Health Coaching (1)

Question 1

What are the 5 major diseases that contribute to 70% of deaths globally?

Answer 1

Cardiovascular disease (CVD)
Stroke
Cancer
Chronic lung diseases 
Diabetes

= associated with modifiable risk factors such as smoking, poor diet, lack of exercise and excessive alcohol consumption.

Question 2

What is Motivational Interviewing (MI)?

Why is it useful in health coaching?

Answer 2

A counselling approach that adopts a person-centred mindset and skillset

The practitioner’s role broadens from expert to enabler

Question 3

What are the 4 spirit of MI (Motivational interviewing) involves?

Answer 3

Compassion: Act from a desire to support the patient’s wellbeing  

Acceptance: Take a respectful, non-judgemental approach, and value and affirm the patient’s autonomy
 
Partnership: Work in partnership with the patient, recognising that the patient is resourceful and an ‘expert’ in their own situation.

Evocation:  Help a patient to identify their own perspectives and motivation for change

Question 4

What are some examples of questions that do not take a health coaching perspective?

Why are these questions not ideal?

Answer 4

What is the problem?
Why has this problem happened?
Why haven’t you addressed the problem yet?
Who else is this affecting?
What will happen if you don’t address this problem?

Assumes the issue is someone’s fault, explores the problem but doesn’t get closer to finding a path forward
May make person feel worse about problem

Question 5

What are some examples of questions that do take a health coaching perspective?

Why are these questions better?

Answer 5

What’s the issue?
What do you want ideally around this issue?
What part of this do you have control over?
What are your options going forward?
What is your next step?

Assumes there will be a solution and the person can find it for themselves - more empowering

Question 6

What are some issues with a health coaching / MI perspective?

Answer 6

You assume the patient’s resourcefulness

The relationship must have mutual trust and respect

Coaching is about change and action, but a patient may not want to explore the issue and move forward

Question 7

where and how can you use a health coaching approach in life and practice

Answer 7

• Referral to a health coach for a series of sessions
- Focus on changing health behaviours
- Improving diet/increasing exercise/smoking cessation/reducing alcohol
• Opportunistically within routine consultations
- Supports person-centred conversations and shared decision making

Question 8

Key principles of health coaching

Answer 8

The patient’s assumed resourcefulness

A relationship based on mutual trust and respect

Coaching is about change and action

Question 9

issues to consider in health coaching approach

Answer 9

Patients assumed resourcefulness issues -Can patient retain information and weigh up pros and cons? (eg. dementia, substance misuse)

A relationship based on mutual trust and respect Issues - May not be appropriate if patient is manipulative/dishonest or they do not trust/respect you

Coaching is about change and action issues - The patient needs to want to address their issue and be prepared to explore it (if not ready to address, non judgemental, offer brief information and let them know they can discuss when ready)

Question 10

What are the wider determinants of health

Answer 10

social, economic and environmental factors that shape people’s lives.

• influenced by local, national and global distribution of power and resources which shape the conditions of daily lives.

Question 11

Define motivational interviewing

Answer 11

 ‘a collaborative, person-centred form of guiding to elicit and strengthen motivation to change’.

Question 12

Whats wrong with these questions:
What is the problem?
Why has this problem happened?
Why haven’t you addressed the problem yet?
Who else is this affecting?
What will happen if you don’t address this problem?

Answer 12

• assumes that the issue is someone’s fault and goes down the route of exploring the problem further but getting no closer to finding a way forward.
• often result in a person feeling worse about their issue.
• may contribute to further anxiety or stress in someone who is already experiencing this.

Question 13

Why are these questions good?

What’s the issue?
What do you want ideally around this issue?
What part of this do you have control over?
What are your options going forward?
What is your next step?

Answer 13

• assume that there will be a solution and that you can find this solution for yourself.
• They are more empowering and designed to facilitate your thinking on what the solution/s might be and what you will do about it.

Question 14

What do health coaching approaches enable

Answer 14

behaviour change, person-centred communication and consultation styles, patient empowerment and shared decision-making.

Question 15

Why is health coaching patients’ families important

Answer 15

• explore perspectives and values and enable shared decision making in situations where family members are key, e.g. parents or guardians, carers etc.

Question 16

What does it mean for a practitioners role to broaden from expert to enabler ( key principle when using coaching skills in healthcare contexts)

Answer 16

By recognising that the patient is resourceful and an expert in their own life situation, the practitioner’s role broadens from expert to enabler, supporting the patient’s own thinking about the goals they want to set for themselves and how best to achieve these goals.

Question 17

What does it mean for the patient to be resourceful ( key principle when using coaching skills in healthcare contexts)

Answer 17

to acknowledge the patients’ own resourcefulness and ability to identify and work towards goals that relate to their health and wellbeing.

Question 18

features of a health coaching approach

Answer 18

• relationship based on mutual trust and respect
• —> Successful health coaching
• solution-focused
• —> based on the premise that the patient is resourceful and has the ability to identity their own solutions and identify how best to move forward with their health issue and achieve the goals they set for themselves.
• future-focused
• —> The starting point for conversations is the present situation rather than the past. The aim is to identify what they want to

Question 19

What can a health coaching approach help a patient with

Answer 19

• develop new perspectives about their health issue
• –> actively listens, reflects back, and asks powerful, non-judgemental, solution-oriented questions to support the patient to develop new perspectives, so they feel empowered to move forward with their issue.
• plan how best to achieve their health behaviour goals.
• –> starts with the assumption that people are resourceful and are experts in their own life situation. The healthcare practitioner’s role broadens from expert to enabler of a person’s best thinking on how they work towards achieving their health behaviour goals.

Question 20

key points

Answer 20

Key points
a. Being able to effect positive behaviour change is a key strategy in reducing the burden
of non-communicable disease.
b. Health coaching approaches to support behaviour change have been used
successfully in addressing modifiable lifestyle-related risk factors for chronic disease.
c. Health coaching approaches adopt a person-centred mindset and skillset. MI
practitioners have termed this as the ‘spirit of MI’ which involves: Compassion,
Acceptance, Partnership and Evocation
d. Health coaching is based on the premise that people are resourceful and are experts
in their own life situation. The healthcare practitioner’s role broadens from expert
to enabler of a person’s best thinking on how they work towards achieving their health
behaviour goals.