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9/12/2012 Health TeachingNursing Fundamentals Focus XIII • Three major purposes of health teaching Health Teaching Module – Promoting health – Prevention of illness – Coping with illness and disability Objectives Health Teaching• List 3 major purposes of health teaching and • Promoting Health give examples of each. – Increasing level of wellness• Explain the 3 steps of assessment required to define the client’s learning need. Identify the – Growth and development topics major tasks involved in each step. – Fertility control• Describe 3 different types of learning. Give – Hygiene examples of tasks with each type of learning. – Nutrition• Discuss the factors to be considered for planning the effective “teaching–learning situation” – Exercise – Stress management – Lifestyle modification – Resources within the community Health Teaching Health Teaching• An integral part of the nursing professional • Prevention of illness/injury role – Health screening – Important independent nursing function – Reducing health risk factors – Right of all clients – Specific protective health measures • A Patient’s Bill of Rights – 1992 – First aid – State nurse practice acts – Safety • A function of nursing • Legal and professional responsibility – JCAHO • evidence that patients and family have been taught and understand 1
9/12/2012 Health Teaching Basic right of every patient• Coping with illness and disability • Assessment of the Patient’s Learning – Adaptations in lifestyle Needs – Problem-solving skills – Primary Health Problem – Adaptation to changing health status – Health Beliefs – Strategies to deal with current problems • Medications, home treatments, diet, activity – Cultural Factors limitations – Learning Style – Strategies to deal with future problems – Support System • Pain, cancer, surgery, treatments – Referrals to other agencies or services – Facilitation of a strong self image – Grief and bereavement Basic right of every patient Basic right of every patient • General Data CollectionHow is health education legally mandated in nursingpractice? – Age• Evidence that patients and significant others understand • Developmental considerations what has been taught • Slower psychomotor skills• Evaluate literacy, educational background • Slower recall• Language skills, cultural considerations – Primary Health Problems• Reducing health risk facotrs • Knowledge deficit? Misinformation?• Increase level of wellness • No longer manage ADL?• Specific protective health measures – Health Beliefs • How does client see general health? • Preventive measures for maintaining health? • What changes would client be willing to make? Basic right of every patientThe acquisition of knowledge, behavior or skill-through experience, practice, study, instruction thus • Cultural Factorschanging behavior – Language – Other health practitioners – Herbs or homeopathic medicationsThis is ______________. – Conflict in care? • Learning style – Age and developmental level – Level of education – Like to read? – How do you learn best? • Support system – Who is there to help you 2
9/12/2012 Barriers to Learning Types of Learning Types of Learning • Illness • Cognitivism • Pain – Learning is a complex cognitive activity • Prognosis – Information is structured and processed • Biorhythms – Perceptions are highly personal • Emotion (anxiety, denial, depression, fear) – Social, emotional and physical context to learning • Language – Relies on developmental and personal • Age readiness • Culture • Disabilities The Teaching process vs. the Nursing process Types of Learning Teaching Process Nursing Process • Bloom’s domains of learning1. Collect data, analyze 1. Collect data: analyze – Cognitive – Thinking learning strengths/deficits strengths and deficits – Affective – Feeling2. Make educational 2. Make nursing diagnosis – Psychomotor – Skills diagnoses 3. Plan nursing goals /3. Prepare teaching plan outcomes – Learning outcomes – Select Interventions – Prepare content/time 4. Implement nursing – Select teaching strategies strategies4. Implement teaching plan 5. Evaluate outcomes5. Evaluate client learning based on goal criteria Learning objectives Types of Learning• What is the function of the client teaching plan? – Activities intended to produce learning • Cognitive Domain – Dynamic interaction between teacher and learner – Thinking domain • Exchange of information, emotions, perceptions, attitudes • Knowing, comprehending, applying, analysis, – Take the patient from dependence to independence synthesis and evaluation – Assess previous experiences as resources for learning • Affective Domain – Goal to meet a need in the life situation – Feeling domain – Present useful, timely material to meet a need • Specifies degree of person’s depth of emotional response to tasks• What are the elements of an objective? • Feelings, emotions, interest, attitudes, appreciations 3
9/12/2012 Types of Learning Factors facilitate learning• Psychomotor domain – Skill domain Name 2 factors that facilitate the learning process • Motor skills – injections, dressing changes, medication 1.• Include all domains in teaching plan 2. – Teaching to give insulin • Skill • Why Insulin is needed • What to do when not feeling well • Accept chronic nature of disease/health promotion Principles for Effective Assessment of need Teaching and Learning• Conditions for Effective Learning What are the steps needed to define learning needs?• Conditions for Effective Teaching• (Part of group project to explore these areas) Cognitive: Mental Skills (Knowledge) Health teaching Blooms taxonomy: Classified cognitive behaviors in an ordered hierarchy• What are the factors that effect client teaching? Knowledge: Recall data or information. Example: tell normal lab value from memory• How? to a patient. Comprehension: Understand the meaning, translation, interpolation, and interpretation of instructions and problems. State a problem in ones own words. Application: Use a concept in a new situation or unprompted use of an abstraction. Applies what was learned in the classroom into novel situations in the work place. Analysis: Separates material or concepts into component parts so that its organizational structure may be understood. Distinguishes between facts and inferences. Synthesis: Builds a structure or pattern from diverse elements. Put parts together toPage 503-504-Berman form a whole, with emphasis on creating a new meaning or structure. Evaluation: Make judgments about the value of ideas or materials. Formulate examples of each learning behavior! Page 277-278 4
9/12/2012 Affective (Attitude) Receiving Module questions Awareness, willingness to hear, selected attention. Example: Listen for and remember the name of newly introduced people. • What are the purposes of learning objectives? Responding: Active participation on the part of the learners. Attends and • Which of the learning domain(s) would be necessary reacts to a particular phenomenon. Learning outcomes may emphasize compliance in responding, willingness to respond, or satisfaction in responding to teach a client to learn to give themselves a Valuing: The worth or value a person attaches to a particular object, heparin injection? phenomenon, or behavior. This ranges from simple acceptance to the more complex state of commitment. Valuing is based on the internalization of a set of specified values, • What methods can be utilized to evaluate clients while clues to these values are expressed in the learner overt behavior and are often identifiable. learning? What is the primary focus of evaluation? Organizing: Organizes values into priorities by contrasting different values, • What are the Nsg Dx(s) related to client education? resolving conflicts between them, and creating an unique value system. The emphasis is on comparing, relating, and synthesizing values. • What does complex overt psychomotor learning Characterizing: Has a value system that controls their behavior. The behavior is mean? How can it be achieved? pervasive, consistent, predictable, and most importantly, characteristic of the learner. Instructional objectives are concerned with the students general patterns of adjustment (personal, social, emotional). . Psychomotor Module questionsPerception: Has a value system that controls their behavior. The behavior ispervasive, consistent, predictable, and most importantly, characteristic of thelearner. Instructional objectives are concerned with the students general patterns ofadjustment (personal, social, emotional). Example: detects non communication cues • Name 3 education related nursing diagnosis?Set: Readiness to act. It includes mental, physical, and emotional setsGuided response: The early stages in learning a complex skill that includes imitationand trial and error. Adequacy of performance is achieved by practicing. • Complimenting a client immediately afterMechanism: This is the intermediate stage in learning a complex skill. demonstrating something learned isComplex overt response: The skillful performance of motor acts that involve inappropriate! True or Falsecomplex movement patterns.Adaptation: Skills are well developed and the individual can modify movementpatterns to fit special requirements • Role playing is a demeaning learning activityOrigination:problem. Creating new movement patterns to fit a particular situation or specific for the patient and should not be used in theFormulate examples of each learning behavior! Page 278 teaching plan. True or False Across a life span Bibliography Harkreader H.& Hogan.M. (2007) The Fundamentals of Nursing Caring and Clinical Judgment (3rd ed.) St. Louis MO:Saunders Andrews M. & Boyle J. (2003) Transcultural Concepts In Nursing Care (4th ed.) Philadelphia PN: Lippincott Williams&Compare and contrast learning needs of age groups and suggested teaching WilkinsStrategies Satterly, F. (2004) Where Have The Nurses Gone? Impact of The Nursing Shortage on American Healthcare. Amherst NY: Prometheus Books Bloom B. S. (1956). Taxonomy of Educational Objectives, Handbook I: The Cognitive Domain. New York: David McKay Co Inc. Krathwohl, D. R., Bloom, B. S., & Bertram, B. M. (1973). Taxonomy of Educational Objectives, the Classification of Educational Goals. Handbook II: Affective Domain. New York: David McKay Co., Inc. 5