The study demonstrated that previously sedentary older adults with type 2 diabetes, supported with a coaching intervention, were able to achieve the physical activity targets known to be beneficial to health. However, using a pedometer added no further benefit. Further research on the impact of specific coaching strategies in diabetes management is warranted.

Self-management is a necessary aim in the treatment of chronic illnesses, such as diabetes, heart disease, arthritis, lupus, and chronic obstructive pulmonary disease. Although effective treatments are available for these serious conditions, the rate of adherence to medication, dietary changes, physical activity, blood monitoring, or attendance to regular medical screenings is reported to be approximately only 50%. The role of health professional support in effective self-management of chronic illness has been recently acknowledged. Furthermore, numerous studies on professional support for self-management of chronic illness have focused on the health professional as a ?coach?. Coaching has been defined as an interactive role undertaken by a peer or professional individual to support a patient to be an active participant in the self-management of a chronic illness. A review of the literature revealed a limited number of empirical studies on coaching, with these focusing on one of three areas: disease-related education; behaviour change strategies; or, psychosocial support. Due to the small number of research investigations, only tentative support can be given to the efficacy of the different coaching approaches. However, it was apparent that education-based interventions have a significant role in self-management, but that these were not sufficient by themselves. The role of behaviour change-focused coaching was also shown to be an important factor. However, not all patients are ready for change, and therefore the need for coach interactions that move a patient to a stage of action were evident, as was the need to consider the emotional state of the patient. The challenges for future research is to investigate the relative strengths of these coaching approaches for the support of patient self-management of chronic illness, and the means to effectively integrate these approaches into routine health care, through a wide range of health professional groups.

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This study indicated the existence of a high level of depressive symptoms among individuals diagnosed with lupus, and reinforces the need for screening procedures in chronic illness, and treatment interventions that target maladaptive illness perceptions.

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ObjectiveThis research aimed to identify the skills required by primary health care (PHC) professionals to provide effective chronic condition prevention and self -management (CCPSM) support, according to the perceptions of a sample of Australian consumers and carers. MethodsQualitative data was collected and integrated from a focus group, key informant interviews and National Stakeholder meetings and a National Workshop, supported by an extensive literature review. ResultsWith the exception of health professionals specifically trained or currently working in this area, consumers and carers perceive there is a lack of understanding, competence and practice of CCPSM support among PHC professionals. DiscussionThe PHC workforce appears not to have the full set of skills needed to meet the growing burden of chronic conditions on the health system. Recommendations include education and training that focuses on improved communication skills, knowledge of community support resources, identification of consumers' strengths and current capacities, collaborative care with other health professionals, consumers and carers, and psychosocial skills to understand the impact of chronic conditions from the person's perspective.

The findings supply a richness of detail that is often absent in quantitative studies. This detail may give cardiac rehabilitation professionals additional insight into the complexity of patients' emotional reactions and the interrelationships of these reactions. The results highlight the importance of the identification and referral of patients who present with more than transient emotional difficulties.

The objectives of the study were to assess sleep disturbances in systemic lupus erythematosus (SLE) and to compare these with a working sample and a treatment-seeking sample reporting insomnia. The primary sample was 172 people with SLE. This sample represented 32% of all members of two lupus support association. Two comparison samples were used: 223 adults who expressed interest in taking part in a psychological treatment for sleep problems and 456 Australian adults who were working at a large organization. All individuals completed the Pittsburgh Sleep Quality Index (PSQI; 6). Data derived from the PSQI included total sleep time, sleep onset latency, wake after sleep onset, sleep efficiency, as well as the global and seven component scores. The SLE sample reported significantly worse sleep on all parameters than the working sample, but significantly better sleep than the sample of those seeking treatment for sleep disorders, except for sleep onset latency. The percentages scoring >5 on the PSQI global score was 80.5% for SLE, 91.5% for those seeking treatment for sleep disorders, and 28.5% for the working sample. PSQI component scores for the SLE group more closely resembled those of the treatment-seeking group. Self-reported sleep in this sample of people with SLE was significantly better on most parameters than that of a group seeking treatment for sleep disorders. However, the values obtained tended to be worse than previous reports and indicated less than optimal sleep. However, the low response rate of the sample was of concern and may indicate that the sample was biased. The present results suggest that sleep disturbance is common in those with SLE and deserves more attention in a more representative sample.