Effect of coaching on psychological adjustment in patients with spinocerebellar degeneration: a pilot study
Effect of coaching on psychological adjustment in patients with spinocerebellar degeneration: a pilot study
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DOI：
10.1177/0269215507076678
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发表时间：
2007-11-01
影响因子：
3
通讯作者：
Fukuhara, Shunichi
中科院分区：
文献类型：
--
作者：
Izumi, Shin-Ichi;Ando, Kiyoshi;Fukuhara, Shunichi
目的：目的：探讨训练干预对脊髓小脑变性患者疾病心理适应和健康相关生活质量（HRQOL）的影响。设计：随机对照试验。受试者：12名年龄在20-65岁的脊髓小脑变性患者，无认知障碍或精神障碍，接受训练干预，另12名患者（对照组）推迟训练干预。三名医生教练在三个月内每周10次的指导会议中，每次电话15-30分钟。主要结果测量：主要终点是HRQOL（SF-36）和对疾病的心理适应（诺丁汉适应量表，日文版; NAS-J）。双因素方差分析（组x时间）显示活力时间的主效应具有统计学显著性（F=5.00; P=0.036）、焦虑/抑郁（F=5.15; P=0.033）和心理控制源（F=5.58; P=0.027），表明教练组和对照组的评分均随时间推移而改善。未观察到组或相互作用的主要影响。然而，协方差分析与基线得分作为协变量显示，辅导组有更好的自我效能感得分比对照组在随访（最小二乘均值，实验组，65.1;对照组，52.7;，P= 0.037）。结论：精心设计的电话辅导可以提高脊髓小脑变性患者的自我效能感。
Objective: To examine effect of coaching intervention on psychological adjustment to illness and health-related QOL (HRQOL) in patients with spinocerebellar degeneration.Design: Randomized controlled trial.Subjects: Twelve independently living patients with spinocerebellar degeneration aged 20-65 years old, without cognitive impairment or psychiatric disorder received coaching intervention, which was postponed in another 12 (control).Interventions: Three physician coaches telephoned assigned patients for 15-30 minutes in each of 10 weekly coaching sessions over three months.Main outcome measures: Primary endpoints were HRQOL (SF-36) and psychological adjustment to illness (Nottingham Adjustment Scale, Japanese version; NAS-J).Results: Two-way analysis of variance (group x time) showed statistically significant main effects of time for vitality (F=5.00; P=0.036), anxiety/depression (F=5.15; P=0.033), and locus of control (F=5.58; P=0.027), indicating improvement of scores over time in both coaching and control groups. No main effect of group or interaction was seen. However analysis of covariance with baseline scores as the covariate showed the coaching group to have better self-efficacy scores than controls at follow-up (least-square mean, experimental group, 65.1; control group, 52.7;, P= 0.037).Conclusion: Carefully structured telephone coaching can improve self-efficacy in patients with spinocerebellar degeneration.