Teaching and Learning Strategies for Patients and Family members of Toddlers with Asthma - Essay Example

?Teaching and Learning Strategies for Patients and Family Members of Toddlers with Asthma Overview Given a three-year old newly-diagnosed with asthma, the patient’s quality of life and those of the patient’s family members and friends will be better if the family members and the child would be co-led towards the patient and family members’ autonomous co-management of the child asthmatic condition. A paternalistic approach to teaching and learning will not work because the patient will not be always with the medical professionals. If family members and/or the child are made to over-rely on the medical professionals, medical help may come either too late for child or quality will be unnecessarily difficult for the child and the family members of the child because many of the complications and discomforts of an asthma attack can be prevented or addressed by the family members themselves and the child. As Nys (2008) pointed out, health care must respect, protect, restore or promote autonomy and must not leave insufficient room for individual autonomy. Autonomy is important in asthma for children five years old and below because in the age group, “the clinical symptoms of asthma are variable and non-specific” (Pedersen et al., 2011, p. 1). Based on Pedersen (2011, p. 5-6), “asthma education should be provided to family members and caregivers of wheezy children 5 years and younger.” State of Knowledge on Children with Asthma: The Literature From Koenig (2007), we are informed that in the United States children with asthma 4 years of age and younger are increasing and disproportionately affecting children who live in poverty and urban areas who are African American or Latino. Koenig (2007, p. 223) also informed us that that preventing, identifying, and controlling asthma symptoms “remains complex among children who are very young” although we certainly know more of the pathophysiology of asthma today compared to several years ago. Koenig (2007) pointed out that it is essential for health providers to inquire on the family constellations. This is relevant for training and learning because we have to identify the family members who are with the child most so a nurse can focus on them for teaching and learning activities when appropriate. We also learned from Koenig (2007) that parents and family members can be intimately familiar with a child’s distressed breathing and, because of this, nurses must have respectful stance on the parents’ and family members’ “expertise” in evaluating the severity of a child’s asthma attack. Koenig (2007) emphasized that other than education on symptom recognition and instructions on pharmacological intervention, there is s a need to develop collaboratively developed crisis management with family members or representatives in the event of an asthma attack. Based on the work of Diette et al. (2008) and Koenig (2007), it may be possible that low income groups are more vulnerable to asthma because of their exposure to poor environmental conditions and pollution. It follows therefore that the training and learning strategy must factor in the environmental situation confronted by the asthma patient and it also follows that the nurse must inquire into the environmental conditions confronted by the asthma patient. Some of the risk factors for asthma include house dust mites, companion animal allergens, cockroaches, fungi, pollutants, and distress (Pedersen et al., 2011). The preventive strategies for asthma include avoiding exposure to atmospheric pollution, avoiding unnecessary use of antibiotics in young children, and providing a calm and nurturing environment (Pedersen et al., 11). Pedersen et al. (2011, pp. 9-14) provided a treatment strategy, a set of recommendations on the use of a home action plan for family and caregivers, and identified the situations where hospitalization are likely needed. Guidelines on Children with Asthma The US Department of Health and Human Services, through the National Asthma Education and Prevention Program, has developed a set of guidelines for the diagnosis and management of Asthma. According to the National Asthma Education and Prevention Program (2007), management of asthmas has four components: assessment and monitoring, education for partnership in asthma care, control of environmental factors and co-morbid conditions that affects asthma care, and pharmacologic therapy. It is important to stress that the program emphasizes the importance of asthma education among family members, caregivers, and patients in the management of asthma. Further, it is important to highlight that asthma education must also include the active participation of family members, caregivers, and patient in taking care that the patient avoids environmental factors and comorbid conditions that either trigger an asthma attack or exacerbate the conditions of asthma and asthma attack. Teaching Strategies and Critique In implementing an asthma education, we can have three strategies: lecture with demo, lecture with demo and return demo, and lecture with demo supplemented with videos and brochures and pamphlets. Demo is a short-cut for demonstration. 1. Lecture with Demo In this strategy, the asthma educator or instructor which can be fulfilled by a nurse, briefs the patient on how asthma may be managed. The patient and their family members/caregivers are encouraged to ask questions. The nurse or the asthma educator/instructor demonstrates to the patient and parents/caregivers how asthma situations should be handled, including how ventolin puffers may be used. The demonstrations, of course, will be helpful for patients and their parents/caregivers because they will have a good visual of what to do exactly in managing asthma, especially on those ones that are relatively complicated like using ventolin puffers. The lecture with demo is basically good as patients and their parents/caregivers will eventually internalize asthma management based on experience. If time is problem, then lecture with demo may perhaps be resorted. However, asthma management can be a life and death matter and perhaps patients and their parents/caregiver must be required to fully undergo an asthma education program. This is similar with Durnham’s (2008) discussion on the use of patient simulator. 2. Lecture with Demo and Return Demo This teaching and learning strategy is highly similar to the first one with an important amendment: in this strategy, we require the patient and their parents/caregivers to return or demonstrate to us in turn how asthma will be managed in perhaps various scenarios. We politely require them, for example, to do a return demonstration for us on how the ventolin puffers may be used. The polite request must be accompanied, of course, by an explanation on why a return demo is important. This methodology is great for patients and their caregivers to internalize the knowledge they require to handle, for instance, the first asthma attack after the official diagnosis of asthma. There are dangers, however, that the patient or their parents/caregivers will not take the return demo seriously because they have seen the educator’s or instructor’s demo. However, it will be for the good the patient’s welfare to politely and respectfully suggest or insist that the return demo be done by the patient with the parent and/or caregiver participating in the return demo. The return demo will likely help much in the internalization of asthma management knowledge among the patient and parents/caregivers. However, if asthma attack takes long, there is a chance that what they have learned through the lecture demo and return demo may still be forgotten. 3. Lecture Demo and Return Demo Supplemented with Videos and Brochures/Pamphlets This is basically the earlier teaching and learning strategy but educational brochures/pamphlets and videos, when available, are provided to patients and their parents/caregivers. Of course, there can be problems. One problem that may arise is that the patients lack the educational background to understand the brochures and, maybe, even the educational videos. However, this problem can be addressed by having follow-up programs among the patients and their parents/caregivers. In the follow-up programs, we may follow-up the patients and their parents/caregivers for questions. Another problem that may arise is that brochures and videos that may be available may not be in line with the most recent knowledge in asthma management. The solution to the problem, of course, is to see to it that only brochure/pamphlets and videos from the highest authorities are circulated or that a competent official be asked to review the educational materials before they are circulated among patients and their parents/caregivers. References Diette, G., McCormack, M., Hansel, N., Breysse, P., and Matsui, E. (2008). Environmental issues in managing asthma. Respiratory Care, 53 (5), 602-617. Durnham, C. F. (2008). Enhancing patient safety in nursing education through patient simulator. In: R. Hughes, Chapter 51, Patient safety and quality: An evidence-based handbook for nurses. Agency for Healthcare Research and Quality Publication No. 08-0043. Maryland: Agency for Healthcare and Quality, U.S. Department of Health and Human Services. Hughes, R. (ed). (2008). Patient safety and quality: An evidence-based handbook for nurses. Agency for Healthcare Research and Quality Publication No. 08-0043. Maryland: Agency for Healthcare and Quality, U.S. Department of Health and Human Services. Koenig, K. (2007). Pilot study of low income-parents’ perspectives of managing asthma in high-risk infants and toddlers. Pediatric Nursing, 33 (3), 223-242. National Asthma Education and Prevention Program. (2007). Guidelines for the diagnosis and management of asthma. Full Report of the Expert Pane 3. US Department of Health and Human Services: National Asthma Education and Prevention Program. Nys, T. (2008). Paternalism in public health care. Public Health Ethics, 1 (1), 64-72. Pedersen, S., Hurd, S., Lemanske, R., Becker, A., Zar, H., Sly, P., Soto-Quiroz, M., Wong, G., and Bateman, E. (2011). Global strategy for the diagnosis and management of asthma in children 5 years and younger. Pediatric Pulmonary, 46, 1-17. Read More