Patient Preference and Adherence (Sep 2017)
Coach to cope: feasibility of a life coaching program for young adults with cystic fibrosis
Abstract
Karin Bæk Knudsen,1 Tacjana Pressler,2 Laust Hvas Mortensen,3 Mary Jarden,3,4 Kirsten Arntz Boisen,5 Marianne Skov,2 Alexandra L Quittner,6 Terese Lea Katzenstein1,7 1Department of Infectious Diseases, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark; 2Cystic Fibrosis Center Copenhagen, Department of Pediatric and Adolescent Medicine, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark; 3Department of Public Health, University of Copenhagen, Copenhagen, Denmark; 4University Hospital Center for Health Research (UCSF), Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark; 5Center of Adolescent Medicine, Department of Pediatric and Adolescent Medicine, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark; 6Miami Children’s Research Institute, Miami, FL, USA; 7Department of Clinical Medicine, Faculty of Health and Social Sciences, University of Copenhagen, Copenhagen, Denmark Background: Over the last two decades, lifespan has increased significantly for people living with cystic fibrosis (CF). However, several studies have demonstrated that many young adults with CF report mental health problems and poor adherence to their prescribed treatments, challenging their long-term physical health. Treatment guidelines recommend interventions to improve adherence and self-management. The aim of this study was to test the feasibility of a life coaching intervention for young adults with CF. Methods: A randomized, controlled feasibility study was conducted at the CF Center at Copenhagen University Hospital, Rigshospitalet. Participants were young adults with CF, aged 18–30 years without severe intellectual impairments. Participants were randomized to either life coaching or standard care. The intervention consisted of up to 10 individual, face-to-face or telephone coaching sessions over a period of 1 year. Primary outcomes were recruitment success, acceptability, adherence to the intervention, and retention rates. Secondary outcome measures included health-related quality of life, adherence to treatment, self-efficacy, pulmonary function, body mass index, and blood glucose values. Results: Among the 85 eligible patients approached, 40 (47%) were enrolled and randomized to the intervention or control group; two patients subsequently withdrew consent. Retention rates after 5 and 10 coaching sessions were 67% and 50%, respectively. Reasons for stopping the intervention included lack of time, poor health, perceiving coaching as not helpful, lack of motivation, and no need for further coaching. Coaching was primarily face-to-face (68%). No significant differences were found between the groups on any of the secondary outcomes. Conclusion: Both telephone and face-to-face coaching were convenient for participants, with 50% receiving the maximum offered coaching sessions. However, the dropout rate early in the intervention was a concern. In future studies, eligible participants should be screened for their interest and perceived need for support and life coaching before enrollment. Keywords: life coaching, adherence, depression, quality of life, chronic disease
