CH 25 potter patient education Flashcards
1
Q
is a key component in terms of enhancing a patient’s quality of life, improving self-care, reducing hospital admissions, and improving medication adherence
A
Patient education
2
Q
health promotion and illness prevention, health restoration, and coping.
A
Comprehensive patient education includes 3 important purposes, each involving a separate phase of health care:
3
Q
is the concept of imparting knowledge through a series of directed activities
A
Teaching
4
Q
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”
A
Learning
5
Q
when a person identifies a need for knowing or acquiring an ability to do something
A
Teaching and learning begin
6
Q
it responds to a learner’s needs.
A
Teaching is most effective when
7
Q
asking questions and determining a learner’s interests
A
educator assesses these needs by
8
Q
successful teaching
A
Interpersonal communication is essential for
9
Q
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.
A
In The Patient Care Partnership, the American Hospital Association (2018)
10
Q
including the right to be informed about one’s medical condition, medications, and to see one’s own doctor.
A
Medicare also has standards for residents’ rights in nursing homes,
11
Q
helps patients understand their rights when receiving medical care
A
Joint Commission’s Speak Up program
12
Q
- 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.
A
program offers the following Speak Up tips to help patients become more involved in their treatment: (Joint Commission’s Speak Up program)
13
Q
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
A
Teaching process (similar to communication process)
14
Q
who conveys a message to the patient
A
nurse is the sender
15
Q
Attitudes, values, emotions, cultural perspective, and knowledge influence the way information is delivered.
A
intrapersonal variables influence your style and approach.
16
Q
in the teaching-learning process is the learner.
A
receiver
17
Q
Attitudes, anxiety, physical symptoms, literacy level, and values
A
Factors that influence the ability to understand a message
18
Q
emotional and physical health, education, cultural perspective, patients’ values about their health, the stage of development, and previous knowledge.
A
ability to learn depends on factors such as
19
Q
provides a mechanism for evaluating the success of a teaching plan and then provides positive reinforcement
A
effective educator
20
Q
feedback.
A
Effective communication involves
21
Q
both during and at the completion of each instructional encounter.
A
Feedback provided when
22
Q
cognitive (understanding), affective (attitudes), and psychomotor (motor skills)
A
Learning occurs in three domains:
23
Q
occurs when an individual gains information to further develop his or her intellectual abilities, mental capacities, understanding, and thinking processes
A
Cognitive learning
24
Q
is a hierarchy, which increases in complexity
A
Bloom’s revised taxonomy of six cognitive behaviors (cognitive learning)
25
Recognizing or recalling knowledge from memory
| -includes factual, conceptual, procedural, and metacognitive knowledge
Remember (formerly Knowledge): (least complex)// cognitive learning hierarchy
26
Constructing meaning from different types of messages or activities, such as interpreting, exemplifying, classifying, summarizing, inferring, comparing, or explaining
Understand (formerly Comprehension):(2nd) // cognitive learning hierarchy
27
Carrying out or using a procedure through executing or implementing
Apply: (3rd) // cognitive learning hierarchy
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
Analyze: (4th) // cognitive learning hierarchy
29
Making judgments based on criteria and standards through checking and critiquing
Evaluate: (5th) // cognitive learning hierarchy
30
Putting elements together to form a coherent or functional whole; reorganizing elements into a new pattern or structure through generating, planning, or producing
Create (formerly Synthesis): (6th) // cognitive learning hierarchy
31
deals with the expression of feelings and emotions and the development of values, attitudes, and beliefs
Affective learning
32
Krathwohl and Bloom
affective domains of learning were developed by
33
Learner is passive but is aware of stimuli and willing to receive information.
Receiving: (simplexes behaviour) // affective learning hierarchy
34
Requires active participation. This refers to a learner’s active attention to stimuli, verbal and nonverbal responses, and motivation to learn.
• Responding: (2nd simplest) // affective learning hierarchy
35
Attaching worth and value to the acquired knowledge as demonstrated by the learner’s behavior through acceptance, preference, or commitment.
• Valuing: (3rd) // affective learning hierarchy
36
Developing a value system. Learner internalizes values and beliefs involving (1) the conceptualization of values and (2) the organization of a value system.
• Organizing: (4th) // affective learning hierarchy
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
• Characterizing:(5th) // affective learning hierarchy
38
involves the development of manual or physical skills, such as learning how to walk or how to type on a computer
Psychomotor learning
39
Skills, movements, or behaviors related to walking, running, jumping, pushing, pulling, and manipulating. They are often components for more complex actions.
• Fundamental: (simplest behavior) //psychomotor hierarchy
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
• Perception: (2nd)// psychomotor hierarchy
41
Early stages of learning a particular skill under the guidance of an instructor that involves imitation and practice of a demonstrated act
• Guided response: (3rd) // psychomotor hierarchy
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
Mechanism: (4th) // psychomotor hierarchy
43
Smoothly and accurately performing a motor skill that requires complex movement patterns
• Complex overt response: (4th) // psychomotor hierarchy
44
Motor skills are well developed and movements can be modified when unexpected problems occur
• Adaptation: (5th) // psychomotor hierarchy
45
Using existing psychomotor skills to create new movement patterns and perform them as needed in response to a particular situation or problem
• Origination: (6th) // psychomotor hierarchy
46
through seeing, touch and hearing, reflecting and acting, reasoning logically and intuitively, and analyzing and visualizing.
People process information in a number of ways:
47
is an internal state (e.g., an idea, emotion, or a physical need) that helps arouse, direct, and sustain human behavior
Motivation
48
is a counseling and educational technique that is focused on patient goals and is goal directed and patient centered
Motivational interviewing
49
particularly successful with patients who are not motivated to change
Motivational interviewing
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
MI (Motivational interviewing)
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.
Cognitive Dissonance (learning theory)
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
Health Belief Model (learning theory)
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
Transtheoretical Model of Change (learning theory)
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.
Self-Efficacy (learning theory)
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.
Health promotion (learning theory)
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
social learning theory
57
, a person’s state of mind and intrinsic motivational factors (i.e., sense of accomplishment, pride, or confidence) reinforce behaviors and influence learning
social learning theory
58
a concept included in social learning theory, refers to a person’s perceived ability to successfully complete a task
Self-efficacy
59
verbal persuasion, vicarious experience, enactive mastery experience, and psychological and affective states
Self-efficacy beliefs come from four sources:
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.
six ACCESS model components are: (Cultural Factors)
61
each stage of grieving
Readiness to learn is affected by
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is the mental state that allows a learner to focus on and comprehend a learning activity.
attentional set
63
Physical discomfort, anxiety, confusion, and environmental distractions
influence the ability to concentrate.
64
patient’s developmental level and cognitive and physical capabilities.
- the learning environment is a significant factor affecting learning ability.
influence the ability to learn
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).
Infant (teaching methods on pt developmental capacity)
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.
Toddler (teaching methods on pt developmental capacity)
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.
Preschooler (teaching methods on pt developmental capacity)
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.
School-Age Child (teaching methods on pt developmental capacity)
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.
Adolescent (teaching methods on pt developmental capacity)
70
* Encourage participation in teaching plan by setting mutual goals.
* Encourage independent learning.
* Offer information so adult understands effects of health problem.
Young or Middle Adult (teaching methods on pt developmental capacity)
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* 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.
Older Adult (teaching methods on pt developmental capacity)
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.
health literacy (defined by WHO)
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
People most likely to be at risk for low health literacy
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, including preexisting physical or mental illness, fatigue, body temperature, electrolyte imbalance, oxygenation status, and blood glucose level.
Many factors impair the ability to learn (physical capacity)
75
strength, coordination, and sensory acuity.
To learn psychomotor skills a patient must possess a certain level of
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)
physical characteristics are necessary to learn psychomotor skills:
77
a physical therapist or occupational therapist.
Determining a patient’s ability to perform psychomotor skills is best assessed by
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.
environmental factor that impacts learning setting
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
Teaching a group of patients requires
80
. Instead of outcomes, you develop specific learning objectives for a teaching plan
Teaching process VS Nursing process
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.
The nursing and teaching processes differ in that
82
are defined as “gaps in knowledge that exist between a desired level of performance and the actual level of performance”
Learning needs
83
enjoy learning through pictures, visual charts, or any exercise that allows them to visualize concepts.
visual-spatial learners
84
demonstrates strength in the language arts and therefore prefers learning by listening or reading information.
The verbal/linguistic learner
85
process knowledge by moving and participating in hands-on activities.
-Role-play and return demonstrations are popular activities for the kinesthetic learner.
Kinesthetic learners
86
think in terms of cause and effect and respond best when required to predict logical outcomes.
logical-mathematical reasoning learner
87
is a word-recognition screening test that evaluates reading, spelling, and arithmetic skills for patients from 5 to 74 years of age.
Wide Range Achievement Test (WRAT 3) (literacy test)
88
uses pronunciation of health care terms to determine a patient’s ability to read medical vocabulary.
Rapid Estimate of Adult Literacy in Medicine (REALM) //(health literacy test)
89
used to assess comprehension of health education materials, asks patients to fill in the blanks that are in a written paragraph.
The Cloze test //(health literacy test)
90
they enter the hospital, and involve family if possible.
| -sessions lasting 10 to 15 minutes
to improve patient outcomes, anticipate patients’ educational needs before
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.
telling approach
92
in this method there is opportunity for discussion, feedback, mutual goal setting, and revision of the teaching plan.
participating approach
93
provides a patient the opportunity to manage self-care.
| -after learning they do it on their own
entrusting approach
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
Reinforcement
95
(e.g., nods, smiles, words of encouragement), pleasurable activities (e.g., walks or play time), and tangible rewards (e.g., toys or food).
Reinforcers can come in the form of social acknowledgments
96
such as a smile or verbal praise promotes desired behaviors
Positive reinforcement
97
such as frowning or criticizing can decrease an undesired response, it may also discourage participation and cause the learner to withdraw
negative reinforcement
98
This approach involves sharing information directly with a patient.
verbal one-on-one discussion (most common method of instruction)
99
is simple but enables all health care providers to better guide verbal education and ensure that education is more patient- and family-centered.
EDUCATE model (5 stages of verbal education)
100
typically includes reconsideration or reframing of an emotional event in less emotional terms
Reappraisal (cognitive regulation technique
101
are most effective when learners first observe the educator and during a
Demonstrations (used for psychomotor skills)
102
have the chance to practice the skill.
return demonstration (used for psychomotor skills)
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
Analogies (use similarities to relate the situation where pt can understand)
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.
general principles when using analogies:
105
people are asked to play themselves or someone else
| - technique involves rehearsing a desired behavior
role-playing
106
is a useful technique for teaching problem solving, application, and independent thinking
Simulation
107
is a useful technique for teaching problem solving, application, and independent thinking
Simulation (give pt problem to solve)
108
a set of 15 action steps intended to advance health equity, improve quality, and help eliminate health care disparities
National CLAS Standards
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.
intergenerational conflicts of values
110
is a closed-loop communication technique that assesses patient retention of the information given during a teaching session
Teach-back
