Effect of coaching on psychological adjustment in patients with spinocerebellar degeneration: a pilot study.

摘要

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.