EDUCATING FAMILIES WITH CHRONIC DISEASE

Joanne Douthit RN MN CNS CPNCollege of Nursing

University of ArizonaPediatric Pulmonary Center

Objectives

• Recognize role of chronic disease in health care

• Discuss role of interdisciplinary care• Identify components of educational process

– Developmental issues– Teaching methods– Learning styles– Barriers to learning

Chronic Disease

• Dominant health problem

• Principal cause of disability

• Consumes 78% of health expenditures

• Significant transformation of role of patient

Acute vs Chronic Disease

• Episodic• Passive role of patient• Usually cure• Returns to normal

• Continuous• Patient is experienced• Rare cure• Behavioral changes to

prevent worsening of disease

Chronic Disease

• Multiple facets of disease– Social concerns– Financial fears– Lower self esteem– Depression

Management

• Best provided by coordinated team of health care professionals

• Interdisciplinary care

• Individual discipline members provide service

Management

• Patient involvement with multiple professionals/physicians

• Continuity/integration of care critical

• Specialists must understand overall plan

Role of Patient in Chronic Disease

• Must adapt to ongoing therapy

• Involves change in behaviors

• Adjust to consequences of disease

• Patient becomes a principal caretaker

Role of Health Care Professionals

• Provide Education!– About disease– Treatment– Prognosis– Interpret symptoms– Understand

medications– Manage symptoms – Cope with emotions – Communication skills

Role of Health Care Professionals

• Skills – Medication delivery

• Spacer devices

• Nebulizer use

• Peak flow meters

• Asthma action plan

Developmental Stages

• Toddler (1 to 3 years)– Curious– Eager to learn new skills– Understands simple connection between ideas– Likes to mimic others

Developmental Stage

• Elementary School Age (6 to 12 years)– More complex thought processes– Developing confidence– Has a need to achieve and succeed– Friends and school are important

Developmental Stages

• Adolescents (13 to 18 years)– Peer influences– Separation from family– Development of personal identity– Rapid physical and sexual changes– Denial and immortality

Teaching Methods

• Games

• Videos/CD/interactive computer

• Role playing

• Visual demonstration

• Return demonstration

• Written materials

Learning Styles

• Visual– Must see skill demonstrated– Supplement with written material

Auditory

Hear explanation of skill

Kinesthetic

Hands on experience

Family Education is NOT

• Didactic

• Lists of “should do”

• Lecturing

• Waiting for request for help

Teaching Should Involve:

• Respect for patient

• Understanding of patient’s beliefs

• Co-mangement – agree on goals

• Demonstration/return demonstration of skills

Teaching Should Involve (cont’d)

• Keep it simple– Educate in increments– Involve all aspects of learning styles– Visual, Auditory, Kinesthetic– Repitition Repitition Repitition!!!– Reinforce

Barriers to Learning

• Lack of knowledge or skills– Educational level

• Lack of understanding– Long term consequences of uncontrolled disease

• Poor communication between professionals and family

• Lack of support

friends,family,community, professionals

Barriers to Learning (cont’d)

• Differences in Health Beliefs– Cultural – Religious

• Cost

Summary

Paradigm shift of responsibility towards the patient as primary caretaker

Understanding of developmental levels and learning styles necessary to develop educational methods

Identification of barriers to learning critical to success

THANK YOU!!