Patient 20Education 1

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Patient Education & HealthPromotion


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Introduction Patient education is attempted and

performed during virtually clinical encounterin family practice

Range: simple to complex Patient education involves more than just

presentation of information; it is aninteractive process that aims at changing

knowledge To be an effective educator, family physician

must learn and cultivate effective skill andapproaches


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Reducing Barriers to Nocompliance

The best therapeutic plan is withoutvalue if your patient unable or unwillingto follow it.

50-92 % patient dont follow prescribedmedical regiment

Knowledge alone, not sufficient to

ensure patient will follow necessarytreatment


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Basic requirement

Basic requirement for optimalsuccess

1. Strong doctor/patient relationship:

is the foundation of effectivepatient education and improvecompliance

2. Two-way communication:

physician should avoid focusing tooquickly on what they feel is

important while missing the


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Systematic Approach to EducatingPatient

1. Establish maintain rapport:

Physician-patient rapport needed forsuccessful patient education and therapy

begins as soon as your patient enters theoffice. Staff attitudes and initial face-to-facecontact are crucial

demonstration of interest, empathy

combined with a friendly curteous mannerwill go long way


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2. Identify needs

Assessing the needs of patient is a complexand crucial step.

Identify concern,worries and fear of patient.

Two-way communication addressing thenecessary medical issues and meetingpatient needs, is necessary.

Physician should also assess the specificeducational needs of the patient, preexistingknowledgeof problem


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3. Assess Potential Barriers to Compliance

cause of noncompliance are deficiencies inthe physician-patient relationship,

miscommunication, conflict betweenregiment and the basic patient values (cost,inconvenience, denial) or beliefs (familyissues, side effect).


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4. Negotiate Plan Addressing the patients concerns and

issues

describing findings from physicalexamination Inform the patient of the diagnosis early Discuss cause, prognosis and expectation

Involve patient in decision-making Provide rational plan Resolve physician/patient differences


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5. Instruct the Patient in the Plan Reinforce positive health behaviors

Organize instruction

Instruct in specific skills, allow for practice

Consider use of adjuncts

Emphasize major points and summarize inwriting

Involve the family


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6. Evaluate Understanding of the Plan Allow patient to ask questions

Determine patients level of understanding

Explore expected ability to follow the plan

Work with patient to overcome obstacles

Give support, reassurance andencouragement

Renegotiate plan if necessary


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7. Monitor the Patient Review expected results from regimen

Give patient clear points at which to call or

come in Agree on a plan to monitor the progress

Arrange for follow up


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Putting it All Together

A comprehensive strategy has beenoutlined. At this point, the readermay be wondering how all this can beincorporated effectively into a briefclinical encounter


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Assessment for Helath Promotion

1. Health Risk Appraisal (HRA)

are written or computerized quantitativeand qualitative assessments of patients

major risky or unhealthy behaviors.Proper use of HRAs requires a wellorganized office system and office personelexperienced in use.


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2. Health Maintenance Flow Sheet

flow sheet allow the staff or computer-assisted prompts to remind the physician

about the patients major ongoing unhealthybehaviors

3. Diary Analysis

have the patient keep a detailed record of

all behaviors of interest over a specifiedtime period and then return the diary at afollow-up office visit


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4. Physiological Testing

physiological testing can assess andmotivate some patient. Submaximal

exercise stress testing will help to formallyevaluate a patients overall level of fitness


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Health Promotion and Counseling

Focus your counseling messages intwo domains: Motivate patients to seek healthier

lifestyles

Help motivate patient achieve behavioralchange by guiding them as they make

detailed behavioral changes plans,including resources


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Patient should:

1. Select specific short-term goals, plusone or more long-term goals, based on

their own priorities

2. Monitor their progress by regular follow-up

3. Rewards themselves in tangible andhealthy way

4. Encourage the family member to givepositive reinforcement


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Barriers in Health Promotion

Patient

Barriers can include physiologicaladdiction, fear to change, few

resources, poor self-esteem. Youshould try to identify and deal withbarriers up front rather than hopingthey will not influence ypur

patients outcomes Family

Most familial influence is indirect,

most have strong familial context


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Physician

Include perceived lack of time orremuneration for health promotion,perceived patient disinterest andpoor delivery system.

Physician must examine their

attitudes and behaviors


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Community Health Promotion

Through health promotion, you have theunique ability to become not only apatient advocate, but also community

health promotion specialist

The rules are simple:

1. Know the leading preventable cause of

death in you community2. Choose one or two areas as your targets

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Patient 20Education 1