Pamella Rae Stoeckel, RN, PhD, CNE Professor Loretto Heights School of Nursing Regis University. Client Education

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Jones OT FOR Mary A. Miller, RN, PhD Dean Emeritus Jones School of Nursing, Aurora University Aurora, Illinois Associate Dean Emeritus School of Professional Studies Metropolitan State College of Denver & Bartlett Learning, LLC Denver, Colorado Jones rning STRIB Pamella Rae Stoeckel, RN, PhD, CNE Professor Loretto Heights School of Nursing Jones & Bartlett Learning, LLC Regis University Denver, Colorado OT FOR Client Education Jones OT FOR Jones & Bartlett Learning, LLC THIRD EDITION Theory Jonesand & Bartlett Learning NOT FOR Practice SALE OR DISTRIB rning STRIB. Jones OT FOR 9781284161304_FMxx.indd 1 18/09/17 3:10 PM

World Headquarters Jones & Bartlett Learning 5 Wall Street Burlington, MA 01803 978-443-5000 info@jblearning.com www.jblearning.com Jones & Bartlett Learning books and products are available through most bookstores and online booksellers. To contact Jones & Bartlett Learning directly, call 800-832-0034, fax 978-443-8000, or visit our website, www.jblearning.com. Substantial discounts on bulk quantities of Jones & Bartlett Learning publications are available to corporations, professional associations, and other qualified organizations. For details and specific discount information, contact the special sales department at Jones & Bartlett Learning via the above contact information or send an email to specialsales@jblearning.com. Copyright 2019 by Jones, an Ascend Learning Company All rights reserved. No part of the material protected by this copyright Jones may & be reproduced Bartlett or utilized Learning, any form, LLC electronic or mechanical, including photocopying, recording, or by any information storage and retrieval system, without written permission from the copyright owner. The content, statements, views, and opinions herein are the sole expression of the respective authors and not that of Jones & Bartlett Learning, LLC. Reference herein to any specific commercial product, process, or service by trade name, trademark, manufacturer, or otherwise does not constitute or imply its endorsement or recommendation by Jones and such reference shall not be used for advertising or product endorsement purposes. All trademarks displayed are the trademarks of the parties noted herein. Client Education: Theory and Practice, Third Edition is an independent publication and has not been authorized, sponsored, or otherwise approved by the owners of the trademarks or service marks referenced in this product. There may be images in this book that feature models; these models do not necessarily endorse, represent, or participate in the activities represented NOT in the FOR images. Any SALE screenshots OR in this DISTRIBUTION product are for educational and instructive purposes only. Any individuals and scenarios featured in the case studies throughout this product may be real or fictitious, but are used for instructional purposes only. The authors, editor, and publisher have made every effort to provide accurate information. However, they are not responsible for errors, omissions, or for any outcomes related to the use of the contents of this book and take no responsibility for the use of the products and procedures described. Treatments and side effects described in this book may not be applicable to all people; likewise, some people may require a dose or experience a side effect that is not described herein. Drugs and medical devices are discussed that may have limited availability controlled by the Food and Drug Administration (FDA) for use only in a research study or clinical trial. Research, clinical practice, and government regulations often change the accepted standard in this field. When consideration is being given to use of any drug in the clinical setting, the health care provider or reader is responsible for determining FDA status of the drug, reading the package insert, and reviewing prescribing information for the most up-to-date recommendations on dose, precautions, and contraindications, and determining the appropriate usage for the product. This is especially important in the case of drugs that are new or seldom used. Production Credits VP, Executive Publisher: David D. Cella Executive Editor: Amanda Martin Associate Acquisitions Editor: Rebecca Stephenson Editorial Assistant: Christina Freitas Senior Vendor Manager: Sara Kelly Senior Marketing Manager: Jennifer Scherzay Product Fulfillment Manager: Wendy Kilborn Composition and Project Management: S4Carlisle Publishing Services Cover Design: Kristin E. Parker Jones Rights & Media & Bartlett Specialist: Wes Learning, DeShano LLC Media Development Editor: Troy Liston NOT Cover FOR Image SALE (Title Page): OR DISTRIBUTION Printing and Binding: Edwards Brothers Malloy Cover Printing: Edwards Brothers Malloy To order this product, use ISBN: 9781284142631 Library of Congress Cataloging-in-Publication Data Names: Miller, Mary A. (Mary Alice), author. Stoeckel, Pamella Rae, author. Title: Client education : theory and practice / by Mary A. Miller, Pamella Rae Stoeckel. Description: Third edition. Burlington, MA : Jones & Bartlett Learning, [2019] Includes bibliographical references and index. Identifiers: LCCN 2017036562 ISBN 9781284161304 (pbk. : alk. paper) Subjects: MESH: Patient Education as Topic Nurse-Patient Relations Models, Educational Nurses Instruction Classification: LCC RT90 NLM WA 590 DDC 615.5071--dc23 LC record available at https://lccn.loc.gov/2017036562 6048 Printed in the United States of America 21 20 19 18 17 10 9 8 7 6 5 4 3 2 1.

MirageC /Getty Images Dedication To Nurse Educators and to Our students, Our clients, Our colleagues: Our teachers iii.

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MirageC /Getty Images Contents Preface xi SALE OR Part DISTRIBUTION I A Framework for Health NOT Education FOR 1 1 Overview of the Miller Stoeckel Client Education Model 3 Introduction 4 Purposes and Goals of Health Education 4 The Miller Stoeckel Jones & Bartlett Client Education Learning, Model LLC Jones & Bartlett 4 Lea Nurse NOT as Educator FOR NOT FOR SALE 7 OR DI Client as Learner 8 Nurse Client Relationship 8 Client Education Outcomes 15 Jones & Definitions rning, 17 LLC NOT FOR Context SALE for OR Health DISTRIBUTION Education 20 Summary 22 Part II The Learning Process 27 SALE OR 2 DISTRIBUTION Thinking and Learning 29 Introduction 30 Domains of Learning 31 Thinking 33 Ways of Thinking 33 Reflecting on Your Thinking 37 Promoting Thinking in Clients 38 Styles of Thinking and Learning 39 Summary 46. v

vi Contents 3 Theories and Jones Principles & Bartlett of Learning Learning, LLC Jones & 53Bartlett Lea Introduction 54 Value of Theory 54 Theories of Learning 55 Behavioral Views of Learning 56 Cognitive Views of Learning 60 Social Cognitive View of Learning 65 Principles of Learning 68 Summary 72 Bartlett Part Learning, III Assessment LLC for Health Education 77 4 Learner and Setting Assessment 79 Introduction 80 Psychological Factors 81 Biological Factors 87 Social Factors 91 Intellectual NOT Factors FOR NOT FOR 97 SALE OR DI Environmental Factors 102 Summary 107 Jones 5 Child & Bartlett Learner Learning, LLC rning, 113 LLC Introduction 114 Biologic Characteristics, Psychosocial Stages, and Developmental Tasks 114 Implications for Health Education 125 Orientation to Learning 126 Pedagogy 136 Bartlett Educating Learning, Clients LLCwith Disabilities 139 SALE OR Educating DISTRIBUTION Families 141 Educating Groups and Communities 141 Educating Health Team Members 142 Summary 143 6 Adult Learner 147 Introduction 148 Biologic Characteristics, Psychosocial Stages, and Developmental Tasks 148 Implications for Health Education 150 Orientation to Learning 152 Andragogy 153.

Contents vii Experiential Learning 161 Educating Clients with Disabilities 162 Educating Families 163 Educating Groups and Communities 163 Educating Health Team Members 164 Summary 164 NOT FOR 7 Older SALE Learner OR DISTRIBUTION 167 Introduction 168 Ageism 168 Psychosocial Stages, Developmental Tasks, and Physiologic Changes of Late Adulthood 169 Implications for Health Education 177 Ethnic Elderly 181 Educating Clients with Disabilities 183 Educating Families 188 Educating Groups and Communities 189 Educating Health Team Members 189 Summary 190 8 Culturally Diverse Learner 195 Introduction 196 Jones & Characteristics Bartlett Learning, of Culturally LLC Diverse Learners rning, 197 LLC NOT FOR Cultural SALE OR Competence DISTRIBUTION and Cultural Humility 198 Culturally Congruent Client Education 202 Culturally Specific Client Assessments and Concerns 204 Cross-Cultural Communication 215 Linguistically and Culturally Appropriate Teaching Strategies Bartlett Learning, and Instructional LLC Materials 219 Summary 220 9 Nurse Educator as Learner 225 Introduction 226 Overview of the Continuum of Learning 226 Role of the Nurse as Educator 227 Advanced Role of Nurse as Educator 228 Nurse Educators in the Academic Environment 230 Nurse Educators in the Practice Environment 233 Becoming an Effective Nurse Educator 233.

viii Contents Lifelong Learning 238 Summary 239 Part IV Planning and Implementing Client Education 243 Jones 10 Client & Bartlett Education Learning, Plan LLC rning, 245 LLC Introduction 246 Client Education Plan 246 Mission 246 Goals 247 Learning Outcomes 247 Learning Objectives 248 Selection of Content 256 Selection of Evaluation Methods 256 Case Example: Mrs. Rosa Lopez 256 Summary 257 11 Teaching NOT Strategies FOR NOT FOR 263SALE OR DI Introduction 264 Types of Teaching Strategies 264 Teacher-Directed Strategies 264 Teacher-Facilitated Strategies 273 Learner-Directed Strategies 276 Selecting the Right Teaching Strategy 278 Case Example: Mrs. Rosa Lopez 284 Summary 287 Bartlett 12 Instructional Learning, LLC Materials 291 SALE OR Introduction DISTRIBUTION 292 Health Literacy 292 Types of Instructional Materials 294 Printed Materials 294 Multimedia 301 Internet and World Wide Web 308 Selecting Instructional Materials 312 Clients with Disabilities 315 Evaluating Effectiveness of Instructional Materials 315 Copyright Issues in Using Instructional Materials 315 Summary 316.

Contents ix Part V Jones Client & Education Bartlett Learning, Outcomes LLC Jones & Bartlett 321 Lea 13 Formative Evaluation 323 Introduction 324 Evaluation 324 Formative Evaluation: Evaluation of the Client Education Plan 325 Formative Evaluation: Evaluation of the Learning Environment 328 Formative Evaluation: Evaluation of the Nurse Client Interaction 329 Case Example: Mrs. Rosa Lopez 330 Summary 332 Bartlett Learning, 14 Summative LLCEvaluation 335 Introduction 336 Summative Evaluation: Evaluation of Client Learning 337 Summative Evaluation: Evaluation of Educational Effectiveness 349 Summative Evaluation: Evaluation of Integration of Learning into Daily Living 352 Case Example: Jones Mrs. & Bartlett Rosa Lopez Learning, LLC Jones & Bartlett 359 Lea Summary NOT FOR SALE 361 OR DI 15 Application of the Miller Stoeckel Client Education Model 367 Introduction 367 Overview of the Miller Stoeckel Client Education Model 368 Jones & Conceptual Bartlett and Learning, Theoretical LLC Support rning, 368 LLC NOT FOR Definition SALE OR of Major DISTRIBUTION and Embedded Concepts in the Model 369 Propositions of the Model 370 Assumptions of the Model 370 Application of the Model 370 Summary 372 Appendix: Physical Changes Associated with Aging by System 373 Index 377.

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MirageC /Getty Images Preface We are pleased to present the 3rd edition of our book Client Education: Theory and Practice, written for practicing nurses, nurse educators, and baccalaureate and master s degree nursing students. The Miller Bartlett Learning, Stoeckel Client LLC Education Model continues to Jones be the organizing & Bartlett framework Learning, for the LLC text, with the Nurse Client Relationship as central to the model. We believe this relationship to be paramount SALE OR to DISTRIBUTION the success of client education. The model NOT is our FOR unique SALE contribution OR DISTRIBUTION to the nursing profession. The text has been carefully reviewed and augmented with updated statistics and information on current practices. Many additions were made based on information from our readers. Overall additions to each chapter include evidence-based nursing practice exercises and test questions for ease of use Jones by instructors. & Bartlett PowerPoint Learning, presentations LLCwith audio are provided to Jones enhance & the Bartlett text. Lea Specific changes to the text include the following changes by chapter. We strengthened the conceptual and theoretical underpinning of the Miller Stoeckel Model in Chapter 1. Four embedded concepts were added that further enhance the model. These concepts are cultural caring, communication, negotiation, and collaboration. Chapter 2: Thinking and Learning adds information on critical thinking. Chapter 3: Theories Jones and & Principles Bartlett of Learning, was LLC rewritten for ease of understanding Jones the theories. & Bartlett Chapter Learning, 4: Learner LLC and Setting Assessment was reorganized around a more comprehensive approach using learner assessment factors. Chapter 5: Child Learner, Chapter 6: Adult Learner, and Chapter 7: Older Learner all have new sections on educating clients with disabilities. Chapter 8: Culturally Diverse Learner includes information on cultural humility and social determinants of health that impact client education. We are pleased to present a new chapter, Chapter 9: Nurse Educator as Learner. The need for this chapter became clear as we realized the importance of focusing on the nurse as learner. SALE OR We DISTRIBUTION describe the continuum of learning on NOT the journey FOR to SALE becoming OR a DISTRIBUTION nurse educator. Chapter 10: Client Education Plan was extensively revised to reflect current practice and changing terminology. Chapter 11: Teaching Strategies includes an expanded sample of the client educational plan. Chapter 14: Summative Evaluation includes additional information on cost effectiveness supporting client education. We conclude the text with a new chapter, Chapter 15: Application of the Miller Stoeckel Client Education NOT Model. FOR SALE This chapter OR DISTRIBUTION summarizes the model and serves as a ready NOT resource FOR for SALE those OR D aspiring to apply the model. We find joy in writing and bringing to our readers practical information and guidance in teaching clients. We encourage you to explore the chapters and find application to your practice.. xi

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