A nurse coaching intervention to improve support to individuals living with ALS.

IF 2.5 4区 医学 Q2 CLINICAL NEUROLOGY
Susan Walsh,Zachary Simmons,Sheridan Miyamoto,Andrew Geronimo
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Abstract

OBJECTIVE Health coaching may supplement the multidisciplinary ALS clinic model to facilitate patient-centered health behavior change. The aim of this study was to determine the effects of nurse health coaching (NHC) on the quality of life and self-efficacy of individuals living with ALS. METHODS Twenty-nine participants were randomized at 1:1 to the standard of care and coaching arms. All participants attended multidisciplinary ALS clinic visits quarterly, at which times they completed assessments of quality of life and self-efficacy. Those in the coaching arm participated in monthly coaching with a nurse coach over 12 months. The coaching sessions utilized motivational interviewing to identify personal goals along with barriers and solutions to achieve them. Linear mixed-effect models were used to quantify the effect of coaching on quality of life and self-efficacy outcomes. Thematic analysis was performed to summarize the participants' experiences with coaching. RESULTS Adherence to the coaching intervention was good. No effects of coaching were observed on the primary outcomes of quality of life and self-efficacy, although debriefed participants reported that they would recommend it to others. Patients and caregivers reflected on the impacts of coaching that extended beyond the pre-defined study outcomes and measures put in place to gauge effectiveness. CONCLUSIONS The elicited qualitative themes illustrating patient experience of coaching demonstrate the utility of nurse coaching as an important adjunct support to complement the multidisciplinary ALS clinic model.
护士指导干预,改善对 ALS 患者的支持。
目的健康指导可作为 ALS 多学科门诊模式的补充,促进以患者为中心的健康行为改变。本研究旨在确定护士健康指导(NHC)对 ALS 患者的生活质量和自我效能的影响。所有参与者每季度接受一次 ALS 多学科门诊,并在门诊期间完成生活质量和自我效能评估。辅导组的参与者则在 12 个月内每月接受一次护士教练的辅导。辅导课利用动机访谈法确定个人目标以及实现目标的障碍和解决方案。线性混合效应模型用于量化辅导对生活质量和自我效能结果的影响。结果辅导干预的依从性良好。虽然听取汇报的参与者表示会向他人推荐辅导,但没有观察到辅导对生活质量和自我效能等主要结果的影响。患者和护理人员对辅导效果的反思超出了预先设定的研究结果和为衡量效果而采取的措施的范围。
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来源期刊
CiteScore
5.40
自引率
10.70%
发文量
64
期刊介绍: Amyotrophic Lateral Sclerosis and Frontotemporal Degeneration is an exciting new initiative. It represents a timely expansion of the journal Amyotrophic Lateral Sclerosis in response to the clinical, imaging pathological and genetic overlap between ALS and frontotemporal dementia. The expanded journal provides outstanding coverage of research in a wide range of issues related to motor neuron diseases, especially ALS (Lou Gehrig’s disease) and cognitive decline associated with frontotemporal degeneration. The journal also covers related disorders of the neuroaxis when relevant to these core conditions.
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