Empowering Patients with Heart Failure Through Health Coaching: A Quasi-Experimental Study.

摘要

BACKGROUND: Chronic heart failure (CHF) is a complex and often progressive condition, requiring ongoing self-management and lifestyle adjustments. Empowerment, which refers to a person's ability to oversee their health and be more involved in their care, serves as the foundation of this engagement, and health coaching has emerged as a critical strategy to help patients take an active role and manage their condition effectively. PURPOSE: This study aimed to evaluate the five RE-AIM elements-reach, effectiveness, adoption, implementation, and maintenance-of a health coaching program (H-Coaching) in empowering hospitalized patients with CHF. METHODS: An exploratory study was conducted involving 55 patients admitted to the cardiology unit of a university hospital in northern Spain, who were divided into a preintervention group (n = 25) and a postintervention group (n = 30). The intervention involved the implementation by nurses of H-Coaching to empower patients with CHF during their stay and prepare them for discharge. To measure CHF patient empowerment, the Spanish adaptation and validated version of the Patient Empowerment in Long-Term Conditions questionnaire was used. This tool assesses empowerment across three dimensions (positive attitude and sense of control, shared and informed decision-making, and information seeking and peer sharing) and was administered at two time points: before (T1) and after (T2) the intervention. RESULTS: The difference between pre- and postintervention empowerment scores was statistically significant for the positive attitude and sense of control dimension, with a mean improvement of 0.58. Furthermore, a statistically significant difference was observed for item 33, "I need to know what is happening to me and why," within the shared and informed decision-making dimension. No statistically significant difference was observed for item 35, "I have shared my knowledge about my illness with people who have similar illnesses to mine," within the information-seeking and peer-sharing dimension, although a mean improvement of 0.56 between pre- and postintervention scores was observed. CONCLUSION: The results of this study indicate that health coaching is effective in empowering patients with CHF in hospital settings. Furthermore, several factors were identified that can help ensure the successful implementation and evaluation of health coaching, such as nurse training and professional experience, a supportive environment, and active caregiver involvement. This knowledge can be used to design future interventions to empower hospitalized patients with CHF in other settings.