Page 4

P - Informed Self-Management

Who Provides SCI Patient Education in Canada ? Every participating E-Scan site offers specific services directed to patient education or to promoting adjustment to disability, with the majority of sites indicating services associated with both practice areas. These practices are viewed as interdisciplinary, with nine sites reporting multiple providers. Figure 5.0 shows a summary of the most prevalent provider types delivering education-related services. There is some variation, across the country, with respect to who is involved in delivering education with nurses, psychologists, social workers, PTs, OTs and physiatrists taking key roles, within an interdisciplinary team. There are also several sites (n=7) that partner with offsite or community personnel to deliver these programs, with case coordinators/managers, personnel from SCI Canada, consumers providing peer support, and teachers all playing a role. FIGURE 5.0 prevalent provider types delivering education -related services 0 2 4 6 8 10 12 Nurse (RN) Occupational Therapist Social Worker Physiotherapist Physiatrist Education Specialist Psychologist Case Coordinator Respiratory Therapist Peer Support/CPA TR Specialist Dietitian/Nutritionist Number of Sites Current Practice and Resources Used in Education Programs An in-depth inventory of educational practice was not conducted as part of the Rehabilitation E-Scan. However, several practices and educational resources were noted by E-Scan respondents, which the authors supplemented with others recognized across the country. In general, most programs conduct structured patient education sessions, which often consist of didactic seminar-style sessions, with an opportunity for questions/answers on a series of topics deemed relevant to individuals undergoing SCI rehabilitation (e.g., intro to SCI, skin care, bowel and bladder care). These sessions are typically conducted by a rotating group of healthcare providers (see Figure 5.0) and include multimedia resources (e.g., Powerpoint). For the most part, sites seemed satisfied with their educational programming. Only three sites identified that they felt that their services in this area were not “adequate” and needing improvement. Notably, six sites identified themselves as having specialized expertise in educational initiatives. In addition, three sites reported having specialized clinical educators, while others indicated the use and creation of specific educational resources. These include patient manuals, binders, handouts, websites, eLearning modules and local resource centres. Some of the tools were developed or customized in-house and others, by third parties (see Educational Resources). Peer support services (see Figure 6.0) – identified by at least four sites – are shown to be an important component of effective educational programming to facilitate informed self-management.5 Most often, these services are coordinated in partnership with SCI Canada who identifies suitable candidates and provides training to ensure the provision of effective peer support. FIGURE 6.0 PEER SUPPORT The unique role of the Education Specialist Educational specialists have been hired in three programs to facilitate and enhance patient and/or staff education. These specialists educate staff in the most effective ways to disseminate information, and how to incorporate adult educational or self-management principles, within their programming – an important aspect of their service delivery model. Typically, adult education principles (such as active learning strategies, structured practice and feedback) are not included in training for healthcare providers, nor for many rehabilitation care providers who equate patient education with information dissemination, rather than skill development about general principals of self-management. As part of the clinical team, educational specialists are well positioned to enable staff to deliver the most effective methods for structured and unstructured education sessions, to create educational resources, and to conduct activities for all audiences (patients, families, caregivers and staff). Presently, it’s uncertain to what extent expertise to facilitate self-management skill development is incorporated in staff training (i.e., if care providers are instructed on the best methods to facilitate barrier identification, action planning, systematic problem solving), and whether these approaches are conducted and/or documented during inpatient rehabilitation. INFORMED SELF-MANAGEMENT | PARTICIPATION 161


P - Informed Self-Management
To see the actual publication please follow the link above