DH 361 Health Education Exam 1

Historical foundations for pt education: Phase 1

• emergence of health professions

• technological developments

• emphasis on pt-caregiver relationship

• spread of communicable diseases

• growing interest in welfare of mothers and children

• emergence of florence nightingale as advocate

Historical foundations for pt education: Phase 2

• Division of Child Hygiene established

• education programs created

• recognition that public health nurses were essential

Historical foundations for pt education: Phase 3 (1960s to current day)

• 1965: creation of medicare and medicaid 

• 1973: patient’s bill of rights (pt right to receive current information about their diagnosis)

• 1976: joint commission’s accreditation manual for hospitals (broadened the scope of pt education)

• 21st century: 5 million lives campaign, sullivan alliance

The father of dental hygiene? First dental hygienist 

Alfred Fones, Irene Newman 

Purpose of pt and staff education

increase the competence and confidence of clients for self-managment 

Primary goal of pt and staff education

increase the responsibility and independence of clients for self-care

What is learning?

Change in behavior that can be observed or measured

Barriers to interprofessional education

• time constraints 

• rigid curriculum structures

• desire to maintain professional identity

• llimited faculty support 

Patient Centered Care

the focus on reach shared understanding with patients

Barriers to teaching (define?)

factors that impede one’s ability to deliver educational services 

Obstacles to learning (define?)

factors that negatively impact the learner’s ability to pay attention and process information 

factors that affect the ability to teach

1. lack of time

2. lack of confidence/compretence

3. personal characteristics

4. low-priority status given to pt and staff education

5. environments that do not promote teaching/learning 

6. doubt that pt ed can change outcomes

7. inadequate documentation system (difficult to record teaching efforts)

factors that affect the ability to learn

1. limited time

2. stress of illness

3. low literacy 

4. negative influence of hospital environment

5. variations in readiness to learn, motivation and compliance, learning styles 

6. lack of support, positive reinforcement 

7. denial of learning needs

8. inconvenience, complexity, inaccessibility, dehumanization of healthcare system 

What is natural law?

• resect for others

• truth telling and honesty 

• respect for life 

What are the 6 ethical and legal principles?

1. autonomy

2. veracity

3. confidentiality

4. nonmaleficence

5. beneficence

6. justice 

Autonomy (personal freedom)

respect for individual rights, individuals can make decisions about their own healthcare

Veracity (truthfulness)

healthcare workers are honest and accurate with patients. information regarding the pt’s diagnosis or tx should not be withheld or misrepresented

Confidentiality 

patient information should be protected from unauthorized disclosed. sensitive medical details are private and secure 

Nonmaleficence (do no harm)

make decisions that do no harm to patient

Beneficence (kindness)

providing care that is in the best interest of the patient

Justice (equity and fairness)

fair treatment of all people. fair distribution of resources, equitable access to care, and nondiscriminatory practices 

Negligence vs malpractice

Negligence: failure to exercise reasonable care that results in harm

Malpractice: form of negligence committed by a healthcare professional that falls below the standard of care 

What is the patient’s bill of rights?

• The right to receive current information about one’s diagnosis, tx, and prognosis

• Passed in 1973

What are the two types of direct costs?

1. Fixed: stable and ongoing (e.g. salary of a trauma nurse coordinator)

2. Variable: may fluctuate in volume, program attendance, occupancy rates, etc. (e.g. cost of medications and supplies during treatment)

What is an indirect cost?

Hidden costs, surprise medical bills from out of network providers and facility fees,

• fees from things pt’s are unaware of 

What are cost savings?

reduction of expenses for healthcare services and good for patients, providers, or the system overall

• shortened lengths of stay 

What are cost benefits?

when the institution realizes an economic gain resulting from the educational program (e.g. drop in readmission rates)

What is a cost recovery?

when revenues are equal/greater than spendings

Cost-benefit analysis

relationship between program costs and benefits

• determines if income was made 

Cost-effectiveness analysis

comparison between 2 or more programs

Behaviorist learning theory

views learning as the product of the stimulus conditions (S) and the responses (R) that follow 

• positive/negative reinforcement 

• addresses:

  • skill learning

  • how to break/unlearn bad habits

  • how to correct faulty learning 

Respondent conditioning

Where neutral stimulus becomes associated with a unconditioned stimulus that naturally produces a response, eventually causing the neutral stimulus to elicit the response on its own 

• e.g. dog , chicken (unconditioned), and bell (neutral) analogy 

Spontaneous recovery

response that may reccur and reappear in a negative way

• e.g. smoking, gambling, drug/substance abuse

Systemic desensitization

based on respondent conditioning to reduce fear and anxiety in patients

Stimulus generalization

response to a new stimuli in a similar way to how it would respond to a previously learned stimulus, even if both stimuli are not identical

• e.g. dog that barks at the jingle of owner’s keys may also bar at other similar sounding keys 

Discrimination learning 

The ability to respond differently to different stimuli 

• e.g. ability to distinguish traffic signals meaning “stop” or “go”

Operant conditioning

Rewards introduced to increase behavior (positive/negative reinforcement), consequences introduced to decrease behavior (do nothing, punishment)

Cognitive Learning Theory

involves perceiving, interpreting, and reorganizing information

• pt must be actively participating, process largely directed by the individual  

Gestalt

• one of the oldest cognitive theories 

• emphasize perception in learning 

• based on the assumption that each person perceives, interprets, and responds to any situation in their way 

• our brains like to see things as a whole 

Information processing

helpful for assessing problems in acquiring, remembering, and recalling information

emphasis on thinking processes

• thought, reasoning, memory, information storing

Cognitive Development Perspective

focuses on how age and stage of life can affect learning

• Jean Piaget’s theory of cognitive learning

• Vygotsky’s sociocultural theory

• Adult learning

Jean Piaget’s stages of cognitive development

1. sensorimotor (0-2): babies learn through senses and actions, and develop object permanence (knowing things exist when hidden)

2. preoperational (2-7): use of  symbols and imagination but unable to think from others’ views 

3. concrete operational (7-11): can grasp logic, conservation, and reversibility 

4. formal operation (11-older): abstract and hypothetical thinking 

Vygotsky’s sociocultural theory

cognitive development is influenced by cultural and social interaction. individuals internalize knowledge and skills from those who are knowledged (e.g. language)

Social learning theory 

People observe and learn from others

Social constructivism

Individuals formulate their own versions of reality

• They construct knowledge, meaning, and reality through social interactions and cultural contexts, rather than passively receiving information 

Social Cognition

• influence of social factors on perception, thought, and motivation

• efforts to incorporate emotions 

Psychodynamic learning theory

Behavior may be conscious or unconscious.

Personality develpoment occurs in stages: 

• Id (pleasures must be met immediately)

• Ego (acts based on the reality principle)

• Suger ego (makes choices based on societal standards)

Erikson’s psychosocial stages

8 stages of development characterized by specific conflict that individuals must resolve to develop a healthy personality 

(e.g. Identity vs. role confusion: adolescence (13-19 years))

Humanistic Learning theory

motivation theory, assumption that every person is unique and can grow in a positive way 

Maslow’s hierarchy of needs

1. physiological

2. safety

3. belonging and love

4. self-esteem

5. self-actualization