1. Patient Education CHS 446 Communication Skills for the Healthcare Professional Mohammed S. Alnaif, Ph.D. alnaif@ksu.edu.sa

2. Patient Education  Patient education is a significant component of modern health care.  A process of assisting the patient to gain knowledge, skill, and a value or attitude related to a health problem or for health promotion.

3. Patient Education  Patient education can be divided into two large categories—clinical patient education (or clinical teaching and learning) and health education.  Clinical patient education is a planned, systematic, sequential, and logical process of teaching and learning provided to patients and clients in all clinical settings.

4. Patient Education  Clinical patient education is also a continuous teaching and learning process involving the health care provider and the patient or client (and/or the patient’s family).  The goals of clinical teaching and learning are based on the patient’s assessment, evaluation, diagnosis, prognosis, and individual needs and requirements related to interventions.

5. Patient Education  Health education is also a teaching and learning process similar to patient education.  However, it concentrates mostly on wellness, prevention, and health promotion.  Additionally, health education can be provided to individuals, groups, and communities.  The basic focus of health education is to change and improve societal health behaviors.

6. Patient Education Patient education  The are three important objectives of patient education that may result in positive health outcome.  Changing health behaviors  Improving health status  Improving patient compliance

7. Patient Education  Patient education provides h ealth information and instruction to help patients learn about specific or general medical topics.  Topics include the need for preventive services, the adoption of healthy lifestyles, the correct use of medications, and the care of diseases or injuries at home.

8. Patient Education Patient education  Skill Building and Responsibility – Patients need to know when, how, and why they need to make a lifestyle change  Group Effort – Each member of the patient’s health care team needs to be involved

9. Patient Education Patient education  Patient Education Value is the results of clear communication  Increased Compliance – Effective communication and patient education increases patient motivation to comply  Patient Outcomes – Patients more likely to respond well to their treatment plan which results in fewer complications

10. Patient Education Patient education  Informed Consent – Patients feel you’ve provided the information they need to make the right decision  Utilization – More effective use of medical services – fewer unnecessary phone calls and visits.  Satisfaction and referrals – Patients more likely to stay with your practice and refer other patients.

11. Patient Education Rationale Model of Patient Education Outcomes Patient Education  Print  Verbal  Multimedia  Combination Patient Education  Print  Verbal  Multimedia  Combination Behavior Changes  Health services utilization  Compliance  Lifestyle  Self-care Behavior Changes  Health services utilization  Compliance  Lifestyle  Self-care Costs  Length of stay  Utilization  Provider image  Regulatory compliance Costs  Length of stay  Utilization  Provider image  Regulatory compliance Health Status  Physical health  Well-being  Symptoms  Complications Health Status  Physical health  Well-being  Symptoms  Complications Knowledge and Attitude Changes  Increased understanding  Increased confidence  Increased satisfaction  Improved emotional state Knowledge and Attitude Changes  Increased understanding  Increased confidence  Increased satisfaction  Improved emotional state

12. Patient Education - Steps 1. Assessment of the Patient – Define patient and family needs and concerns; observe readiness to learn. 2. Design of the Instruction Plan – Set objectives with your patient; select materials. 3. Select a Teaching Strategies and resources– Put the plan in motion; help patients along the way to reach the objectives you’ve set together. 4. Go teach the patient – Understand and adapt to barriers to learning 5. Evaluate - Evaluation is critical and should be continuous through all four steps!

13. Patient Education Step 4: Go teach the patient. Step 3: Select a Teaching Strategies and resources Step 2: Design of the Instruction Step 1: Assessment of the Patient Step 5: Evaluate Learning Process Stromberg A. Eur. J. Heart Failure. 2005.

14. Step 1: Assessment Disease-Specific Knowledge  General Questions.  “Why do you think you feel short of breath?”  “Tell me what heart failure means to you?”  “What things do you need to do to take care of your heart failure?”

15. Step 1: Assessment Disease-Specific Knowledge Type of LearnerCharacteristicsSample Approaches to use in teaching VisualPrefers pictures, diagrams, other visuals Use of copious visual aids, process algorithms, and trigger cards AuditoryPrefers to learn via verbal instruction; visuals may distract learners Use oral descriptions, lectures, podcasts KinestheticPrefers to learn via movement and hands-on activities Use demonstrations, simulations, role playing, as well as discussion groups, where possible

16. Assessing Health Literacy  3 General Questions: 1. “What was the highest grade you completed in school?” 2. “How would you rate your ability to read?” 3. “How often do you need to have someone help you when you read instructions, pamphlets, or other written material from your doctor or pharmacy?”

17. Assessing Health Literacy: SOS Method LetterStands for…Question TopicCut Point S "Schooling"Educational attainment Sub-Secondary (6th grade or less) O "Opinion"Patient self-rating of reading ability "Okay" or worse on a 5 point scale (Excellent or very good, Good, Okay, Poor, Terrible or very poor) S "Support"Help when readingSometimes or worse on a 5 point scale (Never, Rarely, Sometimes, Often, Always)

18. Additional Barriers to Learning  Functional  Visual Impairment  Hearing Impairment  Decreased mobility  Illness-Related  Pain  Fatigue  Cognitive Impairment  Dementia  Delirium  Depression

19. Patient Education - Steps Assessment of the Patient – Define patient and family needs and concerns; observe readiness to learn.  Motivation – Patients are motivated when they learn how their lives could improve. Focus on the benefits of education.  Attitude – Denial, Fear, Anger, Anxiety – all could be barriers to education. Patient must know that he or she will make gains by learning new skills.  Outlook – A patient’s beliefs about their situation could effect education. Let them know that learning new skills can help them feel better or slow disease progression.

20. Patient Education - Steps Design of the Instruction Plan – Set objectives with your patient; select materials.  Goals should focus on what is necessary / critical to patient survival first.  Pay attention to patient concerns – they could stand in the way of progress  Respect stated limits – if a patient has refused to do something, try to work around the problem and incorporate something new as best you can.  Helping a Patient understands the need for changing behavior

21. Patient Education - Steps Select a Teaching Strategies and resources– Put the plan in motion; help patients along the way to reach the objectives you’ve set together.  Providing a Good Learning Environment  Tone of voice, eye contact, and touch vary for all cultural backgrounds  Use the knowledge you gained during assessment  Mixing Education Media  Choosing the right patient education materials

22. Patient Education - Steps Select a Teaching Strategies and resources  Potential Statements:  “What would you like to learn more about with regards to your heart failure?”  “It sounds like you understand a lot about how heart failure works. How comfortable are you with managing all the medicines?”  “What are your goals before leaving the hospital or after you get home?”

23. Patient Education - Steps 1. Go teach the patient – Understand and adapt to barriers to learning  Let your patients know:  What they should do and why  When they should expect results  Possible danger signs to watch for  What they should do if problems arise  Whom they should contact for referrals  Ask the patient if they have any questions or concerns

24. Step 4: Go Teach the Patient  Begin with knowledge of patient’s understanding of his/her disease, learning styles, and motivation  Understand and adapt to barriers to learning  Present material in multiple formats, over multiple episodes, and in coordination with other care team members

25. Patient Education - Steps Evaluate - Evaluation is critical and should be continuous through all four steps!  Getting Patient Feedback  Feedback from the patient and family provides valuable perspective on the effectiveness of patient education  Consider surveys, documents for patients to sign, questionnaires

26. THANK YOU