Page 416 - Encyclopedia of Nursing Research

PATIeNT eDUCATION n 383

multiple adherence behaviors by patient con- education and education in healthy lifestyle
tracting needs further study. Second, studies behaviors.
are needed to determine the frequency of con- Historically, patient education in the P
tact needed with subjects to produce progres- United States dates back to the mid-1800s with
sive changes in adherence interventions using some physicians willing to share information
patient contracting. Third, patient contracting regarding disease management and some
during the maintenance phase of adherence guarding this information to prevent ques-
interventions has not been studied. Fourth, tioning of treatment modalities by patients
whenever possible, studies should include (Bartlett, 1986). On the contrary, in europe
objective measures of adherence behaviors, during the mid-1800s, Florence Nightingale
such as electronic event monitors to assess (1859) was providing education to patients
medication adherence and accelerometers or as well as other nurses regarding hygiene,
pedometers to assess physical activity. nutrition, and aspects of health promotion.
Patient education has since evolved from this
Elizabeth A. Schlenk narrow focus to empowering patients to take
a lead in their health care and to changing
health policy to mandate that clinicians in
health care organizations provide and docu-
Patient eDuCation ment proof of adequate patient education in
self-management to receive reimbursement.
Private accreditation organizations, such
Patient education is a process of providing as The Joint Commission (2010), issue stan-
individuals and their families with health dards for patient disease self-management
information related to their medical con- education, and Federal agencies, such as
ditions or procedures, treatment options, the Centers for Medicare and Medicaid, tie
lifestyle behaviors, and health promotion reimbursement to and display the results of
(Centers for Disease Control and Prevention, patient education quality indicators by hos-
n.d.). This information is provided in a variety pital on a public Web site called “Hospital
of ways, including more traditional formats Compare” (U.S. Department of Health and
such as verbal instruction, demonstration Human Services, 2010). This health care pol-
and return-demonstration procedures, and icy attaches an economic incentive to hospi-
written materials, and more recently in elec- tals to provide for these quality controls, and
tronic formats through video, Internet, DvDs it encourages the public to choose hospitals
and CD-ROMs. Nurses are in a key role to with the best quality indicators.
provide health and disease self-management Patient education and self-care have
education to improve outcomes and quality theoretical underpinnings in the works of
of life for the patient, his or her family, and Henderson, Peplau, and Orem. According to
more globally, for the community at large to Henderson (1991), the nurse meets the needs
promote healthy lifestyles. The modern health of the patient during periods of dependency;
care environment has become increasingly however, the nurse must also identify the
complex and more challenging for patients learning needs of the patient and supply ade-
to navigate and understand medical termi- quate knowledge based on that assessment to
nology, technology, and care instructions enable the patient to take over his own care
(Sand-Jecklin, Murray, Summers, & Watson, and return to independence. Similarly, in
2010). As patient advocates, nurses are in the Peplau’s theory of interpersonal relations, the
position to assess patients’ current knowl- nurse is identified in the nurse–patient rela-
edge, learning needs, and readiness to learn tionship as a resource person, teacher, and
to provide effective disease self-management counselor to facilitate patient learning and