Rey Velasco E, Demjén Z, Skinner T C
Liva Healthcare, Københavns Universitet Institut for Psykologi, Copenhagen, Denmark.
Department of Psychology, University of Copenhagen, Kobenhavn, Denmark.
Digit Health. 2024 Mar 15;10:20552076231225889. doi: 10.1177/20552076231225889. eCollection 2024 Jan-Dec.
Digital health coaching interventions for behaviour change (BC) are effective in addressing various health conditions. Implementing these requires accurate descriptions of components and health coaches (HC) delivery methods, alongside understanding patients' perceptions of these interactions. The HC-patient relationship significantly influences BC outcomes. Here, empathy is an important driver that enables HCs to offer tailored advice that resonates with patients' needs, fostering motivation. Yet, defining and measuring empathy remains a challenge. In this study, we draw on various BC frameworks and Pounds' empathy appraisal approach to categorise HCs responses to patient cues and explore the interplay between empathy and BC.
Using a two-round survey, we collected responses from 11 HCs to 10 patient messages from the Bump2Baby and Me trial in a simulated interaction. We analysed 88 messages to identify empathic responses and behaviour change techniques.
Patients' implicit empathy opportunities showed higher response rates than explicit ones. HCs prioritised positive reinforcement and employed various strategies to achieve similar objectives. The most common empathic response was 'Acceptance' for patients' implicit positive expressions of self-judgement. HCs emphasised relatedness-support and competence-promoting techniques for implicit negative feelings and judgements, such as 'Show unconditional regard' and 'Review behaviour goals', and 'Action planning and Problem-solving' techniques to address explicit negative appreciations and feelings.
The use of different techniques with the same objective highlights the complexity of BC interactions. Further research is needed to explore the impact of this variability on patient outcomes and programme fidelity.
用于行为改变（BC）的数字健康指导干预措施在应对各种健康状况方面是有效的。实施这些措施需要准确描述其组成部分和健康指导师（HC）的交付方式，同时了解患者对这些互动的看法。健康指导师与患者的关系对行为改变结果有显著影响。在此，同理心是一个重要驱动力，它使健康指导师能够提供与患者需求相契合的个性化建议，从而激发动力。然而，定义和衡量同理心仍然是一项挑战。在本研究中，我们借鉴各种行为改变框架和庞德的同理心评估方法，对健康指导师对患者线索的反应进行分类，并探讨同理心与行为改变之间的相互作用。
通过两轮调查，我们收集了11名健康指导师在模拟互动中对来自“从怀孕到宝宝成长与我”试验的10条患者信息的回复。我们分析了88条信息，以识别同理心反应和行为改变技巧。
患者的隐性同理心机会比显性同理心机会的回复率更高。健康指导师将积极强化作为优先事项，并采用各种策略来实现类似目标。最常见的同理心反应是对患者自我判断的隐性积极表达的“接受”。对于隐性负面情绪和判断，健康指导师强调关系支持和能力提升技巧，如“表现出无条件的关注”和“回顾行为目标”，以及针对显性负面评价和感受的“行动计划和问题解决”技巧。
使用具有相同目标的不同技巧凸显了行为改变互动的复杂性。需要进一步研究来探讨这种变异性对患者结果和项目保真度的影响。
