Patient counselling and health education最新文献

A controlled study of education-support groups for patients with rheumatoid arthritis showed that participation increased patients' knowledge about their disease (P < 0.05) and improved some patients' perceptions of the adequacy of their families' attitudes and behavior. The groups had little effect on the patients' ability to cope with arthritis or on their compliance with prescribed treatment. Some participants felt threatened by the thought of meeting another patient with more severe rheumatoid arthritis than their own. This finding suggests that group leaders should facilitate open discussion of such emotional concerns, eg, fear and depression, that admixtures may generate.

Some recent developments related to individual health counselling and education are presented. Developments in theories of compliance are described. Leventhal's model of self-regulation has some features that warrant further examination for both research and practice. Developments in behavioral diagnosis or educational assessments indicate that without such an analysis, health-care providers are more likely to use “shotgun” approaches rather than individually tailored approaches to health counselling and education. Health counselling strategies are also described. The art of counselling is becoming more of a science, and applications in the health field are accelerating rapidly, thus creating a need among health-care providers to become more knowledgeable about health-decision counselling methods.

These developments suggest that greater importance needs to be given to the individual in health counselling and education and that the support for doing so can be found in some of the current developments in theory, research, and practice and in the techniques themselves. The movement toward greater concern for individual differences and for greater emphasis on cognitive psychological theory has been supported by developments in assessment techniques and in instructional technology. Although the social health model of care, with its emphasis on prevention, health promotion, and self-care and with its community action orientations, will cointinue to be of interest, there will continue to be a need for new approaches that will work within the framework of the existing health-care system. Individual health counselling and education is one of those important opportunities

The development of health-education services in Israel's Kupat Holim Health Insurance Institution is recounted. It was recognized at the outset, in 1964, that the primary target for attitude and behavioral change should be the system itself and its professional staff. Today health education has achieved formal integration into the services and is recognized as an organic part of the delivery of health care.

This study addresses the issue of individualized instruction, viewing preferences for instructional approaches as an instance of aptitude-treatment interaction. In such interaction, diabetic patients' needs were held to affect their preference for either a structured or unstructured approach to instruction for self-management. Forty-six adult diabetic patients completed the Personality Research Form E and ranked four types of instructional approaches as portrayed in descriptive statements. Need levels of patients preferring structured and unstructured instruction were compared by means of t tests. Results indicated that one of the four composite-need scales, the need for control, significantly (P = 0.003) differentiated structured and unstructured groups. Congruence between certain needs and preferred instructional approaches was thus demonstrated.

A review of the literature on patient education disclosed a high degree of consistency regarding the necessary components of a patient-education program. These components fall into three broad categories: design, implementation, and evaluation. Using these components as criteria for effective patient education, a survey of hospitals was undertaken to determine how closely these criteria are adhered to. Of 200 hospitals sent the questionnaire, 120 responded. Results show that patient educators adhere to the design and implementation components with high to moderate frequency but do little with respect to the evaluation components.