Patient Education and Health Promotion CH 25

Patient Education

• The primary goal of patient education is to help individuals, families, or communities achieve optimal levels of health, maintenance, and promotion of health, and illness prevention.

Success in Patient Education

• Success in patient education is not just about recalling information, but also about incorporating knowledge into everyday life activities to promote health.
• Patients need to learn new knowledge and skills to continue activities of daily living, especially after recovering from illness or injury.

Teaching and Learning

• Teaching is the concept of imparting knowledge through a series of directed activities.
• Learning consists of a conscious, deliberate set of actions that help individuals gain new knowledge, change attitudes, adopt new behaviors, or perform new skills.
• Teaching and learning begin when a person identifies a need for knowing or acquiring an ability to do something.

Effective Teaching

• Effective teaching depends on effective interpersonal communication.
• An educator applies each element of the communication process while providing information to learners.
• Feedback from the learner indicates the effectiveness of instruction and whether the educator needs to modify their approach.

Domains of Learning

• Learning occurs in three domains: cognitive (understanding), affective (attitudes), and psychomotor (motor skills).
• Cognitive learning involves gaining information to further develop intellectual abilities, mental capacities, understanding, and thinking processes.
• Affective learning deals with learning how to express feelings and emotions and to develop values, attitudes, and beliefs.
• Psychomotor learning involves the development of manual or physical skills.

Cognitive Learning

• Cognitive learning includes:
  • Remembering (formerly Knowledge): recognizing or recalling knowledge from memory.
  • Understanding (formerly Comprehension): constructing meaning from different types of messages or activities.
  • Applying (formerly Application): carrying out or using a procedure through executing or implementing.
  • Analyzing (formerly Analysis): breaking materials or concepts into parts, then determining how the parts relate to one another or how they interrelate.
  • Evaluating (formerly Synthesis): making judgments based on criteria and standards through checking and critiquing.
  • Creating (formerly Synthesis): putting elements together to form a coherent or functional whole; reorganizing elements into a new pattern or structure.

Affective Learning

• Affective learning includes:
  • Receiving: the simplest behavior in affective learning.
  • Characterizing: the most complex behavior in affective learning.

Psychomotor Learning

• Psychomotor learning involves the development of manual or physical skills, such as learning how to walk or how to type on a computer.

Motivation

• Motivation is an internal state that helps arouse, direct, and sustain human behavior.
• Using a theory that matches a patient's problems and personal learning preferences helps select interventions that have the best chance of helping the patient become an active participant.

Cultural Competence

• Knowing a patient's cultural preferences and health beliefs helps develop patient-centered interventions that will motivate patients to learn.
• Using the ACCESS model helps focus on cultural factors that influence patient education outcomes.

Readiness to Learn

• Readiness to learn is based on a patient's willingness to engage in learning.
• Assess a patient's level of knowledge and intellectual skills before beginning a teaching plan.
• Learning occurs more readily when new information complements existing knowledge.

Teaching Strategies

• Use evidence-based teaching strategies, such as:
  • Using visuals in explanations
  • Providing examples for multi-step problems
  • Giving students time to practice doing new things
  • Giving feedback

Health Literacy

• Health literacy pertains not only to a patient's ability to read and comprehend health-related information but also to having the skills to problem solve, articulate, and make appropriate health care decisions.
• Low health literacy can lead to more emergency department visits, hospital admissions, and readmissions.

Assessing Patient Needs

• Assess a patient's:
  • Level of physical development and overall physical health
  • Ability to perform psychomotor skills
  • Preferences, values, and expressed needs
  • Readiness and ability to learn
  • Physical and cognitive ability to learn
  • Family caregivers' readiness and ability to learn
  • Home environment and community resources

Teaching Plan

• Develop a teaching plan based on a patient's learning needs and expected outcomes.
• Involve the patient in selecting learning experiences.
• Prioritize teaching activities based on a patient's nursing diagnoses or collaborative problems, outcomes established, and time available to teach.

Implementation Methods

• Use evidence-based interventions to create an effective learning environment.
• Active participation is key to learning.
• Use audiovisual aids, group discussion, and role-playing as effective teaching strategies.### Reinforcement in Teaching
• Reinforcement is used to increase the probability of a desired response by using a stimulus.
• Positive reinforcement (e.g., smile, verbal praise) promotes desired behaviors.
• Negative reinforcement (e.g., frowning, criticizing) can decrease undesired responses, but may discourage participation and cause withdrawal.

Teaching Methods

• Teaching during routine care is efficient and cost-effective.
• Choose instructional methods that match a patient's learning needs, time available, setting, resources, and comfort level.
• One-on-one verbal discussion is a common method of instruction, allowing patients to ask questions and share concerns.
• Group teaching is an economical way to teach multiple patients, promotes social support, and increases active participation.

Preparatory Instruction

• Providing information about procedures decreases anxiety and enhances patients' sense of control.
• Use demonstrations to teach psychomotor skills, such as preparing a syringe or taking a pulse.

Teaching Techniques

• Analogies translate complex language or ideas into understandable words or concepts.
• Role-playing helps patients learn required skills and feel more confident in performing them independently.
• Simulation is a useful technique for teaching problem-solving, application, and independent thinking.

Patient-Centered Approach

• Patients with low health literacy, illiteracy, and learning disabilities require adapted teaching strategies.
• Accept and respect patients' cultural backgrounds and offer culturally sensitive approaches.
• Use strategies to enhance health literacy and create a more patient-centered approach.

Teaching Tools and Evaluation

• Select teaching tools based on instructional method, patient's learning needs, and ability to learn.
• Adapt teaching methods to accommodate sensory changes, such as visual and hearing changes.
• Use the teach-back method to evaluate patient understanding and ensure clear communication.