educating families with chronic disease joanne douthit rn mn cns cpn college of nursing university...
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EDUCATING FAMILIES WITH CHRONIC DISEASE
Joanne Douthit RN MN CNS CPNCollege of Nursing
University of ArizonaPediatric Pulmonary Center
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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
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Chronic Disease
• Dominant health problem
• Principal cause of disability
• Consumes 78% of health expenditures
• Significant transformation of role of patient
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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
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Chronic Disease
• Multiple facets of disease– Social concerns– Financial fears– Lower self esteem– Depression
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Management
• Best provided by coordinated team of health care professionals
• Interdisciplinary care
• Individual discipline members provide service
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Management
• Patient involvement with multiple professionals/physicians
• Continuity/integration of care critical
• Specialists must understand overall plan
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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
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Role of Health Care Professionals
• Provide Education!– About disease– Treatment– Prognosis– Interpret symptoms– Understand
medications– Manage symptoms – Cope with emotions – Communication skills
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Role of Health Care Professionals
• Skills – Medication delivery
• Spacer devices
• Nebulizer use
• Peak flow meters
• Asthma action plan
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Developmental Stages
• Toddler (1 to 3 years)– Curious– Eager to learn new skills– Understands simple connection between ideas– Likes to mimic others
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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
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Developmental Stages
• Adolescents (13 to 18 years)– Peer influences– Separation from family– Development of personal identity– Rapid physical and sexual changes– Denial and immortality
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Teaching Methods
• Games
• Videos/CD/interactive computer
• Role playing
• Visual demonstration
• Return demonstration
• Written materials
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Learning Styles
• Visual– Must see skill demonstrated– Supplement with written material
Auditory
Hear explanation of skill
Kinesthetic
Hands on experience
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Family Education is NOT
• Didactic
• Lists of “should do”
• Lecturing
• Waiting for request for help
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Teaching Should Involve:
• Respect for patient
• Understanding of patient’s beliefs
• Co-mangement – agree on goals
• Demonstration/return demonstration of skills
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Teaching Should Involve (cont’d)
• Keep it simple– Educate in increments– Involve all aspects of learning styles– Visual, Auditory, Kinesthetic– Repitition Repitition Repitition!!!– Reinforce
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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
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Barriers to Learning (cont’d)
• Differences in Health Beliefs– Cultural – Religious
• Cost
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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
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THANK YOU!!