Relevant academic literature has been reviewed to identify major themes and important findings in the area of patient education among heart disease patients. Many studies have been dedicated to the issue, and it is generally acknowledged that patient education efforts made by health care providers can be effective in improving health outcomes, reducing the rates of mortality and re-admission, and helping patients manage their self-care (either in the course of treatment or during the recovery period) more successfully. The presentation of literature review results will explain the importance of patient education, identify barriers to providing it, and address the concept of health literacy.
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Importance of Patient Education
The way to demonstrate the importance of patient education is to turn to indicators of its effects on the achievement of positive health outcomes. For example, such rates as mortality, hospital re-admission, or the average length of recovery periods can be measured among patients who received education concerning their health problems and compared to the same rates among patients who did not receive such education. Scholars have resorted to this approach in many studies; for example, McNaughton et al. (2015) showed that the risk of death was higher for those patients who do not receive proper health education.
Similarly, Díaz-Toro, Verdejo, and Castro (2015) showed that the lack of knowledge on self-care (which can be caused by the failure of health care providers to educate a patient) is a factor that increases hospitalization and mortality. Moreover, the authors mentioned the community perspective, from which patient education is the activity that can be conducted on a higher level than the individual. By engaging patients’ families in the process of treatment and recovery and educating whole communities through health campaigns and programs, health care providers can help many people address or prevent serious health problems, including heart disease.
Patient Education Barriers
Although it is recognized that patient education is beneficial, there are several barriers to providing it properly identified in the relevant literature. First of all, there is the matter of retention; the fact that education is delivered does not necessarily mean it is retained by the patients. Giuse, Koonce, Storrow, Kusnoor, and Ye (2012) emphasize that there are different forms of patient education, e.g. oral, written, illustrated (or supplemented with other visual components, such as video), and interactive. The authors argue that no form would be universally beneficial in terms of retention because different patients may perceive some forms of information better than other forms based on those patients’ learning characteristics. Therefore, educators should incorporate different teaching strategies into their education plans to appeal to different types of patients. However, the proposed research will strive for identifying a method that is more appealing to larger numbers of patients—whether it is conducting instructional speaking sessions or distributing written materials; therefore, the proposed study will contribute to the body of evidence that helps educators choose teaching strategies.
Another barrier is that patient education may be ineffective unless it is supplemented with incentives for patients to commit to learning and behaving according to what they learn about their health. McNaughton et al. state that “[p]atient education alone has generally not been enough to improve [heart failure chronic self-care and patient-centered] outcomes” (p. 5). To achieve this improvement, health care providers should not only deliver knowledge to patients but also motivate them to apply it correctly. A strategy proposed by Nouri and Rudd (2015) suggests the method of “interactive communication loop” (p. 568) that implies a high degree of patient engagement in the learning process. It was confirmed to increase the patients’ willingness to commit to practical advice they receive from patient education. Another thing that can be added to patient education to increase its effectiveness is family engagement. Nouri and Rudd (2015) described a study in which the speech of educators was compared to that of patients’ family members present at the sessions. One of the results was that patients were more likely to comprehend educational materials if they were assisted by family members.
As a result of reviewing academic literature, it has been revealed that many studies of patient education among heart disease patients pay particular attention to the concept of health literacy. Literacy means the ability to read and write and refers not as much to knowledge as to the ability to gain knowledge; similarly, health literacy does not refer to possessing a substantial body of knowledge about medicine but to the ability to find, check, and apply health information (Giuse et al., 2012). This skill has been recognized as crucial because, even if large amounts of comprehensive health-related information is provided to patients, a significant portion of their knowledge about their health problems will come from sources different from education under clinical conditions. These sources may include the Internet, television, books, and magazines, or advice from their friends and acquaintances. Therefore, a patient must know how to verify health-related information and how to apply it.
Health literacy is exactly the concept that describes this ability of patients, and teaching health literacy should be included in patient education programs. Díaz-Toro et al. (2015) confirmed that health illiterate patients were less capable of managing their self-care successfully than health literate ones. Several methods of measuring health literacy in the learners are proposed, but the general idea behind them is that educators should provide not only educational materials related to diseases and treatments but also instructions on how to read (watch, listen to) those materials because patients may find the language used in the instructional process difficult. Also, the materials themselves should be simple because their target audience may contain health illiterate people, and the portion of such people, according to McNaughton et al. (2015), may exceed 20 percent (depending on the measurement criteria). Therefore, in the proposed study, both spoken and written materials should contain health literacy information; without it, a study of the effects of patient education may be inaccurate.
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Patient education is important because its effective provision positively affects patients by reducing the risk of death and enabling better self-care practices. Two major barriers to providing patient education effectively are low retention of information and the insufficiency of patient education alone. The former can be overcome by diversifying teaching strategies; the latter can be overcome by making the instructional process more interactive, engaging families in patient education, and using other instruments to motivate patients to use the knowledge they receive. Finally, it was identified that the measurement of the effectiveness of patient education should consider the concept of health literacy, and educational materials should contain not only information related to health but also guidelines on how to process health-related information in general.
Díaz-Toro, F., Verdejo, H. E., & Castro, P. F. (2015). Socioeconomic inequalities in heart failure. Heart Failure Clinics, 11(4), 507-513.
Giuse, N. B., Koonce, T. Y., Storrow, A. B., Kusnoor, S. V., & Ye, F. (2012). Using health literacy and learning style preferences to optimize the delivery of health information. Journal of Health Communication, 17(3), 122-140.
McNaughton, C. D., Cawthon, C., Kripalani, S., Liu, D., Storrow, A. B., & Roumie, C. L. (2015). Health literacy and mortality: A cohort study of patients hospitalized for acute heart failure. Journal of the American Heart Association, 4(5), 1-9.
Nouri, S. S., & Rudd, R. E. (2015). Health literacy in the “oral exchange”: An important element of patient-provider communication. Patient Education and Counseling, 98(5), 565-571.