EMPOWERING ELDERLY BY HEALTH EDUCATION

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1 EMPOWERING ELDERLY BY HEALTH EDUCATION ¹ ²Kirsi Johansson, PhD, RN, Coordinator; ¹Brita Pasila, MNSc, RN, PhD-student; ¹Sirkku Rankinen, MNSc, RN, PhD-student; ¹Sanna Salanterä, PhD, RN, Professor; ¹ ² ³Helena Leino-Kilpi, PhD, RN, Professor ¹ University of Turku, Department of Nursing Science, Turku, Finland ² Finnish Post-Graduate School in Nursing Science, Turku, Finland ³ Turku University Hospital, Turku, Finland

³Helena Leino-Kilpi, PhD, RN, Professor ¹ University of Turku, Department of Nursing Science, Turku,

2 BACKGROUND - Numbers of elderly - Hospital stays - Law of patients rights and position - Amount of information - Access to information

3 EMPOWERING PATIENT EDUCATION Research project of Department of Nursing Science, University of Turku Elderly focus: Orthopaedic Prostata cancer Diabetes

4 EMPOWERED PATIENT When patient has knowledge which meets his/her needs, expectations or preferences and which he/she is capable of using (Funnell et al. 1991, Anderson et al. 1995, Leino- Kilpi et al. 1998, Pellino et al. 1998, Leino-Kilpi et al. 1999a, 1999b)

of using (Funnell et al. 1991, Anderson et al.

5 THE AIM OF EMPOWERING EDUCATION To help patients increase and develop their knowledge and skills so that they can make decisions about their own health and care for themselves The ultimate goal is to increase patient empowerment (Feste & Anderson 1995, Leino-Kilpi et al. 1998, Funnell 2004, Anderson & Funnell 2005)

and care for themselves The ultimate goal is to increase patient empowerment

6 EMPOWERING PATIENT EDUCATION CONSISTS OF Biophysiological Functional Experiential Social Ethical Financial dimensions of knowledge (Leino-Kilpi et al. 1998, 1999a, 1999b)

7 EDUCATIONAL SOLUTIONS IN EMPOWERING EDUCATION Patients have a sense that they are at the centre of their learning process; Patients own knowledge needs are assessed and these needs are met (Poskiparta et al. 2001) * Patients are helped to select the relevant knowledge (Teasdale 1998, Tones 1998, Anderson & Funnell 2005) * Equal relationship between patients and health care personnel (Feste & Anderson 1995, Poskiparta et al. 2001, Kettunen 2001, Funnell 2004)

2001) * Patients are helped to select the relevant knowledge (Teasdale 1998, Tones 1998, Anderson & Funnell 2005) *

8 OUTCOMES OF EMPOWERING EDUCATION E.g.: Patient has empowering learning experience (Pellino et al.1998) Patient has high self-efficacy or patient has knowledge and sense of certainty about that knowledge and can make use of that knowledge (Anderson et al. 1995, Pellino et al. 1998, Krouse 2001, Tsay & Hung 2004, Wong et al. 2004) Patient has more active role in decision-making (Davison & Degner 1997) Patient has better quality of life (Pibernik- Okanovic et al. 2004)

make use of that knowledge (Anderson et al. 1995, Pellino et al. 1998, Krouse 2001, Tsay & Hung 2004, Wong et al.

9 EXAMPLE STUDY OF EMPOWERING EDUCATION AMONG ORTHOPAEDIC PATIENTS (Johansson)

10 GOAL AND FOCUS To make orthopaedic patient education more empowering Patients educational needs Current orthopaedic patient education Empowering education intervention for patients

11 1. PHASE I Descriptive and comparative study EDUCATIONAL NEEDS Postoperative orthopaedic patients at hospital n = 212 Postoperative orthopaedic patients at home n = 144 (Johansson et al 2002a)

12 2. PHASE II Descriptive and comparative studies Systematic review CURRENT PRACTICE OF ORTHOPAEDIC PATIENT EDUCATION Postoperative Pre- and Preoperative orthopaedic postopera- orthopedic patients tive orthopaedic patient patients written educational education n = 146 and materials research nurses n = 56 n = 25 papers n = 11 (Johansson et al 2002b, 2004, 2005)

orthopedic patients tive orthopaedic patient patients written educational education n = 146

13 3. PHASE III Clinical trial TESTING THE OUTCOMES OF EMPOWERING EDUCATION INTERVENTION Pre- to postoperative orthopaedic patients n = 123 patients; group A n = 62, Group B n = 61 (Johansson et al 2007)

14 INTERNATIONAL PHASE 2008> ELDERLY OSTEOARTHRITIS PATIENTS FIVE COUNTRIES

15 EXAMPLE STUDY OF EMPOWERING EDUCATION AMONG PROSTATA CANCER PATIENTS (Rankinen)

16 GOAL AND FOCUS To make prostata cancer patient education more empowering Analysis of patients current, expected and received knowledge Strategies of cognitive processing Outcomes of patient education

17 YEARS Interviews of prostate cancer patients (n=100) strategies of cognitive strategies and creating types of information processing Instrument development and piloting for measuring the cancer-related knowledge structuring Measurement of the cancer-related knowledge expectations and received knowledge and types of processing

development and piloting for measuring the cancer-related knowledge structuring

18 EXAMPLE STUDY OF EMPOWERING EDUCATION AMONG DIABETES PATIENTS (Pasila)

19 GOAL AND FOCUS To make elderly diabetes patient education more empowering To develop and test an individually tailored face-to-face patient education program for elderly (>65 years) with type B2-diabetes in a primary health care.

tailored face-to-face patient education program for

20 Randomised control trial for elderly (>65 years) Type B2- diabetes patients (n=191, int 95, contr 96) in health center (altogether 4 healthstations) of one small commun.

21 As a conclusion The quality of patient education and care among elderly Elderly empowerment New methods for patient education New instruments for measure the patient education

22 THANK YOU! Contacts: PhD, Coordinator Kirsi Johansson, Finnish Post-Graduate School in Nursing Science, University of Turku, Department of Nursing Science, Turku, Finland

Ambulatory orthopaedic surgery patients knowledge expectations and perceptions of received knowledge

Ambulatory orthopaedic surgery patients knowledge expectations and perceptions of received knowledge JAN ORIGINAL RESEARCH expectations and perceptions of received knowledge Katja Heikkinen, Helena Leino-Kilpi, Ari Hiltunen, Kirsi Johansson, Anne Kaljonen, Sirkku Rankinen, Heli Virtanen & Sanna Salanterä