The encounter between a physician and patient is vital in establishing a therapeutic relationship. Patient education is a major part of the recovery as it deals with the communication of information about the health, treatment, and risks or alternatives of the patient. Thus, in ensuring better compliance, a participative and interactive education procedure where the physician plays the role of a facilitator and the patient the recipient is required. Two peer-reviewed articles will be critically analyzed with the sole intent of recognizing the improved compliance in the health care sector via patient education. A critique of the articles will aim to answer the question “Is patient compliance dependent on effective patient-physician communication?”
Improved Compliance through Patient Education
The communication between a physician and a patient promotes a strong therapeutic bond between them. Patient education is described as a set of organized learning actions that utilize a variety of techniques offered by the physician. These activities are behavior modification, counseling, and training developed to promote patient conduct and knowledge. Patient education is a subject of interest to nurses in all sorts of practicing environment in the nursing domain. Teaching is a part of a nurse’s professional function, and in a modern health care setting, it is necessary for the patients to take the role of self-care management. Therefore, nurses are expected to provide high-quality patient education.
The purpose of this essay is to identify the benefits of patient education in enhancing compliance in nursing. For example, medication compliance is a fundamental factor that indicates the success of most patient education programs consisting of the drug as a component of therapeutic recommendation and plan. It is estimated that non-compliance in medication ranges from 20% to 70% (Curtis, Ramsden, & Lord, 2011). In the long-term medication regime for chronic disorders, the rate is approximated to be between 50% and 65% (Curtis, Ramsden, & Lord, 2011). From this perspective, patient education facilitates medication compliance that results in enhanced patient outcomes along with the reduced drug contraindication (Curtis, Ramsden, & Lord, 2011).
The relevance of this work to evidence-based practice is to give the best available proof about the level of compliance through patient education. Additionally, this paper will produce the most current evidence regarding patient education in nursing practice. Overall, the information generated by this assignment will be founded on the researches that have been carried out by other health care professionals and nurses.
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Strengths and Limitations of the Study Authors
The article by Zayas and McLean (2007) targets nurses, nursing students and other healthcare providers who are eager to promote better patient outcome through education. To start with, the title of the article by Zayas and McLean “Asthma Patient Education Opportunities in Predominantly Minority Urban Communities” reflects precisely what the study is about. In addition, the title has a suitable length and it provides key information to the audience about patient education in a population of people suffering from asthma. Looking at the article heading, one can identify two variables – these are patient education and urban minority communities. On the other hand, Kav et al. (2008) have conducted an investigation that purposed to discover the role of nurses in patient education as well as follow-up. The title of the research as well spells the topic under investigation along with the variables that are patient follow-up and education and the role of nurses. The peer-reviewed article is intended for health care providers and nurses that are engaged in patient education.
Zayas and McLean’s affiliations give them the potential and the credibility to conduct the investigation. The two researchers are associated with the Department of Family Medicine and Anthropology at the State University of New York, 462 Grider Street and 501 Tenth Street. At the same time, the study conducted by Kav et al. is also credible based on their work connections. All the authors are connected to various health departments in various countries.
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Major Themes Addressed in the Literature Review
The literature review by Zayas and McLean (2007) defines asthma regarding its prevalence to indicate the percentage of the adults, who suffer from the condition, living in the United States. Furthermore, the literature review identifies Hispanics and Blacks among the racial minority in America who are greatly affected by asthma, especially those that live in Niagara Falls, New York, where the research is conducted. Furthermore, the literature review addresses the concept of patient education and suggests that it is a critical part of asthma management. On a positive note, the review notes that the acquisition of knowledge does not mean that preventive behaviors will be adopted. To elaborate more about this problem, the literature review recognizes various factors that influence patient education such as business pressures, insufficient time and resources, and competing practice needs. Moreover, the review section shows the application of critical theory in the study.
The theory is used to raise questions of asthma inequities from the view of a political economy by assessing types of ideas and it gives the understanding of rationality. Whereas, the literature review by Kav et al. (2008) discusses oral chemotherapy that is used as a component of cancer patient therapy regimens. The themes that arise include non-adherence to medication by the patients as well as the nurse’s role in education and compliance. The review shows that in most events, health care providers presume that their patients take the prescribed drugs properly. However, the increasing rate of non-compliance to drug therapy among the patient populations, medical specialists as well as in health care environments is an indication of a big problem (Kav et al., 2008).
Strengths and Limitations of the Literature Review
The strength of the literature review by Zayas and McLean (2007) lies in its ability to provide a summary of what is known about asthma and patient education. Likewise, it clearly explains what has been investigated along with the participants. Additionally, the literature review mentions the research questions that have given the predictions that are underpinned by the review. The study question states: “What educational interventions are present and can be developed to ensure enhancement in asthma self-management expertise among individuals in disenfranchised and unfortunate urban minority groups suffering from high asthma rates?” (Zayas & McLean, 2007). Moreover, the literature review provides a clue about the study design by stating that a qualitative inquiry would be used to obtain the opinion of the participants. In contrast, the literature review by Kav et al. (2008) has failed to show the research hypothesis; this could be used to predict the research outcomes. In addition, the literature review fails to provide a hint about the type of research methodology that is used by the investigators. The researchers emphasize that there is a remarkable variation in the level of nurses’ education (Kav et al., 2008).
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Gap (Problem Statement)
In their study, Zayas & McLean (2007) note that there is a gap between patient education and knowledge. The traditional office-based patient education is not very effective in the promotion of asthma coping behaviors and management that is responsive to the setting of urban minorities. For this reason, the researchers have performed an analysis on alternative and existing asthma education along with information sources among the urban minorities living in New York. Similar to Zayas and McLean (2007), Kav et al. (2008) agree that there is a variation between the patient’s level of awareness and the process of patient education.
The study by Zayas and McLean (2007) aims to uncover teaching methods that are currently used to educate patients about asthma as well as other techniques that could be implemented for better management. To attain this objective, the researchers have explored alternative and traditional strategies to asthma while Kav et al. (2008) intended to find out the universal gap in oral CT education. In addition, the study evaluated the function of the nurse in follow-up and education in individuals who were scheduled for oral CT regime.
Consistency between the Literature Review, Problem, and Purpose Statements
It is worth noting that there is consistency between purpose statements, the literature review, and the problem in the report written by Zayas and McLean (2007). Mainly, the issue of asthma patient education is addressed throughout the document that is assessed through the analysis of the available learning materials. On the other hand, the literature review by Kave et al. (2008) lacks consistency because divergent issues are brought up through the evaluation of different investigations. While the intention of the research is to explore the role of the nurse in patient education, the literature review focuses on medical errors and lack of protocols and guidelines.
Zayas and McLean (2007) aimed to conduct the study among the Black and Hispanic communities residing in Western New York. Town hall meetings that made it easier to access the targeted population were held in four locations. These localities include Buffalo Hispanic West Side, Buffalo Black East side, and black Niagara Falls neighborhoods. The study employed four focus groups that obtained information about asthma management (Zayas & McLean, 2007). At the same time, Kave et al. (2008) conducted the investigation in Thailand, India, Spain, Lithuania, Serbia, USA, China, Greece, the UK, Kenya, Denmark, Israel, Finland, Australia, and Palestine. The researchers involved nurses working with cancer patients from each country.
The research by Zayas and McLean (2007) employed a convenience sampling technique, where a not-for-profit health education entity, which was in touch with the target minority groups, was used to get the study sample. Convenience sampling is used by a researcher to choose a sample from a group of people who are at reach. The methods used to recruit the subjects entailed word of mouth, postings, and presentations in community centers.
Major Characteristics of Sample
The sample was made up of adults who either took care of asthma patients or those who had been diagnosed with the illness. Additionally, the public took part in three town hall meetings, mainly, high school students aged between 15 and 16 years, regardless of whether they had the illness or not. Most of the high school scholars were of black descent.
Representativeness of Sample
The study sample had a total of 168 participants, of which 109 attended town meetings while 59 were in the focus groups. Black participants constituted 71% of the group, which represented a number of 42 persons. Hispanics constituted 24% of the group, or 14 individuals. At least three whites, or 3%, took part in the study (Zayas & McLean, 2007). Kav et al. (2008) recruited 1,115 oncology nurses from the identified countries.
The research sample employed by Zayas and McLean (2007) is small as compared to the one that was used by Kav et al. (2008). From this point of view, the small sample implies that the results of the study cannot be generalized to the entire population of Hispanics and blacks living in other parts of the United States. In addition, a small sample makes it impossible to achieve any statistical significance of the outcomes unlike a big sample.
The Strengths and Limitations of Study Design
The study design by Zayas and McLean (2007) comprised small and large discussion groups. Likewise, Kav et al. (2008) used 17 focus groups that constituted both professional and patient categories. The strength of this study methodology is that it has been able to extract creative and stimulating ideas as well as the exchange of information and identification of challenges. Moreover, this design provided a platform where innovative asthma solutions could be realized (Zayas & McLean, 2007).
Major Study Variables
The predominant study variables in the study by Zayas and McLean (2007) were patient education and knowledge of asthma management skills among the participants.
Data Collection Process
During the trial, data was collected using semi-structured interview schedule by trained moderators selected from every community in-charge of the meetings. Medical anthropologists qualified in asthma experiments developed a set of 10 questions that were utilized in interviews. At least 10 open-ended questions were subjected to the focus group, whereas the town meeting sample was exposed to 8 of the 10 questions (Zayas & McLean, 2007). Similarly, Kav et al. (2008) employed a questionnaire with 16 open-ended and multiple-choice questions. Only one open-ended question was used to determine the nurses’ opinion on how to improve patient education.
The tools used to collect data were the use of interviews and paper pencil questionnaires. The interviews consisted of 10 questions that were open-ended. The questionnaire consisted of 16 open-ended and multiple-choice questions. The use of open-ended questions to perform the interviews enabled the researchers to get a variety of answers from the study sample. In addition, it promotes the response rates because most people tend to engage the participants. Nevertheless, the use of open-ended questions may have limited this research in the view that most individuals do not like to engage in activities that require them to write and compose a response. From this angle, the researchers may have missed critical data because of the type of questions employed in the questionnaire, whereas the use of multiple-choice questions made it easy to obtain a code during analysis. The validity of both studies was based on the questions in the questionnaire, whether they reflected the intent of the study and the extent the respondents were in a position to respond to the questions. Reliability in both studies was measured on the correlations amid the variables.
The university institutional review board and other institutional review boards gave their consent to the studies for the safety of the subjects to uphold their human rights (Zayas & McLean, 2007). The consent implies that the researchers informed the participants regarding the study and the expected risks. In addition, the investigation must have obtained a participation consent where the subjects were at liberty to withdraw from the research at any given time and were assured of personal respect.
Strengths and Limitations of Data Collection
The strength of the process employed to protect the subject was based on respect for beneficence, autonomy, and non-maleficence. There is no indication of any limitations encountered by the process of protecting the study sample.
Process Used To Protect Participants
The investigation respected the autonomy of the participants by selecting a sample from a group of volunteers and providing a consent form.
Ethical Conduct of Research
The principle of beneficence was promoted through patient education that enlightened the participants about asthma self-management expertise, whereas the principle of non-maleficence was maintained through the implementation of Hippocratic Oath of the medical discipline.
Data Analysis Process
Data analysis by Zayas and McLean (2007) was separated into two groups, that is, town meeting and focus groups. In addition, data analysis was grounded on the age and ethnicity of the subjects. Thereafter, different results were contrasted to develop asthma education sources, perceptions, coping activities along with therapy. The findings were classified and itemized through consensus. In order to confirm the analysis, audio recordings were reviewed to clarify the accuracy of transcription and particular statements. Likewise, to increase the degree of trustworthiness of the analysis, an assessment of conflicting and missing proof in the transcripts was conducted.
Descriptive and Inferential Statistics
Descriptive statistic was based on the information derived from the use of the questionnaire. The statistical analysis carried by Kav et al. (2008) involved chi-square and descriptive tests. The accepted findings included those with a p value of less than 0.05 and the answers obtained from open-ended questions were categorized in themes and analyzed as percentages (Kav et al., 2008).
On the perspective of patient education, the research findings reveal that sources of asthma information fall under four categories. These categories encompass education organizations, health care system, public health, and media communication. On the view of fundamental asthma knowledge, the outcomes show that a good number of patients are unaware of the management and the nature of the condition (Zayas & McLean, 2007). In addition, the effectiveness of patient education depends on the role of nurses. The availability of work protocols and professional competencies makes it easy to promote patient compliance to therapy (Kav et al., 2008).
Study Limitations and Usefulness
Both studies have produced evidence, which proves that patient education is the key to improved compliance. Patients as well as the public use unconventional and conventional methods to obtain information regarding diseases and treatment. Furthermore, the participants perceive Community Asthma Workshops as complementary to office-based training because it comprises health care advocates and professionals. These findings are consistent with the argument by Kav et al. (2008) that nurses are the key players in patient education, which enhances adherence to therapy. The researchers note that patients do not follow medication regime prescribed by health care professional due to ignorance. While some patients say that they forget to take the drugs on time, others state that they deliberately refuse to administer the medication. This behavior has dire consequences such as adverse drug effects. To prevent these challenges, nurses should train the patients and families on the need to take the prescription at the right time in the correct way (Kav et al., 2008). Hence, nurses are an integral part in facilitating proactive follow-up in disease management, patient education, symptom management, and communication. This form of reasoning could be used to explain the failure of traditional office-based patient education, which could be attributed to the performance of nurses involved in the process. As noted by Kav et al. (2008), the nurses are in a better position to make personal support; however, these nurses encounter challenges such as insufficient education materials and workplace protocols (p. 1075-1083). Workplace guidelines lay out the process of patient education, which has an impact on the quality of patient education.
The degree of believability of these research outcomes is high, which is grounded on the point that conflicting results were resolved through the provision of supportive proof (Zayas & McLean, 2007). Overall, the major study restrictions include the use of convenience sampling and the size of the sample. Nevertheless, these investigations are useful in nursing because they give recommendations for the use of patient education as a way of enhancing compliance. The implications of the research results in nursing are the generation of information on alternative and standard asthma information sources and education. Additionally, the critique discloses ways to improve patient education, for instance, training programs for nurses, the development of guidelines, and availing enough resources to ensure accessibility of educational materials. Other approaches that promote compliance entail one-on-one counseling, improved patient-nurse relationship, and written information that is supported verbally (Kav et al., 2008).
In conclusion, the critique reveals that patients and others learn more about diseases from various sources that are convenient to them. Secondly, most people lack useful information, which interferes with disease management. Third, community asthma workshops are more effective as compared to office-based training. Fourth, it is evident that nurses are the backbone of patient education.
One thing I have learned from this critique is that disease management is satisfied when the patients or caregivers are more informed about a disease. Hence, patient education is a platform that is capable of making it possible for the patients to understand the importance of medical treatment. Therefore, in future, my role as a nurse will be to advocate patient education as a component of individualized action plans with an aim of achieving the intended results through therapy compliance. Additionally, I will implement patient education with an objective of minimizing severe drug effects as well as to educate patients and families about self-management.
After the completion of this critique, I have learned that nursing decisions are informed by outcomes of experiments that are performed in the area of interest, which is referred to as EBP.