Page 417 - Encyclopedia of Nursing Research

384 n PATIeNT eDUCATION

promote experiences leading to health promo- support and education to transition patients
tion (Reed, 2005). Central to Orem’s self-care to independence would fit. Other patient
P framework are nursing systems designed to education research aims to reduce hospital
assist the individual to continue to provide recidivism in chronic disease. In one study,
his or her own self care or care of dependent discharge nurses hired as part of the study
family members, thus reducing the length of worked with patients throughout their hospi-
time the individual requires health care ser- tal stay to coordinate appointments and post
vices (Fawcett, 2000). In all three of these the- discharge diagnostic testing, provide educa-
oretical works, patient education is central tion related to medications and medication
to patient self-management and health pro- reconciliation, and conduct patient education
moting behaviors. In contemporary nursing with written materials. In addition, a phar-
care, clinical or critical pathways that include macist made telephone calls to the patients
components of patient education assist in after discharge to reinforce medication edu-
mapping the education plan to progress the cation and the discharge plan, with a sub-
patient along the trajectory from illness to sequent reduction of 30% rehospitalization
wellness and return to the highest level of rate within 30 days of discharge for the study
independence possible. participants (Jack et al., 2009). Although this
Research aimed at the effects of patient study demonstrated a reduction in rehospi-
education has supported beneficial effects talization, it included an elaborate education
in many studies, particularly in chronic plan that may prove to be complicated and
disease self-management. In a systematic challenging to continue long range because
review of 35 meta-analyses, comprising 598 of limited staff time and patient census.
studies and approximately 61,000 patients Health literacy in patient education
for chronic conditions including diabetes, is an emerging topic of research. There is
asthma, COPD, hypertension, obesity, rheu- a strong correlation between literacy lev-
matology, and oncology, the majority of the els and patient knowledge of disease self-
studies, or 64%, demonstrated improvement management (Horner, Surratt, & Juliusson,
of patient outcomes because of therapeutic 2000). Complex written patient care instruc-
patient education (lagger, Pataky, & Golay, tions and medication schedules are difficult
2010). Another meta-analysis for chronic dis- for patients to comprehend. In addition, cli-
ease self-management programs for older nicians who provide verbal patient education
adults supported a beneficial effect on some using medical jargon may not be successful
physiologic outcomes, such as blood glucose in providing quality education to patients.
control and blood pressure reduction in dia- In this situation, patients may be too embar-
betes and hypertension; however, there was rassed to disclose that they do not under-
no evidence to support a beneficial effect stand the written or verbal instruction and
on weight loss among diabetic patients or thus be unable to comply with their treat-
improved physiologic functioning among ment regime. As health care and technology
patients with arthritis (Chodosh et al., 2005). used to treat patients become more complex,
In another study, the combination of qual- a future challenge will be conveying health
ity nursing care in a bariatric surgery prac- care information to patients in a manner that
tice along with effective patient education is easily understood by the layperson.
supported positive patient outcomes during There are many future opportunities and
the postoperative period for self-care, recov- challenges in providing patient education in
ery, and successful weight loss (Grindel & different formats to address varying learn-
Grindel, 2006). Although this study does not ing styles. An evolving method for patient
name a theoretical model, Henderson’s the- education delivery is interactive Web-based
ory of nursing in the provision of adequate education programs aimed at providing