FUTURE DIRECTIONS FOR CLIENT EDUCATION

Patient education facilitates the maintenance and promotion of self-care

behavior through voluntary behavioral change activities. This usually
occurred at the bedside, in clinic waiting rooms, or in groups on the
hospital premises

GREATER EMPHASIS ON WELLNESS

it is expected for us to have a greater emphasis on wellness, which
shifts from a care system that focuses on illness to one that focuses on
wellness
emphasis on illness prevention and health promotion (Abruzzesse)

Wellness – state of complete physical, mental, and social well-being,

and not merely the absence of disease or infirmity
8 dimension of wellness
 intellectual wellness
 physical wellness
 environmental wellness
 occupational wellness
 emotional wellness - encourages autonomy
 financial wellness
 social wellness - helps create boundaries
 spiritual wellness - finds meaning in life and helps us find our
purpose

- wellness of an individual will be put into much focus and attention

through careful and convenient tracking and monitoring of individuals
habits daily activities and lifestyle

- nurses and health educators will have more opportunities to apply

empirical, aesthetic expressions, creativity, personal and ethical
wellness knowledge to their patients because of technology

- the role of the nurse would come in (in terms of giving info and caring
to prevent further illness)

PATIENT AND FAMILY CENTERED CARE

- patient and family centered care rather than provider of centric care, is
essential for patients and family in terms of giving them appropriate
responsibilities as well for self-management at home or in the hospital
- acknowledge that patients know themselves best
- quality care can only be achieved when we integrate patients and
family into decision making and care
- family is recognized as part of the health care team
- patient centered
- engaging the patient in shared decision making and shared care plans
so they are not objects of care

INCREASED 3RD-PARTY REIMBURSEMENT

Reimbursement – a sum paid to cover money that has been spent for
health care

- it is expected to increase as the cost-benefit ratios establish the cost-

effectiveness of customer education(Abruzzesse), as this helps in
accomplishment of payment for home health and allow educators and
social workers to work and assist their clients commendably
- organizes the flow of money and payment

- REIMBURSEMENT ASSITANCE (in the Philippines)

- provides enough finances to run health care organizations
- ensures that there is enough funding to take care of short-term
health care expenses and also long-term expenses
ex. PhilHealth - a mandatory national health insurance program for
employed Filipinos, which provides basic health care services
 Philhealth- sss, gsis procedure
 Pt- provide evidence for insurance, and pay partial of the expense

The rising costs associated with illness and resulting overuse of the
healthcare system have resulted in increased interest on the public and
health care providers to control costs. Today, more emphasis is given to
health promotion, health maintenance, and disease prevention. The
push for healthcare reform in this country has resulted in widespread
efforts targeted toward the concept of managed care

Concept of Managed Care

- Managed care would mean the reallocation of healthcare money to
selected groups who will share the money as well as the risks of
keeping people healthy
- It also means the opportunity to contain costs and eliminate
duplication or misuse of tertiary healthcare services As a result of some
economic concerns, the current trends in health care are directed
toward teaching individual show to attain and maintain health.

ECONOMIC FACTORS IN HEALTH CARE EDUCATION: JUSTICE

AND DUTY RESPONSIBILITIES
-the patient as a human-being has a right to good-quality care
regardless of his/her economic status , national origin, race and the like.
- organizations are challenged to ensure that their professional staff are
competent to provide educational services, while at the same time doing
so in the most efficient and cost effective manner possible.

Patient’s Bill of Rights – a document that provides patient’s with

information on how they can reasonably expect to be treated during the
course of their hospital stay.

Direct costs – are tangible, predictable expenses, a substantial portion

of which include
personnel salaries. Employment benefits and equipment.
- Time as a direct cost is a major factor included in a cost-benefit
analysis.
- Equipment classified as a direct cost. No organization can
function without proper materials and tools, which also means there is
the need to replace them when necessary.

TYPES OF DIRECT COST

1. FIXED COST
- Expenses that are predictable, remain the same over time and can be
controlled.
(e.g. salaries, mortgages, loan repayments.)
2. VARABLE COST
- Are those costs that, in the case of healthcare organizations, depends
on volume.
3. INDIRECT COST
- Are those cost not directly related to the actual delivery of an
educational program.
4. HIDDEN COST
- A type of indirect cost cannot be anticipated or accounted for until after
the fact.

COST SAVINGS, COST BENEFIT AND COST RECOVERY

Hospitals incur COST SAVINGS when patient lengths of stay are

shortened or fall within the allotted diagnosis related group time frames.

COST BENEFIT occurs when there is increases patient satisfaction

with the services an institution provides, including educational programs
such as childbirth classes, weight and stress reduction session and
cardiac fitness and rehabilitation programs.

COST RECOVERY results when either the patient or the insurer pays a
fee for educational services that are provided.
REVENUE GENERATION refers to income earned that is over and
above the cost of the program offered.
 FIlipino Cultural characteristics &
health care beliefs and practices in health education

WHAT IS CULTURE?
 Is defined as the "totality of socially transmitted pattern of thoughts, values,
meanings, and beliefs".
 Culture has been called "the way of life for an entire society." As such, it includes
codes of manners, dress, language, religion, rituals, and art.
 Culture determines the beliefs and values important to the learner that may
delineate her potential development for change. Some cultures compete with
change, others welcome change while some resist change. Thus, the socio-
cultural background and the learners' personal characteristics influence the
process of change. (Tan, 2017)

FILIPINO CULTURE
 The Philippines is a country that has varied cultural influences. Most of these
influences are results of previous colonization, deriving mainly from the culture of
Spain and the United States.

FILIPINO CULTURAL CHARACTERISTICS

 Filipinos are also mapagbigay or generous that even if they have nothing left,
they will still give you the best.
 They are always nakangiti or smiling even with the difficulties they are facing.
 Filipinos are very hospitable
 Filipinos have a very strong sense of “utang na loob” or indebtedness.

COMMON FILIPINO CULTURAL BELIEFS

 Say "tabi tabi po" when walking in the forest
 Do not go to shower when it is 12 noon
 Wounds take a longer time to heal during Good Friday
 Jump at the stroke of midnight every exact New year
 Do not go outside with no hat at night when you are pregnant
 Eat a twin banana when you are pregnant to have twin babies

WHAT IS FLIPINO CULTURE IN TERMS OF HEALTH

 SOME PRESENT-DAY FILIPINOS STILL BELIEVE THAT ILLNESSES ARE
BROUGHT BY LUCK, HEREDITY, THE CONCEPTION OF MATERNAL
CRAVINGS, HOT AND COLD SYNDROME, CURSES, MYSTICAL AND
SUPERNATURAL CAUSES, AND GOD'S WILL.

 A COMPLETE CURE OR EVEN THE SLIGHTEST IMPROVEMENT IN A MALADY

OR ILLNESS IS VIEWED AS A MIRACLE. FILIPINO FAMILIES GREATLY
INFLUENCE PATIENTS' DECISIONS ABOUT HEALTH CARE.HEALTH BELIEFS
AND HEALTH CARE PRACTICES OF FILIPINOS .

WHAT IS HEALTH BELIEF?

Health beliefs, particularly feelings of self-efficacy, relate to an individual's
perceived ability to perform a certain behavior. These perceptions of self-efficacy
may influence whether individuals will attempt certain behaviors and how the
behaviors will be carried out.
THREE THEORIES OF ILLNESS
Mystical Theory
- Is that if there are unfulfilled obligations from ancestors then this could result in
mystical experiences and behaviors. It also goes asfar asto say that during sleep the
soul can be lost or if you are having nightmaresthen they are often the result of
consuming a heavy meal and it could eventually lead to death (McBride, n.d.).

Personalistic Theory
- is that evil spirits or witches seeking retribution or social punishment can cause
illness. This theory can be protected by wearing religious objects or using holy
oils(McBride, n.d.).

Naturalistic Theory
- This theory states that stress, infection, food and drugs, and natural events such as
thunder, lightning, and drafts are all causes of illness(McBride, n.d.).

EXAMPLES OF HEALTH BELIEFS IN THE PHILIPPINES:

 Filipino older adults tend to cope with illness with the help of family and friends
and by faith in God. A complete cure or even the slightest improvement in a
malady or illness is viewed as a miracle.
 Herb men were called “herbicheros” meaning one who practiced witchcraft.
Persons suffering from diseases without any identified cause were believed
bewitched by “mangkukulam” or “manggagaway”.
 “Sumpa and gaba are beliefs in the Filipino culture pertaining to a curse. In
sumpa, the curse is inflicted by a human being. Gaba is a curse inflicted by a
divine being and it is usually God.
 Put a thread on your baby's forehead when they have hiccups.
 Not patting your sweat dry with a towel can cause you to get
pneumonia.Washing sweaty hands can lead to spasmodic hands or pasma.
 “Don’t sleep with wet hair”
 “Don’t take a bath when you have your period”
 By showing fondness or affection when meeting a baby for the first time, you
may cause the baby to feel uneasy or make the baby cry non-stop which is
commonly referred to as “na-usog.”
 During labor, the “mabuting hilot” (good midwife) was called in. If the birth
became difficult, witches were supposed to be the cause. To disperse their
influence, gunpowder were exploded from a bamboo cane close to the head of
the sufferer.

Folk Medicine Practices in the Philippines

 Orasyon or bulong (mystical prayers)
 Himulso (pulse checking)
 Pagtatawas (diagnostic ritual using candle wax dropped in a basin of water)
 Pasubay (determining the cause of sickness and possible treatment)
 Pangalap (searching of medicinal plants)
 Tayhop (gentle blowing),
 Tutho (saliva blowing)
 Hilot (traditional massage)
 Tapal (applying folk medicine on the affected area),
 Pangontra or kontra-usog (carrying an amulet to prevent diseases)
 Anting-anting or pampaswerte (lucky charm)
 Barang (sorcery)