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The training of health operators in patient education
Patient education is recognised as an essential therapeutic tool in all chronic diseases, but is not yet inserted into normal curricula for doctors or other health operators. Things are changing, however, in certain experimental medical courses in Europe and the United States and in numerous paramedical university diplomas, in which training in patient education is becoming a basic subject.
Setting up the patient in a self-managed program for a chronic illness requires, in fact, knowledge of the communication tools and psycho-social factors which motivate the patient to treat himself on a daily basis, rather than seeing the therapy as an imposition and impediment to leading a normal life. For today's health operators this entails accepting a new professional identity which does not correspond to the standards previously proposed, either as a health operator or an educator. The new health operator must be motivated to assume a participatory rather than a prescriptive attitude, a supporting rather than a guiding role, and he must be able to translate professional jargon into everyday language. In the framework of educational activity, the old-fashioned educator set as his objective improving the compliance (obedience) of patients to his prescriptions, adopting attitudes and methods of traditional education. Shifting the objective from compliance to participation proves too difficult for numerous health operators. By participation we signify that today's educator is one who pays attention, listens, responds and unconditionally accepts the other. He does not find gratification in the obedience of others but is committed to promoting the autonomy of each patient.
Until the moment when students will be able to benefit from a new type of training, it is now, in any case, necessary to promote initiatives to train today's operators to educate diabetic patients.
In recent years the DESG has offered one-week training workshops for doctors, nurses and dieticians involved in diabetes care. Health care providers have also had the possibility to train in diabetes education participating in the patient education process in selected European and American diabetes units. But now the time is ripe for the development of formal curricula for health care providers in the field of therapeutic patient education.
For this reason in 1998 a WHO-Euro Working Group published a report entitled, "Therapeutic Patient Education: continuing education programmes for healthcare providers in the field of the prevention of chronic diseases". This document lays down the basic principles concerning educational programmes for chronically ill patients and defines the competencies of health care providers in the field of patient education. Moreover, it provides a list of all the chronic diseases for which patient education may have a therapeutic role. Finally, several examples of one-week to three-year formal courses for health care providers are given, which observe the strictest educational standards and provide different levels of proficiency in the field of therapeutic education.
When courses based on this document are implemented, patients suffering from chronic diseases will be more effectively treated by doctors, nurses and dieticians skilled in the multidimensional approach to the person - at once biomedical, psychological and educational - which alone can close the present gap between the progress of science and its translation into practice. |
