Problem-solving counselling or phone-call support for outpatients with chronic illness: effective for whom?

The purpose of this randomized controlled trial (RCT) was to determine the effectiveness of problem-solving counselling or phone-call support provided by nurses to outpatients not well adjusted to chronic illness. Subjects (N = 293) completed measures at baseline and after the six-month period of intervention for psychosocial variables including coping behaviours, purpose in life, and psychosocial adjustment to illness. Subjects receiving phone-call support from nurses demonstrated less psychological distress. Results also suggest that problem-solving counselling improves psychosocial adjustment to chronic illness for outpatients who live alone, infrequently use problem-solving coping skills, or frequently use avoidance coping methods. As well, outpatients with a low purpose in life who show infrequent use of problem-solving coping skills appear to benefit most from problem-solving counselling provided by nurses. On the other hand, those not well adjusted who frequently use problem-solving coping seem to be served more effectively by phone-call support.