There have always been many difficulties in catering to the needs of Patients with Chronic Complex Health Care Needs. The rising prevalence and morbidity associated with chronic medical conditions across the world has prompted a re-evaluation of the procedures employed to manage the condition as well as exploring new training methods for educating patients to take care of themselves. This report looks at one particular disorder – asthma – and tries to evaluate a new plan of education, devised to educate patients to scientifically and effectively use the inhaler. The patient participating in this study will be referred to as Lisa in order to maintain confidentiality. But first, a glimpse into what is the state of existing patient education systems is warranted.
Healthcare institutions concerned with respiratory disorders have been in existence for many decades now. In the case of the United Kingdom, the Asthma Training Centre (ATC) was established in 1986 and has done commendable work in alleviating the suffering associated with this illness. This charitable foundation was set up with a grant from the Asthma Society (now the National Asthma Campaign), and contributions from the pharmaceutical industry. Although its initial days were a little shaky, the continued pursuit of their long-term objectives has paid off for the ATC, which now owns two large medical facilities. While most training programs implemented by organizations like ATC are of high merit, the changing nature of chronic health-care and changing medical interventions require a modified education program. This applies to the effective use of symptom control devices like a salbutamol inhaler as in the case of chronic asthma.
Before charting out the plan for patient education, a look into some key considerations is called for. A comprehensive education program directed at practice-nurses is of high significance. These practice-nurses are not only directly involved in handling asthma patients during the course of their practice, but will also serve as suitable trainers for patient education programs. The training program that will be designed and implemented as part of this exercise will try to follow the ATC model, which has a qualified team of nearly fifty regional trainers “who are lecturers recruited from the ranks of the original practice-nurses”. Other pre-requisites for choosing practice-nurses include their previous experiences in “maximal nurse involvement” cases, so that they are thoroughly knowledgeable and equipped to deal with all sorts of questions during the patient-training programs (Buckner, 2005). While the program pertaining to the use of inhaler is a relatively simple one, the systematic approach with which it is carried out can be adapted to any other chronic medical conditions as well.
The training program that is to be designed will also have to include research design and statistics components that are developed in association with the Applied Psychology Research Group. The research projects that result from these training programs will later be integrated with special research groups dedicated for the implementation of further programs in asthma patient education. Moreover,
“Specialized courses will be developed for nurses working in specialized settings, such as in school and paediatric nursing, as well as those working in respiratory medicine. Programs in allergy management are also highly relevant and this program will have to be developed in collaboration with the British Society of Allergy and Clinical Immunology”. (Barnes, 1994)
An important challenge for patient-trainers is making sure that the patients are using their inhalers “appropriately and correctly” (Barnes, 1994). It has to be kept in mind that a written instruction is always preferable to orally passed on instructions. These written instructions also called action plans. The trainers must also check with the patient if they are employing the right technique in using the inhaler. A newly-diagnosed patient needs to be taught how to use the inhaler in order for it to be effective in alleviating the symptom temporarily. The significance of an audio/visual approach to training cannot be overstated. Hence, the leaflet handed to the patient must have illustrations and suitable use of colour. The psychological and cognitive factors in transmission and assimilation of information need be factored into the assessment. The following four steps are a handy reference for patient-educators to check for the above key indicators of the effective employment of the inhaler.