Kinn’s Chapter 29 – Patient Education

socioculturalspiritualsocialphysicalpsychological

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Emotional effect of the disease2. Social impact on family and employer3. Intellectual impact4. Economic impact5. Spiritual impact

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Denial and isolation2. Anger3. Bargaining4. Depression5. Acceptance

1. reinforce each education intervention with hand-outs that explain the diseases and treatment.2. use therapeutic communication techniques, especially reflection, to acknowledge the patient's feelings about the diagnosis.3. rely on the physician's recommendation regarding postponing of certain treatments.

4. use available community resources to provide support for the patient and family.5. take advantage of this time to renew education efforts by providing multiple methods for learning about the disease, such as CD's, DVD's, professional websites and community support services.

Patient's opinion of the CHANCES of getting the disorderPatient education use: Supply information on risk level; individual risk based on health habits and family history

Patient's opinion on the SERIOUSNESS of the condition and its health risksPatient education use: Outline the potential complications of the disease

Patient's belief in the VALUE of altering lifestyle factors and complying with treatmentPatient education use: Emphasize the positive results that can occur if the patient is compliant with healthcare recommendations

Patient's opinion of the financial and psychological COSTS of compliancePatient education use: Identify patient barriers and work to reduce them through patient education, family outreach, utilization of community resources

Methods developed to ACTIVATE patient compliancePatient education use: One-on-one education interventions; detailed handouts; family Involvement in education efforts; follow up at subsequent office visits; referral to community resources

Patient has the CONFIDENCE to take action towards a healthier statePatient education use: Ongoing education and support

1. Perception of disease vs actual state of disease2. Patient's need for information3. Patient's age and development level4. Patient's mental and emotional state5. Influence of multicultural and diversity factors on patient education6.

Patient learning style7. Impact of physical disabilities

1. Provide KNOWLEDGE AND SKILLS to promote recovery and health2. Provide INFORMATION about accessing community resources3.

Include FAMILY and significant others in education interventions, with patient's approval4. Promote SAFE, APPROPRIATE use of medications and treatments5. Encourage PATIENT ADAPTATION to healthy behaviors6. Encourage PATIENT OWNERSHIP AND PARTICIPATION in the teaching process

Previous life experience can influence patient's perception of diagnosis Does patient recognize and accept the seriousness of diagnosis? Does patient overreact to potential disease risks?

Perception of impact of disease on his or hergeneral health also determines need for information about disease Encourage patient ownership of the learning process

Adapt the teaching plan to meet specific learning needs Be flexible and creative in providing learning opportunities that support the physician's attempt to educate the patient

Patients frequently use defense mechanisms to protect themselves Be sensitive and adapt teaching interventions as needed

Be aware of and sensitive to the impact of these factors on patient learning- Is language an issue with your patient?- Do patient's culture, ethnic background, or religious beliefs influence the way he or she perceives disease and role of healthcare workers?- What strategies or techniques might minimize patient education problems?- Are community resources available that could facilitate patient learning?

Address patient by last name Be courteous and formal in communications Use gestures, tone of voice, facial expressions, and eye contact Use pictures, handouts, models, and other visual aids Monitor patient's body language, especially facial expressions Use simple, everyday words Demonstrate all procedures Implement the teaching plan in small, manageable steps Give patients written instructions for all procedures and treatments Use an interpreter, if available and appropriate

Individual learning styles affect your patient's understanding Ask your patient how he or she prefers to learn new material and pattern your teaching interventions along these lines

Alert patient that you are in the room and identify yourself Patient is unable to pick up your body language; use clear, concise language and a normal tone of voice Provide all written material in a large font or print size

Allow patient to see your mouth May need to touch patient lightly to gain attention Use expanded speech Observe body language for understanding or confusion Use gestures or demonstration Clearly print any information needed to clarify and provide written handouts Request family assistance to verify patient understood

Determine whether patient can read and/or understand English If possible, have an interpreter or family member present If available, use a dictionary that translates as many words as possible for patient Use gestures or demonstration to get message across Carefully observe patient's body language to determine level of understanding Order educational materials in patient's native language

1. Individual learning style2. Age and developmental level3. Use of defense mechanisms4. Language5. Motivation to learn6.

Physical limitations or disabilities7. Emotional or mental state8. Cultural or ethnic background9. Pain10.

Time limitations

Confirm what patient knows about theproblem and attempt to correct any potential misconceptions Go on to new material that is causing patient the most anxiety Begin with basic details about disease and add more information during each patient visit Take advantage of every "teaching moment" Use waiting room as a place for learning by providing up-to-date educational materials

Individualized instruction is key to understanding and patient compliance Include a handout or some type of printed material that reinforces information and that patient can use as a resource

Should be written in lay language at a 6th to 8th grade level to promote general patient understanding Information should be well organized and clearly described All material should be checked for accuracy Handouts should be attractive and professional Copies should be available in other languages when possible and in large print

Assist patients and families in finding and using community education and support services Keep up-to-date file of area resources

Use community resources to reinforce the message Teach patients specific skills Have patient keep a journal of his or her activities and response to treatment Involve family members in patient education

Conduct lesson in a quiet area away from distractions Assemble equipment the patient will need Present only material or skill it is possible for patient to master before end of appointment Restate, repeat, or rephrase the material Evaluate teaching plan throughout the process

Reinforce physician instructions and information Encourage patients to take an active role in their health Use each patient interaction as an opportunity for health teaching Keep information relevant to the patient's needs Establish and maintain rapport with the patient Communicate clearly Be sensitive to the patient's learning factors Modify the teaching plan as needed to best meet the patient's needs

All patients have the right to information before they agree to receive care Conduct adequate patient education and follow-up Document each patient education intervention completely and accurately Meet needs of all patients without evidence of prejudice

Patient has the right to restrict who can receive personal health information (PHI) Only person or persons identified on HIPAA release form completed by patient have the right to patient's personal information Contact the family only if patient has given approval