Health coaching for healthcare employees with chronic disease: A pilot study

Lifelong development in medicine: a thematic analysis of coaching goals throughout medical careers

OBJECTIVES

Healthcare grapples with staff shortages and rising burnout rates for medical students, residents and specialists. To prioritise both their well-being and the delivery of high-quality patient care, it becomes imperative to deepen our understanding of physicians' developmental aims and needs. Our first aim is, therefore, to gain comprehensive insights into the specific developmental aims physicians prioritise by examining the coaching goals they set at the beginning of coaching. Since physicians face distinct roles as they advance in their careers, our second aim is to highlight similarities and differences in developmental aims and needs among individuals at various medical career stages.

DESIGN

We conducted a qualitative analysis of 2571 coaching goals. We performed an inductive thematic analysis to code one-half of coaching goals and a codebook thematic analysis for the other half. Our interpretation of the findings was grounded in a critical realist approach.

SETTING

Sixteen hospitals in the Netherlands.

PARTICIPANTS

A total of 341 medical clerkship students, 336 medical residents, 122 early-career specialists, 82 mid-career specialists and 57 late-career specialists provided their coaching goals at the start of coaching.

RESULTS

The findings revealed that coachees commonly set goals about their career and future, current job and tasks, interpersonal work relations, self-insight and development, health and well-being, nonwork aspects and the coaching process. Furthermore, the findings illustrate how the diversity of coaching goals increases as physicians advance in their careers.

CONCLUSIONS

Our findings underscore the significance of recognising distinct challenges at various career stages and the necessity for tailoring holistic support for physicians. This insight holds great relevance for healthcare organisations, enabling them to better align system interventions with physicians' needs and enhance support. Moreover, our classification of coaching goals serves as a valuable foundation for future research, facilitating a deeper exploration of how these goals influence coaching outcomes.

Lifestyle behaviors and stress are risk factors for overweight and obesity in healthcare workers: a cross-sectional survey

BACKGROUND

Overweight and obesity have become major public health concerns worldwide. Persistent stress can activate the human hypothalamic‒pituitary‒adrenal axis (HPA) and increase the intake of "self-rewarding food", thereby raising the incidence of obesity. Health care workers (HCWs) experience higher workloads and mental stress than workers in many other industries, which may put them at increased risk for overweight/obesity. However, few studies have been carried out on overweight and obesity among HCWs in China, and the overall scenario and behind-the-scenes factors of their overweight and obesity are unknown. The aim of this study is to understand the epidemic of overweight and obesity and risk factors among Chinese HCWs.

METHODS

Based on a cross-sectional web survey design, 23,234 HCWs from 100 health institutions in 5 provinces/autonomous regions/municipalities across China were sampled to answer a self-administered questionnaire that was purposely developed using a multi-staged clustered random-sampling method. Chi-square test and ANOVA were performed to compare variables between two or more groups. Univariate analyses were conducted to identify the influence of self-reported persistent stress and/or recurrent anxiety/depressed mood on lifestyle behaviors. A multivariate binary logistic regression model was used to analyse the risk factors of overweight/obesity.

RESULTS

Among the respondents, 34.26% were overweight, and 11.22% were obese. Most of the respondents had regular exercise habits (68.17%), had habitually stayed-up late (65.06%) and had been affected by persistent stress and/or recurrent anxiety/depressed mood (62.04%). A higher proportion of those with persistent stress and/or recurrent anxiety/depressed mood than those without habitually staying-up late (76.18%); consumed take-out food (54.92%), fried food (49.93%), snacks or desserts (50.51%); drank sugary drinks (46.57%); smoked (14.27%); and drank alcohol (23.34%). Gender (Female) (OR: 0.314, 95%CI: 0.292-0.336), age (OR: 1.742-2.334, 95%CI: 1.544-2.858), education (OR: 0.620-0.728, 95%CI: 0.445-0.973), living and working area (OR: 1.271, 95%CI: 1.192-1.355), breakfast (OR: 0.898, 95%CI: 0.839-0.960), fried food (OR: 1.133, 95%CI: 1.048-1.224), and alcohol consumption (OR: 1.111, 95%CI: 1.017-1.214) were factors for overweight/obesity. All of the aforementioned results were significant (P < 0.05).

CONCLUSIONS

The overweight/obesity rate of Chinese HCWs is rather high, which might be directly associated with lifestyle behaviors. However, these behaviors fundamentally originated from persistent stress and/or recurrent anxiety/depression, mediated by lifestyle behaviors. Substantial measures should be taken for stress reduction and mental health promotion for overweight/obesity prevention and control among HCWs.

A scoping review of sleep education and training for nurses

BACKGROUND

Shift work and resulting sleep impairment among nurses can increase their risk for poor health outcomes, occupational injuries, and errors due to sleep deficiencies. While sleep education and training for nurses has been recommended as part of a larger fatigue risk management system, little is known about training programs designed specifically for nurses.

OBJECTIVE

Investigate the literature for current sleep education or training programs specifically for shift working nurses, with intent to assess training content, delivery characteristics, and outcome measures.

DESIGN

A scoping review conducted October 2020 through September 2021.

METHODS

The bibliographic databases Cumulative Index of Nursing and Allied Health (CINAHL), Scopus, PubMed, and NIOSHTIC-2 were searched using words such as "nurse," "sleep hygiene," "shift work," and "education". Studies were included if they: 1) were original research; 2) discussed sleep education, training, or sleep hygiene interventions; 3) included a study population of nurses engaging in shift work; 4) focused on sleep as a primary study measure; 5) were written in English language; and 6) were published in 2000 or later.

RESULTS

Search results included 17,237 articles. After duplicates were removed, 14,620 articles were screened. Nine articles were found to meet established criteria. All studies included sleep hygiene content in the training programs, with five studies adding psychological and/or behavior change motivation training to support change in nurse sleep habits. Three studies added specific training for nurses and for managers. Delivery modes included in-person training of various lengths and frequency, mobile phone application with daily engagement, an online self-guided presentation, and daily reading material coupled with audio training. Pittsburgh Sleep Quality Index and Epworth Sleepiness Scale were the outcome measures most frequently used. Although studies demonstrated improved sleep measures, most were pilot studies testing feasibility.

CONCLUSION

Although there is a paucity of studies focused on sleep education and training for shift working nurses, we found the inclusion of sleep hygiene content was the only common characteristic of all nine studies. The variability in training content, delivery methods, and outcome measures suggests further research is needed on what constitutes effective sleep education and training for nurses.

2022 Prevention of chronic non-communicable diseases in Of the Russian Federation. National guidelines

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Preliminary Effectiveness Study of a Community-Based Wellness Coaching for Cancer Survivors Program

Purpose: Substantial cancer burden may be prevented through lifestyle modifications. The purpose of this study was to determine the preliminary effectiveness of health coaching for the improvement of health, fitness, and overall well-being of cancer survivors in a community setting. Methods: Participants were recruited from Cancer Support Community Delaware locations. Health coaching was provided to people diagnosed with cancer anywhere along the survivorship continuum. Coaches provided 6 individual sessions. Surveys were sent pre- and post-intervention on topics including fitness, eating habits, sleep, perceived stress, anxiety, depression, and quality of life. Results were analyzed using multilevel modeling. Results: 48 participants completed an average of 85% of health coaching sessions. Coaching participants noted improvements in weekly physical activity frequency, including moderate–vigorous physical activity. Increases were found in healthy eating behavior. Participants reported improvements in the quality of their sleep, including changes in sleep duration and sleep efficiency. Significant reductions were found in perceived stress, anxiety, and depression. Importantly, participants reported improved quality of life, particularly in areas of physical and emotional well-being, as well as functional and total well-being. Conclusion: Preliminary findings indicate significant behavior change in measured outcomes and suggest health coaching may be an important tool for cancer survivorship.

Supporting active ageing before retirement: a systematic review and meta-analysis of workplace physical activity interventions targeting older employees

OBJECTIVE

With the growing representation of older adults in the workforce, the health and fitness of older employees are critical to support active ageing policies. This systematic review aimed to characterise and evaluate the effects on physical activity (PA) and fitness outcomes of workplace PA interventions targeting older employees.

DESIGN

We searched Medline, PreMedline, PsycInfo, CINAHL and the Cochrane Controlled Register of Trials (CENTRAL) for articles published from inception to 17 February 2020. Eligible studies were of any experimental design, included employees aged ≥50 years, had PA as an intervention component and reported PA-related outcomes.

RESULTS

Titles and abstracts of 8168 records were screened, and 18 unique interventions were included (3309 participants). Twelve studies were randomised controlled trials (RCTs). Seven interventions targeted multiple risk factors (n=1640), involving screening for cardiovascular disease risk factors, but had a non-specific description of the PA intervention. Four interventions targeted nutrition and PA (n=1127), and seven (n=235) focused only on PA. Interventions overwhelmingly targeted aerobic PA, compared with only four interventions targeting strength and/or balance (n=106). No studies involved screening for falls/injury risk, and only two interventions targeted employees of low socioeconomic status. Computation of effect sizes (ESs) was only possible in a maximum of three RCTs per outcome. ESs were medium for PA behaviour (ES=0.25 95% CI -0.07 to 0.56), muscle strength (ES=0.27, 95% CI -0.26 to 0.80), cardiorespiratory fitness (ES=0.28, 95% CI -22 to 0.78), flexibility (ES=0.50, 95% CI -0.04 to 1.05) and balance (ES=0.74, 95% CI -0.21 to 1.69). Grading of Recommendations Assessment, Development and Evaluation criteria-rated quality of evidence was 'low' due to high risk of bias, imprecision and inconsistency.

CONCLUSIONS

The lack of high-quality effective workplace PA interventions contrasts the importance and urgency to improve the health and fitness in this population. Future interventions should incorporate strength and balance training and screening of falls/injury risk in multi risk factors approaches.

PROSPERO REGISTRATION NUMBER

CRD42018084863. (https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=84863).

Exploring Sex Differences in the Effectiveness of Telehealth-Based Health Coaching in Weight Management in an Employee Population

PURPOSE

To explore a telehealth-based lifestyle therapeutics (THBC) program on weight loss (WL) and program satisfaction in an employer population.

DESIGN

This study was a collaboration between inHealth Lifestyle Therapeutics and a large national employer group including 685 participants (296 women [64% obese] and 389 men [62% obese]).

MEASURES

Percent WL and subjective rating (Perceived Program Value measured by a questionnaire) were assessed.

INTERVENTION

Average number of visits was 3.1 ± 0.4; each visit ranged between 20 and 45 minutes.

ANALYSIS

This study utilized a 2 × 2 block design using analysis of variance techniques based on sex (male and female) and initial body mass index (BMI) category (overweight and obese) tested at P ≤ .05.

RESULTS

There was no statistical difference in %WL between by sex (F_1,681 = 0.398, P = .528) nor an interaction between sex and BMI (F_1,681 = 0.809, P = .369). There was a statistically significant difference in %WL from pre to post program across initial BMI category (F_1,681 = 13.707, P ≤ .001) with obese participants losing an average of 1.1% (0.5%-1.6%) more than overweight participants (overweight 2.5% [2.1%-3.0%] vs obese 3.6% [3.2%-3.9%]). Obese participants were 1.15 (1.07-1.25) times more likely to lose weight compared to overweight participants. Analysis of variance power analysis indicated sufficient power on minimum factor combination n = 106 ( Effect Size = 0.282).

CONCLUSION

Results support the efficacy THBC in supporting WL with no reported differences between men and women, while having a high perceived value for employee participants.