ABSTRACT

To examine the fit between core concepts of self-determination theory and patient experiences with health coaching, 18 participants at one large United States Veterans Affairs medical centre completed semi-structured, audio-recorded interviews (40–60 min) about their experiences with health coaching. Transcripts were analysed using thematic analysis, and self-determination theory concepts (autonomy, competence, relatedness, and self-integration) were applied to the data. Participant descriptions of their experiences with health coaching were consistent with the process of motivation and goal attainment proposed by self-determination theory. Participants felt the programme supported their sense of autonomy by helping them select goals that were important to them and recognising their ownership over outcomes. Competence was described as the ‘confidence’ to tackle any challenge and relatedness was discussed as a consistently strong rapport with the health coach. Participants spoke to self-integration by discussing their ability to maintain behaviour change beyond the coaching programme, with some explicitly making the connection between behaviours and their values and life purpose. This study provides initial support for the use of self-determination theory as a theoretical basis of health coaching. Support for patient autonomy, competence, and relatedness may be important components of health coaching practice.

摘要

为了检验自我决定理论的核心概念与患者在健康指导方面的经验之间的契合度，一个大型美国退伍军人事务医疗中心的18名参与者完成了关于其健康经历的半结构化录音采访（40-60分钟）教练。使用主题分析对成绩单进行分析，并将自决理论概念（自主性，能力，关联性和自我整合）应用于数据。参与者对他们的健康指导经验的描述与自决理论提出的动机和目标达成过程一致。参与者认为该计划通过帮助他们选择对自己重要的目标并认识到他们对成果的主人翁精神，来支持他们的自治意识。能力被描述为能够应对任何挑战的“信心”，而与亲戚的关系则被认为是与健康教练之间始终如一的融洽关系。参与者通过讨论他们在教练计划之外保持行为改变的能力来进行自我整合，其中一些参与者明确地将行为与其价值观和生活目标联系起来。这项研究为使用自决理论作为健康指导的理论基础提供了初步的支持。支持患者的自主权，能力和相关性可能是健康教练实践的重要组成部分。