NR 222 unit 2 health and wellness (Unit 2 Edelman Chp 10) | Complete Study Guide | (STUDY THIS ONE)

1. Nursing and health education a. Health education Unit 2 Edelman Chp 10 Edelman Chp 10 a.i. Any combination of planned learning experiences based on sound theories that provide individuals, groups, and commun ...

1. Nursing and health education a. Health education Unit 2 Edelman Chp 10 Edelman Chp 10 a.i. Any combination of planned learning experiences based on sound theories that provide individuals, groups, and communities the opportunity to acquire the info and the skills needed to make quality health decisions a.ii. Involves providing relevant info and facilitating health-related behavior change a.iii. Involves use of teaching-learning strategies, the learners maintaining voluntary control over decision to make changes in their actions, and focusing on behavior changes that have been found to improve health status a.iv. The nurse can assist in achieving their health goals so that they are consistent with personal lifestyles, values, and beliefs a.v. Health education encourages self-care, self-empowerment, and, ultimately, less dependence on the health care system a.vi. Use behavioral theory and social cognitive theory to develop health knowledge b. Health teaching and health promotion are primary nursing responsibilities b.i. Educating about healthy lifestyles, risk reduction, developmental needs, activities of daily living, and preventive self-care c. Nurse provides health teaching and counseling based on individual interests and decisions to enable individuals to make informed decisions about their health d. Goals d.i. Help individuals, families, and communities to achieve, through their own actions, optimal states of health d.ii. Health literacy d.ii.1. Degree to which individuals have capacity to obtain, process, and understand health info and services needed to make appropriate health decisions d.ii.2. Includes ability to read, write, speak, listen, compute, and comprehend, and to apply those skills to health situations d.iii. Strategies to promote health literacy: d.iii.1. Create a shame-free environment d.iii.1.a. Encourage questions d.iii.1.b. Show respect, helpfulness, and caring attitude d.iii.1.c. Provide handout and review d.iii.1.d. Convey empathy and reassurance d.iii.1.e. Assist in form completion d.iii.1.f. Speak slowly and distinctly d.iii.1.g. Ensure privacy d.iii.1.h. Ask for patient to share info and clarify d.iii.1.i. Invite family member or friend d.iii.1.j. Be positive and supportive d.iii.2. Use clear, purposeful communication d.iii.2.a. Speak clearly and distinctly d.iii.2.b. Use plain, everyday language d.iii.2.c. Avoid medical terms d.iii.2.d. Limit key points d.iii.2.e. Face person d.iii.2.f. Be specific and concrete d.iii.2.g. Define new words d.iii.2.h. Conclude with summary d.iii.3. Communicate in a person-centered manner d.iii.3.a. Identify person’s personal motivators d.iii.3.b. Asses unique interests and activities d.iii.3.c. Address person’s main concern d.iii.3.d. Link info to past experiences d.iii.4. Reinforce spoken word d.iii.4.a. Use photos, audio, drawings, etc d.iii.4.b. Select highly readable info d.iv. Health disparities d.iv.1. Systematic, potentially avoidable health differences that adversely affect socially disadvantaged groups d.iv.2. Addressing health literacy and providing culturally sensitive health education are critical to reducing health disparities d.v. How to facilitate learning d.v.1. Stimulate variety of senses d.v.2. Involve person actively d.v.3. Establish comfortable learning environment d.v.4. Assess readiness of learner, which may be affected by physical, social, emotional, and financial factors d.v.5. Make info relevant d.v.6. Use repetition d.v.7. Make learning positive d.v.8. Start with what’s known/simple to what’s unknown/complex d.v.9. Apply to several settings d.v.10. Pace learning appropriately e. Health behavior change e.i. Use of health belief model to analyze probability that person will make changes to improve health or prevent disease, the application of the social cognitive theory to clarify environmental and social factors that affect learning of new health behaviors, and the use of stages of change, or transtheoretical model in planning health teaching e.ii. Health behavior- any activities that an individual undertakes to enhance health, prevent disease, and detect and control symptoms of disease e.iii. Health belief model e.iii.1. Used to predict and explain health behavior e.iii.2. Developed to describe why people failed to participate in programs to detect or prevent disease e.iii.3. Explains responses to symptoms, disease, prescribed treatments, and potential health problems e.iii.4. Assists nurse in formulating action plan that meets needs and capabilities of individual making health behavior changes e.iii.5. Guidelines e.iii.5.a. Individual perceptions or readiness for change e.iii.5.b. Value of health to individual compared with other aspects of living e.iii.5.c. Perceived susceptibility to health problem, disease, or complications e.iii.5.d. Perceived susceptibility to health problem, disease, or complications e.iii.5.e. Perceived seriousness of disease level threatening achievement of certain goals or aims e.iii.5.f. Risk factors to disease attributed to heredity, race or culture, medical history, or other causes e.iii.5.g. Perceived benefits of health action e.iii.5.h. Perceived barriers to promotion action e.iii.6. Doesn’t specify interventions to influence individual’s likelihood of taking action e.iii.7. Explains role of values and beliefs in predicting treatment outcomes and adherence while generating data that guide nurses in choosing effective educational strategies e.iv. Social cognitive theory e.iv.1. Adds to understanding of determinants of health behavior e.iv.2. Emphasizes influence of self-efficacy (Bandura) on health behavior e.iv.2.a. Self-efficacy- individual’s belief in being personally capable of performing behavior required to influence one’s own health e.iv.3. Describes roles of reinforcement and observational learning in explaining health behavior change e.iv.4. Use modeling or opportunities for imitating behavior for health education e.iv.5. Assists nurse in formulating action plan that meets needs and capabilities of individual making health behavior changes e.v. Transtheoretical model of change (AKA: stages of change) e.v.1. Useful for determining where a person is in relation to making behavior change e.v.2. Based on extensive research with smoking cessation e.v.3. Stages of change: e.v.3.a. 1. Precontemplation e.v.3.a.i. Person isn’t thinking about or considering quitting or adopting behavior change within next 6 months e.v.3.b. 2. Contemplation e.v.3.b.i. Person is seriously considering making specific behavior change within next 6 months e.v.3.c. 3. Planning/preparation e.v.3.c.i. Person who has made behavior change is seriously thinking about making change within next month e.v.3.d. 4. Action e.v.3.d.i. Person has made behavior change and it has persisted for 6 months e.v.3.e. 5. Maintenance e.v.3.e.i. Period beginning 6 months after action has started and continuing indefinitely e.v.4. Useful in determining person’s readiness for learning in relation to changing a behavior e.v.5. Self-efficacy is a key e.vi. Use to help develop interventions: e.vi.1. Asses behavior e.vi.2. Educate about need for and benefits of change e.vi.3. Motivate using personalized messages 2. Ethics a.i.1. Assess and increase self-efficacy a.i.2. Assess and offer resources to decrease barriers to change a.i.3. Modify behavior a.i.4. Maintain behavior change a. Applying principles of respect, autonomy, justice, and beneficence, nurses have active role as advocates in empowering care recipients to make own informed decisions about their health and care b. nurse needs to exercise caution in using tools of persuasion in communication with people because of potential manipulation and coercion 3. diversity and health teaching a. ethnic diversity demands that we provide culturally appropriate health education and health promotion b. cultural groups influence beliefs about health, perceptions of disease and illness, help-seeking behaviors, and attitudes toward health providers, and play a role in their use of traditional and complementary healing practices c. prevention strategies must address each group’s unique culture, experiences, language, age, gender, and sexual orientation and be culturally and linguistically appropriate in order to be effective d. when there is a language barrier: d.i. use courtesy and formal approach d.ii. address person by his or her last name d.iii. attempt to use words in person’s language d.iv. simple, everyday words d.v. hand gestures d.vi. instruct in small increments d.vii. have person demonstrate d.viii. provide written instructions d.ix. consider customs, values, and beliefs 4. social marketing a. application of commercial marketing technologies to analysis, planning, execution, and evaluation of programs designed to influence voluntary behavior of target audiences to improve personal welfare b. offer benefits and reduce barriers to influence target group’s behavior 5. Teaching plan a. Emphasizes phase of behavior change process that is related to individual’s health-promotion needs/problems b. Represents package of educational services provided to consumer or student c. Written from learner’s point of view d. Steps in teaching-learning process: d.i. 1. Assessment d.i.1. A. learner characteristics d.i.2. B. learning needs d.i.3. Involves determining characteristics of learner and identifying learning needs d.i.4. Important characteristics to know: d.i.4.a. Age, developmental stage, and level of education d.i.4.b. Health beliefs d.i.4.c. Motivation and readiness to learn d.i.4.d. Health risks and problems d.i.4.e. Current knowledge and skill d.i.4.f. Barriers and facilitators to learning d.ii. 2. Development of expected learning outcomes d.iii. 3. Development of teaching plan d.iii.1. A. Content d.iii.2. B. Teaching strategies, learning activities d.iv. 4. Implementation of teaching plan d.v. 5. Evaluation of expected outcomes d.v.1. A. Achievement of learning outcomes d.v.2. B. evaluation of teaching process e. Program goal e.i. Reflects desire to facilitate improvement in some health problem or social living condition e.ii. Broad statements on long-range expected accomplishments that provide direction (not stated in measurable terms) f. Learning goals f.i. Reflect health behavior or health status change that person will have achieved by end of education intervention g. Learning objectives g.i. Indicate steps to be taken by individual toward meeting learning goal and may involve development of knowledge, skill, or change in attitude g.ii. Most useful when stated in behavioral terms and when they contain these components: learner and precise action verb that indicates what learner will be able to do; condition under which task is performed; and level of performance expected g.iii. Guide selection of content and methods and help narrow focus of teaching plan to more achievable steps h. Selecting content h.i. Considers what info, skills, and attitudes need to be taught and level of learning to be achieved i. 3 domains of learning i.i. Cognitive i.i.1. Development of new facts or concepts and building on or applying knowledge to new situations i.ii. Psychomotor i.ii.1. Involves developing physical skills from simple to complex actions i.iii. Affective i.iii.1. Alludes to recognition of values, religious and spiritual beliefs, family interaction patterns and relationships, and personal attitudes that affect decisions and problem-solving progress i.iv. Nurse need to research resource materials (books, teaching guides, journal articles, pamphlets, and flyers) created by nonprofit agencies and professional organizations to meet behavioral objective from the 3 domains i.v. Nurse needs to select action verbs that indicate observable learning when writing learning objectives i.vi. Levels of learning i.vi.1. Cognitive i.vi.1.a. 1. Knowledge i.vi.1.a.i. Person recalls facts and concept i.vi.1.b. 2. Comprehension i.vi.1.b.i. Person understands meaning of concept i.vi.1.c. 3. Application i.vi.1.c.i. Person uses concept i.vi.1.d. 4. Analysis i.vi.1.d.i. Person can examine or explain concept i.vi.1.e. 5. Synthesis i.vi.1.e.i. Person integrates concept with other learning i.vi.1.f. 6. Evaluation i.vi.1.f.i. Person judges or compares concept i.vii. Teaching strategies i.vii.1. Lecture- teacher verbally presents info and instructions to person/audience i.vii.2. Discussion- involves interaction between nurse and individuals with questions to guide discussion i.vii.3. Role play- acting out potential scenario to allow individuals to practice appropriate responses i.vii.4. Cognitive (understanding) i.vii.4.a. Lecture, one-on-one instruction, discussion, discovery, audiovisual/printed materials, computer-assisted instruction i.vii.4.b. Describes a/o explains info relevant to behavior change i.vii.5. Affective (feeling/attitude) i.vii.5.a. Role modeling, discussion, role playing, simulation, gaming i.vii.5.b. Expresses positive feeling, attitudes, values toward changing behavior i.vii.6. Psychomotor (acting/motor skills) i.vii.6.a. Demonstration, practice, mental imaging i.vii.6.b. Demonstrates performance of skills related to behavior change i.vii.6.c. Use demonstration and practice: giving oneself an injection, changing a dressing, or performing exercises i.viii. Group presentation i.viii.1. Address several activities: i.viii.1.a. Create sense of preparedness and organization by providing physical facilities with adequate furnishings and suitable audiovisual materials and handouts i.viii.1.b. Anticipate needs of group and communicate info about schedule and facilities to make group more comfortable i.viii.1.c. Focus on nurse’s assessment of individual and group learning needs i.viii.1.d. Seek to maintain high level of motivation, sense of individualized attention and progression i.viii.1.e. Work with group to maintain learning climate i.ix. Evaluate teaching-learning process i.ix.1. Through written or oral testing, demonstrations, observation, self-reports, and self-monitoring i.ix.2. Obtain feedback about teaching performance (nonverbal communication cues from participants can be feedback) i.x. Referring individuals to other resources i.x.1. Provide resources for people to use for continuing education, counseling, peer support, and health services Potter: Chp 25 1. Domains of learning a. Any health topic involves one or all domains or any combo b. Patients with diabetes need to learn how diabetes affect the body and how to control blood glucose levels (cognitive). Patients begin to accept chronic nature of diabetes by learning positive coping mechanisms (affective). Many patients living with diabetes learn to test their blood glucose levels at home, which requires learning how to use glucose meter (psychomotor). c. Cognitive c.i. Includes all intellectual behaviors and requires thinking c.ii. Includes: c.ii.1. Knowledge: Learning new facts or information and being able to recall them c.ii.2. Comprehension: The ability to understand the meaning of learned material c.ii.3. Application: Using abstract, newly learned ideas in a concrete situation c.ii.4. Analysis: Breaking down information into organized parts c.ii.5. Synthesis: The ability to apply knowledge and skills to produce a new whole c.ii.6. Evaluation: A judgment of the worth of a body of information for a given purpose c.iii. Teaching methods: c.iii.1. Discussion (one­on­one or group, promotes active participation, allows peer support, enhances application and analysis of new info) c.iii.2. Lecture (more formal method, helps learner acquire new knowledge and gain comprehension) d. Affective d.i.1. Question and answer (addresses patient’s specific concerns, assists patient in applying knowledge) d.i.2. Role play, discovery (allows patient to actively apply knowledge, promotes synthesis of info and problem solving) d.i.3. Independent project (computer­assisted instruction, field experience, allows patient to assume responsibility for learning at own pace, promotes analysis, synthesis, and evaluation of new info and skills) d.ii. Deals with expression of feelings and acceptance of attitudes, opinions, or values d.iii. Includes: d.iii.1. Receiving: being willing to attend to another person’s words d.iii.2. Responding: active participation through listening and reacting verbally and nonverbally d.iii.3. Valuing: attaching worth to an object or behavior demonstrated by learner’s behavior d.iii.4. Organizing: developing a value system by identifying and organizing values and resolving conflicts d.iii.5. Characterizing: acting and responding with a consistent value system d.iv. Teaching methods: d.iv.1. Role play (allows expression of values, feelings, and attitudes) d.iv.2. Discussion (allows discussion of personal, sensitive topics) d.iv.3. Group discussion (allows patient to receive support from others in group, helps patient learn from others’ experiences) e. Psychomotor e.i. Involves acquiring skills that require integration of mental and muscular activity e.ii. Includes: e.ii.1. Perception: being aware of objects or qualities through use of sense organs e.ii.2. Set: readiness to take particular action (mental, physical, and emotional) e.ii.3. Guided response: performance of act under guidance of instructor involving imitation of demonstrated act e.ii.4. Mechanism: higher level of behavior by which person gains confidence and skill in performing behavior that’s more complex or involves several more steps than guided response e.ii.5. Complex or overt response: smoothly and accurately performing motor skill that requires complex movement pattern e.ii.6. Adaptation: ability to change motor response when unexpected problems occur e.ii.7. Origination: using existing psychomotor skills and abilities to perform highly complex motor act that involves creating new movement patterns e.iii. Teaching methods e.iii.1. Demonstration (provides presentation of procedures or skills, permits patient to incorporate modeling of nurse’s behavior, allows nurse to control questioning) e.iii.2. Practice (gives patient opportunity to perform skills using equipment in controlled setting, provides repetition) e.iii.3. Return demonstration (permits patient to perform skill, provides source of feedback and reinforcement) e.iii.4. Independent projects, games (requires teaching method that promotes adaptation, permits learner to use new skills) 2. Motivation a. Force that acts on or within a person to cause person to behave a particular way b. Low level of anxiety motivates a person, but high level inhibits ability to learn c. Social motive- need for connection, social approval, or self-esteem d. Task mastery motive- based on needs like achievement and competence e. Physical motive- motivated to return to level of physical normalcy 3. Use theory to enhance motivation and learning a. Social learning theory a.i. Explains characteristics of learner and guides educator in developing effective teaching interventions a.ii. People continuously attempt to control events that affect their lives, which allows them to attain desired outcomes and avoid undesired outcomes, resulting in improved motivation a.iii. Self-efficacy (Bandura) is important part because when people believe they can execute particular behavior, they are more likely to perform behavior consistently and correctly a.iv. Self-efficacy come from: enactive mastery experiences (practicing after demonstration), vicarious experiences (demonstrating how to use), verbal persuasion (encouraging ability), and physiological and affective states (positive feedback after completion of action) 4. Psychosocial adaptation to illness a. Stages of grief: a.i. Denial/disbelief (provide support, empathy, and careful explanations) a.ii. Anger (don’t argue, listen, reassure) a.iii. Bargaining (continue to introduce only reality, teach in present tense) a.iv. Resolution (encourage feelings, begin to share info for future) a.v. Acceptance (focus teaching on future skills, continue teaching about present, involve family) 5. Cognitive development, physical ability, and learning environment can all affect ability to learn 6. The nursing and teaching processes are not the same. a. The nursing process requires assessment of all sources of data to determine a patient's total health care needs. b. The teaching process focuses on the patient's learning needs and willingness and capability to learn. 7. Nursing process: a. Assessment a.i. Thoroughly assess patient and critically analyze findings to ensure patient- centered clinical decisions are made that are required for safe nursing care a.ii. Collect data about patient’s physical, psychological, social, cultural, developmental, and spiritual needs from patient, family, diagnostic tests, medical record, nursing history, and literature b. Nursing diagnosis b.i. Identify appropriate diagnoses based on assessment findings c. Planning c.i. Develop individualized care plan and set priorities based on patient’s immediate needs, expected outcomes, and patient-centered goals c.ii. Collaborate with patient on plan d. Implementation d.i. Perform nursing care therapies d.ii. Include patient as active participant in care e. Evaluation e.i. Identify success in meeting desired outcomes and goals of cursing care e.ii. If goals not met, alter interventions 8. health literacy a. cognitive and social skills that determine the motivation and ability of individuals to gain access to, understand, and use information in ways that promote and maintain good health b. includes patients’ reading and mathematics skills, comprehension, ability to make health-related decisions, and successful functioning c. Persons most likely to be at risk for low health literacy include the elderly, minority populations, immigrant populations, persons of low income, and people with chronic mental and/or physical health conditions d. Functional illiteracy- the inability to read above a fifth-grade level 9. Nurse teaching approaches a. Different from teaching methods because some situations require a teacher to be directive while others require a nondirective approach. b. b.i. b.ii. If a patient is highly anxious, but it’s vital for info to be given, telling is effective b.iii. Outline the task and give explicit instructions b.iv. No feedback c. Participating c.i. Nurse and patient set objectives and become involved in learning process together c.ii. Patient sets objectives and becomes involved in learning process c.iii. Opportunity for discussion, feedback, mutual goal setting, and revision of teaching plan d. Entrusting d.i. Provides patient opportunity to manage self-care d.ii. Patient accepts responsibilities and reforms tasks d.iii. Nurse observes patient’s progress e. Reinforcing e.i. Requires using a stimulus that increases probability for response e.ii. Reinforcement increases chance of learner to repeat behavior e.iii. Social reinforcers- smiles, compliments, or encouragement e.iv. Material reinforcers- food, toys, and music (best with children) e.v. Activity reinforcers- rely on principle that a person is motivated to engage in activity if he or she has opportunity to engage in more desirable activity after completion of task (ex: more likely to do mental health counseling after going outside for a walk) 10. Instructional methods a. Choose one that match a patient’s learning needs, time available for teaching, the setting, the resources available, and your comfort level with teaching b. One-on-one discussion b.i. Most common method b.ii. Nurse shares info directly in an informal manner, allowing patient to ask questions or share concerns b.iii. Use different teaching aids c. Group instruction c.i. Economical way to teach a number of patients at one time, and patients are able to interact with one another and learn from experiences of others c.ii. Involves lecture and discussion d. Preparatory instruction d.i. Providing info about procedures often decreases anxiety because patients have better idea of what to expect during procedure, which helps give them a sense of control d.ii. Describe physical sensations, cause of sensation, and only prepare patients for aspects of experience that are common e. Demonstrations e.i. Use when teaching psychomotor skills e.ii. Most effective when learners first observe teacher, then during a return demonstration, have a chance to practice skill e.iii. Combine with a discussion f. Analogies f.i. When teacher translates complex language or ideas into words or concepts that patient understands f.ii. Supplement verbal instruction with familiar images to make complex info more understandable g. Role play g.i. People are asked to play themselves or someone else g.ii. Patients learn required skills and feel more confident in being able to perform independently h. Simulation h.i. Useful for teaching problem solving, application, and independent thinking h.ii. Pose problem during discussion for patients to solve