Division of Population Medicine, Cardiff University, Cardiff, UK.
School of Social Sciences, Cardiff University, Cardiff, UK.
Health Expect. 2020 Aug;23(4):919-933. doi: 10.1111/hex.13071. Epub 2020 May 28.
Supporting people to self-manage their long-term conditions is a UK policy priority. Health coaching is one approach health professionals can use to provide such support. There has been little research done on how to train clinicians in health coaching or how to target training to settings where it may be most effective.
To develop theories to describe how training health professionals in health coaching works, for whom and in what circumstances, with a focus on those working with people with progressive neurological conditions.
Realist evaluation using mixed methods (participant observation, pre- and post-training questionnaires, and telephone interviews with participants and trainers). Realist data analysis used to develop and refine theories.
Two 1-day face-to-face training sessions in health coaching with 11 weeks between first and second days.
Twenty health-care professionals who work with people with neurological conditions in the UK, two training facilitators.
Four theories were developed using context-mechanism-outcome configurations to describe how training triggers critical reflection; builds knowledge, skills and confidence; how participants evaluate the relevance of the training; and their experiences of implementing the training. Some participants reported a major shift in practice, and others implemented the training in more limited ways.
Fully embracing the role of coach is difficult for health professionals working in positions and settings where their clinical expertise appears most highly valued.
Training should address the practicality of using coaching approaches within existing roles, while organizations should consider their role in facilitating implementation.
支持人们自我管理长期疾病是英国的政策重点。健康教练是健康专业人员提供此类支持的一种方法。关于如何培训临床医生进行健康教练以及如何针对可能最有效的环境进行培训，研究甚少。
针对健康专业人员的健康教练培训的效果、对象和环境，开发描述其工作原理的理论，重点关注那些与进行性神经疾病患者合作的人员。
采用混合方法（参与式观察、培训前后问卷调查以及对参与者和培训师进行电话访谈）进行的真实评估。采用真实评估数据分析来开发和完善理论。
为期两天的面对面健康教练培训，两次培训之间间隔 11 周。
20 名在英国从事神经疾病患者护理的医疗保健专业人员，2 名培训师。
通过上下文-机制-结果配置开发了四个理论，以描述培训如何引发批判性思考；建立知识、技能和信心；参与者如何评估培训的相关性；以及他们实施培训的经验。一些参与者报告说他们的实践发生了重大转变，而另一些参与者则以更有限的方式实施了培训。
在其临床专业知识最受重视的职位和环境中工作的卫生专业人员，完全接受教练的角色是具有挑战性的。
培训应解决在现有角色中使用教练方法的实用性问题，而组织应考虑其在促进实施方面的作用。
