Patient education in Finland

No mandated policies, practices, and procedures of patient education or patient health education exist in Finland but the efforts have been local in nature. Traditionally, primary and secondary health education as a part of maternal health care and during dental appointments have been known to exist. Hospital patient education efforts which may have resulted from past public health problems or legislative endeavors do exist in many hospital units but official hospital policies or strategies still do not. Patient education is often seen as health education. Voluntary agencies tend to emphasize practical issues rather than strategic planning in patient education. Finland complies with the WHO health strategies of 2015, and as a part of the Finnish strategies, it is considered important that large groups of people participate. A recent movement in health care to plan and implement shared decision-making activities (Seamless Macro Project, Path-project) is still short-term in nature. Practical actions are guided by professional skills, ethical practices, professional norms, and habits of the land, and of the three laws (public health law, occupational health law, patient status and rights law) guiding health education activities, the third one is specifically directed to patient education with an intent that when a treatment is not acceptable, another acceptable one must be found. Empowerment is a term seen in many contexts.     

Patient education in Hungary

Patient education is a highly context dependent activity. The Hungarian scene is conditioned by three well articulated aspects. First, the well developed and still cherished roots of dissemination of knowledge; second, the traditional sensitivity of ethical issues in health related, including death and dying issues; third, the present fast socio-political changes in this country. The health promoting hospital movement's widespread activities as well as behavioral sciences, mental health and health psychology aspects of patient education are also reviewed. The theoretical as well as skills aspects of communication and systematic attempts to increase the effectiveness of interactions are also presented.     

Patient education in Estonia

Following the developments in Health Promotion in Estonian Health Care during the past 5-6 years, it is possible to observe remarkable progress in this field. The fundamental achievement is the shifting of a patient into the attention centre of the health care system. The patient-oriented approach means: to increase the involvement of the patient and his/her family in valuing and maintaining their health and modelling healthy behaviour; coping with chronic disease in relation to everyday activities; patient satisfaction; psycho-social support and counselling. The patient education is a multiprofessional teamwork and interdisciplinary co-operation that should be carried out in two levels mainly: primary health care and hospital levels. The key-persons in patient education are family doctors, nurses and trained hospital staff. It is essential for the development of health promotion in hospitals to incorporate the idea of health promotion as an integrated part of everyday work in addition to the traditional curative function.     

Patient education in thyrotoxicosis

The aim of the study was to assess the need for a thyrotoxicosis patient education programme and to evaluate a group education session. Patients with thyrotoxicosis were sent questionnaires on knowledge, satisfaction and mood. Patients showed limited knowledge about thyrotoxicosis. Newly diagnosed patients did not differ significantly from those who had been diagnosed more than a year previously. There was no significant relation between knowledge and other measures, but satisfaction was significantly correlated with mood. A further 82 patients were recruited to evaluate a group education session. Patients were randomly allocated either to receive a leaflet about thyrotoxicosis or to attend a group education session in addition to a leaflet. Comparison of the two groups showed a significant difference in anxiety (p = 0.02) but no significant difference in knowledge. Only 9 of 31 patients attended the group education session, and no significant differences were found between those who did and did not attend. Patients in the trial who all received leaflets, were more knowledgeable (p = 0.05) and more satisfied (p < 0.05), than those in the initial survey. Patients with thyrotoxicosis have limited knowledge about their condition. The offer of a group education programme had little effect on that knowledge but was associated with a reduction in anxiety. The provision of leaflets alone seemed to improve knowledge and satisfaction compared with no leaflets, but as this was not a randomised comparison, further evaluation is needed.     

Patient education in general practice

To study health education as provided by physicians, 550 videotaped doctor-patient interactions have been observed. Attention has been paid to the amount of information given about cause of illness, diagnosis, examination, purpose of treatment and prognosis. Though in most cases some information is given about some of these aspects, a real explanation is a far more unusual phenomenon. Instructions about the use of medication and home remedies are given in 70% till 80% of the cases. In 7% of the cases, the doctor imparted basic knowledge about illness, while in 15% of the cases life-style was discussed. These last two activities, going beyond the particular complaints that the patients presented, are called patient education.After describing the amount of information, instruction, and education given, the relationship between the interaction during the consultation and the information communicated is studied. Interest and concern for the patient, as shown by the doctor has a positive relationship with information giving. However, it did not increase patient's tendency to ask questions. Patient centered behaviour of the doctor did not show a relationship with information giving nor with question asking. In fact, the best predictor of both the amount of information given in a consultation as well as of the degree of questioning was the duration of the consultation.     

Regional differences in semen quality in Europe

Recent reports have indicated a decrease in semen quality of men in some countries, and suggested regional differences. A study was undertaken of semen samples from 1082 fertile men from four European cities (Copenhagen, Denmark; Paris, France; Edinburgh, Scotland; and Turku, Finland). Semen analysis was standardized, inter-laboratory differences in assessment of sperm concentration were evaluated, and morphology assessment centralized. Lowest sperm concentrations and total counts were detected for Danish men, followed by French and Scottish men. Finnish men had the highest sperm counts. Men from Edinburgh had the highest proportion of motile spermatozoa, followed by men from Turku, Copenhagen and Paris. Only the differences between Paris/Edinburgh and Paris/Turku were statistically significant (P < 0.003 and P < 0.002 respectively). No significant differences in morphology were detected. A general seasonal variation in sperm concentration (summer 70% of winter) and total sperm count (summer 72% of winter) was detected. Semen quality of a 'standardized' man (30 years old, fertile, ejaculation abstinence of 96 h) were estimated. Typically, sperm concentrations (x 10(6)/ml) for winter/summer were: Turku 132/93; Edinburgh 119/84; Paris 103/73; and Copenhagen 98/69. These differences in semen quality may indicate different environmental exposures or lifestyle changes in the four populations. However, it remains to be seen whether such changes can account for these differences. These data may also serve as a reference point for future studies on time trends in semen quality in Europe.     

Patient education in nursing-Polish literature condition

The aim of the review is to present the results of an analysis and evaluation of the state of research on patient education based on the Polish nursing literature. A review and analysis of 139 research works was carried out, which during the years of 1990-2001 appeared in Polish nursing journals as well as in post-conference and convention proceedings and reports. The collected material was evaluated according to the following criteria: defining the research problem, defining and operationalising the variables studied, the research tool applied, the research method used, the size and selection of the research sample, the results achieved. The analysis of research works carried out in the area of patient education became the basis of the objective knowledge of the current state of research and its relation to the nursing practice in this area.     

Patient education in Dutch hospitals.

Studies among patients, nurses, and doctors in Dutch hospitals reveal the need for health education. Patients are dissatisfied with the information received and feel that nurses and doctors fail to meet their expectations regarding health education. More attention needs to be given to older, alienated, and low socioeconomic-status patients. The exclusive use of health-education media (like booklets and videotapes) is limited. It is recommended that hospitals and nursing departments pay greater attention to the in-service training of personnel, appoint specialized health educators, and organize efforts at ward level to create a positive climate for educating patients about various diseases. The policy of the Dutch government and the activities of private organizations (eg, patient movements, radio and TV broadcasts) support the development of patient education in Dutch hospitals.     

Patient confidentiality: implications for teaching in undergraduate medical education

Respect for patient confidentiality is one of the core concepts of professionalism and should have high priority in medical education. Confidentiality should be introduced early in the curriculum so that students understand their ethical, professional, and legal obligations throughout their medical studies and later professional career. Anatomists have important opportunities for teaching professional values including confidentiality and should be major contributors to a multidisciplinary teaching on professionalism. Students should make a formal commitment to and be assessed on patient confidentiality in the context of professionalism. A Faculty development program on confidentiality and data protection will inform and support teachers in delivering these objectives. It is recommended that medical schools have a policy on patient confidentiality and a disciplinary procedure for the management of students who breach patient confidentiality.     

Patient education in general practice: opinions of general practitioners

Fifty-two general practitioners were interviewed regarding their task in patient education and various aspects of it. The view general practitioners have on patient education is complex. Although they consider it a central task, the range of methods they are willing to use is limited. Many general practitioners tend to overlook the fact that they are not the only source of information and explanation for patients. They would prefer to keep control over information given patients, fearing that patients might be confused. It is notable that many general practitioners have no clear standards of what patients need to know. Much depends on the questions the individual patient asks. There are several kinds of information that general practitioners are disinclined to give, particularly relating to uncertainties or information that might alarm the patient. The outlook for improvement must not be overestimated. Some directions are given for supporting the development of patient education.     

Patient education in Switzerland: from diabetes to chronic diseases

The Division of Therapeutic Education for Chronic Diseases at the University Hospital of Geneva has been playing an important role in the field of therapeutic patient education for more than 25 years. More than 16,000 patients have been hospitalised and an excess of 75,000 h have been spent with a rather novel interdisciplinary approach involving doctors, nurses, dieticians, psychologists, podiatrists and pedagogues. For the past 12 years, our division has held over 50 seminars of 1-week postgraduate training attended by over 3000 participants coming from more than 60 countries worldwide. In 1998, the faculty of medicine at the University of Geneva implemented a 3-year curriculum on therapeutic patient education leading to a postgraduate university diploma. In 1983, the WHO designated the Swiss teaching division as a WHO Collaborating Center for reference and research in diabetes education. In 1998, a WHO-Euro Working Group Report entitled "Therapeutic Patient Education. Continuing education programmes for health care providers in the field of prevention of chronic diseases" was published.