerships likely have positive effects beyond the individual participants that can be used to promote desired organizational change.
尽管针对慢性病预防和管理中行为改变的健康指导研究日益增多，但迄今为止，尚无研究报告提供者在参加健康指导课程后将哪些概念和技能融入其临床实践。这项定性研究的目的是评估退伍军人健康管理局（VHA）的提供者对他们在全国8个VHA医疗中心与同事一起参加为期6天的全健康指导课程后所观察到的个人层面和系统层面变化的看法。
本研究的数据来自完成培训2至3个月后对参与者进行的后续调查。使用内容分析法对总共142份关于个人层面变化的回复和99份关于系统层面变化的回复进行了分析。
出现了八个关于个人变化的主要主题，包括更加重视退伍军人的价值观、在临床角色中更多地使用倾听和其他特定的健康指导技能，以及将健康指导添加到他们的临床实践中。出现了四个关于系统层面变化的主要主题，包括领导支持、工作人员意识/支持/学习和分享的增加、设施内健康指导技能或工具使用的增加，以及组织变化表明劳动力更积极参与，例如形成新的工作小组或现有小组变得更加活跃。
研究结果表明，参加健康指导培训的VHA提供者确实察觉到他们自身以及他们的组织内有积极的变化。强调以患者为中心的护理并促进患者与提供者伙伴关系的健康指导课程可能会产生超出个体参与者的积极影响，可用于促进期望的组织变革。
