Alliance not compliance: coaching strategies to improve type 2 diabetes outcomes.
OBJECTIVE
To explore strategies for improving patient outcomes in type 2 diabetes.


METHODS
The literature related to type 2 diabetes management, behavior change, communication, diabetes self-management, and coaching.


CONCLUSIONS
The strategies currently suggested for improving patient outcomes, e.g., increasing provider adherence to evidence-based management guidelines, streamlining practice systems, and promoting patient lifestyle changes through intensive education, have produced mixed outcomes. Of the many complexities involved in managing type 2 diabetes, motivating patients to change behavior may be the most challenging. A suggestion for improving patient self-management of type 2 diabetes is to use coaching communication within a framework of behavior change in the context of the primary care encounter between nurse practitioners (NPs) and their patients.


CONCLUSIONS
Given the varied outcomes of current strategies, coaching by NPs may provide a feasible alternative for improving patient outcomes in type 2 diabetes. Coaching communication can be implemented during office visits as an intervention without cost. To effectively implement this approach, however, practicing NPs and NP students need more formal education in this expected but underdeveloped NP role competency. NPs are called upon to contribute to the body of knowledge needed to validate the merits of coaching for their patients.
Hayes
Eileen
E
School of Nursing, University of Massachusetts, Amherst, Massachusetts, USA. efhayes@nursing.umass.edu
McCahon
Cynthia
C
Panahi
Margaret Reeve
MR
Hamre
Taryn
T
Pohlman
Karen
K
D003142:Communication; D003299:Cooperative Behavior; D003376:Counseling / Q000458:organization & administration*; D003924:Diabetes Mellitus, Type 2 / Q000517:prevention & control / Q000523:psychology; D006293:Health Promotion / Q000458:organization & administration*; D006301:Health Services Needs and Demand; D006801:Humans; D009042:Motivation; D009722:Nurse Practitioners / Q000193:education / Q000458:organization & administration* / Q000523:psychology; D024802:Nurse's Role / Q000523:psychology; D009723:Nurse-Patient Relations; D010349:Patient Compliance / Q000523:psychology*; D010353:Patient Education as Topic; D011320:Primary Health Care; D012648:Self Care / Q000523:psychology