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管理的一般原则:教育

General principals of management: education.

作者信息

Musto Patricia K

机构信息

Oakbrook Allergists, S.C., and Midwest Research Associates, L.L.C., Oak Brook, IL, USA.

出版信息

Nurs Clin North Am. 2003 Dec;38(4):621-33. doi: 10.1016/s0029-6465(03)00104-x.

Abstract

Asthma education is an essential part of the treatment of this disease. Health care professionals must establish a partnership with the patient with asthma and the patient's family to devise a plan of care with which the patient voluntarily will comply. The partnership with the patient begins at the first encounter and continues throughout the therapeutic relationship. Each member of the health care team can be instrumental in reinforcing the crucial information the patient must know to be an informed participant in his or her care. Nursing professionals are in a particularly advantageous position to foster this partnership because of their patient-focused outlook and the quality of time spent with patients. When the partnership is based on mutual trust and cooperation, the clinician can direct asthma care that is consistent with current expert guidelines. Educational interventions should be meaningful to the patient, learner centered to incorporate the patient's needs, and sensitive to the patient's cultural influences. The patient and his or her significant social and family support should be actively involved. The clinician should be alert to the patient's readiness to learn and tailor the message to suit the setting in which it is delivered. The patient should receive information that allows his or her participation in goal setting for treatment. Essentials to be included are the significance of the diagnosis, basics about inflammation as the primary cause of symptoms, the difference between controllers and relievers, how to use the medications and monitoring devices, how to reach the provider, and the need for continuous ongoing interaction with the clinician. Goals set in the partnership are objectified in the asthma action plan or guided self-management plan. The success of the treatment can be assessed from the patient's improved asthma control and reduced reliance on emergency treatment. Every health care provider is a potential wealth of patient education. Every patient encounter is an opportunity to reinforce knowledge and proficiency in asthma management. Nursing professionals can play a fundamental and crucial role in asthma education by maintaining the focus of the medical treatment on the priorities in asthma care--the learning needs and goals of the patient.

摘要

哮喘教育是这种疾病治疗的重要组成部分。医疗保健专业人员必须与哮喘患者及其家人建立伙伴关系,以制定患者自愿遵守的护理计划。与患者的伙伴关系始于首次接触,并贯穿整个治疗关系。医疗团队的每个成员都有助于强化患者为明智参与自身护理而必须了解的关键信息。护理专业人员因其以患者为中心的观点以及与患者相处的时间质量,在促进这种伙伴关系方面处于特别有利的地位。当伙伴关系基于相互信任与合作时,临床医生可以指导符合当前专家指南的哮喘护理。教育干预措施应对患者有意义,以学习者为中心以纳入患者需求,并对患者的文化影响敏感。患者及其重要的社会和家庭支持应积极参与。临床医生应留意患者的学习意愿,并根据传递信息的环境调整信息内容。患者应获得能使其参与治疗目标设定的信息。应包含的要点有诊断的意义、炎症作为症状主要原因的基础知识、控制药物和缓解药物的区别、如何使用药物和监测设备、如何联系医疗服务提供者以及与临床医生持续互动的必要性。在伙伴关系中设定的目标在哮喘行动计划或指导性自我管理计划中得以具体化。可以从患者哮喘控制的改善以及对急诊治疗依赖的减少来评估治疗的成功与否。每位医疗服务提供者都是患者教育的潜在宝库。每次与患者接触都是强化哮喘管理知识和技能的机会。护理专业人员可以通过将医疗治疗的重点保持在哮喘护理的优先事项——患者的学习需求和目标上,在哮喘教育中发挥根本且关键的作用。

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