Matthews Jessica A, Matthews Simon, Faries Mark D, Wolever Ruth Q
College of Health Sciences, Point Loma Nazarene University, San Diego, CA.
Department of Family Medicine, Centers for Integrative Health, UC San Diego Health, San Diego, CA.
Mayo Clin Proc Innov Qual Outcomes. 2024 May 18;8(3):263-275. doi: 10.1016/j.mayocpiqo.2023.10.002. eCollection 2024 Jun.
Behavior change is the foundation for effective lifestyle prescriptions, yet such change is individualized, nonlinear and typically requires ongoing support. Health and wellness coaching (HWC) is a behavior change intervention with rapidly accruing evidence of positive impact on health behaviors such as exercise, nutrition and stress management. Furthermore, HWC enhances prevention and mitigates exacerbation of chronic lifestyle diseases, at least in the short-term (up to 6 months post intervention). Although the impact on long-term stability of behavior change remains unclear, it is evident that effective partnering with patients using key communication strategies, autonomy promotion, and flexible permissiveness can empower patients to develop healthy lifestyles. This partnership can be cultivated by clinicians as well as clinical team members including nationally board-certified coaches. Although much research is needed regarding the ongoing maintenance of lifestyle changes beyond 6 months, this article seeks to equip clinicians with current evidence, theoretical insights and practical strategies from a "coach approach" to foster more intrinsic forms of motivation which, in turn, empowers patients to adopt and maintain health-promoting behaviors.
行为改变是有效生活方式处方的基础，但这种改变是因人而异的、非线性的，通常需要持续的支持。健康与 Wellness 教练指导（HWC）是一种行为改变干预措施，越来越多的证据表明其对运动、营养和压力管理等健康行为具有积极影响。此外，HWC 至少在短期内（干预后长达 6 个月）可增强预防并减轻慢性生活方式疾病的恶化。尽管对行为改变的长期稳定性的影响尚不清楚，但很明显，通过使用关键沟通策略、促进自主性和灵活宽容与患者建立有效的合作关系，可以使患者有能力养成健康的生活方式。临床医生以及包括国家认证教练在内的临床团队成员都可以培养这种合作关系。尽管对于 6 个月以上生活方式改变的持续维持还需要进行大量研究，但本文旨在为临床医生提供来自“教练方法”的当前证据、理论见解和实用策略，以培养更内在的动机形式，进而使患者有能力采用并维持促进健康的行为。
