A pilot study of health and wellness coaching for fibromyalgia
A pilot study of health and wellness coaching for fibromyalgia
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DOI：
10.1186/s12891-016-1316-0
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发表时间：
2016-11-08
影响因子：
2.3
通讯作者：
Buffington, C. A. Tony
中科院分区：
文献类型：
--
作者：
Hackshaw, Kevin V.;Plans-Pujolras, Marcal;Buffington, C. A. Tony
背景资料：本研究的目的是测试的假设，健康和健康教练（HWC）为基础的干预纤维肌痛（FM）将导致持续改善健康和生活质量，并减少医疗保健utilization.Methods：9名女性受试者符合美国流变学学院的诊断标准原发FM进行了研究。《重武器公约》议定书有两个组成部分，在12个月期间通过电话提供。首先，在为期12个月的研究期间，每位患者按照患者偏好的时间表和频率（范围：22-32 x 45分钟）单独会见教练。教练是接受过健康和保健教练任务、知识和技能培训的卫生专业人员。第二，在为期12个月的研究中，每位患者参加了每两个月（前六个月）和每月（后六个月）一次的自我辅导策略小组课程。在干预之前，以及在6个月和12个月的指导之后，使用修订的纤维肌痛影响问卷（FIQR）来测量健康和生活质量，并使用简明疼痛量表-简表（BPI）来测量疼痛强度和对功能的干扰。使用电子病历记录总的和与流变学相关的健康接触。结果：9例患者均完成了HWC方案。FIQR评分改善了35%（P = 0.001）。BPI评分总体下降32%（P = 0.006），严重程度下降31%（P = 0.02），干扰下降44%（P = 0.006）。卫生保健利用率下降了86%（P = 0.006）的总和78%（P < 0.0001）的风湿病相关encounters.Conclusion：HWC程序添加到标准FM治疗产生临床显着改善生活质量的措施（FIQR），疼痛（BPI），并显着减少卫生保健利用。这种改善通常不会自发发生在FM患者中，这表明HWC值得进一步考虑作为FM的干预措施。
Background: The purpose of this study was to test the hypothesis that a health and wellness coaching (HWC)-based intervention for fibromyalgia (FM) would result in sustained improvements in health and quality of life, and reductions in health care utilization.Methods: Nine female subjects meeting American College of Rheumatology criteria for a diagnosis of primary FM were studied. The HWC protocol had two components, which were delivered telephonically over a twelve-month period. First, each patient met individually with a coach during the 12 month study at the patient's preference of schedule and frequency (Range: 22-32 x 45-min sessions). Coaches were health professionals trained in health and wellness coaching tasks, knowledge, and skills. Second, each patient participated in bimonthly (first six months) and monthly (second six months) group classes on self-coaching strategies during the 12 month study. Prior to the intervention, and after 6 months and 12 months of coaching, the Revised Fibromyalgia Impact Questionnaire (FIQR) was used to measure health and quality of life, and the Brief Pain Inventory-Short Form (BPI) was used to measure pain intensity and interference with function. Total and rheumatology-related health encounters were documented using electronic medical records. Data were analyzed using repeated measures ANOVA.Results: All nine patients finished the HWC protocol. FIQR scores improved by 35 % (P = 0.001). BPI scores decreased by 32 % overall (P = 0.006), 31 % for severity (P = 0.02), and 44 % for interference (P = 0.006). Health care utilization declined by 86 % (P = 0.006) for total and 78 % (P < 0.0001) for rheumatology-related encounters.Conclusion: The HWC program added to standard FM therapy produced clinically significant improvements in quality of life measures (FIQR), pain (BPI), and marked reductions in health care utilization. Such improvements do not typically occur spontaneously in FM patients, suggesting that HWC deserves further consideration as an intervention for FM.