Patient Engagement in Health Coaching and Self-Management Abilities in Chronic Obstructive Pulmonary Disease

Abstract

Objective: Health coaching has the potential to improve self-management abilities (SM) in patients with Chronic Obstructive Pulmonary Disease (COPD). Patient engagement with health care providers has a beneficial effect on patient outcomes. We examined the association of patient engagement with the health coach on SM abilities in patients with COPD. Methods: We analyzed the association between the degree of engagement measured by the Working Alliance Inventory (WAI-SR) and the SM measured by the Self-Management-Ability-Scale-30 (SMAS-30) at the end of a COPD health coaching intervention. Results: The cohort included 146 moderate to severe COPD patients. The WAI-SR total score was 85% of the maximum possible scores indicating a high degree of engagement between the health coach and the patients. The WAI-SR Task and Bond domains were positively associated with SM abilities after adjusting for lung function (FEV1 %) and depression symptoms (PHQ-2). Conclusion: The degree of engagement between a health coach and patients is associated with the perception of SM abilities in patients with COPD. Our results may inform self-management intervention and clinical practice.

Understanding the Patient Experience of Home-Based Pulmonary Rehabilitation With Health Coaching for COPD: A Qualitative Interview Study

“…This further supports the importance of social engagement and partnership with the patients in PR 17,18,20 and aligns with our previous findings that health coach engagement can positively impact self-management abilities. 17 Previous studies have found that interactions with peers help patients stay active and compliant with behavior change programs. 8,11 The health coaching component of this PR program may provide a sufficient substitute for the lack of interaction Discussion "The longer I was doing it, the better I was feeling.…”

“…Health coaching has been reported to motivate patients to continue with PR through social support. 11,17 In this study, we found that coaching motivated behavior change through empowerment and accountability and that coaches also provided support to adapt exercises to fit participant needs. This further supports the importance of social engagement and partnership with the patients in PR 17,18,20 and aligns with our previous findings that health coach engagement can positively impact self-management abilities.…”

“…11,17 In this study, we found that coaching motivated behavior change through empowerment and accountability and that coaches also provided support to adapt exercises to fit participant needs. This further supports the importance of social engagement and partnership with the patients in PR 17,18,20 and aligns with our previous findings that health coach engagement can positively impact self-management abilities. 17 Previous studies have found that interactions with peers help patients stay active and compliant with behavior change programs.…”

“…The health coaching component was key in how participants experienced behavior change. One likely factor for the positive impact of the health coach on the patient experience of PR stems from the use of motivational interviewing, 11,17 which promotes autonomy. Specifically, the health coach does not tell the patient what to do but instead uses their values to illicit behavior change in the patients.…”