NURSES ROLE IN PATIENT AND FAMILY EDUCATION, AND THE CHALLENGES FACED IN CDC COTTAGE HOSPITAL TIKO

Abstract

Introduction: Patient and family education is a critical part of nursing care and is one of the most challenging roles that nurses have today. Patient education is the process by which health professionals impart information to patients and their caregivers that will alter their health behavior or improve their health status.

Health education is, therefore, a tool used by managed care plans and may include both general, preventive education or health promotion and disease or condition-specific education.

This study is aimed at assessing ways to incorporate patient teaching into routine nursing care and to describe the challenges faced during patient teaching.

Methods: This was a descriptive, observational, and cross-sectional study supplemented with qualitative methods.

Nurses were enrolled from the CDC Cottage Hospital in Tiko to represent their frequency in Cameroon’s health delivery system. Letters of authorization were obtained from the Faculty of Health Science and the administrative head of the hospital to carry out this study.

Results: A total of 50 nurses participated in the study, 62% mostly faced the challenge of non-compliance in the form of denial, disagreement, aggression, withdrawal, and nonparticipation during patient teaching.

Other challenges identified were that of language, religion, and cultural barriers, lack of knowledge. Nurses attributed these challenges as a result of patient and family education is ineffective and thus a neglected aspect in nursing care.

Conclusion: Nurses in Cameroon do indeed face major challenges inpatient teaching which are of diverse origins and this could have devastating consequences for the patient and the family. Nevertheless, when nurses value patient and family education and are able to implement it, patients are better prepared to adopt health care responsibilities.

CHAPTER ONE

INTRODUCTION

1.1 Background of the Study

Patient and family education is one of the most important roles for a nurse in any health care setting. It is the process by which health professionals impart information to patients and their caregivers that will alter their health behaviors or improve their health status [1].

Health education is therefore a tool used by managed care plans and may include both general, preventive education or health promotion and disease or condition-specific education [2]. Thus, important elements of patient education are skill building and responsibility.

Patients need to know when, how, and why they need to make a lifestyle change. Learning is not just listening to instructions. Learning is the purposeful acquisition of new knowledge, attitudes, behaviors and skills [3].

Complex patterns are required if the patient is to learn new skills or change existing attitudes [4]. For example, a new mother exhibits learning when she demonstrates to the nurse how to bathe her newborn.

Learning also occurs when there is internal mental change characterized by rearrangement of neural paths. It can result to a persistent change in behavior.

Observation of this behavior is an indication that learning has occurred [5]. For example, learning is also demonstrated when a patient preparing for abdominal surgery demonstrates deep breathing and coughing while splinting the abdomen with a pillow.

Teaching is not just imparting information but is an interactive process that promotes learning. It consist of a conscious, deliberate set of actions that help individuals gain new knowledge, change attitudes, adopt new behaviors, or perform new skills and tasks [3,4].

The nurse, who has a role to play as a teacher, provides information that prompts the learner (patient) to engage in activities that lead to the desired change. Generally, teaching and learning begin when a person identifies a need for knowledge or acquires an ability to do something. Teaching is most effective when it responds to the learner’s identified needs.

Thus, the nurse as a teacher assesses these needs by asking questions and determining the learner’s interest. Also, interpersonal communication is essential for successful teaching to occur. Whether patients adequately manage their chronic illnesses and maintain quality of life depends primarily on what they are taught and learn about their condition.

The nurse is a visibly, competent resource person in the improvement of the physical and psychological well-being of patients. In the school, home, clinic, or workplace, the nurse provides information and skills that allow patients to adopt healthier behaviors [6].

For example, in childbearing classes, nurses teach expectant parents about physical and psychological changes in a woman and about fetal development. After learning about normal childbearing, the mother is more likely to eat healthy foods, engage in physical exercises and avoid substances that might harm the fetus.

Greater knowledge can result in better health maintenance habits. When patients become more health-conscious, they are more likely to seek early diagnoses of health problems [4]. Patients recovering from illness or injury and adapting to the resultant changes often seek information about their conditions.

However, patients who find it difficult to adapt to illness may become passive and uninterested in learning. Thus, the nurse is called upon to identify patients’ difficulties and speed up his/their willingness to learn, and help motivate his/her interest in learning [7].

The family can be a vital part of a patient’s return to health and may need to know as much as the patient [10]. If the nurse excludes the family from a teaching plan, conflicts may arise. Thus, the nurse should not assume that the family should be involved and must first assess the patient-family relationship.

For example, if the family of the patient does not understand the patient’s needs to regain independent function, their efforts may cause the patient to become unnecessarily dependent and slow the patient’s recovery. Not all patients fully recover from illness or injury.

Many must learn to cope with permanent health alterations [14]. New knowledge and skills are often necessary for patients to continue activities of daily living [3]. For example, a patient whose ability to speak is lost after surgery of the larynx must learn new ways of communicating.

In the case of serious disability, the patient’s family needs to understand and accept these changes. Thus, the nurse elaborates specific lessons to teach patients at different levels of wellness, after assessing patients’ needs and abilities.

Learning occurs when information is practical and useful to the learner [3]. Comparing the desired level of health with the actual state enables the nurse to plan effective teaching programs.

1.2 Problem Statement

In spite of mandates from the Joint Commission on Accreditation of Health care Organizations (JCAHO) and the institutional regulations that nurses offer patient and family education, constraints on time, resources, and noncompliance and shorten lengths of inpatient hospitalization affect the nurse’s ability to provide education [6].

Also, patient teaching is frequently a neglected nursing intervention and this has devastating consequences for the patient.

1.3 Justification

• Nurses provide patient and family education to help patients and their families maintain health and cope with acute and chronic health problems.
• Primary health education can promote health and prevent disease thereby facilitating a high level of wellness throughout the lifespan.
• Educating patients about their health conditions helps them to develop interest in getting information on health practices and treatment choices.
• Moreover, patient education is a nursing intervention that most often makes a difference in a patient’s quality of life.

1.4 Research Objectives

The research goal was to describe ways to incorporate teaching into routine nursing care and to describe the challenges faced during patient and family education.

The specific objectives of this research study include:

1. To identify the purposes of patient education.
2. To assess the methods used by nurses to educate patients.
3. To identify the challenges faced by nurses during patient education and suggest approaches on how to overcome these challenges.

1.5 Research Questions        

1. What is the purpose of patient education?
2. What methods do nurses use to teach patients?
3. What challenges do nurses who work in CDC (CHT), face when educating patients and their families?