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A closer look at self-determination theory & autonomy in nurse coaching.

12 Person-centered care is central to the practice of nurse coaching. Rather than concentrating solely on the management of disease, the main focus is on the individual person and identifying opportunities for growth, overall health and wholeness. Nurse coaching is all about people and their “innate power and capacity for the achievement of well-being” (Hess et al., 2013, p.6)—what are their goals, how do they want to accomplish them, and how do they evaluate their progress and success. The patients are in the driver’s seat and draw on their wisdom and resources with the support of the coach. It is no wonder that nurse coaching is burgeoning because most nurses want patients to be at the center of the health and wellbeing process. It is also easy to see how personcentered care and the nurse coaching culture align with self-determination and autonomy. Coaching values a safe and supportive environment for learning and growth by maintaining a stance of curiosity and venturing into the unknown of a client’s inner world (Bark, 2011). Coaching also wants the patient to make choices, and it assists clients in moving toward their goals. However, with the current merging of coaching into lifestyle and behavior change, there is some debate surrounding the appropriateness of clientdetermined goals, client-centered care, predetermined goals from the healthcare provider, and the mutual agreement of goals between healthcare provider and client. Turning to the literature on selfdetermination and autonomy can serve to enlighten and offer evidence-based reasoning to the discussion and forward movement of person-centered care. Current research has related autonomous motivation and autonomysupportive care (often discussed as “patient-centered” care) to improved patient outcomes in the management of diabetes (Williams, Freedman, & Deci, 1998; Senecal, Nouwen, & White, 2000; Williams, McGregor, Zeldman, & Deci, 2004; Williams, et al. 2009). Studies PERSON-CENtERED CARE