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退伍军人事务部整体健康指导如何影响退伍军人的健康和生活质量:一项混合方法试点项目评估

How VA Whole Health Coaching Can Impact Veterans' Health and Quality of Life: A Mixed-Methods Pilot Program Evaluation.

作者信息

Purcell Natalie, Zamora Kara, Bertenthal Daniel, Abadjian Linda, Tighe Jennifer, Seal Karen H

机构信息

San Francisco VA Health Care System, San Francisco, California.

University of California, San Francisco, San Francisco, California.

出版信息

Glob Adv Health Med. 2021 Mar 5;10:2164956121998283. doi: 10.1177/2164956121998283. eCollection 2021.

Abstract

PURPOSE

To examine the impact of a pilot VA Whole Health Coaching program, including whether and how the program helps veterans improve their health and quality of life.

INTERVENTION

Whole Health Coaching is a structured program to support veterans in making healthy behavior changes to promote holistic well-being.

DESIGN

This mixed-methods quality-improvement evaluation combined surveys (pre- and post-coaching) with follow-up qualitative interviews.

SETTING

The setting was a large VA healthcare system, encompassing a medical center and six community-based clinics in Northern California.

PARTICIPANTS

65 veterans completed surveys at both time points; 42 completed qualitative interviews.

METHOD

Telephone surveys administered at baseline and 3 months assessed global health (PROMIS-10), perceived stress (PSS-4), and perceived health competency (PHCS-2). Pre- and post-scores were compared using t-tests. A subsample of participants completed a qualitative interview evaluating program experience, goal attainment, and the coaching relationship.

RESULTS

Surveys showed significant improvements over baseline in mental health (p = 0.006; d = 0.36), stress (p = 0.003; d = -0.38), and perceived health competence (p = 0.01; d = 0.35). Interviewees were highly satisfied with their coaching experience, describing both effective program components and improvement opportunities.

CONCLUSION

Whole Health Coaching can help participants make meaningful progress toward health goals, reduce stress, and improve quality of life. The Whole Health model's emphasis on holistic self-assessment; patient-driven goal-setting; supportive, non-judgmental inquiry; and mindful awareness contributed to program success and enhanced participants' experience.

摘要

目的

探讨退伍军人事务部(VA)整体健康指导试点项目的影响,包括该项目是否以及如何帮助退伍军人改善健康状况和生活质量。

干预措施

整体健康指导是一个结构化项目,旨在支持退伍军人做出健康行为改变,以促进整体幸福感。

设计

这项混合方法的质量改进评估将(指导前后的)调查与后续定性访谈相结合。

研究背景

研究背景为一个大型VA医疗系统,涵盖加利福尼亚州北部的一个医疗中心和六个社区诊所。

参与者

65名退伍军人在两个时间点都完成了调查;42人完成了定性访谈。

方法

在基线和3个月时进行电话调查,评估整体健康状况(PROMIS - 10)、感知压力(PSS - 4)和感知健康能力(PHCS - 2)。使用t检验比较前后得分。部分参与者完成了定性访谈,评估项目体验、目标达成情况以及指导关系。

结果

调查显示,心理健康(p = 0.006;d = 0.36)、压力(p = 0.003;d = -0.38)和感知健康能力(p = 0.01;d = 0.35)较基线有显著改善。受访者对他们的指导体验高度满意,描述了有效的项目组成部分和改进机会。

结论

整体健康指导可以帮助参与者在健康目标方面取得有意义的进展,减轻压力,提高生活质量。整体健康模式强调整体自我评估、患者驱动的目标设定、支持性的、无评判性的询问以及正念意识,这些因素促成了项目的成功并增强了参与者的体验。

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