Health Education
FINALS
EVOLUTION OF TEACHING ROLES OF NURSES
Mid 1800s Nursing was first
acknowledged as a unique
discipline and the
responsibility for teaching
has been recognized as an
important role of nurses as
caregivers.
Early 1990s Public health nurses in the
United States clearly
understood the significance
of the role of the nurse as
teacher in preventing
disease and in maintaining
the health of society.
1918 National League for
Nursing (NLN), observed
the importance of health
teaching as a function
within the scope of nursing
practice.
1950 NLN had identified course
content in nursing school
curricula to prepare nurses
to assume the role.
2006 NLN developed the first
Certified Nurse Educator
(CNE) exam.
2012 ICN endorsed the nurse’s
role as patient educator to
be an essential component
of nursing care delivery.
2015 ANA issued statements on
the function, standards, and
qualifications for nursing
practice, of which patient
teaching is a key element.
Remember: By teaching patients and families, nurses
can achieve the professional goal of providing cost-
effective, safe, and high-quality care.
ROLE OF NURSE AS EDUCATOR IN HEALTH
PROMOTION:
A. Facilitator of Change:
 Considered in the context of nursing interventions
that will effect change on the client.
B. Contractor:
 Stating mutual goals to be accomplished, devising an
agreed-upon plan of action, evaluating the plan, and
deriving alternatives.
 Educational contracting:
 Key to informed consent
 Learning is individualized
 Involves a trusting relationship
 Free to learn and make mistakes
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C. Organizer:
 Manipulation of materials and space, sequential
organization of content from simple to complex, and
determination of the priority of subject matter.
D. Evaluator:
 Ensuring that all teachings have been applied and
improved the health of individuals, families and
groups.
THE ROLE OF THE FAMILY IN HEALTH
EDUCATION:
 Primary motives of involving the family:
a. Decrease the stress of hospitalization
b. Reduce the costs of care
c. Increase satisfaction with care
d. Reduce hospital readmissions
e. Prepare the patient for self-care
management
 Family role enhancement and increased
knowledge on the part of the family have
positive benefits for the learners as well as the
teachers.
 The more individuals involved, the greater the
potential for misunderstanding of instruction.
 Nurse educator must explore caregiver’s:
 Learning style
 Cognitive abilities
 Fears and concerns
 Current knowledge of the situation
 What the family is to do is important, but
what the family is to expect also is essential
information to be shared during the teaching-
learning process.
FUTURE DIRECTIONS IN HEALTH EDUCATION
Fourth Industrial Revolution:
 Characterized by a fusion of technologies that are
blurring the lines between the physical, digital and
biological spheres.
I. CURRENT HEALTH AND WELLNESS TRENDS
a. Telehealth (Virtual Care, Remote Medicine)
 use of digital information and
communication technologies, such as
computers and mobile devices, to access
health care services remotely and manage
your health care (Mayo Clinic)
 Doctor appointments and check-ups need
not be face-to-face all the time. Consultations
are done online.
 Goals:
 Make health care accessible to
people who live in rural or isolated
communities.
 Make services more readily available
or convenient for people with limited
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mobility, time or transportation d. Technology has given rise to a dramatic increase
options. in educational opportunities for nurses
 Provide support for self-
management of health care. IV. STRATEGIES FOR USING TECHNOLOGY IN
b. Healthcare Consumerization HEALTHCARE EDUCATION:
 People continue to consume health and a. World Wide Web
wellness products with pride  virtual space for information
 Stores (physical & digital) carry health and  INTERNET  huge global network of
wellness products prominently computers established to allow the transfer
c. Preventive Medicine of information from one computer to another
 “An ounce of prevention is worth pounds of  Information Literacy Competencies:
cure” i. The ability to identify the
 Better avoid getting sick than paying for information they need
costly medical bills ii. The skills to access the information
 AIM: Disease Prevention they need
 The primary method used to carry out iii. Knowledge of how to evaluate the
preventive medicine is education. information they find
d. Smart Hospitals iv. The ability to use the information
 Presence of automation and artificial they deem valid
intelligence (AI) to make hospitals smarter  Importance of Information Literacy:
for both staff and patients i. Patients mostly have searched the
 those that optimize, redesign or build new web for information
clinical processes, management systems and ii. Tremendous resource for both
potentially even infrastructure, enabled by clients and professional education
underlying digitized networking iii. Provides a powerful mechanism for
infrastructure nurses to offer healthcare education
to a global audience
 Goals:
 provide a valuable service or insight b. Social Media
which was not possible or available  “Internet sites and applications that allow users to
earlier create, share, edit and interact with online content”
 achieve better patient care, c. Blog
experience and operational efficiency  “weblog”
 Three (3) areas addressed:  an online journal or informational website
i. Operations displaying information in reverse
ii. Clinical tasks chronological order
iii. Patient Centricity  a platform where a writer or a group of
e. Immune Boosting Supplements writers share their views on an individual
 People are getting all the vitamins they need subject
for optimum physical performance d. Wikis
 Over-the-counter supplements are and will  A website that allows multiple users to come
still continue to sell. together to collaboratively write and edit the
content and structure of a collection of
II. Health Education in a Technology-Based World webpages
 How has technology affected health education?  They are asynchronous
i. Linkage  Tool for professional education
ii. Healthcare applications availability  Either open or close
iii. Information accessibility e. Webcasts and Webinars

III. The Impact of Technology on the Teacher and Webinar Webcast

the Learner • Web • Live
a. Educators are becoming facilitators of learning conferenci broadcast
rather than providers of information ng s
b. Nurses must structure their approach to • Interactive • Limited
healthcare education to be consistent with the and interactio
needs of today’s patients collaborati n
c. Empowered and enlightened clients to engage in ve • Types:
their health care plan
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• Componen i. Pod  guiding principles of behavior
ts: cast  having to do with moral standards, conforming to
i. comp s the standards of conduct of a given professional
uter- ii. Vod group
based cast  Bioethics - application of ethical principles to life
displa s and death issues
y  Ethical - norms and standards of behavior by the
ii. live society to which a person belongs
discu
ssion MORAL VALUES
 internal belief system
 Guidelines for a smooth delivery of  This value system, defined as morality, is
content and good audience participation: expressed externally through a person’s behaviors.
 Allow adequate time to publicize
the event LEGAL RIGHTS and DUTIES
 Develop a lesson plan or meeting  rules governing behavior or conduct that are
agenda in advance enforceable by law under threat of punishment or
 Upload and do a test run of slides penalty, such as a fine, imprisonment, or both
or media to be used
 Make sure adequate staffing is Mandates and Directives
available for the webinar  1918 – National League of Nursing Education
 Send instructions and any (NLNE) now known as the National League for
necessary materials to Nursing (NLN), recognized the importance of
participants several days in health teaching as a responsibility of the nurse for
advance the promotion of health and prevention of illness
 Start early in different settings
 Reduce background noise
 1938 – NLNE declared that a nurse was
 Keep the conversation moving
fundamentally a teacher & an agent of health
and the agenda on track
 1950 – NLNE specified course content and
 Follow up with participants after
principles of teaching & learning as part of the
the session
curriculum; International Council of Nurses (ICN)
f. Online Class
endorsed health education as an essential
 a course conducted over the Internet requisite for the delivery of nursing care
 generally conducted through a learning  1993 – Joint Commission on Accreditation of
management system Healthcare Organizations (JCAHO) delineated
 Learning Management System (LMS)  a nursing standards or mandates for patient
software that is designed specifically to education which are based on positive outcomes
create, distribute, and manage the of patient care. The teachings must be patient and
delivery of educational content family-oriented.
 1998 – PEW Health Professions Commission
V. Issue Related to the Use of Technology recommended the importance of patient & staff
 Digital Divide education & role of nurses as educator
 gap between those individuals who have ETHICAL THEORIES:
access to information technology a. Deontological
resources and those who do not
 stresses the importance of doing one’s
 Influencing Factors:
duty and following the rules
i. Low Income Levels
 considers the intention of the action, not
ii. Low Literacy Levels
the consequences of the action
iii. Lack of Motivation to Learn
iv. Lack of Physical Access to  individuals goodwill that determines
Technology worthiness, not the outcome
v. Geographical Restrictions b. Teleological
 the greatest good for the greatest number
ETHICO-LEGAL FOUNDATIONS OF CLIENT of people
EDUCATION  right encompasses actions that have
positive outcomes, wrong is composed of
ETHICS actions that result in poor outcomes

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 what makes an action right or wrong is its rights: consequenc
usefulness  Right not e is
to be killed suspected
ETHICAL PRINCIPLES  Right not
 provide a foundation for nursing practice to have
 basis for nurse’s decisions on consideration of bodily
consequences and of universal moral principles injury or
when making clinical judgments pain
inflicted to
Principle Definition Example oneself
Autonomy  right of self- A patient  Right not
chooses to to have
determination
accept or one’s
 action should not
reject a confidence
be constrained by
recommend revealed to
others
ed others
 Basic elements: a. Negligence -
 ability to treatment
plan conduct which falls
decide below the standard
 power to act established by law
upon one’s for the protection
decision of others against
 respect for the unreasonable risk
individual of harm
autonomy of
others ELEMENTS:
Veracity  truth-telling A patient 1. Existence of duty
 no forms of asks if the 2. Failure to perform the
deception: procedure duty
 intentional will hurt, 3. Injury resulting from
lying and the failure to perform the duty
 non nurse 4. Proximate cause
disclosure truthfully
of explains any b. Malpractice –
informatio potential limited class of
n discomfort negligent activities
 partial committed within
disclosure the scope of
Confidentiali  privacy of Patient performance by
ty information medical those pursuing a
 personal records are particular
information that is secured so profession
entrusted and they can be involving highly
protected as accessed skilled and
privileged only by technical services
information via a persons who Beneficence  “Doing good” for A nurse
social contract, need to see the benefit of protects and
healthcare them. others defends the
standard or code,  Actions should rights of a
or legal covenant promote patient’s person with
Non  “Do no harm” A nurse welfare a mental
Maleficence  ethics of legal does not health
determinations administer disability
involving an ordered Justice  fairness and the Patients
negligence and/or medication equitable receive the
malpractice when a distribution of same level
 Related human potential goods and services of care,
negative regardless of
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 to treat equals race, b. Supported by climate of mutual trust and
equally religion or respect
 Each individual payer status c. Focus on essential knowledge, skills and
should receive attitude
what his due by  Models of Clinical Teaching:
right such as: a. Clinical Instructor assigned to 8-12
 Life students in a clinical area (based on
 Informatio CHED mandate)
n needed Ratio of Students to Clientele
for LEVEL 1st 2nd
decision SEMESTER SEMESTER
making 2 1:1 1:2
 Confidenti 3 1:2-3 1:3-4
ality of 4 1:5 1:6
private
informatio Prescribed Faculty-Student Ratio
n LEVEL 1st 2nd
Fidelity  being faithful to A nurse SEMESTER SEMESTER
your promise or followed 2 1:8 1:8
word through on 3 1:10-12 1:10-12
 nurse must be obtaining a 4 1:12-15 1:12-15
faithful and true to list of low-
their professional sodium b. Students are retained in the nursing skills
promises and foods for a lab until they are proficient in the skills
responsibilities by patient required by a certain nursing procedure.
providing high c. Clinical nursing course to be conducted in
quality, safe care in the classroom area (Packer)
a competent
manner  Difference between classroom teaching and
clinical teaching
CLINICAL TEACHING AND TEACHING SPECIAL Classroom Teaching Clinical Teaching
POPULATION  Large groups  Small group
 No focus on  Focus on
Clinical Teaching
patient patient
 an individualized or group teaching to the nursing
 Knowledge  Application of
student in the clinical area by the nurse educators,
 Theoretical knowledge
staff and clinical nurse manager
framework  Clinical
 vehicle that provides students with opportunity to
 Teacher- reasoning
translate basic theoretical knowledge into learning
student ratio is  Teacher-
of variety of intellectual and psychomotor skills
needed to provide patient – centered quality large student ratio is
 Passive small
nursing care (Schweer)
students  Active students
 Purposes:
a. Offers opportunity for the application of  Less interactive  More
theoretical concepts, rationales and interactive
procedures
b. Skills are perfected in the clinical area II. Teaching Special Population
c. Honing of skills of observation, problem-  Habilitation – activities and interactions that
solving and decision making enable an individual with a disability to develop
d. Organization of data students have new abilities to achieve his or her maximum
compiled, as well as the intellectual and potential
psychomotor skills they need to perform  Rehabilitation – relearning of previous skills,
e. Cultural competence which often requires an adjustment to altered
f. Skills of socialization are learned functional abilities and altered lifestyle
 Principles:
a. Should reflect the nature of professional Disability
practice
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 Complex phenomenon, reflecting an interaction  Conduct teaching sessions in a quiet
between features of a person’s body and features environment
of the society in which he or she lives (WHO)  Consider using an interpreter
 Universal human experience, focusing on the
impact of disability rather than it’s cause (ICF)
 Individual’s ability to work (SSA) Nurse Educator Should Nurse Educator Must
 A physical or mental impairment which Avoid
substantially limits one or more of the major life  Be natural  Talking and
activities of the individual (ADA)  Use short, simple walking at the
sentences same time
A. Sensory Disability  Speak at moderate  Move head
 include the spectrum of disorders that affect a pace excessively
person’s ability to use one or more of the five  Get attention before  Speaking while in
senses (auditory, visual, tactile, olfactory, and talking the other room
gustatory)  Face the patient, not  Standing directly
more than 6 feet in a bright light
A1. Hearing Impairment away  Joking and using
 People with impaired hearing—both the deaf and  Ask to eliminate slang words
the hard of hearing—have a complete loss or a environmental  Placing
reduction in their sensitivity to sounds noise intravenous line in
 Hearing loss is generally described according to  Make sure hearing the hand used for
three attributes: (1) type of hearing loss (2) degree aid is turned on sign language
of hearing loss (3) configuration of the hearing
loss. A2. Visual Impairment
 Three basic types of hearing loss:  some form and degree of visual difficulty and
a. Conductive hearing loss –usually includes a wide spectrum of deficits, ranging from
correctable and causes reduction in the partial vision loss to total blindness
ability to hear faint noises  may also include visual field limitations, such as
b. Sensorineural hearing loss – tunnel vision, alternating areas of total blindness
permanent and caused by damage to the and vision, and color blindness
cochlea or nerve pathways that transmit  Some major diseases that causes serious visual
sound; sometimes referred to as nerve impairment:
deafness; not only results in a reduction a. Macular Degeneration
in sound level but also leads to difficulty b. Cataract
in hearing certain sounds c. Glaucoma
c. Mixed hearing loss – combination of d. Diabetic Retinopathy
conductive and sensorineural losses  Strategies in Teaching Visually Impaired Clients:
 Ways of Communicating with Deaf Clients: a. Assessment
a. Sign Language – American Sign Language b. Speak directly to patient
(ASL) c. Contact low-vision specialist
b. Written Information – Most reliable and d. Rely on patients’ other senses
safest approach; Keep message simple e. Announce your presence, identifying
c. Lip Reading – process of interpreting yourself and explaining clearly
speech by observing movements of the f. Take client’s hand first if handshake is
face, mouth, and tongue appropriate
d. Sound Augmentation – use of hearing g. Describe clearly steps of a procedure
aids; cupping of hands or use of h. Use tactile learning technique –
stethoscope in reverse characteristics and placement of objects
 In lip reading: i. Enlarge the font size
 Speak normally j. Use bold colors
 Make sure clients are wearing their k. Use proper lighting
eyeglasses l. Provide large-print watches and clocks
 Provide sufficient lighting on their faces m. Make use of audiotapes and recordings
and remove all barriers from around the n. Use standard computer features (screen
face magnifiers, high contrast, screen
 Supplement teaching using other forms of resolution adjustments)
communication
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o. Access appropriate resources for rs
information (braille library)
p. Use sighted guide technique in teaching
ambulation B2. Output Learning Disability
q. Hold teaching sessions in quite, private  process of orally responding and performing
spaces physical tasks, include language and motor
disorders
B. Learning Disability
 disorder in one or more of the basic psychological Language Disability Motor Disability
processes involved in understanding or in using  struggle answering  encounter problems
language, spoken or written, that may manifest questions and with fine motor
itself in an imperfect ability to listen, think, speak, providing skills such as
read, write, spell or do mathematical calculations explanations writing, cutting, or
 Common Characteristics:  tend to have more buttoning a shirt
 learning problems and uneven patterns of difficulty  also have difficulty
development generating with gross motor
 identified in childhood and persist into responses than skills that affect
adulthood initiating running and
 neurobiologically based conversations walking
 result of a different wiring of the human
brain  Strategies for Effective Instruction on Patients
B1. Input Learning Disability with Learning Disability
 process of receiving and recording information in a. Be clear and explicit
the brain, include visual perceptual, auditory  Break your instruction into small,
perceptual, integrative processing, and memory manageable pieces.
disorders  Demonstrate or model what you
Dyslexia Auditory Dyscalculia are teaching.
Processing  Guide your learners in practicing
Disorder new learning.
 characteri  umbrella  severe  Give specific feedback.
zed by term used learnin  Allow independent practice.
slow and to describe g  Gradually remove support
inaccurate a ability (scaffolding)
word condition that b. Give intensive instruction
recognitio that impair  Give instruction on the same topic
n causes s those for a longer period (can be broken
 associated listening parts up into shorter sessions)
with difficulties of the  Allow time for teaching
reading despite brain individually or in small groups
difficulty normal or involve  Engage your learners: frequently
 deficit in near d in ask questions that elicit
“working” normal mathe interactions, physical responses,
or “short- hearing matical or reflection and thought
term acuity process c. Give extensive instruction
memory”  characteri ing –  Identify key words and ideas
zed by the inabilit  Review frequently
inability to y to  Explicitly teach vocabulary and
distinguis unders recycle frequently: a learner needs
h subtle tand to meaningfully engage with a
difference abstrac word at least twelve times to learn
s in t it
sounds concep d. Teach strategies for reading, writing
ts and learning
associa  Teach phonological awareness
ted  Teach learners how words are
with formed
numbe  Teach word attack strategies

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 Help learners to develop reading
fluency
C. Communication Disorders
 affect an individual’s ability to both send and
receive messages and can also weaken speech and
language skills, or impair the ability to hear and
understand messages
C1. Aphasia
 impairment of language, affecting the production
or comprehension of speech and the ability to read
or write
 one of the most common residual deficits of a
stroke
 Types:
a. Global aphasia – most severe form;
produce deficits in both the ability to
speak and understand language as well as
to read and write
b. Expressive aphasia – having difficulty
conveying their thoughts, speaking
haltingly, and using sentences consisting
of a few disjointed words, but they
understand what is being said to them
c. Receptive aphasia – damage to
Wernicke’s area of the temporal lobe and
affects auditory and reading
comprehension
d. Anomic aphasia – understand what is
being said to them and can speak in full
sentences, but they have difficulty finding
the right noun or verb to convey their
thought; circumlocution
 Ways of Teaching:
a. Speech therapy
b. Environmental control
 have individual’s full attention
before attempting to
communicate
 quiet, disruption-free area is
created
c. Augmentative and alternative
communication (AAC)
 Be sure you have the patient’s
attention
 Establish a consistent system for
everyone to use for patient’s
response to a yes/no questions
 Teach the patient to point to
certain objects to quickly express
common needs
 Speak slowly and use simple
sentence structure
 Avoid jumping from one topic to
topic
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 Teach patient to use exaggerated
facial expressions, hand
movements or tone of voice
 Make use of available
communication boards
 Support patients’ speech therapy
programs by having them recall
word images
 Goal: COMMUNICATION rather than perfection
C2. Dysarthria
 neuro-motor disorder caused by damage to the
nerves or muscles associated with eating and
speaking (tongue, mouth, larynx, vocal cords)
 range from mild to severe
 Speech: unintelligible, audible, natural and
efficient
 Interventions:
 Speech-language pathologist
 Prosthetic palate
 Communication techniques:
 control the communication environment
– reduce distractions
 pay attention to the patient and watch
him/her while speaking
 be honest and let the patient know when
understanding him/her is difficult
 encourage patient to speak more slowly
 convey the part of the message that is not
understandable
 ask a yes/no questions
 conduct teaching sessions when the
patient is rested
D. Physical Disabilities
 physical condition that affects a person's mobility,
physical capacity, stamina, or dexterity
D1. Traumatic Brain Injury
 Causes:
 fall
 car accident
 gunshot wound
 blow to the head
 Greater at risk:
 football players
 skiers
 cheerleaders
 involve in recreational sports
 Types:
a. Open head injury – penetrating
resulting in brain tissue exposure and
disruption of normal protective barriers
b. Close head injury – non penetrating
 Cognitive Deficits:
 poor attention span
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 slowness in thinking a. Anterograde Amnesia – have memory
 confusion until the brain injury but are unable to
 difficulty with short-term and long-term form memories in the present
memory b. Retrograde Amnesia – have memory loss
 distractibility prior to the brain injury
 sleep disorders & mental fatigue
 difficulty with organization, problem
solving, reading & writing  Teaching Strategies:
 Stages of Treatment: a. emphasize memory techniques
a. Acute care (in an intensive care unit) b. encourage patient to take notes during
b. Acute rehabilitation (in an inpatient sessions if communication is intact
brain-injury rehabilitation unit) c. minor memory problems – assist patient
c. Long-term rehabilitation after discharge to create a system of reminders
(at home or in a long-term care facility) d. use vivid pictures or have patient draw
 Learning Needs: e. teach patient to “chunk information”
 Patient Safety f. have brief, frequent repetitive sessions
 Family Coping g. involve the family or caregiver

 Guidelines for Effective Teaching of the TBI

Patients:
DO DONT
 Use simple  Stop talking or
rather than give up trying
complex to
statements communicate
 Use gestures to  Speak too fast
enhance what  Talk down to
you are saying the person
 Give step-by-  Talk to others
step directions as if the
 Allow time for patient is not
response there
 Recognize &
praise all
efforts to
communicate
 Use listening
devices
 Keep written
instructions
simple

D2. Memory Disorders

 MEMORY → complex process that allows people
to retrieve information that has been encoded and
stored in the brain

 Types of Memory:
a. Short-term  information that can be
remembered immediately
b. Long-term  information that has been
repeated and stored

 Brain injury often results in a memory disorder

referred to as amnesia

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