The long-term effects of the health coaching self-management program for nursing-home residents

Background and aims: Little is known about whether a self-management program for nursing-home residents (NHR) with cognitive impairment is likely to have an impact on the care of this growing population. This study aimed to evaluate the effects of the health-coaching self-management program for NHR (HCSMP-NHR) on 1) self-efficacy and goal attainment scaling (GAS), 2) health status and quality of life (QoL) among older people, including those with cognitive impairment, in Korean nursing homes. Methods: This was a cluster-randomized controlled trial. Participants in the intervention group (n= 43, mean age = 80.91 +/- 7.65 years) received the HCSMP-NHR intervention, composed of group health education and individual coaching, for 8 weeks. Conventional care was provided to the conventional group (n= 47, mean age = 80.19 +/- 7.53 years) during the same period. The effects of the HCSMP-NHR were measured three times: at baseline, week 9, and week 20. Results: The intervention group showed better results for self-efficacy (P= 0.007), health distress (P= 0.007), depression (P<0.001), and QoL (P= 0.04) at week 9. Mean GAS score of the intervention group gradually increased from -0.38 to 0.74. The time x group interaction showed that the intervention group had significant improvements in QoL (P= 0.047), and significant reductions in health distress (P= 0.016) and depression (P<0.001), while showing no deterioration in shortness of breath (P<0.001). Conclusion: Our study findings indicate that the HCSMP-NHR improved self-efficacy and GAS and enhanced the health status and QoL of NHR with chronic conditions who also had mild-to-moderate cognitive impairment. Moreover, these effects were successfully maintained over the 5 months of the trial. Further research is needed to establish the optimum intervention period and to assess the possibility of nationwide implementation of the HCSMP-NHR.