Patient education

Patient training courses are structured advanced training programs for patients , in which particular care is taken to ensure that the medical content relevant to them is understood by the target group and can be used in everyday life. The course (usually in the form of a course or seminar ) is not only carried out by doctors, but also by specialists from other health care professions , such as medical assistants , health and nurses , occupational therapists , physiotherapists , nutritionists , psychologists . Members of self-help groups and other affected parties can also be among the trainers' speakers. In the field of psychiatry and psychotherapy , patient and relatives training courses are called psychoeducation .

Patient education is used not only for chronic illnesses, but also as an aid to coping with foreseeable problems (for example, dealing with pain in connection with surgical procedures).

aims

Patient training courses aim to increase self-competence and self-management of those affected. They achieve this by imparting action-relevant knowledge (e.g. about the causes, consequences and therapeutic options of the disease), improving self-perception (e.g. keeping a diary) and practicing diagnostic and therapeutic skills (e.g. correct inhalation) or injecting medication, relaxation exercises). But psychosocial aspects of coping with illness are also discussed (e.g. dealing with fears, sadness, stigmatization in order to ensure that the patients participate). The exchange in the group of equally affected is an essential factor.

Patient education can often increase life expectancy and quality of life , even with chronic diseases . In childhood asthma, participation in a group training program was identified as a key predictor of achieving somatic and psychosocial therapy goals. Studies show that self-management-oriented patient training leads to improved lung function and well-being. The number of inpatient emergency admissions and days absent from school have also been reduced. The multi-professional patient training courses proved to be superior to the pure instruction in the use of medication. Patient education is therefore an integral part of the long-term therapy of asthma in the international medical guidelines.

Controversy

The achievement of lifestyle changes sought through patient education does not depend directly on the training competence of medical staff.

Legal status and quality criteria

In the law applicable to statutory health insurance ( Social Security Code  V), Section 43 (Supplementary benefits for rehabilitation ) regulates that patient training courses can be funded by the health insurance funds under certain conditions. Patient training courses for children and adolescents with asthma and diabetes are offered nationwide through the respective disease management program . Training courses for atopic dermatitis are financed through framework agreements with health insurance companies. There are currently no secured financing concepts for any other patient training in pediatric medicine. In Germany there are different pediatric clinical pictures, B. for obesity, asthma, diabetes and neurodermatitis, working groups that have defined quality criteria for the content and implementation of patient training courses. These quality criteria are recognized by the relevant medical societies and are checked by the cost bearers (especially the health insurance companies). Since 2009, the modular training program for chronically ill children, adolescents and their parents, ModuS, has also been a cross-disease training concept for pediatric diseases. The program funded by the Federal Ministry of Health comprises disease-specific modules and generic, i.e. H. modules that can be used for all diseases, such as B. Introduction and getting to know each other, coping with illness in the family system. Based on this, there are modular trainer training and a joint quality management system, so that the development of new training programs is simplified.

literature

• Review articles:
  • H. Faller, A. Reusch, K. Meng: DGRW update patient training. In: Rehabilitation. 50, 2011, pp. 284-291.
• Study results on the effectiveness and efficiency of neurodermatitis patient training for children, adolescents and their parents:
  • TL Diepgen, M. Fartasch, J. Ring, S. Scheewe, D. Staab, R. Szcepanski, T. Werfel, U. Wahn, U. Gieler: Neurodermitis training. Concept and current status of the German Randomized Intervention Multicentre Study. In: dermatologist. 54, 2003, pp. 946-951.
  • D. Staab, TL Diepgen, M. Fartasch, J. Kupfer, T. Lob-Corzilius, J. Ring et al .: Age-releated, structured education improve the management of atopic dermatitis in children and adolescens: results of the German Atopic Dermatitis Intervention Study (GADIS). In: BMJ. 332, 2006, pp. 933-938.
  • E. Weisshaar, TL Diepgen, T. Bruckner, M. Fartasch, J. Kupfer et al .: Itch Intensity Evaluated in the German Atopic Dermatitis Intervention Study (GADIS): Correlations with Quality of Life, Coping Behavior and SCORAD Severity in 823 Children. In: Acta Derm Venerol. 88, 2008, pp. 234-239.
• Study results on the effectiveness and efficiency of asthma patient training for children, adolescents and their parents:
  • Health education and outpatient training for secondary prevention of children and adolescents with asthma.
• Study results on the effectiveness and efficiency of diabetes patient training courses for children, adolescents and their parents:
  • R. Couch, M. Jetha, DM Dryden: Diabetes education for children with type 1 diabetes mellitus and their families. In: Evidence Reports / Technology Assessments. No. 166, 2008, pp. 1-144.

Model project of the Federal Ministry of Health, Volume 112 (1999)

• • T. Lob-Corzilius, F. Petermann: Asthma training - effectiveness in children and adolescents. Beltz, PVU, Weinheim 1997.

Individual evidence

1. ↑ V. Köllner et al.: Patient training in arterial hypertension. Urban & Fischer-Verlag, 2011, ISBN 978-3-437-59780-0 , pp. 1-5. (on-line)
2. ^ F. Schneider: Nursing patient training in the context of perioperative pain therapy. GRIN Verlag, 2007, ISBN 978-3-638-73824-8 . (on-line)
3. ↑ A. Weber, S. Groos, B. Hagen, J. Kretschmann, L. Altenhofen: Influential factors in the achievement of quality goals in the care of children and adolescents suffering from bronchial asthma. Findings of the DMP bronchial asthma from the North Rhine region . In: Prev. Rehab. tape 26 (2014) 10-15 .
4. ↑ J. Guevara, F. Wolf, C. Grum, N. Clark: Effect of educational interventions for self-management of asthma in children and adolescents: systematic review and meta-analysis . In: BMJ . tape 326 (2003) 1308-1313 .
5. ^ R. Szczepanski, R. Jaeschke, T. Spindler, for the ASEV study group: Preschoolers 'and parents' asthma children education trial (P2AET) - a randomized controlled study . In: Eur. J. Pediatr. tape 169 (2010) 1051-1060. .
6. ↑ Christopher C Butler: Training practitioners to deliver opportunistic multiple behavior change counseling in primary care. In: BMJ. 346, 2013, p. F1191.
7. ↑ G. Ernst, K. Lange, R. Szczepanski: Patient training in pediatric and adolescent medicine. Inventory of German-language concepts and needs analysis. In: Prev Rehabilitation. 2013, pp. 18–24.
8. ↑ Competence network for patient training
9. ↑ Ernst, G./Menrath I, Lange K, Eisemann N, Staab D, Thyen U, Szczepasnki R: Development and evaluation of a generic education program for chronic diseases in childhood . Ed .: Patient Education Counceling. 2017th edition. in press.

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