Chapter 10 - Health Education

the end of a teaching plan includes ..?

resources for people to use for continuing education, counseling, peer support, and health services

Health education encourages ..?

self-care, self-empowerment, and ultimately less dependence on the health care system

refers to an individual's belief in being personally capable of performing the behavior required to influence one's own health

self-efficacy

Lifestyle changes are what type of prevention?

should not be viewed as only primary prevention (all of them i guess)

Define health literacy.

"health literacy is about communicating health information clearly and understand- ing it correctly." Health literacy includes the ability to read, write, speak, listen, compute, and comprehend, and to apply those skills to health situations.

When nurses begin to teach groups of people, they automatically enter a program ..?

planning and administrative process

people-centered care is an essential part of ____?

quality and safety

Nurses usually function as ____ for individuals in their care

health care coordinators

"any combination of learning experiences designed to help individuals and communities improve their health, by increasing their knowledge or influencing their attitudes"

health education

What are some examples fo public health interventions to reduce health disparities in the US?

include Vaccines for Children; Many Men, Many Voices, for black men who have sex with men; Healthy Love, to reduce the risk of HIV infection in heterosexual black women; and an initiative to reduce motor vehicle accidents in four Native American nations

Name the Domain of learning and if it is measurable or not (correct or incorrect) Dan will correctly select low-fat foods from the options provided.

Cognitive - measurable- correct because the verb used allows the learning to be observed

what is social marketing?

-Social marketing is defined as "a process that uses marketing principles and techniques to influence priority audience behaviors that will benefit society as well as the individual. The process relies on creating, communicating, delivering, and exchanging offerings that have value for individuals, clients, partners, and society at large" -The primary objective of social marketing is to change behavior. Social marketing provides a strategy for reaching members of the group and implementing a service that will satisfy these members as consumers. -Social marketing strategies could be used in designing programs for health promotion (tobacco use, obesity), injury prevention (seat belt wearing, gun storage), and environmental protection (pesticides, water conservation)

Describe the Transtheoretical Model of Change ("stages of change model") and how a nurse uses it

-is useful for determining where a person is in relation to making a behavior change -5 Stages: 1. Precontemplation- not intending to make changes 2. Contemplation- considering a change 3. Planning or preparation- making small or sporadic changes 4. Action - actively engaged in behavioral change) 5. Maintenance- sustaining the change over time - The TTM is useful in determining the person's readiness for learning in relation to changing a behavior so that health educa- tion or behavior change interventions can be matched to the stage. Self-efficacy is a key construct in this model. This model also acknowledges the importance of continuing intervention to maintaining behavior change long term.

Demonstration and practice is used in learning how?

performing exercises

What are the steps in the teaching-learning process?

1. Assessment -involves determining the characteristics of the learner and identifying learning needs 2. Development of expected learning outcomes 3. Development of teaching plan 4. Implementation of the teaching plan 5. Evaluation of expected outcomes

What are the 3 domains of learning? Describe each.

1. Cognitive-refers to the development of new facts or concepts, and building on or applying knowledge to new situations. 2. Psychomotor- involves developing physical skills from simple to complex actions. 3. Affective - alludes to the recognition of values, religious and spiritual beliefs, family interaction patterns and relationships, and personal attitudes that affect decisions and problem-solving progress.

According to the 2003 National Assessment of Health Literacy study what percentage of US adults had proficient health literacy?

12%

A nurse is developing health education content for an educational session with adults about the prevention of cardiovascular disease. Which of the following domains should be considered when developing the teaching plan? (select all that apply) a. Cognitive b. Psychomotor c. Gross motor d. Affective

ANS: A, B, D

A nurse is developing an educational session for adolescents related to avoidance of risky behaviors. Which of the following steps of the teaching-learning process will need to be considered? (select all that apply) a. Assessment b. Diagnosis c. Development d. Implementation

ANS: A, C, D

A nurse is providing a group presentation about the importance of healthy eating. Which of the following activities must be addressed to ensure an adequate learning climate? (select all that apply) a. Creating a sense of preparedness and organization b. Planning for alternative learning activities c. Assessing group needs d. Observing group interactions

ANS: A, C, D Several activities need to be addressed in group presentations. They include creating a sense of preparedness and organization; anticipating group needs; assessing group needs; maintaining a high level of motivation and a sense of individualized attention and progression; and observing group interactions.

role modeling, discussion, role playing, stimulation gaming Expresses positive feeling, attitudes, values toward changing the behavio

Affective (feeling)

Name the Domain of learning and if it is measurable or not (correct or incorrect) Dan will verbalize the importance of weight loss.

Affective - measurable - correct because the verb used allows the learning to be observed

Name the Domain of learning and if it is measurable or not (correct or incorrect) Dan will demonstrate the importance of weight loss.

Affective - not measurable - incorrect because the verb does not indicate observable learning

why does the family play an important role in health and illness?

Because the family is the unit within which health values, health habits, and health risk perceptions are developed, organized, and per- formed, individual's health, understanding, and intervening with the family is essential to promoting health and reducing health risks in individuals and communities

Name the Domain of learning and if it is measurable or not (correct or incorrect) Dan will understand the correct food choices for following a low-fat diet.

Cognitive Not measurable - incorrect because the verb does not indicate observable learning.

lecture, one-to-one instructions, discussion, discovery, audiovisual or printed materials, computer-assisted instruction Describes and/or explains information relevant to the behavior change

Cognitive (thinking)

Examples of cognitive learning

Discussion involves interaction between the nurse educator and the individuals. The nurse pre- pares questions in advance to guide the discussion. This method allows an opportunity for the nurse to gain a better perception of the individuals' understanding of the topic and to clarify the information

How does discussion as a teaching strategy work?

Discussion involves interaction between the nurse educator and the individuals. The nurse pre- pares questions in advance to guide the discussion. This method allows an opportunity for the nurse to gain a better perception of the individuals' understanding of the topic and to clarify the information

Describe the process of health education

First, health education involves the use of teaching-learning strategies. Second, learners maintain voluntary control over the decision to make changes in their actions. Third, health education focuses on behavior changes that have been found to improve health status.

Name the Domain of learning and if it is measurable or not (correct or incorrect) Dan will demonstrate correct measurement of a one-serving portion.

Psychomotor - measurable - correct because the verb used allows the learning to be observed

What are health disparities? what groups are affected?

Health disparities are systematic, potentially avoidable health differences that adversely affect socially disadvantaged groups. The groups affected are those with characteristics such as race/ethnicity, skin color, religion, language, or nationality; socioeconomic resources or position; sex, sexual orientation, or gender identity; age; physical, mental, or emotional disability or illness; geography; political or other affiliation; or other characteristics that have been linked histori- cally to discrimination or marginalization

How are Health education and health counseling mutually supportive?

Health educators often use one-to-one and group counseling techniques as strategies for active health learning. Counselors may refer people to health-education resources or assist them in acquiring information pertinent to solving a health problem.

How does lecture as a teaching strategy work?

Lecture provides a way to present a large amount of information to a number of people in a nonthreatening way. This can be an effective method if active learning strategies such as questioning are integrated

How does fostering empowerment help with health education?

People who believe that they can make a difference in health and who are involved in decision-making are more likely to make changes

What is the difference between one-to-one interventions and group intervention?

Planning to teach one person is different from planning to teach a group. One-to-one interventions tend to follow a counseling or problem-solving approach. Group interventions can range from guided discussions on concerns that evolve from the group to a more structured learning experience involving presentations, skill practice, and attitude-awareness exercises.

demonstration, practice, mental imaging demonstrates performance of skills related to the behavior change

Psychomotor (acting)

Name the Domain of learning and if it is measurable or not (correct or incorrect) Dan will know how to determine a serving.

Psychomotor - not measurable - incorrect because the verb does not indicate observable learning

Describe the Social Cognitive Theory and how a nurse uses it.

Social cognitive theory is another model that adds to the understanding of the determinants of health behavior. Social cognitive theory also describes the roles of reinforcement and observational learning in explaining health behavior change.

The following health scenario is an example of what ..? Sada Thompson, a 21-year-old university senior, visits uni- versity health services because she wants to change her method of birth control. She has experienced side effects from the birth control pill that she has been taking for the past year and knows little about other options. She has recently started dating John after breaking up with Steven 3 months ago. Having decided to be sexually active with John, Sada is feeling uncertain about what she needs to do to take care of herself and how to discuss this uncertainty with John. She is aware of all the talk about AIDS on campus, and she knows that John is popular and has dated several other women in school, which concerns her. Sada needs to learn new information, she may need to acquire new skills, and she needs to clarify any feelings or attitudes that affect her decision to use a new birth control method and ensure her continued safety. After recording her health assessment history and arranging for a gynecological examination and laboratory tests, the nurse develops a teaching plan. Selecting one or more strategies for helping Sada review all the birth control options, the nurse establishes an environment in which Sada can choose to try a new method or request a change in her prescription for oral contraceptives. Together they identify actions that Sada can take to use the method properly. They also anticipate and identify ways that Sada can solve problems of adjusting to the new method. The nurse answers Sada's immediate questions about safe sex, gives her several pamphlets written for college students about this topic, and suggests that she participate in the peer counseling night on sexually transmitted diseases that will be held on campus in 2 weeks. The peer counseling hotline number and drop-in hours are given to Sada. The nurse explains that the students who provide the peer counseling are trained to help other students talk about and deal with this important issue. The nurse invites Sada to call or come back to the office for additional help, information, and problem-solving discussion.

The following scenario is an example of a therapeutic situation in which a health-education approach may be used to meet an individual's health needs. This example illustrates that educational interventions, in addition to direct health services, are necessary to meet the individual's goal

Describe the Health Belief Model and how it helps nurses.

The health belief model is a paradigm used to predict and explain health behavior. The following components of the health belief model provide guidelines for nurses to analyze factors that contribute to a person's perceived state of health or risk of disease and to the individual's probability of making an appropriate plan of action: -individual perceptions of susceptibility to a health condition or disease -perceived seriousness of the disease; • perceived benefits of health action -perceived barriers to the health action; -cues that promote action (feelings or media responses) -perceived ability to perform the action

How does the process of generating a teaching plan help a nurse?

The process of generating a teaching plan helps the nurse recognize and use methods of learning that involve the individual as an active participant.

How can nurses provide a welcoming environment for the lesbian, gay, bisexual, and transgender community?

This involves, but is not limited to, using inclusive language (such as "partner" rather than "spouse" and "relationship status" instead of "marital status"), not making assumptions, and respecting each person's sexual self-identity

The Healthy People 2020 vision for health education includes..?

a commitment to providing early health literacy and prevention education beginning with preschool, then continuing throughout the K-12 education continuum and beyond.

A nurse distributes a demographic questionnaire to attendees of a weight management program. Which step in the teaching-learning process is being implemented? a. Assessment b. Development c. Implementation d. Evaluation

a. Assessment The assessment step in the teaching-learning process is comprised of assessing the students characteristics and needs. Obtaining demographic data from the attendees will help the nurse determine the characteristics of the students.

Which of the following illustrates that the objectives of health education and counseling have been met? a. Asthmatic who has a decrease in emergency department visits b. Asthmatic who has been prescribed an albuterol inhaler c. Asthmatic who attends an asthma education program d. Asthmatic who visits the emergency department with an exacerbation

a. Asthmatic who has a decrease in emergency department visits Health education encourages positive, informed changes in lifestyle behaviors that prevent acute and chronic disease, decrease disability, and enhance wellness. Two main objectives of health education and counseling are to change health behaviors and to improve health status. An asthmatic with a decrease in emergency department visits is an improvement in health status, which is a reflection of behavior changes used to prevent acute exacerbations of a chronic disease.

A nurse would like to assist Americans in improving their health. Which strategy would be most beneficial to improve the health of the American public? a. Encourage Americans to stop smoking. b. Lobby for state-of-the-art magnetic resonance imaging machines in all hospitals. c. Provide free medications for Americans. d. Offer free condoms to teenagers.

a. Encourage Americans to stop smoking. The greatest opportunity to improve the health of the American people lies in addressing unhealthy, personal, behavioral risk factors. Intensive lifestyle changes can be effective not only in preventing chronic diseases, but also in reversing their progression and significantly reducing health care costs. Improvement of the publics health is more likely to come from behavior change than technology. Therefore, people deciding they are going to change their behavior and stop smoking are likely to lead to improvements in the health of the public.

The goal for the educational session is to have the individual explain when he should check his blood sugar level. Which of the following teaching strategies would be most effective for the nurse to implement? a. Provide the individual with one-on-one education about blood sugar monitoring. b. Provide the individual with a scenario about blood sugar monitoring. c. Provide the individual with the opportunity to practice blood sugar monitoring. d. Provide the individual with a blood sugar monitor.

a. Provide the individual with one-on-one education about blood sugar monitoring. Teaching is directed toward one or more of the three learning domains. The goal of having the individual explain when to monitor blood sugar levels relates to the cognitive domain, and it is best achieved by using strategies such as lecture, one-on-one education, and discussion. This allows the educator to provide the individual with a large amount of information at one time.

Which of the following emphasizes that an individuals belief in being personally capable of performing the behavior is required to influence ones own health? a. Social cognitive theory b. Self-efficacy theory c. Health belief model d. Transtheoretical model

a. Social cognitive theory

A nurse is providing health education about the importance of dental health to Latino residents in a community. Which of the following considerations should be made to promote health literacy within this program? a. Speak slowly and distinctly. b. Refer the client to an interpreter. c. Use photographs whenever possible. d. Consider methods to facilitate empowerment.

a. Speak slowly and distinctly. Strategies to promote health literacy include creating a shame-free environment (speaking slowly and distinctly), using clear and purposeful communication (being specific and concrete), communicating in a patient-centered manner (assess what is already known), and reinforcing the spoken word (using a variety of methods: photographs, audio, and drawings).

A nurse is counseling a teenager who smokes one pack of cigarettes a day. The teenager states he likes to smoke with his friends and does not recognize the connection between his smoking and his asthma. When planning an intervention for this person, the nurse must first recognize that the teenager is in the: a. precontemplation stage of change. b. preparation stage of change. c. action stage of change. d. maintenance stage of change.

a. precontemplation stage of change

A nurse plans to use lectures, handouts, and a video to teach a group of teenagers the importance of safe sex practices. Which step in the teaching-learning process is the nurse demonstrating? a. Assessment b. Development c. Implementation d. Evaluation

b. Development

A nurse is counseling a person who has recently started to receive treatment for alcohol abuse. Which factor would most negatively influence the persons decision to stop abusing alcohol? a. He is a Catholic. b. His wife recently died from breast cancer. c. Buying alcohol is expensive. d. He was educated on the dangers of excessive drinking.

b. His wife recently died from breast cancer.

A teenager, who lives at home with her parents and school-aged brother, has been diagnosed with anorexia nervosa. Which of the following would be the most appropriate teaching goal for this family? a. Increased energy level b. Improved coping c. Enhanced self-esteem d. Facilitated family conversation

b. Improved coping The family plays an important role in health and illness. Understanding and intervening with the family is essential to promoting health and reducing risk. Health teaching includes all family members although the general teaching goal is the same for all, approaches and specific goals for each member will be different. An illness in one member of the family can alter the entire familys ability to cope. As a result, improved coping is the most appropriate goal.

The goal is for the individual to verbalize the importance of checking blood sugar levels. Which of the following strategies would be best for the nurse to implement to achieve this goal? a. Provide one-on-one education about blood sugar monitoring. b. Provide the individual with a scenario about blood sugar monitoring. c. Provide the individual with the opportunity to practice blood sugar monitoring. d. Provide the individual with a blood sugar monitor.

b. Provide the individual with a scenario about blood sugar monitoring. Teaching is directed toward one or more of the three learning domains. The goals of having the individual verbalized the importance of checking blood sugar levels relates to the affective domain. Teaching strategies for this domain include role modeling and role playing. Such strategies allow the individual to formulate appropriate responses, attitudes, and feelings.

A nurse is using a health education component when teaching about smoking cessation. Which of the following actions is the nurse implementing? a. Setting a quit date for people in a smoking cessation class b. Providing education regarding the benefits of smoking cessation c. Allowing smokers to participate in a smoking cessation program only if they use the patch nicotine replacement system d. Encouraging attendees of a smoking cessation program to participate in a research study

b. Providing education regarding the benefits of smoking cessation

A nurse is educating a group of adults who are attempting smoking cessation. Which intervention would be most effective for the nurse to implement? a. Give the group members a handout on the dangers of smoking. b. Set a quit date with the group and determine which pharmacological method is most suitable for group members. c. Provide a months supply of nicotine replacement to use before the next visit. d. Have a guest speaker who has been diagnosed with lung cancer speak to the group.

b. Set a quit date with the group and determine which pharmacological method is most suitable for group members. Educators can increase a persons motivation and capabilities to change by involving the person in the planning and goal setting. By picking a quit date and developing an action plan with the person, the educator is positively influencing the persons motivation level. Education alone is not enough to influence change.

A nurse is developing learning objectives for an individual who has been placed on a low-fat, low-cholesterol diet. Which is an example of an appropriately written cognitive learning objective? a. The individual will understand the importance of a low-fat, low-cholesterol diet. b. The individual will correctly identify and purchase low-fat, low-cholesterol foods. c. The individual will believe that his heart will benefit from a low-fat, low-cholesterol diet. d. The individual will feel healthier if he follows a low-fat, low-cholesterol diet.

b. The individual will correctly identify and purchase low-fat, low-cholesterol foods. Cognitive learning refers to the development of new facts or concepts and builds on or applies knowledge to new situations. Objectives of this domain must incorporate action verbs that indicate observable learning. Identifying and purchasing low-fat, low-cholesterol foods demonstrates that the individual has learned which foods are low in fat and cholesterol.

A nurse is providing education about safe driving with a group of newly licensed teenagers. Which factor would most likely influence a teenagers decision to drive within the speed limit? a. A speed limit sign b. Having his parents telling him not to speed c. A previous traffic violation for speeding d. Seeing someone get pulled over for speeding

c. A previous traffic violation for speeding

An overweight woman is in the preparation stage of change. Which of the following interventions would be the most appropriate for the nurse to implement? a. Inform her of the health risks associated with being overweight. b. Prepare her for the setbacks. c. Develop a low-calorie/low-fat diet with her so she can follow it at home. d. Praise her for her recent successes.

c. Develop a low-calorie/low-fat diet with her so she can follow it at home.

Which of the following illustrates that the objectives of health education and counseling are being met? a. Diabetic who attends a diabetes education program b. Diabetic who watches a video about self-administration of insulin c. Diabetic who starts taking his medications regularly d. Diabetic who is admitted in diabetic ketoacidosis

c. Diabetic who starts taking his medications regularly Health education encourages positive, informed changes in lifestyle behaviors that prevent acute and chronic disease, decrease disability, and enhance wellness. Two main objectives of health education and counseling are to change health behaviors and to improve health status. A diabetic who starts taking his medications regularly is an example of a behavior change intended to decrease disability.

A teenager, who lives at home with her parents and school-aged brother, has been diagnosed with anorexia nervosa. Which of the following would be the most appropriate teaching goal for this teenager? a. Increased energy level b. Improved coping c. Enhanced self-esteem d. Accomplished activities of daily living

c. Enhanced self-esteem Health teaching includes all family members; although the general teaching goal is the same for all, approaches and specific goals for each member will be different. Teenagers with anorexia nervosa often have decreased self-esteem. As a result, an appropriate goal for this teenager would be enhanced self-esteem.

A nurse is using the health belief model as a framework when developing a community action campaign to increase the percentage of the population who receives the influenza vaccine. Which of the following considerations will need to be made? a. How empowerment can be used to motivate community members b. How modeling can be used in the community to increase public awareness c. Perceived susceptibility in the community about getting influenza d. Perceived stage of behavior change that exists in the community

c. Perceived susceptibility in the community about getting influenza The components of the health belief model that need to be considered are: individual perceptions or readiness for change; the value of health to the individual compared with other aspects of living; perceived susceptibility to a health problem, disease, or complications; perceived seriousness of the disease level threatening the achievement of certain goals or aims; risk factors to a disease attributed to heredity, race or culture, medical history, or other causes; perceived benefits of health action; perceived barriers to promotion action.

The goal for the educational session is for the individual to correctly demonstrate proper technique for checking blood sugar levels. Which of the following teaching strategies would be most effective? a. Provide the individual with one-on-one education about blood sugar monitoring. b. Provide the individual with a scenario about blood sugar monitoring. c. Provide the individual with the opportunity to practice blood sugar monitoring. d. Provide the individual with a blood sugar monitor.

c. Provide the individual with the opportunity to practice blood sugar monitoring. Teaching is directed toward one or more of the three learning domains. The goal of having the individual demonstrate the proper technique for checking blood sugar levels relates to the psychomotor domain and is best achieved through demonstration and practice. These strategies allow the nurse to provide the individual with feedback and encouragement.

are any activities that an individual undertakes to enhance health, prevent disease, and detect and control the symptoms of a disease.

health behaviors

A nurse is developing learning objectives for an individual who is becoming more physically active. Which of the following is an example of an appropriately written affective learning objective? a. The individual will understand the importance of daily exercise. b. The individual will demonstrate the importance of daily exercise. c. The individual will verbalize the importance of daily exercise. d. The individual will believe in the importance of daily exercise.

c. The individual will verbalize the importance of daily exercise. Affective learning alludes to the recognition of values, religious and spiritual beliefs, family interaction patterns and relationships, and personal attitudes that affect decisions and the problem-solving process. Objectives of this domain must incorporate action verbs that indicate observable learning. Verbalizing the importance of daily exercise alludes to the recognition of the value of daily exercise to the individual.

Any combination of planned experiences based on sound theories that provide individuals, groups, and communities the opportunity to acquire the information and skills needed to make quality health decisions is known as health: a. promotion. b. counseling. c. education. d. knowledge.

c. education.

An overweight woman joins a support group to help her lose weight. During her first session, the nurse explains the components of a healthy diet and discusses with the woman how she can eat out and still maintain a healthy diet. She asks the woman what her goal is and emphasizes that she herself is the key to success. What is the nurse promoting through the use of this strategy? a. Communication b. Values c. Advanced planning d. Empowerment

d. Empowerment

A nurse is developing learning objectives for an individual who has been recently diagnosed with asthma. Which is an example of an appropriately written psychomotor learning objective? a. The individual will understand how to correctly use an inhaler. b. The individual will realize the importance of using an inhaler correctly. c. The individual will feel better when using the inhaler correctly. d. The individual will demonstrate proper use of the inhaler.

d. The individual will demonstrate proper use of the inhaler. Psychomotor learning involves developing physical skills from simple to complex. Objectives of this domain must incorporate action verbs that indicate observable learning. Demonstrating proper use indicates that the individual has developed the necessary skills to use an inhaler correctly.

The primary objective of social marketing is to: a. plan behavior. b. analyze behavior. c. limit behavior. d. change behavior.

d. change behavior.

Nursing: Scope and Standards of Practice describes health teaching and health promotion as primary nursing responsibilities which includes..?

educating people about healthy lifestyles, risk reduction, developmental needs, activities of daily living, and preventive self-care.

Nurses acting as _____ play a key role in improving the health of the nation.

educators

How do nurses obtain written feedback?

end-of-program questionnaires

Health education involves not only providing relevant information but also ..?

facilitating health-related behavioral change

What are examples of having high health literacy?

following directions on a prescription drug label or adhering to a childhood immunization schedule using a standard chart

what can be used as a health-education tool that may influence a person's health practices

the internet

What areas have the lowest levels of health literacy?

the more vulnerable members of our communities - those with lower education levels, racial/ethnic minorities, the uninsured and publicly insured, and the elderly

What is the nurse able to recognize when viewing health behavior through an ecological model?

the nurse recognizes the complex interaction of individuals with their environment and the multiple influences of the individual, the interpersonal group, and the community on health behavior.

health teaching includes how many family members?

the whole family

What is the goal of health education?

to help individuals, families, and communities achieve, through their own actions and initiative, optimal states of health. Also to improve health literacy.