[NCM 102] Health Education
1st Year, 2nd Semester
o
Piaget: preoperational period - Egocentric; thinking
is literal and concrete; precausal thinking
o
Erikson: initiative vs. guilt - Taking on tasks for the
sake of being involved and on the move; learning to
express feelings through play
o
Salient Characteristics
Developmental Characteristics
o
o
o
o
Chronological age vs. stage of development
Growth and development interact with experiences,
health, motivation, and environmental factors to
affect a person's ability and readiness to learn.
Maturity continuum
✓ Dependence (infant and young child)
✓ Independence (child)
✓ Interdependence (advanced individual)
Best time to teach is when learner is ready.
• Pedagogy is the art and science of helping children learn.
• Stages of childhood divided by behavior patterns
✓ Infancy and Toddlerhood
✓ Early Childhood
✓ Middle and Late Childhood
✓ Adolescence
o
o
o
Piaget: sensorimotor stage - Learning is through
sensory experiences and through movement and
manipulation of objects, eventual object permanence
and causally
Erikson: trust vs. mistrust (birth to 12 months),
autonomy vs. shame and doubt (1-3 years) - Building
trust and establishing balance between feelings of
love and hate: learning to control willful desires
✓
o
✓
Cognitive - Example: responds to step-by-step
commands; language skills develop rapidly
during this stage
Psychosocial - Example: aggravated by personal
and external limits; routines provide sense of
security
✓
✓
✓
✓
Focus on normal development, safety, health
promotion, and disease prevention
Use repetition and imitation
Stimulate the senses.
Provide safety
Allow for play and manipulation of objects
Build trust
Allow for manipulation of objects
Use positive reinforcement
Encourage questions
Provide simple drawings and stories
Focus on play therapy
Stimulate the senses
o
Piaget: concrete operations stage - Developing
logical thought processes and syllogistic reasoning;
understands cause and effect and conservation
o
Erikson: industry vs. inferiority - Gaining a sense of
responsibility and reliability; increased susceptibility
to social forces outside the family unit; gaining
awareness of uniqueness of special talents and
qualities
o
Salient Characteristics
✓
✓
Teaching Strategies
✓
Cognitive - Example: animistic thinking: limited
sense of time; egocentric causation thinking
transductive reasoning
Psychosocial - Example: separation anxiety; play
is his/her work; fears loss of body integrity;
active imagination; Interacts with playmates
Teaching Strategies
✓
✓
✓
✓
✓
✓
✓
Salient Characteristics
✓
o
✓
o
Cognitive - Example: able to draw conclusions
and intellectually can understand cause and
effect
Psychosocial - Example: fears failure and being
left out of groups; fears illness and disability
Teaching Strategies
✓
✓
✓
✓
✓
Encourage independence
Use logical explanations and analogies
Relate to child's experience
Use subject-centered focus
Use play therapy
[NCM 102] Health Education
1st Year, 2nd Semester
✓
✓
o
o
o
o
Piaget: formal operations stage - Abstract thought;
propositional reasoning; adolescent egocentrism
(imaginary audience)
Piaget: formal operations stage (begins in
adolescence and carries through adulthood) Abstract thought; reasoning is both inductive and
deductive
o
Erikson: identity vs. role confusion - Struggling to
establish own identity; seeking independence and
autonomy
Erikson: intimacy vs. isolation - Focusing on
relationships and commitment to others in their
personal, occupational, and social lives
o
Salient Characteristics
✓
Salient Characteristics
✓
✓
▪
▪
▪
▪
o
Provide group activities
Use drawings, models, dolls, painting, digital
media, and computers
Cognitive - Example: propositional thinking;
complex logical reasoning; can build on past
experiences; conceptualize the invisible
Psychosocial
Need for belonging to a group
Need or personal space
Example: personal fable — feels invulnerable,
invincible/immune to natural laws
example: imaginary audience intense personal
preoccupation
✓
o
✓
✓
✓
✓
✓
✓
✓
✓
✓
Establish trust
Identify control focus
Use peers for support and influence
Negotiate for change-contract
Focus on details
Make information meaningful to life.
Ensure confidentiality and privacy
Use role play, contracts, reading materials, and
technology
Allow for experimentation and flexibility within
safe limits
Teaching Strategies
✓
✓
✓
✓
✓
✓
Teaching Strategies
Piaget: formal operations stage - Abstract thought;
reasoning is both inductive and deductive
o
Erikson: generativity vs. self-absorption and
stagnation - Reflecting on accomplishments and
determining if life changes are needed
o
Salient Characteristics
o
o
✓
Young Adulthood
Middle-Aged Adulthood
Older Adulthood
Adulthood: Teaching & Learning
Andragogy: the art and science of teaching adults
Adult Learning Principles: relates learning to
immediate needs; self-directed; teacher is facilitator;
learner desires active role
Use problem-centered focus
Draw on meaningful experiences
Focus on immediacy of application
Allow for self-direction and setting own pace
Organize material
Encourage role play
o
✓
o
o
o
Cognitive - Example: cognitive capacity is fully
developed but continuing to accumulate new
knowledge and skills
Psychosocial
Example:
autonomous;
independent; stress related to the many
decisions being made regarding career,
marriage, parenthood. and higher education
o
Cognitive - Example: ability to learn remains
steady
Psychosocial - Example: facing issues with grown
children, changes in own heath, and increased
responsibility for own Parents
Teaching Strategies
✓
✓
✓
Maintain independence and reestablish normal
life patterns
Assess positive and negative past learning
experiences
Assess potential sources of stress
[NCM 102] Health Education
1st Year, 2nd Semester
✓
Provide information relative to life concerns and
problems
What is practice act?
o
Piaget: formal operations stage - Abstract thought;
reasoning is both inductive and deductive
o
Erikson: ego integrity vs. despair - Coping with
reality of aging, mortality, and reconciliation with
past failures
o
Geragogy: the teaching of older persons,
accommodating the normal physical, cognitive, and
psychosocial changes
o
Salient Characteristics
✓
▪
▪
✓
o
Teaching Strategies
✓
✓
✓
✓
✓
✓
✓
✓
✓
✓
✓
✓
✓
✓
o
o
o
Cognitive
Fluid intelligence - capacity to perceive
relationships, to reason, and to perform abstract
thinking, which declines with aging
Crystallized intelligence - the intelligence
absorbed over a lifetime, which increases with
experience
Psychosocial - Example: adjusting to changes in
lifestyle and social status
Use concrete examples
Build on past experiences
Focus on one concept at a time
Use a slow pace
Use repetition and reinforcement
Provide brief explanations.
Use analogies
Speak slowly and clearly
Use low-pitched tones
Minimize distractions
Rely on visual aids, and supplement with verbal
instructions
Use large letters and well-spaced print
Provide a safe environment
Give time to reminisce
Family is one of the most important variables
influencing patient outcomes
The nurse educator and family should be allies
It is important to choose the most appropriate
caregiver to receive information
Practice acts are documents that define a
profession, describe that profession's scope of practice,
and provide guidelines for state professional boards of
nursing regarding standards for practice, entry into a
profession via licensure, and disciplinary actions that can
be taken when necessary
Practice acts are developed to protect the public
from unqualified practitioners and to protect the
professional title, e.g., such as registered nurse (RN),
occupational therapist (OT), respiratory therapist (RT), and
physical therapist.
What are the six ethical principles applied to patient
education?
1.
Autonomy - is derived from the Greek words
"auto"(self) and "nomos" (law) and refers to the right
of self-determination. Laws have been enacted to
protect the patient's right to make choices
independently.
2.
Veracity -telling the truth, is closely lo informed
decision making and informed consent.
3.
Confidentiality - refers to personal information that
is entrusted and protected as privileged information
via a social contract, health care standard or code,
or legal covenant.
4.
Nonmaleficence - is defined as "do no harm" and
refers to the ethics of legal determinations involving
negligence and/or malpractice.
5.
Beneficence of others - is defined as "doing good" for
the benefit
6.
Justice - speaks to fairness and the equitable
distribution of goods and services. The law is the
justice system
[NCM 102] Health Education
1st Year, 2nd Semester
o
Student-Teacher Relationship
o
o
o
o
Students and teachers have their own perspectives,
visions, values, and preferences that are known to
each other
They must be negotiated and understood by each
party for the process of education to proceed with
trust and respect. A balance of power exists between
the teacher (expert) and the student (novice].
The teacher possesses discipline-specific expertise,
which is key to the student's academic success, career
achievement, and competent care of patients.
Students must be able to trust their teachers-even
instantaneously-and believe that the instruction
provided by them will be accurate, appropriate, and
up to date. students are autonomous agents
Patient-Provider Relationship
o
o
o
o
o
o
Nurses (and nursing students) and the patients they
care for also have their own worldviews that come
together in the practice setting These perspectives
must be negotiated and understood by each party
for the process of patient education to occur with a
sense of trust.
As with the student-teacher relationship, it is
important to recognize the balance of power that
exists between a nurse-even a nursing student-and a
patient.
The blurring of professional boundaries is also an area
of ethical importance common to nurse' (or 'nursing
students') relationships with their patients.
Are tied to licensure, state and federal laws, scope of
practice and a public expectation that nurses
practice at a high professional standard.
The nurse's education, license and nursing standard
provide the framework by which nurses are expected
to practice.
When a nurse's practice falls below acceptable
standards of care and competence, this exposes the
nurse to litigation. The basis for litigation can relate
to negligence, railing to exercise the level of care that
a reasonable, prudent nurse would under similar
o
o
circumstances; malpractice; and professional
negligence, which means an act of neglect committed
in the nurse's professional role.
Acts of omission and commission will also subject the
nurse to litigation and professional license review.
Both litigation and professional license review can
result in reprimand of a nurse's license or loss of a
license. Poor or inaccurate documentation, significant
financial losses can result from missed notation.
The patient's right to adequate information regarding
his or her physical condition, medications, risks, and
access to information regarding alternative
treatments is specifically spelled out in the revised
edition of a Patient's Bill of Rights.
In addition, state regulations pertaining to patient
education are published and enforced under threat of
penalty by the department of health in many states.
Physicians are responsible and accountable for
proper patient education.