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Overview:
Traditionally, client education has been done in a behavioral, rote, routine way. Content has been chosen based on a client’s specific diagnosis, or some other distinguishing feature. Education of any kind, including client education, should attend to the whole person and “....recognize that learning is subjective, contextual, dialogic and values-driven,” (Watson, 1988, p.1). Client education is shifting from a “received knowledge” paradigm to a facilitative partnership between the nurse and the client. Nurses are becoming enablers, helping clients to practice self care and autonomy. Enabling includes coaching, informing and explaining, helping the client to generate alternatives, guiding them to think issues through and validating the client’s reality. The first step in phenomenological client education is to “be with” clients, engaging in dialogue, exploring the personal meaning of the client’s experiences and situatedness. Clients are viewed as beings for whom things have significance and value because of being situated, (Leonard, 1989). Given the same experience or situation, different interests and concerns will stand out for different people depending on their situatedness (Hartrick & Lindsey, 1995). Clients are also constituted, are interpretive beings, who are always engaged in, and constituted by their interpretative understandings of their experiences. People’s backgrounds influence how they approach an experience and how they make meaning of it, including a learning experience. To facilitate an understanding of each client’s personal health education needs, nurses engage in dialogue to illuminate and reflect on patterns and themes within the client’s experience. Once they are identified, clients are assisted to imagine possibilities. From these realizations, unique learning needs can be identified. Nursing knowledge of health and healing strategies is used to cultivate deeper levels of understanding and personal meaning. Phenomenological nursing illuminates the everyday taken for granted health patterns and discovers new patterns and ways of being to promote health and healing in ways congruent to the client’s preferred learning styles and strategies.
Ends In View
This learning activity gives the learner the opportunity to:
2. Create a unique learning tool to facilitate a selected client’s learning.
In Preparation:
1. Engage in phenomenological nursing inquiry to explore a specific client’s situatedness, constitutedness, personal meaning, patterns and themes and imagined possibilities related to their health experience.
2. Dialogue with your client to co-discover their perceived health education needs. Outline the themes to be addressed in the learning tool you will design.
3. View the following online examples of common patient education materials:
a) Bladder Infections at: http://lib-sh.lsumc.edu/fammed/pted/uti.html
b) Chickenpox at:
http://www.health.state.ny.us/nysdoh/consumer/chickenp.htm
c) Women's Health Interactive at http://www.womens-health.com/index.phtml
d) Web-Based Surgical Simulators and Medical Education Tools at:
http://synaptic.mvc.mcc.ac.uk/simulators.html
e) Best Health Guide Patient Reference from PraxisMD at: http://www.praxis.md/bhg
f) Helping Children Cope with the Intensive Care Unit
at: http://www.vh.org/Patients/IHB/Peds/Psych/ICU/CoverPage.html
4. Reflect on the patient education materials viewed in #3.
5. Visit the “Patient Education: An Author’s Guide” for guidance on creating effective patient education materials. Topics include: Readability (SMOG formula); Clear writing; Literacy
facts; Pre-testing, and more. In Practice:
1. Using a computer system, create a learning tool for your specific client, incorporating the health education needs perceived in your preparation.
Possible approaches include:
a) Use a wordprocessing or desktop publishing program to create a pamphlet, handout, booklet.
b) Use a multimedia program to create a mixed text and images document.
c) Create a series of storyboards to sketch out the process of designing a Computer Assisted Instruction (CAI) learning experience for your client.
Be Creative! Remember to target your client’s preferred learning methods. In Reflection: 1. How can a nurse engage in phenomenological client education within the busy existing health care system?2. How could computer technology be used in health care settings to facilitate unique learning experiences for clients? 3. As you work with CAI and IVD programs to augment your own learning (available in the Learning Resource Center) evaluate the scope of these programs. Would they be useful for client education? References:
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