Nursing 101 - LO4: Differentiate Between Client Education, Health Literacy, and Mental Health Literacy PDF

LO4: DIFFERENTIATE BETWEEN CLIENT EDUCATION, HEALTH LITERACY, AND MENTAL HEALTH LITERACY DEVELOPED BY DAN LEE DEFINITIONS Pedagogy Andragogy – teaching – teaching children of adults  LEARNING STYLES 1. Visual 2. Auditory What sty...

LO4: DIFFERENTIATE BETWEEN CLIENT EDUCATION, HEALTH LITERACY, AND MENTAL HEALTH LITERACY DEVELOPED BY DAN LEE DEFINITIONS Pedagogy Andragogy – teaching – teaching children of adults  LEARNING STYLES 1. Visual 2. Auditory What style do you think you are 3. Reading/Writing vs. What style are you according to VARK 4. Kinesthetic 5. Logical VARK Questionnaire: How do you learn best? 6. Social 7. Solitary  David Kolb David Kolb’s theory is known as the Experiential Learning Cycle. This model describes learning as a continuous process where knowledge is created through the transformation of experience. The cycle consists of four stages: Concrete Experience: Engaging in a new experience. Reflective Observation: Reflecting on the experience. Abstract Conceptualization: Forming new ideas or modifying existing concepts based on the reflection. Active Experimentation: Applying these new ideas to the world to see what happens. This cycle emphasizes that effective learning involves moving through all four stages, allowing learners to gain a deeper understanding and apply their knowledge in practical ways.  Howard Gardner is a developmental psychologist that developed a theory of multiple intelligences. He proposed there are 8 types of intelligence. 1.Linguistic Intelligence 2.Logical-Mathematical Intelligence 3.Spatial Intelligence 4.Bodily-Kinesthetic Intelligence 5.Musical Intelligence 6.Interpersonal Intelligence 7.Intrapersonal Intelligence 8.Naturalistic Intelligence Howard Gardner Linguistic Intelligence: Sensitivity to spoken and written language, ability to learn languages, and capacity to use language to accomplish certain goals. Logical-Mathematical Intelligence: Capacity to analyze problems logically, carry out mathematical operations, and investigate issues scientifically. Spatial Intelligence: Ability to recognize and manipulate the patterns of wide space (like those used by navigators and pilots) as well as the patterns of more confined areas (such as those used by sculptors, surgeons, chess players, or architects). Bodily-Kinesthetic Intelligence: Using one’s whole body or parts of the body to solve problems or create products, often seen in athletes, dancers, surgeons, and craftspeople. Musical Intelligence: Skill in the performance, composition, and appreciation of musical patterns, including the capacity to recognize and compose musical pitches, tones, and rhythms. Interpersonal Intelligence: Ability to understand and interact effectively with others, involving effective verbal and nonverbal communication, sensitivity to the moods and temperaments of others, and the ability to entertain multiple perspectives. Intrapersonal Intelligence: Capacity to understand oneself, to appreciate one’s feelings, fears, and motivations, and to use such knowledge in planning and directing one’s life. Naturalistic Intelligence: Ability to recognize, categorize, and draw upon certain features of the environment, often seen in botanists, farmers, and biologists  The patient’s ability to find, access, read, and understand health information and ability to use information to make informed decisions. Examples of activities requiring health literacy: reading and understanding medication bottles, filling out health forms correctly, HEALTH knowing when to vaccinate or get screening tests (mammography, LITERACY colonoscopy) Some with high levels of education are health illiterate. One statistic says 45% of high school graduates have low health literacy (USHHS, 2010 as cited in Bastable, Myers, & Bastable Poitevent, 2019). Most people’s health literacy is significantly lower than their literacy ability  CHALLENGES FACING PEOPLE “Medicalese” – Complex medical lingo Unfamiliarity with anatomy, physiology, and pathophysiology Emotions when diagnosed with an illness (fear, anxiety) Complex instructions to follow when diagnosed with an illness (CDC, 2016 as cited in Bastable et al., 2019)  CHARACTERISTICS OF HEALTH LITERACY Context dependent: A trained professional may have trouble understanding information from another field. Some material may be challenging reading. Cannot make assumptions about someone’s health literacy. Health literacy has become a predictor of clients’ ability to take care of themselves. Low health literacy can result in inappropriate use of resources such as emergency rooms. Bastable et al., 2019 People are increasingly being made responsible for their own care.  MENTAL HEALTH LITERACY “Knowledge and beliefs about mental disorders which aid their recognition, management or prevention.” Canadians are fairly knowledgeable about what mental illnesses are. Canadians can identify protective factors. Canadians believe that mental illness is related to psychosocial factors and biomedical issues. Medical care is recommended for Tx: believe that recovery is possible. Stigma still an issue. Canadian Alliance on Mental Illness and Mental Health. (2007, May). It would be interesting to repeat these focus groups and survey now when there is more publicity. (Bell Let’s talk).  HOW DO PSYCHIATRIC NURSES CONTRIBUTE TO HEALTH AND MENTAL HEALTH LITERACY? We are responsible for giving the client the tools required for them to be successful. We play the role of health educator with all of our clients. We must assess the client’s literacy levels and tailor our education accordingly. We must create a safe environment where our clients feel safe to ask questions. We must boost the client’s health literacy so they can be successful. An entry level competency in psychiatric nursing. Health teaching plays an important role in helping the client’s success.  Education requires Four steps: Assessment – Learning needs, learning style, HOW DO Readiness/ability to learn PSYCHIATRIC Planning – Create a teaching plan based on NURSES mutually determined goals EDUCATE Implementation – Perform the teaching using specific methods and materials CLIENTS? Evaluation –Determine behavioral changes in knowledge, skill, attitude. Similar to the nursing process Starts when you meet the client  What is the client’s current level of knowledge? Talk to the client about their understanding of the situation/treatment. Open ended questions are ASSESSMENT: ideal. LEARNING What does the client need to know to be NEEDS successful, safe, and healthy? What is the client’s background? Does the client’s family need education and can I supply this education while abiding by HIPA?  VARK: Visual, Auditory, read and write, kinesthetic. Gardner’s eight intelligence types: Linguistic, spatial, kinesthetic, logical-mathematical, musical, interpersonal, intrapersonal, naturalistic Kolb’s experiential learning model: Accommodator, diverger, ASSESSMENT: converger, assimilator Accomodator: hands-on; likes new, challenging situations; LEARNING relies on intuition over logic STYLES Diverger: concrete situations, observers (take things in) rather than actors, link to personal experience. Converger: Practical application to ideas; structure and facts; technical tasks Assimilator: can understand large amounts of info.; like abstract ideas; likes theory Accommodators: RP, gaming, simulations are ways of teaching Divergers: group discussion, and brain storming Converger: demonstration/return demo, handouts and diagrams Assimilator: lecture, 1-1 instruction, self-instruction, ample reading material to support learning. What is the client’s background? Sometimes gives ideas about how they learn (e.g. an exercise instructor would likely be kinesthetic); Nurse may be accommodator or converger ASSESSMENT: READINESS/ABILITY TO LEARN Does the client have any Motivation: what is the Environment: is the health issues/learning client’s motivation to learn? environment conducive to disabilities/intellectual Does the client have learning? Do I have the disabilities that would motivation at all? Can my appropriate materials to prevent them from learning? educational plan support teach? Is the client in an emotional increased motivation? state where they can learn?  Barriers to teaching Obstacles to learning ❖ Lack of space, privacy, ❖Lack of space, privacy, noise noise (semi-private (semi-private room) room) ❖Lack of time (early d/c) ❖ Lack of time (early d/c) ❖Stress of illness (poor concentration) ❖ Lack of confidence by educator ❖Literacy issues (limited English) ❖Lack of support (spouse reluctant that education is beneficial)  FIVE STAGES OF CHANGE 1 2 3 4 5 Precontemplatio Contemplation Preparation Action Maintenance n Precontemplation – I don’t want to change. Contemplation – I might need to do something about it. Preparation – I would like to do something about it Action – I am doing something about it. Maintenance – I have done something about it.  HIERARCHY OF LEARNING Evaluation Synthesis Analysis Application Comprehensio n Knowledge We can go from knowing something to being able to apply it it specific situations to being able to use that knowledge to create new ideas in synthesis and evaluation.  Create learning objectives – what do you want the person to learn? Will they be open to learning this? Highly specific. SMART goals. Gather/create your materials and organize appropriately – Material should go from simple to complex. Building appropriately. If creating new material, complexity should be scaled. Ideally, grade 8 PLANNING level. Use pre-existing knowledge. Select teaching method: ideally, using multiple methods and with good client engagement. Timing: When should the client be taught? Who should be taught? SMART goal: Specific, can be measured, Achievable, Realistic, timed. Gathering: You need to learn to wash hands before doing sterile technique. Timing: sometimes, we have to wait until the client is better before we can teach them. Sometimes, it is the family/caregiver that needs the education.  Fracus Learning, 2018 from https://commons.wikimedia.org/ wiki/ File:Bloom%E2%80%99s_Taxo nomy_Verbs.png license type CC-BY-SA-4.0 Bloom’s Taxonomy is a way to categorize different levels of thinking and learning. Imagine it as a pyramid with six levels, each representing a different type of cognitive skill  Break 15 Minutes  1) Behaviorist 5 2) Cognitive PSYCHOLOGICAL LEARNING 3) Social Learning THEORIES 4) Psychodynamic OUTLINED HERE: 5) Humanistic We have different ways of learning and teaching. Behaviorist – stresses behaviors Cognitive – stresses thoughts Social learning – stresses role modeling and learning from others. Psychodynamic – stresses emotions  IMPLEMENTATION: METHODS Pick method based on the client’s learning needs and what is to be taught. Domains of learning: Cognitive: Discussion, storytelling, lecture, Q & A, RP, independent study Affective: RP, discussion Psychomotor: demonstration, practice, return demonstration, independent practice, games Can get creative with the methods: using computers, videos, pictures, simulations, games, songs You need to have access to the required materials so pick accordingly If teaching in a low tech environment, do what you can.  HOW TO PICK APPROPRIATE TEACHING STRATEGIES One size fits all does not exist – Self-awareness of own teaching style Must take into account client variables: Client learning style Literacy level Sensory alterations Language Culturally safe teaching Illness/learning disability/attention issues/emotional state Client’s age Client’s motivation We often have a teaching style we fall back on. Be self-aware as this style may be ineffective and you will need to try something else with some clients. You all went to post-secondary so you might be inclined to fall back on lecture style teaching HOW TO PICK APPROPRIATE TEACHING STRATEGIES What is to be taught? Do I have access to required resources? Can I make the teaching engaging? Does the teaching allow for feedback?  Anything used to teach the client Handouts Presentation materials Items required for procedure IMPLEMENTATION: Posters MATERIALS Audiovisual material Videoconference equipment Technology Might evolve based on the client’s developmental stage. Older adults may have difficulty with technology while young adults may be more technologically inclined.  EVALUATING MATERIAL APPROPRIATENESS Is it accurate? Is the material up Does it come from Material leveling? to date? a reputable place? Will the material Is the material Does the material be useful for specific enough for fit with the teaching the client the client? teaching plan? given the client’s variables? Bastable recommends around a grade 5 reading level. There should not be room for interpretation.  EVALUATION: DID THE TEACHING ACHIEVE THE GOAL? Evaluation has to be measurable and linked to learning outcome. Essential for safe hospital discharge where supervision is decreased. Essential to decrease readmission. Assessment is not the same as evaluation Start figuring out your evaluation when you start planning the education. Assessment refers to initial gathering of data to determine direction for action. Evaluation – refers to judging the value of the education (after the education)  EVALUATION FOCUS Audience – Purpose of Questions- Scope- one Resources – Who is being evaluation – What person or a time, evaluated? Why is the questions will group? expertise, evaluation be asked? personnel, being materials, conducted? facilities, equipment. Questions related to the purpose and have measurable outcomes. (not necessarily questions being asked directly of the person who is being taught)  TYPES OF EVALUATION Formative – process evaluation Content evaluation – Experience Summative – Outcome evaluation Impact evaluation – Effects on institution or community. Program evaluation – Activities meet goals of program? Formative – evaluation takes place during the process of learning so adjustment can be made Summative – evaluation at the end of the teaching process to determine effects of teaching efforts. Content evaluation –What did learners acquire from experience?  EVALUATION METHODS Type of data What data will be How, when, and Who will do the collected? collected from where will the collecting? whom? collection occur? Type – quantitative vs qualitative; how does it tie into the purpose? Whom- the person/group being evaluated? Family members? Caregivers? How? – observation, interview, questionnaire, written exam, record review, secondary analysis if existing databases? When – directly after teaching? After a few days lapse?, months lapse? Who collects- outside observer? The nurse? Another client? (some cases may be an outside observer if program is being evaluated)  EVALUATION METHODS USED WITH CLIENTS The top five points. Return The quick quiz. demonstration.