Healthcare & Patient Education Strategies

This assignment delves into various healthcare education strategies and their application in a real-world scenario: organ transplantation. It examines learning theories relevant to nursing practice, explores the role of patient navigators in improving adherence to treatment plans, analyzes the impact of effective doctor-patient communication, and considers psychological factors influencing medication adherence after transplantation. The assignment draws upon research articles and scholarly sources to provide a comprehensive understanding of these crucial aspects of healthcare delivery.

Running head: PATIENT EDUCATION 1
Patient Education on Adherence to Post-Transplantation Regime in Cornea Graft Failure
Introduction
Name

PATIENT EDUCATION 2
Introduction
Eyesight is one the most cherished senses among humanity. Those born without the gift
of sight or those whose ability to see is impaired go to unimaginable lengths to restore or
improve it. The eye, the organ whose primary function is to see, has various vital parts including
the cornea. For various reasons including congenital disabilities, injury and infections, the
cornea’s ability to perform its functions can be compromised. There are various treatment
options available for corneal treatment depending on the source of the defect. Over the past half
of the century, millions of patients have undergone corneal transplantation around the world due
to corneal infection, corneal degeneration and corneal injuries in an attempt to restore and
improve vision (Tan et al., 2012). These patients require post-transplantation regimen adherence
to improve outcomes. In this paper, we will focus on the post-translation regimen adherence
patient education following corneal transplantation in Singapore.
In modern medical care, patients are part of the medical team. They should be involved in
every decision made regarding their treatment. This is important because it fosters adherence to
treatment regimens and self-care among many other reasons (Davis et al., 2007). However, it is
difficult to include patients without conducting proper education.
Transplantation of the corneal at times poses complications including graft rejections just
like in the other cases of organ transplantation (Panda et al., 2007). Statistics indicate graft
rejections following corneal transplantation take place in 5 to 30% of recipients. According to
(Bachmann et al., 2008), corneal graft rejection is regarded the severest of the complications
occurring after corneal transplantation. One of the common causes of corneal graft rejection is
patient’s non-adherence to the post-transplantation treatment, and it has been known to

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orchestrate dreadful consequences, including acute rejection and severely reduced quality of life.
According to Radhakrishnan, Yadav, and Sachdeva (2009), preparing organ recipients before the
procedure puts them on right path to knowing how to take care of their new organ.
The efforts to avoid graft rejection need to start immediately when recipient has
consented to organ transplant through education. Proper education can enable them to recognize
early graft rejection, report it early, improve adherence to the prescribed regimen and schedule
checkups with a corneal specialist in case of any complications (Radhakrishnan, Yadav &
Sachdeva, 2009). In addition, it will make it easier for the patients to take an active role in their
journey back to recovery. Various scholars have reviewed literature in which they have asserted
that patient education is fundamental in fostering adherence to the post-transplantation regimen;
all of which have a substantial anchorage in behavioral, social, cognitive and Roger’s learning
theories. Ha and Longnecker (2010) note that patient education is geared towards making
recipients have knowledge about the disease, acquire precise skills necessary during treatment,
and ultimately equip them with coping tactics. It is paramount that that organ recipients and
healthcare counselors sustain a cordial relationship, which is instrumental in enhancing
adherence to the post-transplantation treatment and improving the quality of life and keeping
medical expenses in check.
Various theories have been put forward as integral during the teaching process.
Teachers’, in this case, healthcare practitioners, are at liberty to choose the most suitable theory
or theories suitable in the instructional process. Andragogy, unlike pedagogy, focuses on adult
teaching. Following an andragogy approach, healthcare practitioners can transfer to corneal
transplantation adult patients with ease (Bover Draganov et al., 2013).

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Principle of Patient Education and Adult Learning Theory
Principles of Patient Education
Patient learning is guided by various principles. The first principle indicates that the instructor
cannot avoid teaching whether intentional or not. Teaching takes place in many ways as
healthcare practitioners make contact with their patients including words, actions and nonverbal
behavior (Mann, 2011). As such, it is the practitioners’ choice to teach well or not. The second
principle reminds the nursing practitioners that teaching is an integral part of the caring process.
Good teachings stay with the patients and their families for a long time (Glanz, Rimer &
Viswanath, 2008). Studies have established that the impact of teaching is never immediate and
may go unnoticed by the healthcare practitioners during physical contact with patients and as
such, it should not deter physicians from dispensing the correct amount and quality of education.
It is important for the nursing practitioners to assess patient’s knowledge before dispensing more
knowledge. Adult patients are likely to have a lifetime of experience and knowledge.
The fourth principle of teaching underscores the fact that a good session must embody an
introduction, body, and conclusion. It is important for the instructors to introduce themselves
during which they should involve the patients in ice-breaking and establishing the goal of the
session. It is this stage that nursing counselors need to build their anticipation of the learning
session. For instance, the nurse educators can identify things that they expect the patients to
perform at home (Mann, 2011). The second phase is all about the body. The information should
be delivered with patient involvement. It should be planned carefully to ensure patients grasped
key concepts. Simple information communication materials may be used to convey the main
points. The instructor can start the conclusion part of teaching sessions by asking the patients to

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do what was discussed in the expected outcome. It is important for instructors to offer positive
reinforcements even for the smallest of the achievements realized by the patients. Additional
reinforcements can be given alongside further guidance in areas patients make errors. Each
session should end with a positive note.
Another principle opines that adults tend to be autonomous and self-directed and as such,
it is important for the nursing counselor to let them direct their own learning. In cases where the
learning exercise is taking place from a classroom, it vital for the facilitator to actively involve
the adult learners in the learning process. Adult education facilitators must be specific in guiding
the learners rather than just supplying information. It is important that the nursing counselor
allows learners assume responsibility in which discussions and group-based presentations are
most fundamental in the instructional process (Mann, 2011).
Is always advisable to teach “ the what” before “the how” to hasten to grasp of ideas.
Detailed explanation about corneal transplantation can come after the patients have understood
what the subject matter is all about. This principle gives leeway for the nursing counselor to
teach more than the patient can use at that particular moment. Use of time blocks is highly
encouraged when teaching. Here, instructors are discouraged from teaching everything at ones.
Teaching one concept per session ensures that patients retain most of the information taught
(Freeman & Rodriguez, 2011).
The last principle encourages the nursing counselors to rehearse. Rehearsing of one’s
material is beneficial in many ways. It ensures that appropriate time is allocated for each session
besides enhancing mastery and delivery of the information. In the event that demonstrations are
required, rehearsal ensures that the presenter adequately demonstrates each step having rehearsed

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it by themselves (Freeman & Rodriguez, 2011). In addition, when presenters rehearse, it is
quicker for them to solve any problems that may arise because they master the complex steps
when rehearsing.
Adult Learning Theories
The andragogy learning theory has been cited as the best theory in imparting patient
education among adults. The theory is anchored on the principle that adults are a rich source of
information with wide ranging experiences that offers the basis of new information. As such, the
customary tactic instructional process suitable for children is not suitable (Gremigni et al., 2007).
The theory emphasizes that the process of teaching about cornea transplantation is important
than the actual outcome of avoiding it (Babakhani et al., 2013). As noted earlier, the impact of
the education is hardly felt immediately. The information was given, however, stays with the
patients and their families’ years after the fact. The transfer of knowledge is not automatic when
applying this theory. It takes patience and continued coaching and support for the patient to
master the skills of self-managing and adherence to drug regimens following cornea
transplantation (Braungart & Braungart, 2007).
Constructivist theory (CLT) is similar in approach to andragogy. However, it deviates a
little in that it is also applicable to children. When applying CLT in teaching cornea transplant, it
is paramount to keep in mind Piaget’s (1964) who insists of earning by way of discovering.
Vgotsky (1962) also asserted that clear instructions and socialization are vital in supporting
patients make meaning of the conditions afflicting them. CLT is primarily learner centered. The
nursing instructor is regarded as just a facilitator. The facilitator must come up with practical
ways of promoting self-care and self-management following corneal transplantation. When the

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instructor is dealing with multiple patients, he or she must be aware that different patients
experience different causes of cornea rejection and as such will require dissimilar approaches
(Glanz, Rimer & Viswanath, 2008).
Components of Effective Patient Education
Effective patient education must meet certain parameters in order to foster adherence,
self-care, and self-management in post-transplantation regimen in corneal graft failure. The first
component relates to the amount time taken per session. Patients are likely to be in discomfort,
and therefore their attention spans are likely to be short. Most studies recommend a session
spanning between half an hour to one hour (Griffiths et al., 2007). This is critical to ensuring that
the patient’s excitement to learn remaining riveted throughout out the session.
During my sessions, I have always found the use of verbal teaching only not enough. It is
always important to supplement it with written material and other media to reinforce the
information and make it a little more exciting and memorable. For instance, in the case of adults,
they are more of visual learners than verbal ones. The instructor ought to provide patients with
post-transplantation regimen diaries that comprise activities that can be incorporated into daily
routine. When patient’s reading skills proof inadequate, it is important to provide pictograms that
can paint images in patient’s minds on the steps involved in cornea care following
transplantation (Aliakbari et al., 2015).
Writing down an action plan has been known to work for most patients. It is used in
communicating the anticipated information from the nursing counselors to their patients. It has
also been used in emphasizing communication on how organ recipients can identify the peak
flow measurements and take the most suitable responses. Organ recipients who comprehend this

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stand better chances of managing symptoms of graft failure. A well-drafted organ transplant
management action plan must incorporate the drugs taken every day and their corresponding
dosages. It is important to understand how the drugs are taken and dosages required for each
session. The written plan may also entail information that the recipients have a firm grasp the
actions required to regulate and keep off triggers completely. Patient’s readiness to identify and
handle deteriorating signs and symptoms is also a part of the action plan in addition to patient’s
comprehension of medication and the dosages needed as a response to aggravating symptoms as
emanating from graft failure. Lastly, the patient needs to have emergency contacts for hospitals
and even their doctors.
Conclusion
The review has shown that patient education enables the patients to lead a comfortable
life and even without symptoms after cornea transplants. Various parameters have been
highlighted as integral to leading symptom-free life after corneal transplantation in graft failure
and may embody regular and unhindered access to care, awareness of the prescribed regimens
and knowledge on the adjustments of the environment to reduce exposure to unaccommodating
conditions. Notwithstanding this, current findings indicate that most people with cornea
transplant hardly get the necessary care as specified in most treatment guidelines. On top of that,
patients shy away from seeking cornea care on a frequent basis particularly those who come
from economically disadvantaged households.
The general purpose for expert treatment and enhanced self-management via doctor-
patient education is to keep graft rejection under check. Put differently, doctor-patient education
is fundamental in the reduction of the graft rejection rates and related morbidity as well as

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augmented functional ability and a better quality of life. Teaching patients promote avoidance of
triggers, raises patient adherence and enhances patient ability to notice the symptoms of graft
rejection and seek medical services in timely manner.

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References
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Cursiefen, C. (2008). Promotion of graft survival by vascular endothelial growth factor a
neutralization after high-risk corneal transplantation. Archives of Ophthalmology, 126(1),
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Bover Draganov, P., de Carvalho Andrade, A., Ribeiro Neves, V., & Sanna, M. C. (2013).
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