A Growing Trend in Pediatric Nursing: Coaching
1Istanbul Bilgi University, Istanbul, Turkey
In modern nursing, nurses seek for different ways to express their knowledge and qualifications. The most important one of those ways is coaching. In coaching programs, nurses play an active role in the solving of health problems and development of health care system. According to some studies, this kind of programs/interventions resulted positive outcomes. Coaching, that is implemented in all fields of nursing such as pediatric nursing, comes out with positive outcomes. Coaching programs in pediatric nursing deal mostly with the management of chronic diseases. The purpose of this brief paper was to emphasize the successful results of coaching applications also to make the readers consider the use of coaching programs in different fields of pediatrics.
Keywords: Chronic illness; Coaching; Pediatric nursing
TCoaching is a collaborative relation between the coach and a volunteer client . The coaching relationship has a time limit and includes a series of significant dialogues between the coach and the client. The coaching interventions begin with interviews, new action and new practice occur at the last part of interviews . Coaching is not giving advice, not teaching or directing, it is a collaborative relationship . Coaching begins with the question “How can we motivate the patient and the caregiver to create behavioral change?” It includes supporting and encouraging the individual as well as helping him utilize past experiences to facilitate the process of behavioral change [13,15]. Coaching is related to performance improvement and aims to enhance the learning process and assist the client in acquiring new skills. A coach is both a consultant and a motivator who helps the client identify and achieve his goals [5,12].
Coaching, first appeared in nursing literature in the last decade as more nurses began to seek innovative ways to expand the nurses’ role in providing patient care [5,12]. Nurse coaches will play an essential role in transition from a disease-focused health care system to a culturally sensitive health care system which focused on disease prevention and health promotion. Nurse coaches will also address the spiritual and biopsychosocial dimensions of health care as essential stepping stones to reaching that goal . Developing an efficient coaching relationship with the client includes creation of a safe environment, identification of desired outcomes, facilitation of self discovery, planning of actions and establishing mutual trust. Nurse coaches emphasize recognizing and reinforcing the client’s strengths rather than “fixing” his weaknesses .
Coaching methodology is based on helping the client develop critical thinking skills that will enable him to gain a deeper understanding of himself. The goal of coaching that is based on behavioral change is to help the client replace undesirable outcomes with desirable, positive results [12,13]. Parsloe and Wray  emphasized that the role of coaches should include analyzing current performance, planning suitable teaching, implementing plans, and evaluating performance.
Coaching has facilitated important advances in pediatric nursing practices recently by providing patient-centered care and communication-focused interventions. A review of the literature reveals that both children and parents achieved dramatically increased positive outcomes and improved management of chronic diseases due to coaching interventions. Nurses have examined coaching for asthma and diabetes, which are the most common diseases of childhood [2,3,4,6,10]. In addition, coaching programs have been developed for obesity, pain management, behavioral impairments, reduction of secondhand smoke exposure, sexual education and parental skills’ acquisition [8,9,11,16,17].
When the target age groups of pediatric coaching were examined, it was clear that children and adolescents constituted the target age groups. That age group of children have the necessary competencies to acquire healthy lifestyle behaviors and to take the responsibility of managing a chronic disease. Thanks to coaching programs, necessary support and counseling are provided in order to let the children perform desired behaviors. The target group of coaching programs, developed for 0-6 age group of children including preschool children, is parents because 0-6 age group of children are not in appropriate level of growth to take the responsibility of healthy lifestyle behaviors and disease management [6,16].
The most significant reason why coaching interventions lead to positive outcomes in chronic diseases and other childhood health problems is that these programs include multifaceted strategies. Because it has been shown that unidirectional strategies are inadequate in the management and/or resolution of health problems such as chronic diseases so that health care providers have begun to devise and implement multifaceted strategies. Coaching is an ideal way to apply such comprehensive strategies. Coaching built on behavior change involves many strategies that are a combination of skills and principles. Furthermore, coaching in nursing is a crucial step in the transition of the traditional health care model into a modern care model.
In pediatrics, different coaching models such as telephone coaching, home-based coaching, internet based coaching, symptom-control coaching, and practice coaching have been examined. Some of these coaching models have been implemented for 3 months, some for more than 6 months and others for 2 years [2,4,6,8,9]. Coaching in pediatric nursing has occurred face-to-face and via telephone or email communications, and typically involves several coaching sessions. Although outcomes vary according to the conditions under which the assessment of coaching outcome is made, reductions in the cost of health care and positive lifestyle changes are among the most important and the most common results of studies that examine the efficacy of coaching.
In pediatrics, coaching process is influenced by many variables. First of all; the key point for a successful coaching program is to know well the characteristics and requirements of the target group. Secondly; the coach should have necessary competencies to meet the needs of target group. Thirdly; the process itself needs to be planned well from very beginning to the end. Also; problems occurring during the process, expected outcomes and positive/negative factors affecting the process should be taken into consideration in the planning phase and the families should be informed accordingly.
Pediatric nurses, having deep knowledge and skills on pediatric health care, are the professionals about child care from the birth till young adult. Such care should support optimum health of the child within the context of family-society and environment. Pediatric nurses should have some competencies in terms of coaching. Those competencies are defined as “important nursing ability” that aim to develop psychomotor skills of ill or healthy individuals . Coaching modeling includes individualized interventions and interpretation abilities together with patient advocacy and tutoring activities . In coaching, pediatric nurses should primarily provide counselling appropriate for the age of the target population and their developmental expectations. Pediatric nurses should be able to assess developmental theory based- development tasks and coping styles of the child by recognizing developmental states and individual differences. Moreover; the coach should have effective communication skills with the child and his parents.
The coach needs to be able to develop new strategies against lifestyle changes in order to make the child and family adapt the new conditions more easily [1,7]. Acquiring of all those skills should start from undergraduate programs. Theory based development characteristics of the child, effective communication strategies with the child and family, and critical thinking skills should be placed in undergraduate curriculums. Besides, at post-graduate, training and certification programs to improve coaching might be beneficial [12,15].
In conclusion, coaching programs implemented by pediatric nurses to facilitate the management and/or resolution of childhood health problems should strive to attain significant outcomes in terms of reducing cost of care and achieving positive outcomes. The holistic approach that is the backbone of nursing care is also the starting point of coaching interventions. Coaching is a valuable tool for the biopsychosocial assessment of patients and caregivers, to facilitate cooperation between them and to enhance communication. Thanks to coaching interventions, nurses present themselves as competent and cost effective providers of care and education for the complex health challenges of modern world. At the same time, coaching is an opportunity for nurses to perform their roles as consultants, mentors, and collaborators as well as caregivers. A well-structured coaching program can be an important supportive strategy that allows nurses to assist patients and providers in achieving their goals.
Cite this article: Ekim A. A Growing Trend in Pediatric Nursing: Coaching. J J Nurs Care. 2015, 1(2): 006.