Health and Wellness Coaching in COPD: An Integrative Review.

Abstract

Objective: This integrative review applies Self-Determination Theory to synthesize literature on Health and Wellness Coaching (HWC) interventions for Chronic Obstructive Pulmonary Disease (COPD), mapping intervention components to the core constructs of autonomy, competence, and relatedness. Methods: We searched five databases (PubMed, CINAHL Complete, SCOPUS, Healthcare Administration, and PsycINFO). Inclusion criteria: (1) adult COPD-only population, (2) reported a clearly defined quality of life (QOL) outcome measuring intervention effectiveness, and (3) met all four HWC intervention components established in prior compendia. SDT guided data extraction, with the Mixed Methods Appraisal Tool (MMAT) evaluating study quality. Results: Ten distinct HWC interventions were evaluated across 17 studies published between 2009 and 2022. Of the eight studies reporting positive QOL outcomes, all used Motivational Interviewing (MI) practices. Three of four studies showing no significant QOL improvements did not explicitly report use of MI. Interventions that did not purposely address psychological barriers (depression, anxiety, apathy, perceived futility, and fear of dyspnea) were less consistently associated with positive outcomes than those that did. Conclusion: Effective HWC interventions supported autonomy through MI-informed, flexible goal-setting; built competence by addressing psychological barriers (depression, anxiety, fear of dyspnea) alongside disease knowledge and skills training; and fostered relatedness through empathic coach-patient relationships.