Abstract
Objective: To evaluate the influence of structuring the clinician’s communication according to coaching theory on stroke patients’ quality of life and satisfaction. Methods: Prospective observational study was carried out at outpatient clinics for patients in the chronic poststroke phase. Thirty-four clinicians involved in the management of patients with stroke and their105 patients in the chronic post-stroke phase. The clinicians enrolled in this study received training in communication skills based on coaching theory and utilized these skills when interviewing their patients with stroke. We assessed the main outcome measures and the clinicians’ self-assessments of their communication skills before and after the training. The main outcomes were the patients’ (1) satisfaction, (2) health-related quality of life, and (3) goal setting and action scores. Results: The training significantly increased the patients’ satisfaction with the clinicians’ communication (46.8 before training vs. 48.6 after training, p<0.001), overall satisfaction (16.8 vs. 17.4, p<0.001), and goal setting/action (14.6 vs. 15.2, p<0.05) scores. Additionally, the training significantly increased the SF-36 subscale scores for bodily pain (56.6 vs. 65.0, p<0.01), general health (49.8 vs. 54.1, p<0.05), and social function (61.1 vs. 69.9, p<0.05).The patients whose satisfaction with the clinician’s communication improved exhibited significantly greater improvements in their physical function scores and tended to exhibit greater improvements in their bodily pain and vitality scores than the no-improvement group. Furthermore, the patients whose goal setting and action improved tended to have greater improvements in their physical function, role limitation by physical problems, and mental health scores than the noimprovement group. Conclusion: Training in coaching theory-based communication skills influenced stroke patients’ satisfaction, goal setting and action, and HQOL. Clinicians should intentionally use structured communication to facilitate patients’ active involvement in their rehabilitation.
Highlights
Stroke is a disease with a high incidence and is one of the 3 major causes of death in Japan and the leading cause of need for long-term care, accounting for a high percentage of the total costs of medical care [1]
Residual disabilities after stroke include functional impairments, psychological problems, and loss of social adjustment, and the sequela of stroke hugely impact the quality of life (QOL) of both the patients and their family members for prolonged periods [2,3]
Clinicians involved in the management of stroke patients are required to deal with their patients’ physical disorders and to monitor such subjective aspects as the patients’ and family members’ adjustments to such disorders
Summary
Stroke is a disease with a high incidence and is one of the 3 major causes of death in Japan and the leading cause of need for long-term care, accounting for a high percentage of the total costs of medical care [1]. Residual disabilities after stroke include functional impairments, psychological problems, and loss of social adjustment, and the sequela of stroke hugely impact the quality of life (QOL) of both the patients and their family members for prolonged periods [2,3]. Clinicians involved in the management of stroke patients are required to deal with their patients’ physical disorders and to monitor such subjective aspects as the patients’ and family members’ adjustments to such disorders. Previous studies have shown the effectiveness of patient/family education [4]. Many researchers have considered what content should be included in the educational programs provided to the patient and family, but we should consider the communication capabilities of the clinicians who are involved in advising and educating the patients. Providing clinicians with training in communication skills can be highly effective
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