The Effect of Health Coaching Programs on Self-Efficacy, Health Behaviors, and Quality of Life in Hypertensive People Living in Poverty

Sun Ok Eom; Insook Lee

doi:10.4040/jkan.2017.47.3.380

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Eom and Lee: The Effect of Health Coaching Programs on Self-Efficacy, Health Behaviors, and Quality of Life in Hypertensive People Living in Poverty

Original Article

J Korean Acad Nurs 2017;47(3):380-391.

Published online: 15 January 2017

DOI: https://doi.org/10.4040/jkan.2017.47.3.380

The Effect of Health Coaching Programs on Self-Efficacy, Health Behaviors, and Quality of Life in Hypertensive People Living in Poverty

Sun Ok Eom^1,, Insook Lee²

¹Depertment of Nursing, Songgok College, Chuncheon

²College of Nursing, Seoul National University, Seoul, Korea

Address reprint requests to : Eom, Sun Ok Depertment of Nursing, Songgok College, 34 Songgok Daehak-gil, Namsanmyun, Chuncheon 24465, Korea Tel: +82-33-260-3677 Fax: +82-33-261-4599 E-mail: eom2015@songgok.ac.kr

Received 2 December 2016 Revised 4 May 2017 Accepted 17 May 2017

This is an Open Access article distributed under the terms of the Creative Commons Attribution NoDerivs License. (http://creativecommons.org/licenses/by-nd/4.0) If the original work is properly cited and retained without any modification or reproduction, it can be used and re-distributed in any format and medium.

Abstract

Purpose

This study was designed to determine the effects of health coaching and mediating variables on quantitative aspect of health in low-income hypertensive people.

Methods

The experimental group for the current study consisted of 21 clients who received health coaching services, and the control group consisted of 22 clients who received home-visiting nursing services. Two groups received health coaching or home-visiting nursing services once a week for 8 weeks. The evaluation variables were self-efficacy, nutrition management, health behaviors, self-rated health, and quality of life.

Results

The results revealed that the level of nutrition management was significantly higher in the experimental group than the control group (F=10.33, p=.005).

Conclusion

These results confirm that health coaching is a useful strategy that encourages clients to continuously maintain their own health behaviors. Thus, the findings of the current study provide useful data for establishing measures for the health management of those afflicted with chronic disease, such as hypertension. Furthermore, health coaching may be developed into useful intervention strategies for dealing with chronic diseases and improving home-visiting nursing.

Keywords: Hypertension, Health behavior, Aged, Health education

References

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Figure 1.

Conceptual framework.

Table 1.

Study Procedures and Intervention Contents

Period		Contents of health coaching program
		Topic and goals	Methods
1^st week	Needs survey	Client confirmation and	- Guide to the program
home visit		needs survey	- Discussion of program schedule and contents with clients
			- Make own schedule
2^nd week~	Conducting	Setting out issues	- Create rapport with clients	Select the appropriate
7^th week	coaching	- dentify coaching conversation	- Share experience with clients	Coaching
home visit	conversations	issues	- Establish definite goals and expected	Conversation,
			results	depending on the
		Searching for strength	- Ask searching question	client’s circumstances
		- Identifying own strengths through	- Search for experiences of success	in each case
		coaching questions	- Find self-confidence and alternatives
		Acting on goals	- Focus on the expected outcome of the
		- Establishing specific implemen-	clients
		tation plans	- Establish specific implementation measures
			and timeline
			- Check available resources
			- Identify controllability
		Seeking out resources	- Identify obstacles
		- Identifying resources to achieve	- Identify measures or actions to eliminate
		objectives	obstacles
			- Identify measures of client cooperation
		Achieving goals	- Identify the client’s wishes
		- Summary of coaching conver-	- Give feedback according to the client’s
		sations	progress
8^th week	Finish	Final evaluation	- Identify factors in success and barriers
home visit		– Evaluation of client’s goal achie-	- Give feedback for entire program
		vement	- Provide encouragement for ongoing health practice

Table 2.

Homogeneity Test of General Characteristics (N=43)

Characteristics	Categories	Range	Experiment n= 21 (48.8％)	Control n= 22 (51.2％)	c² or t	p
			n (%) or M±SD
Gender*	Male		3 (14.3)	0 (0.0)	3.38	.108
	Female		18 (85.7)	22 (100)
Age (yr)*	>65		2 (9.5)	0 (0.0)	4.37	.223
	65~74		6 (37.5)	6 (27.3)
	75~84		10 (62.5)	13 (59.1)
	85≤		0 (0.0)	3 (13.6)
	M±SD		72.76±7.74	77.00±5.78	1.82	.185
Education*	None		4 (19.0)	11 (50.0)	4.54	.110
	Elementary		11 (52.4)	7 (31.8)
	Middle		6 (28.6)	4 (18.2)
Insurance	Medical		16 (76.2)	13 (59.1.)	5.25	.242
	Medicaid		5 (23.8)	9 (40.9.)
Living arrangement	Alone		9 (42.9)	16 (72.7)	1.33	.123
	with family		12 (57.1)	6 (27.3)
Blood Pressure (mmHg)	Systoilc BP		123.62±14.56	114.77±15.16	1.96	.057
	Diastolic BP		75.62±9.22	68.18±11.81	2.30	.027
Body mass index (㎏/m²)			25.55±3.02	25.22±4.02	0.98	.766
Self efficacy		10~50	36.37±4.35	37.82±2.22	-1.01	.318
Health behaviors	Medical use†	3~6	5.42±1.08	5.86±0.35	-1.34	.168
	Blood pressure self-management†	4~17	4.45±0.81	4.73±1.16	-2.17	.030
	Nutrition management	9~45	32.38±3.12	31.64±4.05	0.73	.505
	Health behaviors rate	0~100	43.67±15.26	52.59±8.96	6.56	.024
	Physical activity level (MET. mim)	0~3000	460.10±666.95	322.95±364.38	1.53	.405
Self-rated health^†		1~5	2.76±0.89	2.82±0.85	-0.24	.331
Quality of life		0~1	0.81±0.15	0.82±0.08	1.29	.818

MET.min=Metabolic equivalent minutes.

^*Fisher’s Exact test; ^†Mann-Whitney U test.

Table 3.

Effects of Health Coaching Programs on Self Efficacy, Heath Behaviors and Quality of Life (N=43)

Variables	Group	P0	P1	P2	Sources	F*	p	Differences (P1-P0)			Differences (P2-P0)
		M±SD	M±SD	M±SD				M±SD	t	p	M±SD	t	p
Self efficacy	Exp.	36.37±4.35	43.81±4.80	43.05±4.06	T	0.47	.459
	Cont.	37.82±2.22	42.73±3.61	42.86±3.40	G	2.72	.107
					G*T	0.98	.329
Health behaviors
Nutrition	Exp.	32.38±3.12	37.86±3.05	37.95±2.62	T	10.32	.003	5.48±2.73	3.23	.002	5.57±2.06	0.90	.367
management^†	Cont.	31.64±4.05	33.59±4.35	36.36±3.13	G	5.76	.021	1.96±4.19			4.73±3.78
					G*T	10.33	.005
Exp.	Health	43.67±15.26	68.10±11.26	64.52±9.54	T	8.61	.005
Cont.	behaviors	52.59±8.96	65.23±8.61	62.41±6.56	G	8.96	.005
rate					G*T	8.61	.731
Physical activity	Exp.	460.10±666.95	766.86±518.39	915.38±9.1.09	T	2.42	.127
level	Cont.	322.95±364.38	740.64±612.07	599.55±337.13	G	0.03	.869
(MET. mim)					G*T	0.02	.968
Quality of life	Exp.	0.81±0.15	0.86±0.12	0.86±0.10	T	0.25	.618
	Cont.	0.82±0.08	0.82±0.12	0.84±0.90	G	2.09	.156
					G*T	0.25	.618

Exp.= Experimental group; Cont.=Control group; P0=pre test; P1=post1 test; P2=post2 test; T=Time; G=Group; MET.min=Metabolic equivalent minutes.

^*The pre-test values was analyzed as covariance to ensure the identity of the mean of the pre-test values.

^†Independent t-test: significant differences with one another by Bonferroni correction p<.016.

Table 4.

Effects of Health Coaching Programs on Medical Use, Health Behaviors and Self-rated Health (N=43)

Variables	Group	P0	P1	P2	c²	p	Differences (P1-P0)			Differences (P2-P0)
		M±SD	M±SD	M±SD			M±SD	Z	p	M±SD	Z	p
Medical use	Exp.	5.42±1.08	5.76±0.70	5.71±0.90	4.33	.189
	Cont.	5.86±0.35	5.91±0.29	6.00±0.00	3.50	.296
Health behaviors
Blood pressure	Exp.	4.48±0.81	7.19±1.12	6.62±1.07	31.91	<.001	2.71±1.45	-4.02	<.001	2.14±1.56	-3.78	<.001
self-management*	Cont.	4.82±1.33	6.50±0.60	6.00±0.87	24.73	<.001	1.68±1.39	-3.56	<.001	1.18±1.50	-2.85	.004
Self-rated health	Exp.	2.76±0.89	2.71±0.85	2.85±0.73	0.09	>.999
	Cont.	2.82±0.85	2.73±0.77	2.68±0.72	1.75	.556

Exp.= Experimental group; Cont.=Control group; P0=pre test; P1=post1 test; P2=post2 test; T=Time; G=Group.

*Wilcoxon’s signed rank test: significant differences with one another by Bonferroni correction p<.016.

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