Patient Education PDF

PATIENT EDUCATION Benefits of Patient Education There are three important objectives of patient education that may result in positive health outcomes: 1. Changing health behaviours: For example, the HCP may instruct a patient on the proper use of contraceptives, good nutrition, the...

PATIENT EDUCATION Benefits of Patient Education There are three important objectives of patient education that may result in positive health outcomes: 1. Changing health behaviours: For example, the HCP may instruct a patient on the proper use of contraceptives, good nutrition, the detrimental effects of smoking and drinking, or the beneficial effects of regular exercise. This education may encourage patients to take an active role in their health and medical care. Benefits of Patient Education … cont 2. Improving health status For example, instruction about the use of sunscreen may decrease the risk of a patient developing melanoma. Instruction regarding the performance of routine breast examinations may result in the early detection of breast cancer and, therefore, a markedly improved prognosis for the patient. 3. Improving patient compliance For example, patients with hypertension often have no outward symptoms even though the disease causes profound damage in many of their organ systems. Because they are asymptomatic, some patients do not adhere to their HCP’s treatment recommendations. Approach to Patient Education There are three steps in the approach to patient education: 1. Assessment of the patient 2. Design of the instruction 3. Selection of teaching strategies and resources 1. Assessment of the Patient To determine the type of instruction needed for a particular patient, four categories of variables must be assessed: 1. contexts for the education 2. patient demographics 3. patient learning styles 4. content analysis. 1. Assessment of the Patient (1. contexts for the education) Situational context refers to the medical condition that creates the need for the instruction (e.g., chronic disease, surgery, acute illness). Instructional context refers to the environment in which the instruction will take place (e.g., doctor’s office, hospital room, nursing home, outpatient clinic). Instructional context …. Cont… There are a number of environmental factors of which the HCP should remain mindful, as they may influence the effectiveness of the instruction in a given environment. These include a) Lighting b) room temperature c) the ability of the patient to hear the HCP clearly d) Distractions e) patient privacy 1. Assessment of the Patient (2. patient demographics) Patient demographics refer to certain characteristics of the patient that may influence their response to the instruction. These characteristics include: 1. Ethnicity and cultural background: A patient may prefer alternative therapies such as herbal medicine or acupuncture 2. Socioeconomic background 1. Assessment of the Patient (2. patient demographics) …. Cont. 4. Age: Elderly patients may be more deferential toward HCPs 5. Education level of the patient 6. Healthcare background: Previous experiences with HCPs and healthcare institutions may influence a patient’s perspective 7. Physical and psychological conditions: Pain will certainly be distracting to a patient; anger, depression, or anxiety may also negatively 1. Assessment of the Patient (3. patient learning styles) In other words, they learn best in response to different teaching methods. Visual learners respond well to the use of pictures, diagrams, anatomic models, and literature. Auditory learners prefer to be engaged verbally with the use of questions and answers or discussion. Kinesthetic learners learn by the physical demonstration of a task or technique by the HCP followed by the practice of the technique by the patient. 1. Assessment of the Patient (4. content analysis.) This is where the HCP determines what information should be included in the teaching session for the particular patient. Included in this is the identification of what information is essential as opposed to irrelevant or redundant, or simply interesting. In other words, the HCP must distinguish between need-to-know and nice-to-know. For example, the patient with asthma must be instructed on how to avoid precipitating factors, treatment options, and Strategies for Patient Instruction 1. Welcome your patient warmly and introduce yourself. Establish a caring relationship by ensuring privacy and confidentiality, sitting at arm’s length, and making appropriate eye contact 2. Appear knowledgeable, experienced, and confident Remain patient and adaptable. 3. Ask the patient what they already know and think about the issue at hand. The HCP begins by asking the patient about their understanding and perspective of their condition as well as their expectations for outcomes with treatment. This will help the HCP to tailor explanations to the patient. The HCP then tells the patient about the diagnosis and management plan. Finally, the HCP invites the patient to ask any questions they may have. Strategies for Patient Instruction 4. Be capable of communicating clearly and professionally using plain language. Using plain language is not “dumbing down” or oversimplifying information to the point where it is inaccurate. Plain language is simply about clear and effective communication. For example: Keep sentences short and to the point. Use the second person “you” instead of the third person “patients” or “people. Limit the use of words consisting of three or more syllables. Use shorter words whenever possible. Avoid excessive use of medical terminology as patients may be reluctant to say that they are confused or do not understand. Whenever possible, substitute common terms for clinical terms. Examples of word substitutions include: “Shot” instead of “intravenous or intramuscular injection”, “Pill” instead of “medication”, “Pain reliever” instead of “analgesic Strategies for Patient Instruction 5. Observe nonverbal cues from the patient. This will help you to determine the patient’s reaction to, and understanding of, the instruction. 6. Be aware of your own nonverbal behaviors toward the patient. Maintain a professional appearance, use appropriate eye contact, remain mindful of the use of hand gestures, and situate yourself at an appropriate distance from patient. Strategies for Patient Instruction…cont. 7. Adapt the message according to the beliefs and concerns of the patient. It is very important to identify a patient’s perceptions of their health as well as their behaviours prior to providing instruction that is meant to change their behaviours. 8. Fully inform patients. the purposes and effects of interventions as well as when to expect these effects should be conveyed to the patient. For example, the therapeutic effects of antidepressants often take several weeks to become clinically apparent. 9. Be specific. 10. Recommend smaller changes in behaviour instead of larger changes. 11. Add new behaviour's instead of eliminating old ones. Strategies for Patient Instruction … cont. 12. Link new behaviours to the old ones. Begin by discussing the patient’s daily routine. If a patient needs to take a medication two times per day, you could recommend that the medication be taken in the morning and evening when the patient brushes their teeth. 13. Use your “white coat.” Healthcare professionals are often regarded as authority figures, experts in their areas of specialty. 14. Encourage the patient to make a commitment. For example, a patient who has had a myocardial infarction, or heart attack, must make a commitment to a low fat diet and regular exercise to minimize the likelihood of a second heart attack. Strategies for Patient Instruction … cont. 15. Repeat important information. As with any form of instruction, it is often helpful to tell the patient what you are about to tell them, tell them, and then tell them what you just told them. 16. Interact fully with the patient. Patient instruction will be more effective if the communication is two- way instead of one-way. 17. Employ the technique of “demonstration and practice.” any individuals are kinesthetic learners and benefit from the demonstration of a medical device or instrument prior to practicing how to use it on their own. Strategies for Patient Instruction … cont. 18. Use a combination of instructional techniques. Patient instruction begins with effective verbal communication 19. Ask the patient if they have any questions or concerns. The educational session may have raised additional questions or concerns on the part of the patient. In addition to asking the patient directly, look for nonverbal cues that the patient does not understand the instruction or that they may have concerns. 20. Respect the patient’s choices. the HCP may feel that the patient has not made the best choice in terms of treatment options or health behaviours. However, it is extremely important that the patient is always treated with respect and dignity. Practices to Avoid During a Teaching Session a) Repeatedly exiting and returning to the room or area where the instruction is taking place b) Encouraging interruptions from colleagues c) Avoiding eye contact by continuously writing notes while the patient is speaking d) Making negative facial expressions or using dismissive hand gestures toward the patient e) Making judgmental comments regarding the patient’s concerns or choices