Mechanisms and Effects of Health Coaching in Patients With Early-Stage Chronic Kidney Disease: A Randomized Controlled Trial

Purpose To examine the effects of health coaching on self-management and quality of life (QOL) in patients with chronic kidney disease (CKD) and to evaluate whether self-efficacy and patient activation mediate the effect of health coaching on self-management and QOL. Design and Methods A single-center, parallel-group, randomized controlled trial. A total of 108 patients with stages 1 to 3a CKD participated in the study. Participants were randomly assigned to a health-coaching intervention group or a usual care control group. Participants' QOL (World Health Organization Quality of Life Scale), self-management (CKD Self-Management instrument), patient activation (Patient Activation Measure), and self-efficacy (CKD Self-Efficacy instrument) were measured at baseline, immediately after, and 6 weeks after the intervention. Findings Health coaching improved QOL, self-management, patient activation, and self-efficacy at postintervention and at 12 weeks' follow-up. Health coaching had a significant indirect effect on QOL through improvements in patient activation. Health coaching exerted a significant indirect effect on self-management through improvements in self-efficacy and patient activation. Conclusions The findings demonstrated that health coaching can effectively improve QOL and self-management. A health-coaching intervention can raise self-efficacy and activation levels through which self-management and QOL further improve. Clinical Relevance Health-coaching strategies can be used to assist patients with early-stage CKD in reaching their health goals and becoming activated in self-management of their diseases.