Patient Education in Pain Management: Difference between revisions

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== Factors affecting Patient Education&nbsp;<br>  ==
== Factors affecting Patient Education&nbsp;<br>  ==


#Inadequate assessment of pain. Assessment of the patient's symptoms should be person centred and should follow the biopsychosocial approach.&nbsp;<ref name="Lovell">Lovell, M., Luckett, T. et al. "Patient Education, Coaching, and Self-Management for Cancer Pain." Journal of Clinical Oncology 2014 32(16):1712-1719</ref>&nbsp;In order to effectively assess pain and begin managing and educating patients, it is essential for clinicians to relinquish some of their "authority" and empower the patient to become engaged and proactive.<ref>Lovell, M., Luckett, T. "Patient Education, Coaching, and Self-Management for Cancer Pain." Journal of Clinical Oncology 2014 32(16):1712-1719</ref><br>  
#Inadequate assessment of pain. Assessment of the patient's symptoms should be person centred and should follow the biopsychosocial approach.&nbsp;<ref name="Lovell">Lovell, M., Luckett, T. et al. "Patient Education, Coaching, and Self-Management for Cancer Pain." Journal of Clinical Oncology 2014 32(16):1712-1719</ref>&nbsp;In order to effectively assess pain and begin managing and educating patients, it is essential for clinicians to relinquish some of their "authority" and empower the patient to become engaged and proactive.<br>  
#Inadequate understanding of how patient perceives his/her pain.&nbsp;<span style="line-height: 19.9200000762939px;">Understanding what a patient believes about the causes or consequences of pain will allow the clinician to better inform the patient and correct any misinformation. However clinicians must approach these conversations with respect in order to earn the patient's trust.<ref name="Lovell" />&nbsp;</span>Examples of perceptions of pain common among cancer patients include: a fear of addiction to medications, concerns about side effects, discussing pain will distract the doctor from curing the disease, pain is an indication of the progress of the disease.&nbsp;<ref>Ward, S., Goldberg N., et al. "Patient-related barriers to Management of cancer Pain." Pain 1993 52:319-24</ref>&nbsp;<br>  
#Inadequate understanding of how patient perceives his/her pain.&nbsp;<span style="line-height: 19.9200000762939px;">Understanding what a patient believes about the causes or consequences of pain will allow the clinician to better inform the patient and correct any misinformation. However clinicians must approach these conversations with respect in order to earn the patient's trust.<ref name="Lovell" />&nbsp;</span>Examples of perceptions of pain common among cancer patients include: a fear of addiction to medications, concerns about side effects, discussing pain will distract the doctor from curing the disease, pain is an indication of the progress of the disease.&nbsp;<ref>Ward, S., Goldberg N., et al. "Patient-related barriers to Management of cancer Pain." Pain 1993 52:319-24</ref>&nbsp;<br>  
#Variations/ differences in the information received. { For example, a patient with knee pain is confused whether to do or avoid activities like cycling and walking due to the differences in the information provided even among health care providers}. Education and pain management will be less successful if information varies among clinicians, and if the care pathway is disjointed with poor communication among team members.<ref name="lovell" />&nbsp;<span style="line-height: 19.9200000762939px;">There is no clear consensus on the ideal mode, personnel, intensity, or content of delivery.&nbsp;</span>Content of patient education should address aspects of the condition that the patient may have little knowledge about. Some of these aspects will include: decreased understanding of the various therapies, poor understanding of the disease and the &nbsp;consequences of poor compliance, poor understanding of clinic visits, and poor understanding of medication dosage/regimens.<ref>Jin, J., Sklar, G.,et al. "Factors affecting therapeutic compliance: A review from the patient's perspective." Therapeutics and Clinical Risk Management 2008 4(1):269-286</ref>&nbsp;  
#Variations/ differences in the information received. { For example, a patient with knee pain is confused whether to do or avoid activities like cycling and walking due to the differences in the information provided even among health care providers}. Education and pain management will be less successful if information varies among clinicians, and if the care pathway is disjointed with poor communication among team members.&nbsp;<span style="line-height: 19.9200000762939px;">There is no clear consensus on the ideal mode, personnel, intensity, or content of delivery.&nbsp;</span>Content of patient education should address aspects of the condition that the patient may have little knowledge about. Some of these aspects will include: decreased understanding of the various therapies, poor understanding of the disease and the &nbsp;consequences of poor compliance, poor understanding of clinic visits, and poor understanding of medication dosage/regimens.<ref>Jin, J., Sklar, G.,et al. "Factors affecting therapeutic compliance: A review from the patient's perspective." Therapeutics and Clinical Risk Management 2008 4(1):269-286</ref>&nbsp;  
#Life style  
#Life style  
#Cultural barriers. The format and content of patient education material should be appropriate and culturally sensitive for the target audience; with consideration for language, beliefs, experiences and values.<ref>Wilson, F., Racine, E., Tekieli, V., William, B. "Literacy, readability and cultural barriers: critical factors to consider when educating older African Americans about anticoagulation therapy." Journal of Clinical Nursing 2003 12(2):275-282</ref> Factors such as literacy, age group, and socio-economic status will impact on how well patients will learn from the materials provided. If patients do not understand the information provided then they will nto be able to self-care effectively.&nbsp;
#Cultural barriers. The format and content of patient education material should be appropriate and culturally sensitive for the target audience; with consideration for language, beliefs, experiences and values.<ref>Wilson, F., Racine, E., Tekieli, V., William, B. "Literacy, readability and cultural barriers: critical factors to consider when educating older African Americans about anticoagulation therapy." Journal of Clinical Nursing 2003 12(2):275-282</ref> Factors such as literacy, age group, and socio-economic status will impact on how well patients will learn from the materials provided. If patients do not understand the information provided then they will nto be able to self-care effectively.&nbsp;

Revision as of 21:37, 30 September 2014

Welcome to PPA Pain Project. This page is being developed by participants of a project to populate the Pain section of Physiopedia.  The project is supervised and co-ordinated by the The Physiotherapy Pain Association.
  • Please do not edit unless you are involved in this project, but please come back in the near future to check out new information!!  
  • If you would like to get involved in this project and earn accreditation for your contributions, please get in touch!

Tips for writing this page:

  • The content of this page is already developing. PLease check it, to ensure you are happy it is informed by current best evidence. Are there any gaps in the content or opinions/persetocves you feel should be included? 

Introduction[edit | edit source]

To make it simple, the term patient education means "educating the patient " about his health condition. Even though the patient education has been viewed and practised as a preventive strategy majorly, it includes all the information about the disease/disorder/condition the patient is concerned with. Education is a vital part of any physiotherapy rehabilitation; a process which

 "requires the acquisition of new knowledge and skills. This requires the ability to concentrate, undertsand and process information. The information must also be retained, retrieved, integrated and used in a meaningful way." [1]
Factors which will affect patient education include physiological, psychological, sociocultural and environmental. In Pain Management, the patient has to understand exactly what's happening to him/her in order to tackle the pain. Pain is recognised as the psycho-somatic entity which necessitates the need for better/thorough understanding from the patient's perspective. Unless the patient is convinced with the information provided, the results may not be so good.
  • For example, many patients believe that degeneration is a disease and needs to be cured. The primary goal of patient education should be to make the patient understand that degeneration is not a disease but a normal aging process and has to be treated with that view. 

Need[2][edit | edit source]

Cost containment studies show that educating patients results in significant savings. Educated patients maintain better health and have fewer complications; as a result, they require fewer hospitalizations, emergency department visits, and clinic and physician visits. As the growth of health care continues to outpace inflation in many countries around the world, health policy makers have increasingly focused their attention on cost containment. Managed care has a major focus on reducing the supply of services. There is increasing attention to lowering health care costs through primary prevention efforts.

 

Factors affecting Patient Education 
[edit | edit source]

  1. Inadequate assessment of pain. Assessment of the patient's symptoms should be person centred and should follow the biopsychosocial approach. [3] In order to effectively assess pain and begin managing and educating patients, it is essential for clinicians to relinquish some of their "authority" and empower the patient to become engaged and proactive.
  2. Inadequate understanding of how patient perceives his/her pain. Understanding what a patient believes about the causes or consequences of pain will allow the clinician to better inform the patient and correct any misinformation. However clinicians must approach these conversations with respect in order to earn the patient's trust.[3] Examples of perceptions of pain common among cancer patients include: a fear of addiction to medications, concerns about side effects, discussing pain will distract the doctor from curing the disease, pain is an indication of the progress of the disease. [4] 
  3. Variations/ differences in the information received. { For example, a patient with knee pain is confused whether to do or avoid activities like cycling and walking due to the differences in the information provided even among health care providers}. Education and pain management will be less successful if information varies among clinicians, and if the care pathway is disjointed with poor communication among team members. There is no clear consensus on the ideal mode, personnel, intensity, or content of delivery. Content of patient education should address aspects of the condition that the patient may have little knowledge about. Some of these aspects will include: decreased understanding of the various therapies, poor understanding of the disease and the  consequences of poor compliance, poor understanding of clinic visits, and poor understanding of medication dosage/regimens.[5] 
  4. Life style
  5. Cultural barriers. The format and content of patient education material should be appropriate and culturally sensitive for the target audience; with consideration for language, beliefs, experiences and values.[6] Factors such as literacy, age group, and socio-economic status will impact on how well patients will learn from the materials provided. If patients do not understand the information provided then they will nto be able to self-care effectively. 

Requirement [edit | edit source]

 The following are important in patient education for pain management[7]:
  1. Recognise the impact of, and evidence for, the use of therapeutic neuroscience education and self-management as a critical part of pain management.
  2. Design and apply appropriate educational strategies based on educational science.
  3. Identify the range of educational opportunities available across therapeutic domains (eg, injury, disease, medical and post surgical intervention) with consideration of age, culture and gender.
  4. Consider the scope and evidence for/against various contemporary therapeutic educational styles (e.g. biomedical, psychological, neuroscience) and models (e.g stages of change theory) and service delivery modes including face to face, web-based, group education.
  5. Identify key variables which may impact on knowledge outcomes for the patient (eg self efficacy, health literacy, co-morbidities, culture), the clinician (eg health professional's pain-related beliefs), the message (e.g. use of multimedia), and the context (e.g. insurance limitations; risk reduction; injury prevention)

Boon Or Bane[edit | edit source]

It is to be emphsized that sometimes the patient education may prove otherwise. The role of health-care providers is changing quickly, from making decisions for the patients to providing assistance to them in making informed decisions.
Patients are becoming increasingly educated about health related issues, thanks to the World Wide Web. There are patients patients who do not hesitate to argue over complex medical issues without having much knowledge about the same. [8]


Beware[edit | edit source]

Patients who have in-depth knowledge of their condition encounter problems when their expertise is seen as inappropriate in standard healthcare interactions, and expertise taught to patients in one branch of medicine can be considered non-compliant by those who are not specialists in that field.Although patient education can give people confidence in their own self-management skills, it cannot solve the power imbalance that remains when a generalist healthcare professional, however well meaning, blocks access to medication and supplies needed to manage chronic diseases successfully. There is a role for those involved in primary and hospital care, including those supporting and training healthcare professionals, to recognise these problems and find ways to acknowledge and respect chronic patients’ biomedical and practical expertise. [9]


Recent Related Research (from Pubmed)[edit | edit source]


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References[edit | edit source]

  1. Hamnell, K.Spinal Cord Injury Rehabilitation.London: Chapman & Hall, 1995.
  2. http://www.euromedinfo.eu/the-growing-need-for-patient-teaching.html/
  3. 3.0 3.1 Lovell, M., Luckett, T. et al. "Patient Education, Coaching, and Self-Management for Cancer Pain." Journal of Clinical Oncology 2014 32(16):1712-1719
  4. Ward, S., Goldberg N., et al. "Patient-related barriers to Management of cancer Pain." Pain 1993 52:319-24
  5. Jin, J., Sklar, G.,et al. "Factors affecting therapeutic compliance: A review from the patient's perspective." Therapeutics and Clinical Risk Management 2008 4(1):269-286
  6. Wilson, F., Racine, E., Tekieli, V., William, B. "Literacy, readability and cultural barriers: critical factors to consider when educating older African Americans about anticoagulation therapy." Journal of Clinical Nursing 2003 12(2):275-282
  7. IASP Curriculum Outline on Pain for Physical Therapy. Task Force Members: Helen Slater, Kathleen Sluka, Anne Söderlund, Paul J. Watson
  8. Chandrashekhar A. Sohoni;Patient Education: Boon or Bane?;J Family Med Prim Care. 2013 Apr-Jun; 2(2): 209–210.
  9. Rosamund Snow,Charlotte Humphrey,Jane Sandall :What happens when patients know more than their doctors? Experiences of health interactions after diabetes patient education: a qualitative patient-led study: J. BMJ Open 2013;3:e003583. doi:10.1136/bmjopen-2013-003583