外文文献英文全部Word格式.docx
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外文文献英文全部Word格式.docx
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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
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