Competency in delivering health education: A concept analysis
Introduction
Evidence shows that patient education can potentially save healthcare dollars by improving disease management because it increases mobilization, decreases length of hospital stay, and decreases treatment costs.1 Health or patient education is considered essential for high-quality healthcare2 and for effective clinical nursing care.3 The terms health education and patient education are used interchangeably not only because they have similar theoretical principles, but also because health-related behaviors are important for both patients and for healthy people.4 According to a consensus of 62 international experts in healthcare,5 health education is an important element of health promotion because it improves health maintenance and reduces risky behavior.
Notably, patient or health education is now an integral component of nursing practice and a critical component of allied health professionals.6,7 Health or patient education is included in several scales for measuring nursing competencies.8, 9, 10 Although competency in delivering patient or health education is now considered essential for improving public health, this professional competency has not received the attention it deserves. Possible explanations for the limited interest are the poor understanding of health education competency (HEC) by workers in the medical field; lack of knowledge of and consensus on the definitions and concepts of such competencies; lack of time, skills and clear protocols for developing the teaching competency of clinical nurses; and the indifference of patients.11,12
Additional problems encountered while conducting patient education include the use of disease-centered approach rather than a patient-centered approach,13 exclusion of family or relatives in the education of the patient, lack of educational assessment and outcome evaluation,11 and lack of confidence in the educator due to poor content-specific knowledge and teaching skills.14,15 Finally, the lists of competencies for health educators in World Health Organization declaration are too difficult to achieve and do not indicate the competencies should be prioritized. Especially for healthcare professionals in a busy bedside settings, they have limited value for performing tasks such as coordinating provision of education services or implementing health education programmes.
Thus, to establish realistic requirements for health professionals responsible for delivering health education in their everyday work schedule, this study developed a comprehensive health education model that can be applied by health professionals. Identifying key competencies of health education is an important step in the validation of current practices and provides a springboard for innovation and advancement in health professions education. Notably, the terms health education and patient education are used interchangeably in this study because they are used interchangeably in the literature.
Section snippets
Methods
To explain the properties of concept, this study used the evolutionary method of concept analysis developed by Rodgers.16 The steps of the method are listed in the following.
Results
The data analysis revealed that the education process requires interpersonal interaction and facilitation of health awareness. Competency is both a skill and an attitude. Healthcare workers must provide an atmosphere in which clients perceive that they have support in dealing with their unhealthy behaviors and real-life health problems. Table 1 shows that the three major attributes of competencies in delivering health education are professionalism, empowering, and teaching.
Discussion
This concept analysis raises important considerations for the practice and delivery of health education. Attributes identified in this research substantiate the existing health education practice or research. For example, the three core competencies correspond to the four components of the Health Empowerment Program48 implemented in Hong Kong (i.e., assessing health, promoting health literacy, enabling self-care and acting as health ambassador) and have some similarities with the Four
Conclusion
Based on the results of a synthesis of clients, nurses, and health authorities, this study identified the essential elements in delivering health education and conceptualized it as skills which integrated professional knowledge and interpersonal skill into teaching process. These elements were integrated into an HEC model and can be conceptualized using a golfing metaphor which a golf player holds a club with two hands representing professionalism and teaching. The use of various clubs to hit a
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