A community health-coaching referral program following discharge from treatment for chronic low back pain - a qualitative study of the patient's perspective.

Publisher: BioMed Central Country of Publication: England NLM ID: 101088677 Publication Model: Electronic Cited Medium: Internet ISSN: 1472-6963 (Electronic) Linking ISSN: 14726963 NLM ISO Abbreviation: BMC Health Serv Res Subsets: MEDLINE

Original Publication: London : BioMed Central, [2001-

Low Back Pain*/therapy ; Low Back Pain*/psychology ; Qualitative Research*; Humans ; Female ; Male ; Middle Aged ; Adult ; Chronic Pain/therapy ; Patient Discharge ; Referral and Consultation ; Australia ; Interviews as Topic ; Mentoring/methods ; Social Support ; Community Health Services ; Aged ; Patient Satisfaction

Background: Global policy and guidelines for low back pain (LBP) management promote physical activity and self-management yet adherence is poor and a decline in outcomes is common following discharge from treatment. Health coaching is effective at improving exercise adherence, self-efficacy, and social support in individuals with chronic conditions, and may be an acceptable, cost-effective way to support people in the community following discharge from treatment for LBP.
Aim: This qualitative study aimed to understand which aspects of a community over-the-phone health-coaching program, were liked and disliked by patients as well as their perceived outcomes of the service after being discharged from LBP treatment.
Methods: A purposive sampling approach was used to recruit 12 participants with chronic LBP, from a large randomised controlled trial, who were randomly allocated to receive a health coaching program from the Get Healthy Service ^® in Australia. Semi-structured interviews were conducted, and a general inductive thematic analysis approach was taken.
Results: The main themes uncovered regarding the intervention included the positive and negative aspects of the health coaching service and the relationship between the participant and health coach. Specifically, the participants spoke of the importance of the health coach, the value of goal setting, the quality of the advice received, the benefits of feeling supported, the format of the coaching service, and LBP-specific knowledge. They also reported the health coach and the coaching relationship to be the primary factors influencing the program outcomes and the qualities of the coaching relationship they valued most were connection, communication, care, and competence. The sub-themes uncovered regarding the outcomes of the intervention included positive impacts (a greater capacity to cope, increased confidence, increased motivation and increased satisfaction) and negative impacts (receiving no personal benefit).
Clinical Implications: In an environment where self-management and self-care are becoming increasingly important, understanding the patient's experience as part of a coaching program is likely to lead to improved quality of health coaching care, more tailored service delivery and potentially more effective and cost-effective community-based care for individuals with chronic LBP in the community after being discharged from treatment.
Trial Registration: The GBTH trial was prospectively registered with the Australian New Zealand Clinical Trials Registry (ACTRN12620000889954) on 10/9/2020. Ethical approval was prospectively granted by the Western Sydney Local Health District Human Research and Ethics Committee (2020/ETH00115). Written informed consent was obtained from all participants. The relevant sponsor has reviewed the study protocol and consent form.
(© 2024. The Author(s).)

Phys Ther. 2013 Apr;93(4):470-8. (PMID: 23139428)
Arch Physiother. 2020 Sep 24;10:17. (PMID: 32983572)
J Physiother. 2011;57(4):231-8. (PMID: 22093121)
Pain. 2007 Sep;131(1-2):31-7. (PMID: 17250965)
BMJ Open. 2017 Aug 3;7(8):e016242. (PMID: 28775188)
Asia Pac J Public Health. 2003;15(2):79-87. (PMID: 15038680)
J Cardiovasc Nurs. 2010 May-Jun;25(3):247-51. (PMID: 20386250)
Lancet. 2018 Jun 9;391(10137):2368-2383. (PMID: 29573872)
Acad Med. 2014 Sep;89(9):1245-51. (PMID: 24979285)
Diabetes Educ. 2010 Jul-Aug;36(4):629-39. (PMID: 20534872)
Lancet. 2021 May 29;397(10289):2023. (PMID: 34062132)
BMC Health Serv Res. 2014 Jun 26;14:281. (PMID: 24969758)
Disabil Rehabil. 2007 Dec 30;29(24):1899-909. (PMID: 17852259)
BMC Med Res Methodol. 2013 Sep 18;13:117. (PMID: 24047204)
Br J Gen Pract. 2005 Apr;55(513):305-12. (PMID: 15826439)
Glob Adv Health Med. 2013 May;2(3):40-7. (PMID: 24416671)
BMC Health Serv Res. 2017 May 30;17(1):375. (PMID: 28558746)
Chronic Illn. 2022 Mar;18(1):58-85. (PMID: 31948276)
Spine (Phila Pa 1976). 1996 Aug 1;21(15):1777-86. (PMID: 8855462)
Nurs Health Sci. 2013 Sep;15(3):398-405. (PMID: 23480423)
J Psychosom Res. 2010 Nov;69(5):511-20. (PMID: 20955871)
Lancet. 2018 Jun 9;391(10137):2356-2367. (PMID: 29573870)
Nutrients. 2021 Oct 29;13(11):. (PMID: 34836135)
Syst Rev. 2016 Sep 01;5(1):146. (PMID: 27585627)
Nurse Educ Today. 2004 Feb;24(2):105-12. (PMID: 14769454)
Patient Educ Couns. 2020 Oct;103(10):2029-2038. (PMID: 32448627)
Am Psychol. 1992 Sep;47(9):1102-14. (PMID: 1329589)
Glob Adv Health Med. 2013 Jul;2(4):20-7. (PMID: 24416682)
Musculoskeletal Care. 2018 Jun;16(2):269-277. (PMID: 29327405)
Exerc Sport Sci Rev. 2002 Apr;30(2):64-8. (PMID: 11991539)
Aust Health Rev. 2013 Jun;37(3):381-8. (PMID: 23701944)
BMC Musculoskelet Disord. 2019 Feb 11;20(1):71. (PMID: 30744606)
Prev Med. 2012 Oct;55(4):292-298. (PMID: 22885323)
Man Ther. 2010 Jun;15(3):220-8. (PMID: 20163979)
Spine J. 2018 Apr;18(4):691-711. (PMID: 29373836)
J Manipulative Physiol Ther. 2004 Jun;27(5):327-35. (PMID: 15195040)
BMC Musculoskelet Disord. 2021 Jul 9;22(1):611. (PMID: 34243746)
J Diabetes Res. 2016;2016:2830910. (PMID: 26682229)
J Clin Epidemiol. 2002 Mar;55(3):245-52. (PMID: 11864795)
Spine J. 2015 May 1;15(5):885-94. (PMID: 25681230)
J Eval Clin Pract. 2010 Feb;16(1):166-74. (PMID: 20367828)
J Res Nurs. 2020 Aug;25(5):443-455. (PMID: 34394658)
N Engl J Med. 2010 Sep 23;363(13):1245-55. (PMID: 20860506)
Can Fam Physician. 2015 Mar;61(3):e158-64. (PMID: 25932483)
Lancet Rheumatol. 2023 May 22;5(6):e316-e329. (PMID: 37273833)
J Am Acad Nurse Pract. 2008 Mar;20(3):155-62. (PMID: 18336692)

APP1180474 University of Sydney; 1194703 National Health and Medical Research Council

Keywords: Community-care; Health coaching; Low back pain; Patient’s perspective; Qualitative

Date Created: 20240916 Date Completed: 20240917 Latest Revision: 20240921

20240921

PMC11403819

10.1186/s12913-024-11509-8

39285417