The use of coaching in stroke rehabilitation: a scoping review

Stroke results in long-term impacts on a person’s life requiring ongoing management after formal rehabilitation ends. Coaching can support people to build competencies and skills for managing health-related challenges and has the potential to support stroke survivors to continue achieving goals on their own following rehabilitation. This review sought to describe the research on coaching interventions for adults living with stroke. A scoping review to explore how coaching is defined and used in stroke rehabilitation intervention research. PubMed, CINAHL, Medline, and PsycINFO databases were searched using terms to represent coaching, rehabilitation practitioners, and stroke, the results were extracted into COVIDENCE. Data were described and synthesized to identify similarities and differences among coaching interventions. Twenty-eight articles describing 15 interventions were included and categorized based on their focus as Health Coaching, Coaching for Exercise and Physical Activity, Coaching for Engagement in Activity or Participation, and Transition Coaching. Common elements of coaching interventions were goal setting, problem solving and education with emotional support being infrequent. Notably, coaching definitions and techniques were frequently not described. Coaching in stroke rehabilitation is diverse but has common foci and elements. More research using clear descriptions of coaching is required.

脑卒中（Stroke）会对患者的生活造成长期影响，在正式康复阶段结束后，患者仍需开展持续性的健康管理。辅导（Coaching）可帮助患者提升应对健康相关挑战的能力与技能，有望助力脑卒中幸存者在康复结束后自主达成个人目标。本综述旨在梳理针对成年脑卒中患者的辅导干预相关研究，属于一项范围综述（scoping review），旨在探究脑卒中康复干预研究中辅导的定义与应用方式。研究通过检索PubMed、CINAHL、Medline及PsycINFO数据库，使用覆盖辅导、康复从业者与脑卒中主题的检索式进行文献筛选，并将检索结果导入COVIDENCE平台进行统一管理。对提取的数据进行描述与综合分析，以明确各类辅导干预方案的异同之处。最终纳入28篇阐述15项干预方案的文献，并依据干预核心焦点将其划分为四类：健康辅导（Health Coaching）、运动与身体活动辅导、活动参与辅导及过渡辅导（Transition Coaching）。辅导干预的共性要素包含目标设定、问题解决与健康教育，但情感支持的应用相对少见。值得注意的是，多数相关研究未明确说明辅导的定义与实施技术。脑卒中康复领域的辅导干预形式多样，但具备共同的核心焦点与实施要素。未来仍需开展更多对辅导方案进行清晰阐述的相关研究。