Health Education and Counseling Principles

DR.KANDEEL PRACTICAL Practical - Client –provider interaction "Consultation": interaction between a physician and a patient where patient seeks the medical advice from the doctor - Skills for non-verbal communication: - Sit facing the client - Use encouraging movements as nodding - Care with the nonverbal expressions shown by the client - Avoid the movements that cause distraction as looking at the watch - Look directly to the client but not continuously - Speak in voice tone showing care - Listening: conscious effort to understand words, the way they are said, to be aware of the feelings shown & attempts to hide others (i.e. non-verbal communication from the receiver side). Four principles of consultation 1-Discover reasons for a patient’s attendance: - Listen to the patient describing the symptoms. - Obtain relevant social and occupational information - Look for cues, verbal and non-verbal. - Make hypothesis about the case/ problem 2-Define the clinical problems 3- Address the patient’s problems:  Set your diagnosis & management plan.  Involve patient in management plan 4- Explain the problem to the patient  Share your finding with the patient  Explain your diagnosis, and Management plan  Ensure that explanation is understood & accepted:  Follow- up appointment. DR.KANDEEL PRACTICAL Health education for small groups Principles of effective health education session: a- Define the target group as regards: - Socioeconomic criteria: Age, gender, culture - Needs, and interests - Education and reading level - Educational criteria (Knowledge, attitude) b- Define Key Concepts & Messages: - Information the audience need to know - Concerns of the audience that should be addressed - Misconceptions that should be addressed c- Prepare content: - Objectives are limited and focused - Information is up-to-date - Information is clear and easy to understand d- Prepare the place where session will be conducted - Comfortable - Suitable setting - Allow privacy - Contains educational tools - Basics for effective HE session The educator should: - Apply effective presentation skills - Talk, write and present the message clearly and simply - Allow two way communications: the receiver to be a sender will positively affect the communication process - Use different audio-visual aids to stimulate special senses more The message should be: - start from simple to more complicated knowledge - Start from known to unknown knowledge - Self-explained and familiar to people DR.KANDEEL PRACTICAL Health Education It is an educational process designed to: promote health * Counselling will provide : - Customized (personalized) - prevent illness - Client-oriented information - help people to get well from diseases . - negotiate available alternatives to help take a decision based on clear information - Education is an integral component of the counseling process that helps clients to make informed decisions. * Counselling is a process to : - Provide customized, client-oriented information - Help the client take decision based on clear - Negotiate available * Consultation is the whole process of meeting the patient: - History taking - Examination, alternatives - Management plan - Anticipatory care information - Behavior change: Seeks to solve problems and relieve symptoms by changing behavior and the environmental factors which control behavior Health Believe Model - promoting health beliefs about vulnerability to particular health threat; and beliefs about the consequences of the health problem. - Perceived : susceptibility and severity of health problem. - perceived benefit from the health action - perceived barriers that could be overcome Key principles of counseling: 1.Establish and Maintain Rapport with the Client 3.Work with the Client Interactively to Establish Plan 5. Confirm Client Understanding 2.Assess the Client's Needs 4.Provide Information That Can Be Understood and Retained by the Client 6. Use communication skills DR.KANDEEL PRACTICAL Patient Education Its a continuous teaching and learning process involving: - The patient or client Clinical teaching is personalized, It’s based on : - Patient’s needs assessment - Diagnosis, prognosis - The patient’s or clients family. - Requirements related to interventions. Health education viz Patient Education - Health education is a teaching and learning process similar to patient education. - However, it concentrates mostly on wellness, prevention, and health promotion. - Patient education is teaching process focused on one patient and tailored to his/her needs. Objectives of patient education : - Changing health behavior - Ensure positive health outcome - Improving patient compliance - Patient education help patients build Skills - Patients need to know when, how to make a lifestyle change Step 1: Assessment - Define patient and his family Patient Education - Identify patient needs - Discover concerns - Use direct Questions. Step 1: Assessment 0f patient learning style: Type of Learner Visual Auditory Characteristics Prefers pictures, diagrams, other visuals Prefers to learn via verbal instruction Sample Approaches to use in teaching Use of copious visual aids, process algorithms Use oral descriptions, lectures, podcasts Kinesthetic Prefers to learn via movement Use demonstrations, simulations, role playing, as well as discussion groups Step 2 : Design the Instruction Plan : Set objectives with your patient, Select materials. Step 3: Select Teaching Strategies: Providing a Good Learning Environment Use verbal and non-verbal communication:- Facial expression, head and hand movement - Tone of voice, eye contact, and touch - Listening . DR.KANDEEL PRACTICAL Step 4: Teach the Patient: Start from simple to complex information - consider patient concerns, learning styles, and motivation - Avoid medical jargon (use simple slang language) Step 5: Evaluation Evaluation should be continuous through all four steps! Feedback from the patient and family provides valuable perspective on the effectiveness of patient education Communication with patient family Family role in patient care: - Anticipate problems that may affect other family members - Provide practical support - Provide understanding of beliefs about illness and treatment - Provide information about family history of illness - Provide emotional and social support - Overcome difficulties arising from secrets - overcome compliance problems Guidelines for dealing with a patient’s family 1. Acknowledge their support. 2. Speak to them and give them time to raise issues or concerns. 3. Give them educational material to help them provide care and support. 4 . Identify a key worker (e.g. nurse or doctor) whom they can tell them how they will be contacted if the patient’s health deteriorates. 5. Before giving information to relatives, first give it to the patient and check whether you have the patient’s permission to discuss it with others. 6. Do not examine the patient (unless a child) in front of relatives. 7. Do not carry out procedures (such as taking blood) in front of relatives. 8. Do not discuss family issues in ward rounds. DR.KANDEEL PRACTICAL HE packages for Healthy Life Style WHO defined health as: Health is a state of complete physical, mental and social well-being and not merely the absence of disease What are components of Healthy life Style? - Think positive - Nutrition (healthy food - Quality sleep - Stress management - Avoidance of other harmful behaviours - Physical exercise - Tobacco control 1- Think positive Positive thinking: isn’t magic and it won’t make all of your problems disappear. Some strategies of positive thinking 1- Focus on the good things: Challenging situations and obstacles are a part of life. . - focus on the good things no matter how small or seemingly insignificant they seem 2- Practice gratitude: Think of people, moments, or things that bring you some kind of comfort or happiness . .3- Open yourself up to humor: laughter lowers stress, anxiety, and depression 4- Spend time with positive people: - improve self-esteem and increase your chances of reaching goals. 5- Practice positive self-talk: - even a small shift in the way you talk to yourself can influence your ability to regulate your feelings, thoughts, 6- Identify your areas of negativity: Take a good look at the different areas of your life and identify the ones in which you tend to be the most negative. . . DR.KANDEEL PRACTICAL 2- Proper nutrition (healthy food) 1- Maintain a healthy body weight. Balance energy intake with energy expenditure 2- Eat a variety of foods every day 3- Eat clean and safe food . 4-choose unsalted nuts and seeds5- Consume milk/dairy products daily (preferably low fat 6- Drink lots of clean water: Drink an adequate amount of water per day, 7- Limit intake of fats and oils to <30% of total daily energy needs 8- Limit intake of free sugars to less than 10% of total energy intake. . Sugars intake can be reduced by: )- limiting the consumption of foods and drinks containing high amounts of sugars - Eating fresh fruit and raw vegetables as snacks instead of sugary snacks .9- Limit salt intake: helps prevent hypertension and reduces the risk of heart disease and stroke in the adult population Salt intake can be reduced by -Not having salt or high-sodium sauces on the table -Limiting the amount of salt and high-sodium - Choosing products with lower sodium content -Limiting the consumption of salty snacks 3- Physical exercise .- any bodily movement produced by skeletal muscles that require energy expenditure Regular levels of physical activity - Improve muscular and cardiorespiratory fitness - Reduce the risk of falls as well as hip or vertebral fractures; - Improve bone and functional health -Reduce the risk of hypertension, coronary heart disease 4- Quality sleep Signs of poor sleep quality include: - feeling sleepy or tired even after getting enough sleep - Repeatedly waking up during the night How to improve your sleep: - Go to bed at the same time each night and get up at the same time each morning - Make sure your bedroom is quiet, dark, relaxing, and at a comfortable temperature - Remove electronic devices, such as TVs, computers - Avoid large meals and caffeine before bedtime, Avoid tobacco/nicotine, Get some exercise. DR.KANDEEL PRACTICAL 5- Stress management Management Strategies of stress: The AAAbc’s of Stress: A – alter it A – avoid it b – building our resistance or alter it direct communication,Problem solving planning, and time management A – accept it c – changing our perception: Practice “I can” rather than “I can’t Avoid it withdraw, say “No,, walk away accept it building our resistance - Water relieves stress, Laughter and sleep - Relaxation activities: park, yoga, quiet music, sauna, water sport, bicycle, 6- Tobacco control Health education messages for tobacco smoking 1- Ceasing tobacco smoking markedly decreases the risk for many Non-communicable diseases as - Hypertension - Obesity - Ischemic heart diseases - Lung cancer 2- Stopping tobacco consumption will protect your family and friends from hazards of second hand smoking 3- Ceasing smoking in pregnancy prevents against congenital birth defects 7- Avoidance of other harmful behaviors - Addiction of social media - Mobile phones abuse - Alcohol and drug abuse - Accidents