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

Clin Interv Aging. 2017 Jul 11;12:1079-1088. doi: 10.2147/CIA.S137821. eCollection 2017.


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 × 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.

Keywords: cluster-randomized controlled trial; health coaching; long-term effects; nursing homes; self-management program.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Aged
  • Aged, 80 and over
  • Chronic Disease
  • Cognitive Dysfunction / therapy
  • Female
  • Health Promotion / organization & administration
  • Health Status
  • Homes for the Aged / organization & administration*
  • Humans
  • Male
  • Mentoring / organization & administration*
  • Nursing Homes / organization & administration*
  • Quality of Life*
  • Republic of Korea
  • Self Efficacy
  • Self-Management / education*