Chapter 9 - Teaching and Counseling

‭Teaching Acronym‬ ‭●‬ ‭Tune into the patient‬ ‭●‬ ‭Edit patient information‬ ‭●‬ ‭Act on every teaching moment‬ ‭●‬ ‭Clarify often‬ ‭●‬ ‭Honor the patient as a partner in the education process‬ ‭Three Learning Domains‬ ‭●‬ ‭Cognitive: Storing and recalling new knowledge in the brain‬ ‭○‬ ‭Ex. lecture, panel, discovery, written material‬ ‭●‬ ‭Psychomotor: Learning a physical skill‬ ‭○‬ ‭Ex. demonstration, discovery, printed material‬ ‭●‬ ‭Affective: Changing attitudes, values, and feelings‬ ‭○‬ ‭Role modeling, discussion, audiovisual materials‬ ‭Question:‬‭Which action is an example of cognitive‬‭learning?‬ ‭a.‬ ‭A patient demonstrates how to change his wound dressing‬ ‭b.‬ ‭A new mother follows instructions for calling for the umbilical cord‬ ‭c.‬ ‭A patient describes how to portion food to maintain within a prescribed calorie range‬ ‭d.‬ ‭A patient expresses new confidence following a teaching session on caring for her mother‬ ‭at home‬ ‭ uestion:‬‭What would be the best teaching strategy‬‭for showing a patient how to care for an‬ Q ‭indwelling catheter?‬ ‭a.‬ ‭Lecture‬ ‭b.‬ ‭Role modeling‬ ‭c.‬ ‭Discovery‬ ‭d.‬ ‭Demonstration‬ ‭Factors Affecting Patient Learning‬ ‭●‬ ‭Age and developmental level‬ ‭●‬ ‭Family support networks‬ ‭●‬ ‭Financial resources‬ ‭●‬ ‭Cultural influences‬ ‭●‬ ‭Language deficits‬ ‭●‬ ‭Health literacy level‬ ‭Critical Developmental Areas‬ ‭●‬ ‭Physical maturation and abilities‬ ‭●‬ ‭Psychosocial development‬ ‭‬ C ● ‭ ognitive capacity‬ ‭●‬ ‭Emotional maturity‬ ‭●‬ ‭Moral and spiritual development‬ ‭COPE Model‬ ‭●‬ ‭Creativity‬ ‭●‬ ‭Optimism‬ ‭●‬ ‭Planning‬ ‭●‬ ‭Expert information‬ ‭Ask 3 Questions‬ ‭●‬ ‭What is my main problem?‬ ‭●‬ ‭What do I need to do?‬ ‭●‬ ‭Why is it important for me to do this?‬ ‭Providing Culturally Competent Patient Education‬ ‭●‬ ‭Develop an understanding of the patient’s culture‬ ‭●‬ ‭Work with the multicultural team‬ ‭●‬ ‭Understand the core cultural values of the patient or group‬ ‭●‬ ‭Be aware of personal assumptions, biases, and prejudices‬ ‭●‬ ‭Develop written material in patient’s preferred language‬ ‭Knowles (1990) Four Assumptions About Adult Learners‬ ‭●‬ ‭As a person matures, one’s self-concept is likely to move from dependent to independent‬ ‭●‬ ‭The previous experience of the adult is a rich resource for learning‬ ‭●‬ ‭An adult’s readiness to learn is often related to a developmental task or a social role‬ ‭●‬ ‭Most adults’ orientation to learning is that material should be useful immediately, rather‬ ‭than at some time in the future‬ ‭Teaching Plans for Older Adults‬ ‭●‬ ‭Identify learning barriers‬ ‭●‬ ‭Accommodate for sensory deficits‬ ‭●‬ ‭Allow extra time‬ ‭●‬ ‭Reduce environmental distractions‬ ‭●‬ ‭Plan short teaching sessions‬ ‭●‬ ‭Related new information to familiar activities or information‬ ‭Key Points to Effective Communication‬ ‭●‬ ‭Be sincere and honest‬ ‭●‬ ‭Avoid too much detail and stick to the basics‬ ‭‬ ● ‭●‬ ‭●‬ ‭●‬ ‭●‬ ‭●‬ ‭●‬ ‭●‬ ‭ e a cheerleader for the patient‬ B ‭Use simple vocabulary‬ ‭Keep content clear and concise‬ ‭Vary the tone of voice‬ ‭Ask for questions‬ ‭Listen and do not interrupt‬ ‭Ensure that the environment is conducive to learning and free of interruptions‬ ‭Be sensitive to the timing of teaching sessions‬ ‭Sources of Information‬ ‭●‬ ‭Primary: Patient‬ ‭●‬ ‭Secondary: Medical records, patient’s family‬ ‭Nurse Coaching Process‬ ‭●‬ ‭Establishing relationships and identifying readiness for change‬ ‭●‬ ‭Identifying opportunities, issues, and concerns‬ ‭●‬ ‭Establishing patient-centered goals‬ ‭●‬ ‭Creating the structure of the coaching interaction‬ ‭●‬ ‭Empowering and motivating patients to reach goals‬ ‭●‬ ‭Assisting the patient to determine progress towards goals‬ ‭Obtaining Feedback About Learning‬ ‭●‬ ‭Reinforcing and celebrating learning‬ ‭●‬ ‭Evaluating teaching‬ ‭●‬ ‭Revising the plan‬ ‭●‬ ‭Learning occurs if the patient can demonstrate what the nurse taught‬ ‭Guidelines to Patient Counseling‬ ‭●‬ ‭Make everyone feel comfortable in the situation and surroundings‬ ‭●‬ ‭Counseling may be formal or informal‬ ‭●‬ ‭Use interpersonal skills of warmth, friendliness, openness, and empathy‬ ‭●‬ ‭Caring is fundamental in the counseling role‬ ‭●‬ ‭Counseling may address an immediate concern‬ ‭Types of Counseling‬ ‭●‬ ‭Short-term: For situational crisis‬ ‭●‬ ‭Long-term: For developmental crisis‬ ‭●‬ ‭Motivational interviewing: For a severe health problem‬