Factors Affecting Patient Learning In Health Care and Nursing Education

Patient Learning In Health Care and Nursing Education and Factors Affecting It 

Personal Attributes Affect on Patient Learning,Environmental Influences on Patient Learning,Relationship Systems In Health Care and Effect on Learning Process,Motivational Axioms In Patient Learning,State of Optimal Anxiety In Learning,Learner Readiness and Affect on Learning,Realistic Goals of Learning.

Personal Attributes Affect on Patient Learning 

    Personal attributes of the learner such as developmental stage, age, gender, emotional readiness, values and beliefs, sensory functioning, cognitive ability, educational level, actual or perceived state of health, and severity or chronicity of illness can shape an individual’s motivation to learn. Functional ability to achieve behavioral outcomes is determined by an individual’s physical, emotional, and cognitive status. 

    The individual’s perception of disparity between the current and expected states of health can be a motivating factor in health behavior and can drive readiness to learn.The learner’s views about the complexity or extent of changes that are needed can shape motivation. Values, beliefs, and natural curiosity can be firmly entrenched and enduring factors that also can shape desire to learn new behaviors. 

    Other factors, such as sensory input and processing of information and short term and long term memory, can affect motivation to learn as well. Emerging interest about male female behavioral and learning differences indicates the need for in-depth research on gender related characteristics that affect motivation to learn. 

Environmental Influences on Patient Learning

    Physical characteristics of the learning environment, accessibility and availability of human and material resources, and different types of behavioral rewards all combine to influence the motivational level of the individual. The environment can create, promote, or detract from a state of learning receptivity. Pleasant, comfortable, and adaptable individualized surroundings, for ex- ample, can promote a state of readiness to learn. 

    Conversely, noise, confusion, interruptions, and lack of privacy can interfere with the capacity to concentrate and to learn.The factors of accessibility and availability of resources include physical and psychological aspects. Can the client physically access a health facility, and once there, will the health care personnel be psychologically available to the client? Psychological availability refers to whether the healthcare system is flexible and sensitive to patients’ needs. 

    It includes factors such as promptness of services, socio-cultural competence, emotional support, and communication skills. Attitude influences the client’s engagement with the healthcare system.The way in which the healthcare system is perceived by the client affects the client’s willingness to participate in health promoting behaviors. 

    Behavioral rewards permeate the foundations of the learner’s motivation. Rewards can be extrinsic, such as praise or acknowledgment from the educator or caretaker. Alternatively, they can be intrinsically based, taking the form of feelings of a personal sense of fulfillment, gratification, or self-satisfaction.

Relationship Systems In Health Care and Effect on Learning Process

    Family or significant others in the support system; cultural identity; work, school, and community roles; and teacher-learner interaction are all relationship-based factors that influence an individual’s motivation. The interactional aspects of motivation are perhaps the most salient because the learner always exists in the context of interlocking relationship systems.Individuals are viewed in the context of family/community/ cultural systems that have lifelong effects on the choices that individuals make, including healthcare seeking and healthcare decision making. 

    These significant other systems may have an even greater influence on health outcomes than commonly acknowledged, and the nurse, when in the role of educator, needs to consider the health-promoting use of these systems. Collectively, these factors interact to address the motivation of the learner. They are not comprehensive theory constructs but rather forces that act on motivation, serving to facilitate or block the desire to learn. 

Motivational Axioms In Patient Learning

    Axioms are premises on which an understanding of a phenomenon is based. The nurse as educator needs to understand the premises involved in promoting motivation of the learner. Motivational axioms are rules that set the stage for motivation. 

They include:

(1) the state of optimal anxiety

(2) learner readiness

(3) realistic goal setting

(4) learner satisfaction/success

(5) uncertainty reducing or uncertainty maintaining dialogue 

State of Optimal Anxiety In Learning

    Learning occurs best when a state of moderate anxiety exists. In this optimal state for learning. the learner’s ability to observe, focus attention, learn, and adapt is operative (Peplau, 1979). Perception, concentration, abstract thinking. and information processing are enhanced. Behavior is directed at a learning or challenging situation. 

    Above this optimal level, at high or severe levels of anxiety, the learner becomes increasingly self absorbed (Shapiro, Boggs, Melamed, & Graham Pole, 1992), and the ability to perceive the environment, concentrate, and learn is reduced. If at less than the optimal level, the learner who has low anxiety is not very driven to act. Thus, a moderate state of anxiety can be comfortably managed and is known to be most effective in promoting learning (Kessels, 2003; Ley, 1979; Stephenson, 2006).

    For example, a patient who has been recently diagnosed with breast cancer and who has a high level of anxiety will not respond at an optimal level of retention of information when instructed about treatment options. When the nurse assists the patient in reducing anxiety through techniques such as guided imagery, use of humor, words of reassurance, or relaxation tapes, the patient will respond with a higher level of information retention. 

Learner Readiness and Affect on Learning

    Desire to move toward a goal and readiness to learn are factors that influence motivation. Desire cannot be imposed on the learner. It can, however, be significantly influenced by external forces and be promoted by the nurse as educator. Incentives are specific to the individual learner. An incentive for one individual can be a deterrent to another. 

    For example, suggesting a method of weight reduction that includes physical exercise may be an incentive for one client and totally unappealing for another. Incentives in the form of reinforcers and rewards can be tangible or intangible, external or internal.

    Acting as a facilitator to the learner, the nurse as educator offers positive perspectives and encouragement, which shape the desired behavior toward goal attainment. By ensuring that learning is stimulating, making information relevant and accessible, and creating an environment conducive to learning, educators can enhance motivation to learn. 

Realistic Goals of Learning

    Goals that are within a person’s grasp and possible to achieve will likely be something toward which an individual will work. In contrast, goals that are significantly beyond the person’s reach are frustrating and counterproductive. Setting unrealistic goals that lead to loss of valuable time can set the stage for the learner to give up.

    Setting realistic goals by determining what the learner wants to change is a motivating factor. The belief that one can achieve the task set before him or her facilitates behavior geared toward achieving that goal. Goals should parallel the extent to which behavioral changes are needed. 

    Determining what the learner wants to change is a critical factor in setting realistic goals. Mutual goal setting between the learner and the educator reduces the negative effects of hidden agendas or the sabotaging of educational plans.