● What are some strategies that can be used to help educate Mr. Lopez? Discussion : A Spanish interpreter with formalized communications and education to help Mr. Lopez learn best is needed. Individual education will be valuable for Mr. Lopez, with visual aids and writ- ten information in Spanish for his visual and tactile learning style. He has tested as having low health literacy. Teach-back will be es- sential for Mr. Lopez, using brief and focused education sessions in small segments. His daughter should be included when she is at the facility. Return demonstrations can also be done. Frequent reinforcement may be needed for Mr. Lopez, and there are many potential barriers to learning ● What important content should be covered with Mr. Lopez? Discussion : Mr. Lopez has multiple diagnoses, complications, and medications. The immediate focus is on his safety and broken hip. Too much information will not be helpful and can be overwhelm- ing. Important information for Mr. Lopez is related to ensuring he gets help when moving, such as getting out of bed and ambulat- ing. He also needs continued reinforcement of physical rehabilita- tion to help him regain his independence. Education about the long-term care setting is also important. Teaching is done with Mr. Lopez and his daughter using a Spanish interpreter. Teach-back questions are “Tell me what you will do if you have to get up and use the bathroom,” “How often can you have your pain medication?” and “Show me how you use your walker.” Mr. Lopez says, “I will call for help when I have to go the bathroom” and “I can have my pain medication every time the nurse brings it in.” He can show proper use of his walker when ambulating. Mr. Lopez also states, “I can’t wait to get better so that I can go back home next week.” ● What teaching moments are there for Mr. Lopez? Discussion : The statement “I will call for help” needs to be clari- fied. Does Mr. Lopez mean use the call bell for help, or is he refer - ring to something else, such as using the phone or yelling? His pain medication also needs to be explained again, so he knows that he can use the call bell and ask for pain medication when he needs it, every four hours. Another teaching moment is related to the anticipated length of stay at the facility. It is anticipated that Mr. Lopez will have at least a three-month stay, but he made a statement about going home next week.
home until he has stayed at the facility for at least three months. His daughter arrived at the facility shortly after Mr. Lopez did. ● What are some strategies that will promote building rapport and successful communication? What are some initial considerations when going in to meet Mr. Lopez? Discussion : Mr. Lopez should be welcomed to the facility and asked how he would like to be addressed. Inquiring about his language preference for communication and learning is essential. There may be concerns about his ability to hear in addition to the effects of aging and his dementia. It is also important that Mr. Lo- pez has his hearing aids in while awake. The environment should be as quiet as possible, with effective lighting. Sitting with him at eye level, speaking clearly, and talking at a slower pace show re- spect and can also assist with communication. Being empathetic, courteous, and responsive is important. Active listening and pay- ing attention to body language, including that of Mr. Lopez, are vital for communication. Plain language, open-ended questions, and dialogue are important. Participation should be encouraged to the extent that he wishes, including the involvement of his daughter. There is stress and anxiety associated with transitioning to a new environment. Moving to a long-term care facility may also cause feelings of grief, dependency, helplessness, and hopeless- ness. The independence that Mr. Lopez may have had has now changed. There are safety concerns related to his falls and de- mentia. Pain from his hip fracture is another consideration that can affect his communication and learning. Questions are needed to find out about his cultural needs. Assessments of health literacy and learning style should also be done. Mr. Lopez can speak English, but it is his second language. He prefers to communicate and learns best in Spanish. He moved from Mexico to the U.S. when he was in his teens and is Catholic. He is a retired laborer, and his highest education was high school and completion of a trade school. His health literacy is tested with the Short Assessment of Health Literacy tool, Spanish version, and he scored a 7. His learning style is a combination of visual and tactile. Mr. Lopez says he would like his daughter included in any teaching. He says it’s important to him to regularly attend church services and keep his Bible, crucifix, and rosary near him.
Conclusion The case studies covered in this chapter included questions and discussions related to applying the information and strategies re-
viewed within this course. There are many factors that must be considered in each unique patient situation.
EDUCATING PATIENTS: CREATING TEACHING MOMENTS IN PRACTICE Self-Assessment Answers and Rationales
CHAPTER 1 1. The correct answer is D. Rationale: The correct answer is d. Need for supervision is not a component of the description of a professional. 2. The correct answer is C. Rationale: Education must be individualized to the patient, although there may be standard content. 3. The correct answer is B. Rationale: Patient education should be done systematically, starting with assessment. 4. The correct answer is D. Rationale: Patients older than age 65 reported they had good instructions at discharge, and yet 40% did not understand the purpose of their hospitalization, and 54% did not recall follow- up instructions (Alper et al., 2022).
5. The correct answer is A. Rationale: Research shows that effective patient education can improve patient outcomes and reduce readmission rates. CHAPTER 2 1. The correct answer is A. Rationale: The definition is that of personal health literacy, 2. The correct answer is C. Rationale: Although there is a relationship between literacy, numeracy, and health literacy, it is vital that healthcare professionals do not assume that a person who is well educated has a high level of health literacy. 3. The correct answer is D. Rationale: Considerations for emotional readiness are motivation, stress and anxiety, developmental level, social support, frame of mind, and risk-taking behaviors.
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