CH 25 potter patient education

Question 1

is a key component in terms of enhancing a patient’s quality of life, improving self-care, reducing hospital admissions, and improving medication adherence

Answer 1

Patient education

Question 2

health promotion and illness prevention, health restoration, and coping.

Answer 2

Comprehensive patient education includes 3 important purposes, each involving a separate phase of health care:

Question 3

is the concept of imparting knowledge through a series of directed activities

Answer 3

Teaching

Question 4

is defined as a “conscious or unconscious permanent change in behavior as a result of a lifelong, dynamic process by which individuals acquire new knowledge, skills, and/or attitudes that can be measured and can occur at any time or in any place through exposure to environmental stimuli”

Answer 4

Learning

Question 5

when a person identifies a need for knowing or acquiring an ability to do something

Answer 5

Teaching and learning begin

Question 6

it responds to a learner’s needs.

Answer 6

Teaching is most effective when

Question 7

asking questions and determining a learner’s interests

Answer 7

educator assesses these needs by

Question 8

successful teaching

Answer 8

Interpersonal communication is essential for

Question 9

indicates that patients have the right to make informed decisions about their care.
-The information required to make informed decisions must be accurate, complete, and relevant to patients’ needs, language, and literacy.

Answer 9

In The Patient Care Partnership, the American Hospital Association (2018)

Question 10

including the right to be informed about one’s medical condition, medications, and to see one’s own doctor.

Answer 10

Medicare also has standards for residents’ rights in nursing homes,

Question 11

helps patients understand their rights when receiving medical care

Answer 11

Joint Commission’s Speak Up program

Question 12

• S peak up if you have questions or concerns. If you still do not understand, ask again. It is your body, and you have a right to know.
• P ay attention to the care you get. Always make sure that you are getting the right treatments and medicines by the right health care professionals. Do not assume anything.
• E ducate yourself about your illness. Learn about the medical tests that are prescribed and your treatment plan.
• A sk a trusted family member or friend to be your advocate (adviser or supporter).
• K now which medicines you take and why you take them. Medication errors are the most common health care mistakes.344
• U se a hospital, clinic, surgery center, or other type of health care organization that you have researched or checked carefully.
• P articipate in all decisions about your treatment. You are the center of the health care team.

Answer 12

program offers the following Speak Up tips to help patients become more involved in their treatment: (Joint Commission’s Speak Up program)

Question 13

You use patient requests for information or perceive a need for information because of a patient’s health restrictions or the recent diagnosis of an illness. Then you identify specific learning objectives to describe the behaviors the learner will exhibit as a result of successful instruction

Answer 13

Teaching process (similar to communication process)

Question 14

who conveys a message to the patient

Answer 14

nurse is the sender

Question 15

Attitudes, values, emotions, cultural perspective, and knowledge influence the way information is delivered.

Answer 15

intrapersonal variables influence your style and approach.

Question 16

in the teaching-learning process is the learner.

Answer 16

receiver

Question 17

Attitudes, anxiety, physical symptoms, literacy level, and values

Answer 17

Factors that influence the ability to understand a message

Question 18

emotional and physical health, education, cultural perspective, patients’ values about their health, the stage of development, and previous knowledge.

Answer 18

ability to learn depends on factors such as

Question 19

provides a mechanism for evaluating the success of a teaching plan and then provides positive reinforcement

Answer 19

effective educator

Question 20

feedback.

Answer 20

Effective communication involves

Question 21

both during and at the completion of each instructional encounter.

Answer 21

Feedback provided when

Question 22

cognitive (understanding), affective (attitudes), and psychomotor (motor skills)

Answer 22

Learning occurs in three domains:

Question 23

occurs when an individual gains information to further develop his or her intellectual abilities, mental capacities, understanding, and thinking processes

Answer 23

Cognitive learning

Question 24

is a hierarchy, which increases in complexity

Answer 24

Bloom’s revised taxonomy of six cognitive behaviors (cognitive learning)

Question 25

Recognizing or recalling knowledge from memory

-includes factual, conceptual, procedural, and metacognitive knowledge

Answer 25

Remember (formerly Knowledge): (least complex)// cognitive learning hierarchy

Question 26

Constructing meaning from different types of messages or activities, such as interpreting, exemplifying, classifying, summarizing, inferring, comparing, or explaining

Answer 26

Understand (formerly Comprehension):(2nd) // cognitive learning hierarchy

Question 27

Carrying out or using a procedure through executing or implementing

Answer 27

Apply: (3rd) // cognitive learning hierarchy

Question 28

Breaking materials or concepts into parts, then determining how the parts relate to one another or how they interrelate, or how the parts relate to an overall structure or purpose

Answer 28

Analyze: (4th) // cognitive learning hierarchy

Question 29

Making judgments based on criteria and standards through checking and critiquing

Answer 29

Evaluate: (5th) // cognitive learning hierarchy

Question 30

Putting elements together to form a coherent or functional whole; reorganizing elements into a new pattern or structure through generating, planning, or producing

Answer 30

Create (formerly Synthesis): (6th) // cognitive learning hierarchy

Question 31

deals with the expression of feelings and emotions and the development of values, attitudes, and beliefs

Answer 31

Affective learning

Question 32

Krathwohl and Bloom

Answer 32

affective domains of learning were developed by

Question 33

Learner is passive but is aware of stimuli and willing to receive information.

Answer 33

Receiving: (simplexes behaviour) // affective learning hierarchy

Question 34

Requires active participation. This refers to a learner’s active attention to stimuli, verbal and nonverbal responses, and motivation to learn.

Answer 34

• Responding: (2nd simplest) // affective learning hierarchy

Question 35

Attaching worth and value to the acquired knowledge as demonstrated by the learner’s behavior through acceptance, preference, or commitment.

Answer 35

• Valuing: (3rd) // affective learning hierarchy

Question 36

Developing a value system. Learner internalizes values and beliefs involving (1) the conceptualization of values and (2) the organization of a value system.

Answer 36

• Organizing: (4th) // affective learning hierarchy

Question 37

Highest level of internalization. Acting and responding with a consistent value system; requires introspection and self-examination of one’s own values in relation to an ethical issue or particular experience

Answer 37

• Characterizing:(5th) // affective learning hierarchy

Question 38

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

Answer 38

Psychomotor learning

Question 39

Skills, movements, or behaviors related to walking, running, jumping, pushing, pulling, and manipulating. They are often components for more complex actions.

Answer 39

• Fundamental: (simplest behavior) //psychomotor hierarchy

Question 40

Skills related to kinesthetic (bodily movements), visual, auditory, tactile (touch), or coordination abilities as they are related to the ability to take in information from the environment and react

Answer 40

• Perception: (2nd)// psychomotor hierarchy

Question 41

Early stages of learning a particular skill under the guidance of an instructor that involves imitation and practice of a demonstrated act

Answer 41

• Guided response: (3rd) // psychomotor hierarchy

Question 42

Higher level of behavior in which a person gains confidence and proficiency in performing a skill that is more complex or involves several more steps than a guided response

Answer 42

Mechanism: (4th) // psychomotor hierarchy

Question 43

Smoothly and accurately performing a motor skill that requires complex movement patterns

Answer 43

• Complex overt response: (4th) // psychomotor hierarchy

Question 44

Motor skills are well developed and movements can be modified when unexpected problems occur

Answer 44

• Adaptation: (5th) // psychomotor hierarchy

Question 45

Using existing psychomotor skills to create new movement patterns and perform them as needed in response to a particular situation or problem

Answer 45

• Origination: (6th) // psychomotor hierarchy

Question 46

through seeing, touch and hearing, reflecting and acting, reasoning logically and intuitively, and analyzing and visualizing.

Answer 46

People process information in a number of ways:

Question 47

is an internal state (e.g., an idea, emotion, or a physical need) that helps arouse, direct, and sustain human behavior

Answer 47

Motivation

Question 48

is a counseling and educational technique that is focused on patient goals and is goal directed and patient centered

Answer 48

Motivational interviewing

Question 49

particularly successful with patients who are not motivated to change

Answer 49

Motivational interviewing

Question 50

has also been shown to be effective in primary care settings with improvement in patient management of body weight, alcohol and tobacco use, sedentary behavior, and self-monitoring

Answer 50

MI (Motivational interviewing)

Question 51

Individuals desire consistency and will make necessary changes and adaptations to gain that consistency
-experienced in situations in which a patient is challenged by an inconsistency requiring a life change.

Answer 51

Cognitive Dissonance (learning theory)

Question 52

A patient will perceive a certain susceptibility and severity of their disease. Modifying factors include knowledge, as well as demographics and social and psychological variables. Likelihood of action is based on the perceived barriers and benefits of the situation

Answer 52

Health Belief Model (learning theory)

Question 53

Model is used to define how individuals initiate change in their lives, progress through those changes, and process and maintain behaviors. There are five stages in the model: precontemplation, contemplation, preparation, action, and maintenance

Answer 53

Transtheoretical Model of Change (learning theory)

Question 54

Model focuses on the patient’s belief in his or her own abilities to make and maintain changes and positive outcomes in the patient’s life . Self-efficacy is based on self-confidence and is a good indicator for motivation to make behavioral changes.

Answer 54

Self-Efficacy (learning theory)

Question 55

Model is based on the premise that characteristics and experiences of an individual affect actions specific to behaviors and in turn affect outcomes specific to behavior. The model applies general information from social learning theory to build on the nursing perspective of the holistic patient.

Answer 55

Health promotion (learning theory)

Question 56

is one of the most useful approaches to patient education.
- It considers the personal characteristics of the learner, behavioral patterns, and the environment and guides the educator in developing effective teaching interventions that motivate and enhance learning

Answer 56

social learning theory

Question 57

, a person’s state of mind and intrinsic motivational factors (i.e., sense of accomplishment, pride, or confidence) reinforce behaviors and influence learning

Answer 57

social learning theory

Question 58

a concept included in social learning theory, refers to a person’s perceived ability to successfully complete a task

Answer 58

Self-efficacy

Question 59

verbal persuasion, vicarious experience, enactive mastery experience, and psychological and affective states

Answer 59

Self-efficacy beliefs come from four sources:

Question 60

1. Assessment of a patient’s lifestyle, health beliefs, cultural traditions, and health practices.
2. Communication with an awareness of the many variations in verbal and nonverbal responses.
3. Cultural negotiation and compromise that encourages awareness of characteristics of a patient’s culture and one’s own biases.
4. Establishment of respect for a patient’s cultural beliefs and values; creating a caring rapport.
5. Sensitivity to how patients from diverse backgrounds perceive their care needs and the patterns of communication they use.
6. Safety that enables patients to feel culturally secure and avoids disempowerment of their cultural identity.

Answer 60

six ACCESS model components are: (Cultural Factors)

Question 61

each stage of grieving

Answer 61

Readiness to learn is affected by

Question 62

is the mental state that allows a learner to focus on and comprehend a learning activity.

Answer 62

attentional set

Question 63

Physical discomfort, anxiety, confusion, and environmental distractions

Answer 63

influence the ability to concentrate.

Question 64

patient’s developmental level and cognitive and physical capabilities.
- the learning environment is a significant factor affecting learning ability.

Answer 64

influence the ability to learn

Question 65

• Keep routines (e.g., feeding, bathing) consistent.
• Hold infant firmly while smiling and speaking softly to convey sense of trust.
• Have infant touch different textures (e.g., soft fabric, hard plastic).

Answer 65

Infant (teaching methods on pt developmental capacity)

Question 66

• Use play to teach procedure or activity (e.g., handling examination equipment, applying bandage to doll).
• Offer picture books that describe story of children in hospital or clinic.
• Use simple words such as “cut” instead of “laceration” to promote understanding.

Answer 66

Toddler (teaching methods on pt developmental capacity)

Question 67

• Use role play, imitation, and play to make learning fun.
• Encourage questions and offer explanations. Use simple explanations and demonstrations.
• Encourage children to learn together through pictures and short stories about how to perform hygiene.

Answer 67

Preschooler (teaching methods on pt developmental capacity)

Question 68

• Teach psychomotor skills needed to maintain health. (Complicated skills such as learning to use a syringe take considerable practice.)
• Offer opportunities to discuss health problems and answer questions.

Answer 68

School-Age Child (teaching methods on pt developmental capacity)

Question 69

• Help adolescent learn about feelings and need for self-expression.
• Use teaching as collaborative activity.
• Allow adolescent to make decisions about health and health promotion (safety, sex education, substance abuse).
• Use problem solving to help adolescent make choices.

Answer 69

Adolescent (teaching methods on pt developmental capacity)

Question 70

• Encourage participation in teaching plan by setting mutual goals.
• Encourage independent learning.
• Offer information so adult understands effects of health problem.

Answer 70

Young or Middle Adult (teaching methods on pt developmental capacity)

Question 71

• Teach when patient is alert and rested.
• Involve adult in discussion or activity.
• Focus on wellness and person’s strength.
• Use approaches that enhance patient’s reception of stimuli when he or she has a sensory impairment (see Chapter 49).
• Keep teaching sessions short.

Answer 71

Older Adult (teaching methods on pt developmental capacity)

Question 72

as the cognitive and social skills that determine the ability of individuals to gain access to, understand, and use information in ways that promote and maintain good health.

Answer 72

health literacy (defined by WHO)

Question 73

include older adults, minority populations, immigrant populations, people of low income, people without a high school education, and people with chronic mental and/or physical health conditions

Answer 73

People most likely to be at risk for low health literacy

Question 74

, including preexisting physical or mental illness, fatigue, body temperature, electrolyte imbalance, oxygenation status, and blood glucose level.

Answer 74

Many factors impair the ability to learn (physical capacity)

Question 75

strength, coordination, and sensory acuity.

Answer 75

To learn psychomotor skills a patient must possess a certain level of

Question 76

• Size (patient’s height and weight should match the task to be performed or the equipment being used)
• Strength (ability of the patient to follow a strenuous exercise program)
• Coordination (dexterity needed for complicated motor skills such as using utensils or changing a bandage)
• Sensory acuity (visual, auditory, tactile, gustatory, and olfactory; sensory resources needed to receive and respond to messages taught)

Answer 76

physical characteristics are necessary to learn psychomotor skills:

Question 77

a physical therapist or occupational therapist.

Answer 77

Determining a patient’s ability to perform psychomotor skills is best assessed by

Question 78

The number of people included in the teaching session; the need for privacy; the room temperature; and the lighting, noise, ventilation, and furniture in the room are important factors when choosing a setting.

Answer 78

environmental factor that impacts learning setting

Question 79

a room that allows everyone to be seated comfortably and within hearing distance of the educator. Make sure that the size of the room does not overwhelm the group

Answer 79

Teaching a group of patients requires

Question 80

. Instead of outcomes, you develop specific learning objectives for a teaching plan

Answer 80

Teaching process VS Nursing process

Question 81

•the nursing process requires assessment of all sources of data to determine a patient’s total health care needs. •The teaching process focuses on a patient’s learning needs and willingness and capability to learn.

Answer 81

The nursing and teaching processes differ in that

Question 82

are defined as “gaps in knowledge that exist between a desired level of performance and the actual level of performance”

Answer 82

Learning needs

Question 83

enjoy learning through pictures, visual charts, or any exercise that allows them to visualize concepts.

Answer 83

visual-spatial learners

Question 84

demonstrates strength in the language arts and therefore prefers learning by listening or reading information.

Answer 84

The verbal/linguistic learner

Question 85

process knowledge by moving and participating in hands-on activities.
-Role-play and return demonstrations are popular activities for the kinesthetic learner.

Answer 85

Kinesthetic learners

Question 86

think in terms of cause and effect and respond best when required to predict logical outcomes.

Answer 86

logical-mathematical reasoning learner

Question 87

is a word-recognition screening test that evaluates reading, spelling, and arithmetic skills for patients from 5 to 74 years of age.

Answer 87

Wide Range Achievement Test (WRAT 3) (literacy test)

Question 88

uses pronunciation of health care terms to determine a patient’s ability to read medical vocabulary.

Answer 88

Rapid Estimate of Adult Literacy in Medicine (REALM) //(health literacy test)

Question 89

used to assess comprehension of health education materials, asks patients to fill in the blanks that are in a written paragraph.

Answer 89

The Cloze test //(health literacy test)

Question 90

they enter the hospital, and involve family if possible.

-sessions lasting 10 to 15 minutes

Answer 90

to improve patient outcomes, anticipate patients’ educational needs before

Question 91

when there is limited time for teaching information (e.g., preparing a patient for an emergent diagnostic procedure).
-There is no opportunity for feedback with this method
Ex: If a patient is highly anxious but it is vital for information to be given, telling is effective.

Answer 91

telling approach

Question 92

in this method there is opportunity for discussion, feedback, mutual goal setting, and revision of the teaching plan.

Answer 92

participating approach

Question 93

provides a patient the opportunity to manage self-care.

-after learning they do it on their own

Answer 93

entrusting approach

Question 94

requires the use of a stimulus to increase the probability of a desired response

• can be positive or negative reinforcement
• ex: after they do something u nod, smile, or give words of encouragement

Answer 94

Reinforcement

Question 95

(e.g., nods, smiles, words of encouragement), pleasurable activities (e.g., walks or play time), and tangible rewards (e.g., toys or food).

Answer 95

Reinforcers can come in the form of social acknowledgments

Question 96

such as a smile or verbal praise promotes desired behaviors

Answer 96

Positive reinforcement

Question 97

such as frowning or criticizing can decrease an undesired response, it may also discourage participation and cause the learner to withdraw

Answer 97

negative reinforcement

Question 98

This approach involves sharing information directly with a patient.

Answer 98

verbal one-on-one discussion (most common method of instruction)

Question 99

is simple but enables all health care providers to better guide verbal education and ensure that education is more patient- and family-centered.

Answer 99

EDUCATE model (5 stages of verbal education)

Question 100

typically includes reconsideration or reframing of an emotional event in less emotional terms

Answer 100

Reappraisal (cognitive regulation technique

Question 101

are most effective when learners first observe the educator and during a

Answer 101

Demonstrations (used for psychomotor skills)

Question 102

have the chance to practice the skill.

Answer 102

return demonstration (used for psychomotor skills)

Question 103

supplement verbal instruction with familiar images that make complex information more real and understandable
-ex: when explaining arterial blood pressure, use an analogy of the flow of water through a hose

Answer 103

Analogies (use similarities to relate the situation where pt can understand)

Question 104

• Be familiar with the concept.
• Know the patient’s background, experience, and culture so that you can make an analogy relevant.
• Keep the analogy simple and clear.

Answer 104

general principles when using analogies:

Question 105

people are asked to play themselves or someone else

- technique involves rehearsing a desired behavior

Answer 105

role-playing

Question 106

is a useful technique for teaching problem solving, application, and independent thinking

Answer 106

Simulation

Question 107

is a useful technique for teaching problem solving, application, and independent thinking

Answer 107

Simulation (give pt problem to solve)

Question 108

a set of 15 action steps intended to advance health equity, improve quality, and help eliminate health care disparities

Answer 108

National CLAS Standards

Question 109

This occurs when immigrant parents uphold their traditional values and their children, who are exposed to American values in social encounters, develop beliefs similar to those of their American peers.

Answer 109

intergenerational conflicts of values

Question 110

is a closed-loop communication technique that assesses patient retention of the information given during a teaching session

Answer 110

Teach-back