PPN101 - Week 9

PPN101 - Week 9

  • Explore the goals of client centered education.
  • Discuss client centered learning and L.E.A.R.N.S (RNAO)
  • Describe the 3 learning domains
  • Examine the Transtheoretical Model of Change.
  • Describe the role of the nurse in health teaching.
  • Discuss factors affecting a client’s readiness and ability to learn.
  • Examine the characteristics of different learning styles according to developmental stage and in terms of cultural diversity.
  • Relate the teaching process to the nursing process and Clinical Judgement model.
  • Analyze health literacy and its impact on health

CNA (2017) code of ethics

  • Patients have the right to make informed decisions of their care
  • Information that patient needs to make decisions must be accurate, complete, relevant

Health teaching

  • Focused form of instructional dialogue used in client centered relationships
  • Purpose is to provide clients and families with knowledge and life skills needed to make good decisions, slow or prevent progression of morality and promote highest possible quality of life

Role of nurse in teaching and learning

  • Multifaceted
  • Involves creating and adapting the environment to facilitate learning, using a patient centred approach in assessing the learning needs of the patient, and using the most appropriate educational strategy

Goals of client centered education

  • Engaging clients as active participants in the learning process-individual approach
  • Ensuring that health teaching and interventions are supportive of the clients preferences and values in order to achieve positive clinical outcomes
  • Introduce participatory strategies which build on clients personal strength
  • Collaborative learning environments allow nurses to offer sufficient information, specific instructions and emotional support to clients
  • Teacher must start where the learner is, while supporting the learners desire to learn

RNAO L.E.A.R.N.S

  • Facilitating client centred learning is based on 4 pillars
    • Client centered care
    • Promoting health literacy
    • Building knowledge and skills
    • Supporting self-management strategies

L.E.A.R.N.S

  • Listen, Establish relationship, Adopt intentional approach, Reinforce health literacy, Name new knowledge, Strengthen self-management

Goals of client education

  • Maintaining and promoting health and preventing illness
  • Health restoration
  • Coping with impaired functioning

3 learning domains

  • Cognitive
    • Understanding the content
    • Prerequisite for changing attitudes and developing the mastery of psychomotor skills
  • Affective
    • Changing attitudes and promoting acceptance
  • Psychomotor
    • Hands on skills development

Nurses act as:

  • Guides → coach on actions to improve overall health
  • Information providers → how patients can learn to better care for themselves
  • Resource support → connect clients to appropriate community supports
  • Knowledgeable emotional support → help clients minimize the impact of temporary setbacks

Transtheoretical model of change

  • Model used to explore a person's motivational readiness to intentionally change health habits
  • Stages of change
    • Precontemplation → doesn't think there is a problem
    • Contemplation → thinks there may be a problem
    • Preparation → recognized problem and willing to change
    • Action → engages in concrete action to change
    • Maintenance → perseveres with positive behavioural change

Learning styles

  • Visual
    • Learns best by seeing
  • Auditory
    • Learns best with verbal instructions, likes to talk things through
    • Detail not that important
  • Kinetic
    • Learns best by doing, hands-on involvement, needs action and likes to touch/feel
    • Loses interest with detailed instructions
    • Tries things out

Factors affecting a client's readiness and ability to learn

  • Level of anxiety → emotional capability
  • Ability to learn → intellectual capability
  • Physical capability
    • Pain, nausea, comorbid health problems etc.
  • Crisis and life transitions can improve learning
  • Level of social support
  • Health literacy
  • Developmental stage
  • Culture
  • Self awareness
  • Social determinants of health

Literacy

  • The ability to use printed and written information in society - to achieve one's goals and to develop one's knowledge and potential
    • Low literacy is used to represent almost 9 million adult canadians who have serious problems with reading, writing, and math
    • 4 out of 10 canadians have less than adequate skills
    • Living in an “information culture” requires higher levels of literacy that at any previous time in history

Health literacy

  • Defined as the degree to which an individual has the capacity to obtain, communicate, process, and understand basic health information and services to make appropriate health decisions
  • Includes knowing how to describe symptoms, where to find help for health issues, how to understand medical information and how to safely manage the use of medication
  • 6 in 10 canadians do not have the skills needs to adequately manage their health and health-care needs