1. Health Education and Health Promotion
Chapter 2
Health Education and Health Promotion

2. Health Education
An independent function of nursing practice and a primary nursing responsibility
Nurses must use opportunities in all health care settings to promote wellness.
Every contact an RN has with a health care consumer, whether or not that person is ill, should be considered an opportunity for health teaching
People with chronic illnesses and disabilities are among those most in need of health education.

3. Trends in Health Education
Patients are being encouraged to play an active role in the care and information they receive
Supported by numerous programs
Goal of patient and family education is to improve patient outcomes
Often through encouraging adherence
Especially important for those with chronic health problems

4. Readiness to Learn This must be assessed prior to teaching
Health literacy: “a complex group of reading, listening, analytical, and decision-making skills, and the ability to apply these to health situations” (NNLM, 2010)
As many as 90 million people in the United States lack these skills
Especially among older adults, immigrants, low- income individuals, those with chronic diseases
See Box 2-1 for strategies to implement with older adults.

5. REALM-SF Rapid Estimate of Adult Literacy in Medicine- Short Form
Give pt copy of form, instruct them to read as many words as they can from this list. Begin with the first word and read aloud. When you come to a word that you cannot read, do the best you can or say “blank” and go to the next one
RN marks words (+)(-) to the word.
Count the number of correct words for each list and record the number and grade.

6. Adult words samples Menopause Antibiotics Exercise Jaundice Rectal
Anemia
Behavior

7. 7 words Electronarcosis Pancreaticoduodenal Neuroarthropathy
Epileptogenic
Dopaminergic receptor
Xenodiagnosis
retrognathia

8. Scores and Grades for REALM-SF
0 Third grade and below; will not be able to read most low-literacy materials; will need repeated oral instructions, materials composed primarily of illustrations, or audio or video tapes.
grade will need low-literacy materials, may not be able to read prescription labels.
grade will struggle with most patient education materials; will not be offended by low-literacy materials.
7 high school; will be able to read most patient educaiton materials.

9. Question
Older adults often do not adhere to a therapeutic regimen. What strategy is most likely to promote adherence to an older patient’s therapeutic regimen after surgery?
Demonstrate a dressing change and allow the patient to practice
Provide a pamphlet on a dressing change
Verbally instruct the patient how to change a dressing
Have a family member change the dressing

10. Answer
A. Demonstrate a dressing change and allow the patient to practice
Rationale: Health education that includes visual, tactile and interactive elements is most likely to result in learning, especially among older adults. Engaging the patient himself or herself is more beneficial than deferring to a family member.

11. Nursing Process: Patient Teaching
The health education process utilizes the nursing process:
Begin by assessing learning readiness
Identify any potential barriers to communication
Identify relevant nursing diagnoses

12. Nursing Process: Patient Teaching (cont’d)
Planning
Identify goals, strategies, and desired outcomes.
Choose an appropriate setting and appropriate timing.

13. Nursing Process: Implementation
Utilize a variety of techniques to maximize learning:
Lecture
Discussion
Group learning
Multimedia
Written material
Demonstration

14. Question
The nurse is planning to teach a patient about administering her new asthma medication. How can the nurse enhance the patient's ability to learn?
Provide a list of websites that contain information related to the medication
Exclude family members from the session to minimize distractions
Use color-coded materials
Make the information relevant to the patient’s condition and needs

15. Answer
D. Make the information relevant to the patient’s condition and needs
Rationale: Identifying a link between the patient’s interests and the material to be taught enhances learning. Family members should not normally be excluded from health education. Websites can be a useful source of information, but providing a list of these does not enhance learning.

16. Nursing Process: Patient Teaching
Evaluation
It cannot be assumed that patients have learned just because teaching has occurred
Apply measurements—ideally more than one

17. Question Is the following statement true or false?
The most accurate way to evaluate whether learning has taken place is to observe for a change in the patient’s behavior.

18. Answer
True
Rationale: An observable change in a patient’s behavior is often the most clear indication that the patient has learned and integrated new information.

19. Health Promotion
Defined as “the process of enabling people to increase control over their health and its determinants thereby improving their health” (WHO, 2009)
The concept has evolved because of a changing definition of health and an awareness that wellness exists at many levels of functioning
Includes an element of self-responsibility
Health promotion occurs throughout the lifespan and activities should be planned accordingly

20. Question
Which of the following is the best example of health promotion teaching?
Demonstrating an injection technique to a patient for anticoagulant therapy
Explaining the side effects of a medication to an adult patient
Discussing the importance of preventing sexually transmitted infections to a group of high school students
Instructing an adolescent patient about her allergies

21. Answer
C. Discussing the importance of preventing sexually transmitted infections to a group of high school students
Rationale: Disease prevention through lifestyle changes is a key focus of health promotion. Education about medications and diagnoses is important for many individuals, but this does not clearly demonstrate the proactive focus of health promotion.