Health Educ Report

8/3/2019 Health Educ Report

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CHAPTER 6:The

Determinantsof Learning


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The Criteria For PrioritizingLearning Needs

MANDATORY learning needs that must beimmediately met since they are life threateningor are needed for survival

DESIRABLE learning needs that must be metto promote well-being and are not life-dependent

POSSIBLEnice to know learning needswhich are not directly related to daily activities


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C. METHODS INASSESSING LEARNINGNEEDS


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A. Informal Conversations Or Interview Asking open-ended questions wherethe learner may reveal informationregarding their perceived learning

needsB. Structured Interviews Nurse asks the patient somepredetermined questions to gatherinformation regarding patient needs


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C. Written Pretests Comparing pre-test with the post-testscoresD. Observation Of Health BehaviorsOver A Period Of Different Times Determine established patterns ofbehavior


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To be able to transfer onesskills, knowledge, values,and attitudes to the learneris a teachers ultimategauge of success.

HOW???


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Primarily by providing, arranging ormanipulating experiences andsituations in the environment so thatthe learner can have a betterunderstanding, acquisition and

application of the learning experiencefor intelligent and productive living.


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REMEMBER:Teaching will always be anintegral part of the nursingprofession.


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Factors that will influenceor determine if thelearning process will be asuccess or a failure:


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Assessing the needs will allow the nurse todesign her teaching plan according to whatthe client already knows, what he/she stillneeds to know, and to determine theapproach, strategy, methods and device tobe used. Plan, introduce or even manipulate some

factors in the learning environment or thelearners milieu so that the learnerspotentials are fully maximized andharnessed

.


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READINESS TO LEARNIs the time when the patientis willing to learn or itsreceptive to information.


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When assessing readiness to learn, thehealth educator must:1. Determine what needs to be taught.2. Find out exactly when the learner is ready tolearn.3. Discover what the patient wants to learn.4. Identify what is required of the learner:

- what needs to be learned.- what the learning objectives should be.- find out in which domain of learning and atwhat level the lesson will be taught.


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FOUR TYPES OF READINESS TO LEARN (PEEK)(LICHTENTHAL, 1990)P = Physical readinessE = Emotional readinessE = Experiential readinessK = Knowledge readiness


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Physical Readinessa. Measures abilityb. Complexity of taskc. Environmental effectsd. Health status


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Emotional Readinessa. Anxiety levelb. Moderate level of anxietyc. Support systemd. Nurses who provide emotional support to thepatient and family members go through what istermed as reachable momentse. Motivationf. Risk-takingg. Frame of mindh. Developmental stage


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Experiential Readinessa. Levels of aspirationb. Past coping mechanismc. Cultural backgroundd. Locus controle. Orientation


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Knowledge Readiness Present knowledge base- stock knowledge or howmuch one already knows about the subjectmatter from previous actual or vicarious

learning Cognitive ability- involves lower level of learningwhich includes memorizing, recalling or

recognizing concepts and ideas and the extent towhich this information is processed indicates thelevel at which the learner is capable of learning


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NOTE: The teacher must recognize thatcognitive impairment due to mental

retardation requires specialtechniques & strategies of teachingand the cooperation of the familymust be enlisted especially in theself-care activities of the client.


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Learning disabilities and low-level reading skills will needspecial approaches to teaching toprevent discouragement and

bolster readiness to learn.


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III. LEARNING STYLES LEARNING STYLE is a characteristic ofthe cognitive, affective, and

physiological behaviours that serve asrelatively stable indicators of howlearners perceive, interact with, andrespond to the learning environment.


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LEARNING STYLE also represents bothinherited characteristics andenvironmental influences. As a result of our hereditaryequipment, most people developlearning styles that emphasize somelearning abilities over others.


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Motivation And Behavior Of theLearnerOTIVATION:

comes Latin word movere which means tomove or to set into motion. It is also define as a psychological force thatmoves a person to some kind of action It is the willingness of the learner to embrace

learning, with readiness as evidence ofmotivation Has been conceptualized in terms of moving

forward to reach ones goals or meet a need.


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Hierarchy of Needs- Maslow used this principleas it affects or influences the potency or degreeor a persons motivation.

Motivation is related to learning behavior orlearning and behavior. It is the force that drivesthe learner to learn or to comply or apply theknowledge resulting to a change in behavior.

motivation is significantly related to measuresto the compliance with a medical regimen.


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Behavior Change TheoriesHealth behavior frameworks orprinciples can be used to facilitate

motivation or promote compliance to ahealth regimen or program. They canhelp the nurse educator to maintaindesired behavior or promote behaviorchange.


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Learning Assessment Of ClientsA. Literacy and Readability Literacy- is defined as the ability of adults to read,understand and interpret informationwritten at the eighth grade level or above- the relative ability of persons to use printedand written material commonlyencountered in daily life


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Health Literacy- which refers to how well an individualcan read, interpret and comprehendhealth information for maintaining ahigh level of wellness.-One who is literate is an educatedperson or one who is able to read andwrite


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B. Three factors to consider in assessing levelof literacy1. Reading or word recognition -the process oftransforming letters into words and being able topronounce them correctly.2. Readability - the ease with which written orprinted information can be read.3. Comprehension - the degree to whichindividuals understand what they have read.


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C. Clues Manifested By Patients With LowLiteracy1. Not even attempting to read printedmaterials.2. Asking to take PEMs (Printed educationalMaterials) to discuss with significant others.3. Claiming that eyeglasses were left at home.4. Stating that they cant read somethingbecause they are too tired or dont feel well.5. Avoiding discussion of written material ornot asking any questions about it.6. Mouthing words as they try to read.


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D. Two test which is most often used tomeasure patient literacya. REALM (Rapid Estimate of Adult Literacy inMedicine)

- requires patients to pronounce commonmedical and anatomical words.- It contains 66 words arranged three columnsin ascending order of number of syllabus andincreasing difficulty.


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REALM (Rapid Estimate of AdultLiteracy in Medicine)


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b. WRAT (Wide Range Achievement Test)- the patient is asked to read aloud from a list of42 words of increasing difficulty.- the examiner asks the patient to pronounceeach word and checks off each word that ispronounced incorrectly.- When 10 consecutive words are

mispronounced, the test is stopped.


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Teaching strategies forlow literate patient(Bastable, 2003)


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1. Establish a trusting relationship beforebeginning the teaching learning process

It is very important for the nurse tocommunicate her belief and trust in thepatient ability to undertake self careactivities that could be effectively done by:

Focusing on the strength. Specifying what needs to be learned.


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2. Use the smallest amount of informationpossible by teaching only what the patientneeds to learn

Priorities behavioral objectives : oneor two concepts per section.

Limit the teaching session no morethan 20 to 30 minutes.


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3. Make points of informationas vivid and as explicit aspossible, Explain information in simpleterms.


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4. Teach one step at the time By teaching in increments(starting fromthe simplest and gradually increasing inThe level of difficulty) By organizing Information in to chunks toallow patient Understand Each item firstbefore proceeding to the next To allow the nurse to evaluate progressand give positive reinforcement


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5. Use multiple Teaching methods andtools requiring fewer literacy skills

aside from the repetition of concepts andinformation, simple list, video tapeswitch the patient can take home andrefer from time to time,

6. allow the patient to restate informationin their own words and to demonstrateany procedure that is being thought,


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7. Keep motivation high encouragement to keep ontry,8. Build in coordination with procedure by using theprinciple of Tailoring- coordinating patient regiment to their

daily schedule Cuing - using props and remainders to get aperson to perform a routine task9. Repetition to reinforce information repetition,in the form of saying the same thing in differentways is one of the most powerful tools to helppatient understand their problem and learn self

care.


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A. Organizational FACTORS First sentence is the topic sentence Address no more than 3 or 4 main points Consider using Q and A format Try to use brief headings & subheadings Only one idea per paragraph Reinforce main points with summary hort but descriptive title


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B. Linguistic Factors1. Keep the reading level at grade 5-6 level2. Use 1-2 syllable words and short sentences3. Use personal & conversational style.4. Define technical terms if they must be used.5. Used words consistently throughout the text6. Avoid the use of idioms.7. Use graphics & language that are culturally

accepted8. Use active rather than passive voice.9. Incorporate examples & simple analogies toillustrate concepts.


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C. Appearance Factors1. Avoid a cluttered appearance by includingenough white space2. Include simple diagrams or graphics3. Use upper & lower case letters4. Use 10-14 point type in a plain font.5. Underlined or bold important words6. Use lists when appropriate7. Limit line length for not more than 50-60

characters.


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