Lecture 4 COPD Course: Educationg the patient with COPD
Educating the patient with COPD
Objective:Explain the rational/value of the patienteducation.List and explain the four components of thepatient education processIdentify the barriers to learningList and explain the principles of adult learning.
Illness/Wellness Continuum:TotalWellnessPrematureDeathDisability Signs No Risks Motivation Well-BeingSymptoms Risks EducationBehaviorChangeWellness Model (NewThinking)Illness Model (OldThinking)
Patient Education is a process....With 4 distinct components...AssessmentPlanningImplementationEvaluationAssessmentPlanningImplementationEvaluationThink of the four pieces of the pie
Assessment-The 1st and most overlooked component of the patienteducation process-Assessing the need for patient education(perform a mini-needs assessment).Identifying common problems of the learner(barriers to learning).Assessing readiness of learner.
Frequently Asked AssessmentQuestions:Does the patient understand the nature ofhis/her disease? The pathophysiology?Is he/she aware of the risk factors forprogression of the disease?Does he/she understand strategies to helpminimize dyspnea?Advice when to seek help?Has previous education about his/her conditionbeen provided?
Frequently Asked AssessmentQuestions:Does he/she understand the role of medication?Does he/she smoke, drink?Does he/she maintain on exercise program? Useinhalers? Oxygen?What is his/her level of education is he/sheliterate?Is Arabic the primary language spoken at home?Are there any unusual cultural influences onhis/her health beliefs or practices?Is there adequate medical coverage?
Common Problems of the learner-barrier to learning-Lack of readiness – stages of learning.Physical obstacles – sensory deprivation,discomfort/ illness, energy limitations,decreased mobility.Emotional obstacles – denial, anger, depression,withdrawal, anxiety, low self esteem.
Common Problems of TheLearner- barriers to learning-Language and culture – multiple dialects,religious beliefs, diversity of socioeconomicgroupsLow health literacy levelReading level – average adults at 8th grade level(in US).
Key Risk Factors for LimitedLiteracy:ElderlyLow incomeUnemploymentDid not finish high schoolMinority ethic groupRecent immigrant who do not speak locallanguageBorn in Egypt but Arabic is second language
Low Health Literacy is AssociatedWith:MedicationsAppointment slipsInformed consentDischarge instructionsHealth education materialsInsurance applications
Steps to Address/Improve lowLiteracy LevelsSlow downUse plain language, non-medical languageShow or draw picturesLimit the amount of information provided, andrepeat itUse the teach-back or show-me technique
Planning-the 2nd component of the patient education process-Establishing goals and objectivesLearning domains:▫ Cognitive▫ Psychomotor▫ AffectiveDevelop content
Planning is all about havingdirections and planning entails...Goals and objective: Goals are generally broad statements of whatwould you like to accomplish and should be“SMART”Objectives are more specific and should followthe “ABCD” rule.
Goal Statements should be:SpecificMeasurableAchievable/AttainableRealistic/RelevantTimelines/ Trackable.
The ABCD’s ofAudience – The whoBehavior – the whatCondition – the how – any circumstances orconditions that must be metDegree – another how – to degree of accuracy,or to what standards.
ExampleGiven the components of a metered- doseinhaler and without the aid of the RT ormanufacturer‟s literature (condition), the patient(audience) will be able to assemble a metered-doseinhaler (behavior) in assembled working orderwithin 3 minutes (degree).Legend:o A = Audienceo B = Behavioro C = Conditiono D = Degree
Learning Domains:Cognitive - the knowing (being book smart –knowing the factors), what is COPD, what medsshould I take, what are signs/symptoms.Psychomotor – the doing (being able toperform certain skills), how to monitor your BP,how to use your MDIAffective – the attitudes / feeling (how patientperspective illness – what they think/ believe),do they believe that the meds work, that they cancontrol their COPD?
Another View of How We Learn- the three learning domains -Cognitive Psychomotor AffectiveThe point: we have to know the facts, be able to perform or do, andfinally have feeling towards it
Implementation-The 3rd component of the patient education process-Teaching/learningLearning stylesThe actual teaching (principles of adultlearning)The teaching methodology:▫ Lecture▫ Demonstration▫ Audiovisuals▫ Printed materials▫ Simulations▫ Role playing
Patient Education Skills-Definition-Teaching - is the process of sharing , knowledgeand insight, or facilitating (../ „ another tolearn knowledge, insight, „ and/or skillsLearning - is the process of acquiring wisdom,knowledge, or skill; an overt change inbehavior may be observed
A Word about Learning andLearning Styles....Do you find yourself not being able to get yourpoint across to certain patients?Getting a confusing look, a look that tells youthey may not fully understandWhy is that so?Answer: research suggest that teaching/learning styles may be misaligned
Learning Styles Visual Auditory TactilePoint: Patients learn differently and for more effective patientteaching align your teaching style with your patients learningstyle
Learning Styles-Implications for Visual Learners- Important for them to organize their learning Use color-coded highlighting Use illustrations , graphs, diagram Use visual analogies Use flashcards Include videotapes in learning Encourage them to take notes
Learning Styles-Implications for Auditory Learners-Encourage them to explain to others repeatrhymes to remember facts , dates, namesMake up songs to coincide with subject matterread explanations out loudUse audiotapes to reviewRecord lecturesSay words in syllables
Learning Styles-Implications for Tactile Learners- Hold book in hand while reading Encourage to stand when giving explanations Involve writing while reading/ talking Sit near front of class Use gestures when explaining Allow for extra time in lab sessions Use flash cards Use role playing when reviewing Use hands -on experiences Offer field trips
Learning Style:We should attempt .. to identify the learningstyle of our pat1ent and employ teachingmethods that complement his/her needs.Some are visual, some auditory, some tactilePoint: patients will often subtlety tell you their preferredlearning style in the way they respond to you
Evaluation-The 4th and last component of the patient educationprocess- Evaluation of patient education process Evaluation of individual learning (did it work?)Point: return demonstration is considered a superiormethod of evaluation.
The Basics of Effective PatientTeaching*Principles of adult Learning*
The Nine Basic Principles of AdultLearning:•Recency •Feedback•Appropriateness •Active Learning•Motivation •Multiple sense•Primacy learning •2•ExercisePoint: remember the expression ramp-2-fame"
Impressed the importance/ centrality of pt edDefined patient education and related termsIdentified the 4 components of the pt ed .processIdentified barriers to learningPrinciples of adult learning (Ramp-2-Fame)Concluding remarks