What is patient education?
Patient education refers to a process that doctors and other health professionals and community educators undertake to share information with patients and caregivers about their health and the lifestyle issues that affect it. Patient education has a long history, and has achieved a central importance in the understanding of health development and behaviors.
People often confuse the concepts of patient education and patient counseling. There are, however, fundamental and structural differences between the two. Patient education is a formalized process. The learning process is usually directed, and there are clearly delineated principles, measuring indicators, objectives, and goals to be reached. An educator provides information and material and educates a patient on how to best use it. Counselors, rather than directing and measuring, tend to help patients reach decisions on their own. Counseling also offers guidance for objectives and goals, and is more flexible and individualized.
Patient education has a long history. In the United States, one of the oldest patient education methods is the institution of visiting nurses. The practice of visiting nurses was already in place in the late nineteenth century, when nurses in both rural and urban areas cared for the sick, aging, and poor in their own homes. This was specifically crucial for patients who, due to diverse circumstances, could not be sent to the hospital. Skilled nurses were hired mostly by charity foundations or served as volunteers, although in time they were also sent by government institutions. Not only did visiting nurses provide care for the poor and ill but they also provided instruction and guidance to patients and their caretakers. Caretakers played an important role in patient teaching, as they were trained and instructed on how to care for the sick and to ensure that proper sanitary norms were in place.
Visiting nurses employed for this work were mostly women. They often cared for patients without a doctor in attendance, especially in rural or poverty-stricken areas. At the time, large outbreaks of diseases such as diphtheria, influenza, measles, and polio spread through crowded neighborhoods in major cities. Doctors and visiting nurses provided care and taught caretakers how to respond to emergencies or care for victims disabled for life by the results of diseases such as polio. As time went by, in addition to providing care for illnesses, nurses began to train whole families on preventing disease and leading a healthy life. Doctors also engaged in patient teaching, although in a less structured and personalized manner.
Patient education became very successful. For example, in the 1940s, the Visiting Nurse Service of New York managed to decrease infant mortality by 50 percent. Visiting-nurse programs continue to help communities, offering patient education and other services. They provide HIV/AIDS education and teach new mothers in rural areas about parenting skills and infant care. Patient teaching is also undertaken by community educators, trained volunteers, and others.
Patient education today not only instructs patients and their caretakers but also helps patients themselves become active participants in their own care. To be most effective, patient education must be a patient-centered process. This includes evaluating a patient’s needs and concerns and his or her learning preferences, support system, and possible barriers to learning. It is also important to consider the help of others involved in the patient’s family or community. Healthcare professionals can also plan objectives with the patient and the caretaker, involve the patient in identifying realistic learning objectives, and choose activities and resources that fit the patient’s lifestyle. Including the patient in developing a proper learning plan is crucial to the success of the program. Some patients, for example, may need time to learn new skills, process new information, or make lifestyle changes.
Evaluating a patient’s learning abilities and preferences should guide the teaching methods used and the patient education materials. Experts recommend taking the following steps: identifying the patient’s learning preferences, concentrating on what the patient needs to know, and paying close attention to the patient’s needs and concerns. For example, some patients may need to process information in small amounts or to overcome a fear before learning something new. Experts also recommend organizing the information so that it can be easily processed by the patient. Flexibility is important, because plans may need to be adjusted in accordance with a patient’s needs.
There are different ways to deliver patient education. Teaching methods include one-on-one teaching, which may include a skill demonstration; printed material such as books and brochures; DVDs, online videos, and podcasts; graphics such as posters and PowerPoint presentations; and medical models. Other effective teaching methods include group classes at community centers or clinics, as well as training community educators.
Many experts find that one-on-one teaching works best, along with demonstrations and media support. However, it is important to bear in mind that the resources a patient or caretaker best engages with vary from person to person. In a very diverse community, there may be cultural literacy, language, or other barriers to consider when choosing a teaching plan and education materials.
Many healthcare professionals and patient advocates today find that teaching is a way to prevent disease and nurture a healthful lifestyle. The best means to improve healthcare for all, they claim, is to produce teaching healthcare professionals who are not only technically and scientifically skillful, but also culturally competent. A culturally competent teacher and care provider must individuate patients—that is, see the patient beyond possible ingrained stereotypes related to gender, race, religion, ethnicity, and other sociocultural factors.
It is also important to bear in mind the idea of patient autonomy. Patient autonomy proposes that the actions between healthcare professional and patient should support and strengthen the autonomy and dignity of patients. The role of teaching patients and their caregivers includes coordinating the responsibilities of the caregiver with the dignity and rights of the patient.
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