Collaborative Self Management

and Patient Education

Presented by- Athulya.P.Vijayan, 23001
1st year M.Sc Respiratory Therapy
Moderator- Ms. Riya Ashokan
Contents
01 INTRODUCTION

02 SELF MANAGEMENT EDUCATION

03 DEVELOPING AN INDIVIDUALISED EDUCATION

PROGRAM

04 EDUCATIONAL CONTENT

05 SUMMARY
01 Introduction
• Teaching adults about health has been identified as an important part of healthcare.

• Inclusion of education in an essential component

of a comprehensive Pulmonary Rehabilitation.

• A specialized, individualized program can be

designed with a base of educational needs of
patients.
● The American Thoracic Society/European Respiratory
Society statement:
“Patient education remains a core component of
comprehensive pulmonary rehabilitation, despite the
difficulties in measuring it’s direct contribution to overall
outcomes.”

● Traditional method was either one-on-one or a group

lecture setting and the contents mostly disease specific
than patient specific
 Self management
02 education
• Traditional patient education comprises of a one-on-one or group lecture
setting ;
• Mostly disease specific than patient specific.
• The education process that is currently recommended to utilize is
Collaborative Self Care Management.
• Changes a patient’s behaviour by teaching individualized problem solving
skills.

Models are an important teaching tool in rehabilitation programs.

Models allow patients a close-up view of the systems and organs
discussed during rehabilitation.
• ‘Learning by doing’ to:
1. Increase knowledge
2. Enhance self confidence
3. Increase self efficacy
• Patients become active partners in the
management of their Chronic Lung Disease.
• Patients gain the ability to:
 Assess their proress
 Set Goals
 Problem solving
 Developing an
03 individualised educational
program
An education program must consider patient needs, concerns, diagnosis, disease
severity, and comorbidities.

Characteristics to include in self-management education:

• Encourage active rather than passive learner participation.
• Use repetition liberally.
• Use variety of presentation styles.
• Supply written material for reinforcement and for sharing.
• Take advantage of teachable moments
04 Educational Content
The content of self-management education
should enhance the patient’s ability to:
• Engage in activities that promote health and
prevent adverse sequelae.
• Effectively interact with health care
providers.
• Adhere to treatment protocols.
• Self-monitor physical and mental status and
make appropriate management decisions.
01 NORMAL PULMONARY ANATOMY AND
• PHYSIOLOGY
Foundation on which an understanding of respiratory illness can be.

• Use of demonstration models and other teaching aids.

02 PATHOPHYSIOLOGY OF CHRONIC LUNG

DISEASE
• Explaining the diagnosis and it’s relation to the pathophysiology of the disease.

• Better understanding of the condition adheres the patient to the therapeutic interventions.
03 DESCRIPTION AND INTERPRETATION OF MEDICAL
• Explanations on test results shouldTESTS
be provided.

• Helps the patient to stick to the treatment plan.

04 BREATHING STRATEGIES

• Patients will adopt to strategies once they start seeing changes or improvements.

• Reinforcement and additional education and training may be necessary to ensure that
patients are correctly using their equipment and are adherent to their physician’s
instructions.
a. Pursed lip breathing
b. Active expiration

● The sense of being in control of breathing

when utilizing pursed-lip and active expiration
increases the patient’s self-efficacy.
 05 SECRETION CLEARANCE

• Instruction should begin with coughing, and progress to more complex techniques if clinically
indicated.

• Emphasis on the use of inhaled bronchodilators before secretion clearance,

followed with inhaled steroids and inhaled antibiotics, if prescribed.

• The combination of postural drainage, percussion, and forced expiration

improved airway clearance in patients with COPD and bronchiectasis.

• The goal to maintain secretion clearance, without the need for

hospitalization, is important in self-management and enhancing self-efficacy

• Patients should understand the importance of maintaining a list of all medications and of
telling all their health care providers what medications they are taking.

• Medication instruction should include return demonstrations of proper inhaler technique.

06 RESPIRATORY DEVICES

• Reinforcement and additional education and training to

ensure that patients are correctly using their equipment and
are adherent to their physician’s instructions.
● Ask the patient to bring in all the “gadgets” they have collected from various health
care interactions.
● Instruction should include appropriateness of use, indications, contraindications, and
proper cleaning of each device.

07 BENEFITS OF EXERCISE AND MAINTAINING

PHYSICAL ACTIVITIES

• Teach the importance of adherence to individualized exercise

programs and participation in ADL.
• An exercise log or diary may be useful for patients to self-record their
home exercise and physical activity.
08 ACTIVITIES OF DAILY LIVING

• Apply breathing strategies to ADLs and using energy conservation and work
simplification techniques so patients find they have the self-confidence and breathing
capacity to participate in many activities.

09 EARLY RECOGNITION AND TREATMENT OF

EXACERBATIONS
• Open communication and collaboration in the early stages.

• Strategies that teach patients to recognize an impending exacerbation and promptly

initiate treatment may reduce severity and complications as well as decrease
hospitalizations.
● Eg: The use of an action plan
improves collaborative self-
management.
Action plans can simply instruct
the patient to contact his health care
provider when symptoms increase,
as in
or
if the patient has mastered a higher
level of self-management, action
plans can be personalized with
specific medication and dosage
recommendations.
14 END-OF-LIFE PLANNING

• Palliative care is an example of collaborative self-management, in which the goal is to

relieve suffering and improve quality of life.

• Importance of making patients understand palliative care and hospice more.

• Dispelling these notions by initiating discussions on these topics in pulmonary

rehabilitation is appropriate and encouraged.

• Providing the opportunity to discuss options for end-of-life care leads to an increase in
adoption of advance directives (durable power of attorney for health care, living will, and
prehospital medical directive).
11 IRRITANY AVOIDANCE

• Patients must learn to avoid all environmental and occupational irritants, especially first-
and secondhand cigarette smoke.

• Current and ex-smokers benefit from receiving information on becoming and remaining
nonsmokers.

12 LEISURE ACTIVITIES

• Information on the availability and use of supplemental oxygen when traveling is

readily available on the Internet.
• The inclusion of a discussion on sexuality.
13 COPING WITH CHRONIC LUNG DISEASE
• Two of the most common comorbidities of COPD are depression and anxiety.

• Pulmonary rehabilitation provides the opportunity to assess and intervene.

• Pulmonary rehabilitation is an excellent setting for group discussions on panic control,

where patients can appreciate that they are not alone in their fears.

• Relaxation techniques and stress management strategies should be introduced.

• As with breathing strategies, if the patients find relaxation techniques or stress

management effective, they will adopt their use.
05 Summar
y
Summary
• Collaborative self-management education is an essential component of comprehensive
pulmonary rehabilitation.
• It is important so that patients gain the ability to assess their progress and problems,
set goals, and problem solve.
• Educational sessions are an opportunity to facilitate the discussion of end-of-life
decision making
• Self-management education promotes learning by doing and taking advantage of
teachable moments.
• The recommended content should be patient-specific.
References
• Pulmonary Rehabilitation Guidelines to Success: John E. Hodgkin,
Bartyolome R. Celli. Gerilynn L. Connors

• Guidelines for pulmonary rehabilitation: AACVPR

 Thanks!
Any questions?

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