Lecture 4 COPD Course: Educationg the patient with COPD


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Lecture 4 COPD Course: Educationg the patient with COPD

  1. 1. Educating the patient with COPD
  2. 2. Objective:Explain the rational/value of the patienteducation.List and explain the four components of thepatient education processIdentify the barriers to learningList and explain the principles of adult learning.
  3. 3. Illness/Wellness Continuum:TotalWellnessPrematureDeathDisability Signs No Risks Motivation Well-BeingSymptoms Risks EducationBehaviorChangeWellness Model (NewThinking)Illness Model (OldThinking)
  4. 4. Patient Education is a process....With 4 distinct components...AssessmentPlanningImplementationEvaluationAssessmentPlanningImplementationEvaluationThink of the four pieces of the pie
  5. 5. 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.
  6. 6. 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?
  7. 7. 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?
  8. 8. 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.
  9. 9. Common Problems of TheLearner- barriers to learning-Language and culture – multiple dialects,religious beliefs, diversity of socioeconomicgroupsLow health literacy levelReading level – average adults at 8th grade level(in US).
  10. 10. Key Risk Factors for LimitedLiteracy:ElderlyLow incomeUnemploymentDid not finish high schoolMinority ethic groupRecent immigrant who do not speak locallanguageBorn in Egypt but Arabic is second language
  11. 11. Low Health Literacy is AssociatedWith:MedicationsAppointment slipsInformed consentDischarge instructionsHealth education materialsInsurance applications
  12. 12. Steps to Address/Improve lowLiteracy LevelsSlow downUse plain language, non-medical languageShow or draw picturesLimit the amount of information provided, andrepeat itUse the teach-back or show-me technique
  13. 13. Assessing Readiness-Stages of Learning-Precontemplative stageContemplative stageAction stageMaintenance stage/ termination stage
  14. 14. Planning-the 2nd component of the patient education process-Establishing goals and objectivesLearning domains:▫ Cognitive▫ Psychomotor▫ AffectiveDevelop content
  15. 15. 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.
  16. 16. Goal Statements should be:SpecificMeasurableAchievable/AttainableRealistic/RelevantTimelines/ Trackable.
  17. 17. The ABCD’s ofAudience – The whoBehavior – the whatCondition – the how – any circumstances orconditions that must be metDegree – another how – to degree of accuracy,or to what standards.
  18. 18. ExampleGiven 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
  19. 19. 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 MDIAffective – the attitudes / feeling (how patientperspective illness – what they think/ believe),do they believe that the meds work, that they cancontrol their COPD?
  20. 20. 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
  21. 21. Implementation-The 3rd component of the patient education process-Teaching/learningLearning stylesThe actual teaching (principles of adultlearning)The teaching methodology:▫ Lecture▫ Demonstration▫ Audiovisuals▫ Printed materials▫ Simulations▫ Role playing
  22. 22. Patient Education Skills-Definition-Teaching - is the process of sharing , knowledgeand insight, or facilitating (../ „ another tolearn knowledge, insight, „ and/or skillsLearning - is the process of acquiring wisdom,knowledge, or skill; an overt change inbehavior may be observed
  23. 23. 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 understandWhy is that so?Answer: research suggest that teaching/learning styles may be misaligned
  24. 24. Learning Styles Visual Auditory TactilePoint: Patients learn differently and for more effective patientteaching align your teaching style with your patients learningstyle
  25. 25. 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
  26. 26. Learning Styles-Implications for Auditory Learners-Encourage them to explain to others repeatrhymes to remember facts , dates, namesMake up songs to coincide with subject matterread explanations out loudUse audiotapes to reviewRecord lecturesSay words in syllables
  27. 27. 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
  28. 28. 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
  29. 29. Learning DomainsTeaching Strategies:• Cognitive• Psychomotor• Affective• lecture/guided discussionaudiovisual aid• printed materials• demonstration/drills• instructional guide• group discussion/role playcase study/ simulationLearning Domains Teaching Method of Choice
  30. 30. 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.
  31. 31. The Basics of Effective PatientTeaching*Principles of adult Learning*
  32. 32. The Nine Basic Principles of AdultLearning:•Recency •Feedback•Appropriateness •Active Learning•Motivation •Multiple sense•Primacy learning •2•ExercisePoint: remember the expression ramp-2-fame"
  33. 33. Impressed the importance/ centrality of pt edDefined patient education and related termsIdentified the 4 components of the pt ed .processIdentified barriers to learningPrinciples of adult learning (Ramp-2-Fame)Concluding remarks