Alamy
Opinion
Coaching for life
Lawrence Whyte outlines how nurses can motivate patients to self-manage their conditions and maintain wellbeing THE GROWING number of people with chronic illness in the UK is likely to force up costs of long-term health care and presents new challenges for treatment and management. Strategies must, therefore, be aimed at helping people self-manage their conditions more effectively. Diabetes alone costs the NHS in England about £1.3 billion a year, and the projected increase in the diabetic population means this cost will spiral out of control. In addition, charity Asthma UK estimates there are 5.4 million people in the UK receiving treatment for asthma at a cost of about £1 billion a year, while the government estimates the prevalence of hypertension in men and women over the age of 35 to be at 32% and 27% respectively. Research shows that knowledge acquisition does not necessarily promote change in the behaviour of individuals that leads to improved quality of life (Lundahl and Burke 2009). Real change in behaviour is more likely when information is given alongside techniques for motivating change. NURSING MANAGEMENT
In the business world, coaching is used as an effective tool to promote and sustain changes in individuals’ behaviour in organisations. It has become an acceptable process to improve performance, manage stress, and achieve work and personal goals. Yet there is little research in the UK on the use of coaching in health care. Evidence regarding its use in the US suggests it could prove a rich intervention to help people self-manage their health by engaging them more fully in their own care. A randomised controlled trial of patients with depression being coached by medical assistants in primary care settings found better health outcomes in patients supported by coaches, than in those who received usual care (Gensichen et al 2009). Healthcare coaching is a process that enables people to gain the knowledge, skills and confidence to become active participants in their care and self-manage health and wellbeing more effectively. It assumes a collaborative approach that
elicits from patients what changes they are willing to make, rather than tells them what they need to do. It challenges clients to listen to their inner wisdom, identify their values and transform their goals into action. A primary aim of coaching for health and wellbeing is to help people gain a more comprehensive understanding of their health beliefs – both health enhancing and health inhibiting. Individuals’ perceptions of health and illness vary according to their social circumstances and the severity of their ill health, their susceptibility to improvement or deterioration in their ill health, the benefits of taking preventative action and barriers to taking action. Collaboration By assisting people to examine their health beliefs and increasing their understanding of the inhibiting and enhancing factors that can influence improvements, relationships become collaborative rather than prescriptive. People can be enabled to create visions of wellness unique and personalised to them. A coach can then assist in setting realistic and achievable goals, using a range of disciplines including positive psychology, motivational interviewing and neurolinguistic programming. Nurses are ideally placed to act as health coaches and assist patients in this way. They are knowledgeable about long-term conditions and healthy-living guidance, and they develop sustainable relationships with patients and possess some training in interpersonal psychology. In this way they can improve patient compliance, adherence to recommended treatment plans and motivational levels so that individuals can work towards strengthening their involvement in self-management. Lawrence Whyte is a registered nurse at Riverdale Unit, Sheffield
References Gensichen J, von Korff M, Peitz M et al (2009) Case management for depression by health care assistants in small primary care practices: a cluster randomized trial. Annals of Internal Medicine. 151, 6, 369-378. Lundahl B, Burke B (2009) The effectiveness and applicability of motivational interviewing: a practice-friendly review of four meta-analyses. Journal of Clinical Psychology. 65, 11, 1232-1245.
April 2014 | Volume 21 | Number 1 15
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Opinion
Coaching for life
Lawrence Whyte outlines how nurses can motivate patients to self-manage their conditions and maintain wellbeing THE GROWING number of people with chronic illness in the UK is likely to force up costs of long-term health care and presents new challenges for treatment and management. Strategies must, therefore, be aimed at helping people self-manage their conditions more effectively. Diabetes alone costs the NHS in England about £1.3 billion a year, and the projected increase in the diabetic population means this cost will spiral out of control. In addition, charity Asthma UK estimates there are 5.4 million people in the UK receiving treatment for asthma at a cost of about £1 billion a year, while the government estimates the prevalence of hypertension in men and women over the age of 35 to be at 32% and 27% respectively. Research shows that knowledge acquisition does not necessarily promote change in the behaviour of individuals that leads to improved quality of life (Lundahl and Burke 2009). Real change in behaviour is more likely when information is given alongside techniques for motivating change. NURSING MANAGEMENT
In the business world, coaching is used as an effective tool to promote and sustain changes in individuals’ behaviour in organisations. It has become an acceptable process to improve performance, manage stress, and achieve work and personal goals. Yet there is little research in the UK on the use of coaching in health care. Evidence regarding its use in the US suggests it could prove a rich intervention to help people self-manage their health by engaging them more fully in their own care. A randomised controlled trial of patients with depression being coached by medical assistants in primary care settings found better health outcomes in patients supported by coaches, than in those who received usual care (Gensichen et al 2009). Healthcare coaching is a process that enables people to gain the knowledge, skills and confidence to become active participants in their care and self-manage health and wellbeing more effectively. It assumes a collaborative approach that
elicits from patients what changes they are willing to make, rather than tells them what they need to do. It challenges clients to listen to their inner wisdom, identify their values and transform their goals into action. A primary aim of coaching for health and wellbeing is to help people gain a more comprehensive understanding of their health beliefs – both health enhancing and health inhibiting. Individuals’ perceptions of health and illness vary according to their social circumstances and the severity of their ill health, their susceptibility to improvement or deterioration in their ill health, the benefits of taking preventative action and barriers to taking action. Collaboration By assisting people to examine their health beliefs and increasing their understanding of the inhibiting and enhancing factors that can influence improvements, relationships become collaborative rather than prescriptive. People can be enabled to create visions of wellness unique and personalised to them. A coach can then assist in setting realistic and achievable goals, using a range of disciplines including positive psychology, motivational interviewing and neurolinguistic programming. Nurses are ideally placed to act as health coaches and assist patients in this way. They are knowledgeable about long-term conditions and healthy-living guidance, and they develop sustainable relationships with patients and possess some training in interpersonal psychology. In this way they can improve patient compliance, adherence to recommended treatment plans and motivational levels so that individuals can work towards strengthening their involvement in self-management. Lawrence Whyte is a registered nurse at Riverdale Unit, Sheffield
References Gensichen J, von Korff M, Peitz M et al (2009) Case management for depression by health care assistants in small primary care practices: a cluster randomized trial. Annals of Internal Medicine. 151, 6, 369-378. Lundahl B, Burke B (2009) The effectiveness and applicability of motivational interviewing: a practice-friendly review of four meta-analyses. Journal of Clinical Psychology. 65, 11, 1232-1245.
April 2014 | Volume 21 | Number 1 15
Downloaded from RCNi.com by ${individualUser.displayName} on Nov 06, 2015. For personal use only. No other uses without permission. Copyright © 2015 RCNi Ltd. All rights reserved.
