外文文献英文全部.docx

外文文献英文全部.docx

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外文文献英文全部

外文文献英文全部

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controlanderadication?

BarrierstoPatientEducation

Someofthebarrierstoeducationofpatientsaboutachronicdiseasemayrelatetothesettinginwhichtheconferencebetweennurseandpatientisheld,thelackofclear-cutgoalsforeducationalwork,thefailuretoextendscarce,professionaltimebygroupteaching,limitationsunderwhichtheagencymustoperate,andculturaldifferencesbetweenthepatientsandthenurse.

Conferencesetting.Sinceperson-to-personteachingandinterviewingareanessentialpartofthenurse'sprofessionalwork,arrangementsshouldbemadeforasuitableplacetotalkwithpatients.Ifteachingtakesplaceinthemidstoftelephonecallsandotherdistractions,neitherpatientnornursecanconcentrateonwhattheotherhastosay.Distractionscaninhibitorevenpreventeffectivecommunicationandteaching.

Clear-cutGoalsGoals.todefinewhatthenursehopestoaccomplishinaconference,inteview,orgroupworkareindispensable.Thegoalswillbedeterminedinthepartbythequestionsthepatientorhisfamilyasks,theinterestsheexpresses,whatheandhisfamilyalreadyknowaboutthedisease,andhowthepatientiscooperatinginhismedicaltreatment.Theobjectivesneedtoberelatedtospecificwaysofhelpingthegrouporpersontounderstandthediseaseanditstreatment,tocomprehendthenecessityforcooperationoveraconsiderableperiod,andtodiscoverwhatcommunityservicesareavailabletothepatientandhisfamily.Unlessthenursetakestimetothinkthroughtheobjectivesforeacheducationalexperience,teachingmaybeinadequateandvague,includingtoomuchmaterialatonetimeoromittingimportantaspectsaltogether;italsomaynotbekeyedtotheimmediateneedsofthepatientortohisinterests.

Groupwork.Discussioninwhichtheexperienceofmembersofthegroupiselicitedmayeffectchangesinattitudesandpractices.Wehaveoftenseenpatientsandmembersoftheirfamiliessittingsilentlyinrows,waitingpatientlytoseethephysicianornurse.Cansomeofthistimebespentmoreproductivelyingrouptalksanddiscussion?

Hasthenursetriedworkingwithsmallgroupsineducationalactivities?

Cangroupteachingbedoneinthewaitingroomsofoutpatientdepartmentsandclinics?

Isitpossibletouseeducationalaidssuchasslidesorfilmstripsatthistime?

Andmostimportant,canthenurseinvolvethepatientsandex-patientsinplanningfor,andparticipatingin,educationalactivities?

Othebarriers.Patients'lackofunderstandingandacceptanceoftheeducationalmessagemaybeduetoilliteracy,aloweducationallevel,culturaldifferences,orotherreasons.Languagedifferences,particularlyamongsomeoftheelderly，maypreventthemfromunderstandingandtherefore,fromputtingintopractice,theteachingaboutthedisease.Theremaybeagencybarriers,too,relatingtoshortageofstaff,inadequatefacilities,orinadequatebudget.

ChangingHealthPractices

Clearcommunicationandeducationalexperiencesattunedtomeetthepersonal,family,orgroupsituationcanchangepatients'attitudesand

practices.

Communication.Tothenurse,communicationisatwo-wayprocess,

aninteractioninwhichsheislistening,observing,andspeaking.Whilespeaking,shetransmitsbothinformationandfeelings;whileandobserving,listening,shereceivesbothinformationandfeelings.Aperson's

mannerofspeaking,expression,voice,gesture,andpostureallhelporhindercommunication;encourageorinhibitapermissiveattitude;promoteorrepressquestionsorcomments.Thewayanursemeetsapatientintheclinicandherwayofspeakingoverthetelephonearealsopartofhercommunication.

Whentechnicalexpressionsaredifficulttotranslateintosimplelanguageorwhenwordsseeminadequatetoexplainaprocedure,doesthenursesupplementverbalcommunicationwithademonstrationorasimplevisualaid,suchasachart,photograph,ordiagram?

Tomakesurethatthe

patientclearlyunderstands,somenursessay,"Won'tyoushowmehowyoudoit?

"orattheendofaconferenceorinterview,"Nowlet'sreviewwhatwesaid."

Thenurseinthetuberculosisfield,forexample,usuallyhasintensiveandclosecontactwithpatientsandfamiliesoverafairlylongperiod.Thisperiodprovidestimeforhertogaintheirconfidence;tolearnhowtospeaksothatsheisunderstood;andtodiscoverhowtomakeherteachingacceptableandpracticalforthepatientwithinthefamilymilieu.Shehastheopportunitytoencouragethepatienttoexpresshisfeelings,ideas,andquestions.oftenthefirststepsindevelopingrapport.Thistwo-waycommunicationgivesthenurseleadsastothepatient'sinterests,problems,andneeds.She,too,islearningaswellasteachingduringthesecontactsandespeciallyduringhomevisits,forintheseshecanobservethepatientinhisenvironmentanddiscoverh