Faculty of Medicine and Health, The University of Sydney, Sydney, Australia.
Faculty of Medicine and Health, School of Health Sciences, The University of Sydney, Sydney, Australia.
BMC Health Serv Res. 2024 Sep 16;24(1):1072. doi: 10.1186/s12913-024-11509-8.
Global policy and guidelines for low back pain (LBP) management promote physical activity and self-management yet adherence is poor and a decline in outcomes is common following discharge from treatment. Health coaching is effective at improving exercise adherence, self-efficacy, and social support in individuals with chronic conditions, and may be an acceptable, cost-effective way to support people in the community following discharge from treatment for LBP.
This qualitative study aimed to understand which aspects of a community over-the-phone health-coaching program, were liked and disliked by patients as well as their perceived outcomes of the service after being discharged from LBP treatment.
A purposive sampling approach was used to recruit 12 participants with chronic LBP, from a large randomised controlled trial, who were randomly allocated to receive a health coaching program from the Get Healthy Service in Australia. Semi-structured interviews were conducted, and a general inductive thematic analysis approach was taken.
The main themes uncovered regarding the intervention included the positive and negative aspects of the health coaching service and the relationship between the participant and health coach. Specifically, the participants spoke of the importance of the health coach, the value of goal setting, the quality of the advice received, the benefits of feeling supported, the format of the coaching service, and LBP-specific knowledge. They also reported the health coach and the coaching relationship to be the primary factors influencing the program outcomes and the qualities of the coaching relationship they valued most were connection, communication, care, and competence. The sub-themes uncovered regarding the outcomes of the intervention included positive impacts (a greater capacity to cope, increased confidence, increased motivation and increased satisfaction) and negative impacts (receiving no personal benefit).
In an environment where self-management and self-care are becoming increasingly important, understanding the patient's experience as part of a coaching program is likely to lead to improved quality of health coaching care, more tailored service delivery and potentially more effective and cost-effective community-based care for individuals with chronic LBP in the community after being discharged from treatment.
The GBTH trial was prospectively registered with the Australian New Zealand Clinical Trials Registry (ACTRN12620000889954) on 10/9/2020. Ethical approval was prospectively granted by the Western Sydney Local Health District Human Research and Ethics Committee (2020/ETH00115). Written informed consent was obtained from all participants. The relevant sponsor has reviewed the study protocol and consent form.
全球政策和指南都提倡对下背痛（LBP）进行管理，以促进身体活动和自我管理，但坚持治疗的比例较低，且治疗后结果往往会下降。健康教练在改善慢性疾病患者的运动依从性、自我效能和社会支持方面非常有效，并且在治疗后从 LBP 出院的人群中，这可能是一种可接受且具有成本效益的支持方式。
本定性研究旨在了解社区电话健康辅导方案的哪些方面受到患者的喜爱和不喜爱，以及他们在接受 LBP 治疗后出院时对该服务的感知结果。
采用目的性抽样方法，从一项大型随机对照试验中招募了 12 名慢性 LBP 患者，他们被随机分配到澳大利亚 Get Healthy 服务接受健康教练计划。进行了半结构化访谈，并采用了一般归纳主题分析方法。
干预措施的主要主题包括健康辅导服务的积极和消极方面以及参与者与健康教练之间的关系。具体来说，参与者谈到了健康教练的重要性、设定目标的价值、所获得的建议质量、获得支持的好处、辅导服务的形式以及 LBP 特定知识。他们还报告说，健康教练和教练关系是影响计划结果的主要因素，他们最看重的教练关系的品质是联系、沟通、关怀和能力。干预措施结果方面揭示的子主题包括积极影响（应对能力更强、信心增强、动机增加和满意度增加）和消极影响（没有个人受益）。
在自我管理和自我保健变得越来越重要的环境中，了解辅导计划中患者的体验可能会导致提高健康辅导护理的质量，更有针对性的服务提供，并可能为治疗后出院的社区中慢性 LBP 患者提供更有效和更具成本效益的社区护理。
GBTH 试验于 2020 年 9 月 10 日在澳大利亚新西兰临床试验注册中心（ACTRN12620000889954）进行了前瞻性注册。西悉尼地方卫生区人类研究和伦理委员会（2020/ETH00115）前瞻性批准了伦理批准。所有参与者均获得书面知情同意。相关赞助商已审查了研究方案和同意书。
