Chapter 4: Patient and Caregiver Teaching Flashcards
Patient and Caregiver Teaching
Interactive and dynamic process
Challenging and rewarding nursing role
General goals for patient teaching include:
Health promotion
Disease prevention
Illness management
Selection and use of appropriate treatment options
Every interaction is a potential “teachable moment”
Informal and formal opportunities
Teaching plans provide guidelines for specific learning needs
Difference Between teaching & Learning
Teaching
A complex process that facilitates learning through instruction, coaching, counseling, and/or behavior modification
Learning
A change that may occur when a person acquires knowledge, skills, or attitudes.
Patient has right to choose if change occurs
Social change theories:Theoretical basis of teaching/learning
Knowles - Adult learning principles
How and why adults learn
Health Promotion Models
Transtheoretical Model of Health Behavior Change
Motivational Interviewing
Self-Efficacy (Bandura, 1977)
Patient believes they can succeed
Continued support strengthens commitment to change
Transtheoretical Model / Stages of Change
Three dimensions:
Problems to be changed at different levels within context of therapy or intervention
Situational
Cognitive
Interpersonal
Family systems
Intrapersonal
Stages of change represent a temporal or developmental dimension
People use processes of change to modify problem behaviors
Major Constructs of the theory
Stages of change
Processes of change
Decisional balance
Self-efficacy
Temptation
Two crucial points about the Relationship of “Stage” Within TTM
“Stage” is one of the variables of TTM & is not a theory in and of itself
The Stage variable is not a substitute for processes; It provides an integration of the processes
6 Stages of Change
Pre-contemplation: No intention to change in foreseeable future, usually measured as next 6-months
Contemplation: Serious thoughts about change in next 6-months
Preparation: Ready for action; Plans to change within next month
Action: Specific changes made (total abstinence) in last 6-months
Maintenance: Sustained change in behavior for 6-months or more
Termination: Experience no temptation and 100% self-efficacy
Processes of Change
Strategies & techniques to help modify behaviors
One or more processes (experiential or behavioral) used at different stages; facilitate movement from one stage to another
(Bradley-Springer, 1996; Pender et al., 2006; Prochaska et al., 1988)
Research has demonstrated specific processes tend to be used at various stages of change
Experiential
(Cognitive or Affective)
Consciousness Raising
Dramatic Relief
Self-Reevaluation
Environmental Re-evaluation
Self-liberation
Behavioral
Social Liberation
Counter Conditioning
Stimulus Control
Contingency Management
Helping Relationships
Nursing competencies for teaching
Knowledge of subject matter and reliable resources
Communication skills
Verbal
Nonverbal (also consider culture)
Active listening
Empathy
Challenges to teaching for nurses
Lack of time
Personal feelings as a teacher
Nurse–patient differences in learning goals
Rapid or early discharge from the health care system
Awareness/sensitivity of literacy issues
Caregiver learning needs
Vital in the teaching-learning interaction
Cultural considerations important
Include in patient teaching; goal-setting; priorities; specific learning needs
Identify community resources or support groups
Regulatory mandates
The Joint Commission (TJC)
National Patient Safety Goals
American Hospital Association’s Patient Care Partnership
Institute for Health care Improvement’s National Patient Safety Foundation
Encourage Patients to Ask Healthcare providers
What is my main problem?
What do I need to do?
Why is it important for me to do this?