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Name: Increasing patient education through customized printed materials and using customized plan of care for patients that they can understand. January 2012 The use of care plans is becoming widespread in the United States and further afield, particularly in the case of patients who have longstanding health care needs, such as those suffering chronic conditions, those who are in residential care and in some recovery or palliative care contexts…
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Increasing patient education through customized printed materials and using customized plan of care for patients that they can understand. January 2012 The use of care plans is becoming widespread in the United States and further afield, particularly in the case of patients who have longstanding health care needs, such as those suffering chronic conditions, those who are in residential care and in some recovery or palliative care contexts. This paper reviews the literature on patient education through customized printed materials and customized care plans. It has been known for several decades that standardized leaflets by bodies like the American Heart Association or the American Cancer Society, and various government agencies can play a useful role in patient education. There are, however, some disadvantages in using this generic printed text approach. Many patients are not willing, or indeed not able, to benefit from them. One study of literature designed to educate patients about smoking in the United States, for example, found that there was a serious disparity between the reading level of the smoking education literature and the much lower literacy skills of the patients examined in the sample (Mead and Byrd, 1989, p.204). Clearly, then, if printed literature is to be used, it must be tailored to patient ability. One article examined the role of nurses in the development and maintenance of health care plans in and concluded that primary care nurses were much more involved in health care plan provision and implementation in the UK and New Zealand than they were in Australia. Nurses in Australia were keen to contribute more to the process, arguing that they could provide insights into the patient’s home situation using evidence from their home visits. A barrier to the full implementation of written care plans for patients suffering chronic and complex conditions was, in this case, attributed to reluctance on the part of doctors to relinquish control of the recording function (Patterson et al., 2007). Another empirical study in Norway of 78 asthmatic and 62 COPD patients explored an education intervention which involved the use of specially printed brochures circulated in a class, along with a follow up session on a one to one basis to make a customized care plan. The printed materials and follow up in this intervention helped to produce a reduction in drug use and improvement in patient outcomes in the case of the asthmatic group (Gallefoss and Bakka, 1999, p. 2004). A study carried out in the United Kingdom concluded that information leaflets are useful and desired by patients, but that they are underutilized by health professionals. (Kenny et al. 1998, p. 476). It echoed the concerns of the American study mentioned above, about some poorly written leaflets, but nevertheless recommended the use of printed information leaflets so long as they “ are evidence based as far as possible, peer reviewed, contain references, be dated, give an objective measure of readability, and be evaluated” (Kenny et al., 1998, p. 477). Keeping a database of leaflet titles was suggested as a way of ensuring that practitioners are more aware of their potential. One area of health care which often receives inadequate attention when it comes to patient education is that of psychiatric nursing. Hummelvoll (1996) proposes a “Nurse Client Alliance” model which is designed to support patients who are learning to live in the community. The written customized care plan is the cornerstone of this approach, and it consists of a series of questions and answers. The nurse poses the question, and the patient answers them, with the guidance and support of the nurse. Crucially, the content of the plan, which embraces medical and social needs together, is recorded in the patient’s own words, and the document is given to the patient as a record and reference point. Some drawbacks in the implementation are mentioned, such as reluctance on the part of practitioners because of the time involved in drawing up the plan, or on the part of patients because it is too difficult. This approach may not be effective for patients who are treated against their will, or for very short term engagement with a patient. An important article by Snyderman and Sanders Williams explains the increasing need in modern medicine for a shift from reactive treatment of conditions which have become acute, to a proactive type of care which they call “prospective health care.” They cite chronic conditions such as diabetes as being prime areas for the implementation of a personalized health plan which consists of “a health profile, a description of the individual’s current health status, a health risk analysis (genetic, environmental, and lifestyle aspects) and countermeasures” (Snyderman and Sanders Williams, 2003, p. 1080). This plan, which the authors envision as being produced electronically, feeds into a whole network of information systems including data gathered from tests and scans, and reference materials provided by a panel of experts. This is an exciting but somewhat expensive model that may, in the future, replace current systems which depend on printed leaflets and other hard copy materials for some patients who have access to technology. Digital information may be an exciting prospect for some patients but for many patients, including those who are older and economically weaker, printed media, in conjunction with knowledgeable nurse support, will continue to be an essential part of the customized education and health care planning process. References Gallefoss, F. and Bakke, P.S. (1999) How does patient education and self-management among asthmatics and patients with chronic obstructive pulmonary disease affect medication? American Journal of Respiratory and Critical Care 150 (6), pp. 2000-2005. Hummelvoll, J.K. (1996) The Nurse-Client Alliance Model. Perspectives in Psychiatric Care 32 (4), pp. 12-21. Kenny, T., Wilson, R.G, Purves, I.N., Clark, J., Newton, L.D., Newton, D.P. and Moseley, D.V. (1998) Family Practice 15 (5), pp. 471-479. Meade, C. D. and Byrd, J.C. (1989) Patient Literacy and the Readability of Smoking Education Literature. American Journal of Public Health 79 (2), pp.204-206. Patterson, E., Muenchberger, H. and Kendall, E. (2007) The Role of Practice Nurses in Coordinated Care of People with Chronic and Complex Conditions. The Australian Health Review 31 (2), pp. 231-238. Snyderman, R. and Sanders Williams, R. (2003) Prospective Medicine: The Next Health Care Transformation. Academic Medicine 78 (11) pp. 1079-108. Read More
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