Problematizing health coaching for chronic illness self-management

Area of Science:

• Healthcare reform
• Nursing practice
• Chronic illness management

Background:

• Rising chronic illness care costs drive healthcare reform focusing on patient self-management.
• Health coaching is an implementation strategy to support patient self-management and lifestyle changes.
• This approach differs from traditional health education through nurse-patient interaction and patient-centered care.

Purpose of the Study:

• To trace the development of health coaching within nursing practice.
• To examine the implications of health coaching for chronic illness self-management.
• To highlight health coaching's potential benefits and inherent tensions.

Main Methods:

• Analysis of health coaching as an emerging element of nursing practice.
• Examination of theoretical underpinnings versus practical application of health coaching.
• Consideration of socio-economic contexts influencing health coaching implementation.

Main Results:

• Health coaching, while theoretically patient-centered, can result in social regulation and professional management of patients' lives.
• The practice is particularly problematic in contexts of economic constraint and reduced government care services.
• Tensions exist between the intended support for self-management and the actual delivery of care.

Conclusions:

• Health coaching presents a complex approach to chronic illness self-management.
• Further critical examination is needed to understand its role and impact on patients and healthcare systems.
• The practice requires careful consideration of its potential for social control within resource-limited settings.