مجله دانشکده پزشکی اصفهان

مجله دانشکده پزشکی اصفهان

آموزش بیمار، سواد سلامت و خودمراقبتی در مراقبت‌های پرستاری: یک مطالعه‌ی مروری

نوع مقاله : مقاله مروری

نویسندگان
1 استادیار، گروه پرستاری و مامایی، دانشگاه آزاد اسلامی ، واحد بابل، بابل، ایران
2 دانشیار، گروه فارماکولوژیف، دانشگاه علوم پزشکی بابل، بابل، ایران
10.48305/jims.v44.i863.0819
چکیده
مقدمه: آموزش بیمار، از مهم‌ترین ارکان مراقبت‌های پرستاری و اصلی‌ترین راهبردهای ارتقای سلامت است که نقش حیاتی و مهمی در ارتقاء سواد سلامت و تقویت رفتارهای خودمراقبتی دارد. با افزایش شیوع بیماری‌های مزمن،توانمندسازی بیماران برای مشارکت فعال در مدیریت بیماری بیش از گذشته اهمیت یافته است.این مطالعه با هدف مرور شواهد موجود در خصوص ارتباط آموزش بیمار، سواد سلامت و خودمراقبتی در مراقبت‌های پرستاری انجام شد.
روش‌ها: مطالعه‌ی مروری حاضر با جستجوی منابع در پایگاه‌های اطلاعاتی PubMed، Scopus، Web of Science، Google Scholar، SID و Magiranو با استفاده از کلیدواژه‌های Patient Education، Health Literacy، Self-care، Self-management، Nursing و Nursing Care انجام شد. مقالات منتشرشده به زبان فارسی و انگلیسی که به بررسی آموزش بیمار، سواد سلامت یا خودمراقبتی در مراقبت‌های پرستاری پرداخته بودند، پس از بررسی معیارهای ورود و خروج، مورد بررسی قرار گرفتند.
یافته‌ها: یافته‌های حاصل از مرور مطالعات نشان می‌دهد که آموزش بیمار، سواد سلامت و خودمراقبتی، سه مؤلفه‌ی به‌هم‌پیوسته و محوری در مراقبت‌های پرستاری به‌شمار می‌روند. به‌گونه‌ای که ارائه‌ی آموزش مؤثر، نخستین گام در جهت ارتقای سواد سلامت محسوب می‌شود و این ارتقا، از طریق تقویت توانایی بیماران در دسترسی، درک، ارزیابی و کاربست اطلاعات سلامت، زمینه‌ساز بهبود رفتارهای خودمراقبتی می‌گردد. در ادامه، بهبود خودمراقبتی با پیامدهای بالینی مطلوبی همچون افزایش پایبندی به رژیم درمانی، کنترل کارآمدتر بیماری، کاهش عوارض، کاهش میزان بستری مجدد و در نهایت، ارتقای کیفیت زندگی همراه است. شایان توجه است که به‌کارگیری فناوری‌های نوین آموزشی از جمله تله‌نرسینگ، اپلیکیشن‌های سلامت و هوش مصنوعی، می‌تواند اثربخشی آموزش بیمار را به‌طور قابل‌توجهی افزایش داده و نقش تسهیل‌گری در این زنجیره‌ی مراقبتی ایفا نماید.
نتیجه‌گیری: آموزش بیمار، یکی از حیاتی‌ترین مسئولیت‌های حرفه‌ای پرستاران است و سواد سلامت نقش کلیدی در تبدیل آموزش به رفتارهای مؤثر خودمراقبتی ایفا می‌کند. طراحی برنامه‌های آموزشی بیمارمحور، متناسب با سطح سواد سلامت و استفاده از فناوری‌های نوین اموزشی می‌تواند منجر به افزایش خودمراقبتی، بهبود سلامت و افزایش کیفیت مراقبت‌های پرستاری شود.

تازه های تحقیق

 

 

کلیدواژه‌ها
موضوعات

عنوان مقاله English

Patient Education, Health Literacy, and Self-Care in Nursing Care: A Review Study

نویسندگان English

Majedeh Nabavian 1
Mahmood Baradaran 2
1 Department of Nursing and Midwifery, Bab.c., Islamic Azad University, Babol, Iran
2 Associate Professor of Pharmacology Department of Pharmacology, School of Medicine Babol University of Medical Sciences, Babol, Iran
چکیده English

Background: Patient education is one of the fundamental pillars of nursing care and a primary strategy for health promotion. It plays a vital role in improving health literacy and strengthening self-care behaviors. With the growing prevalence of chronic diseases, empowering patients to actively participate in disease management has become increasingly important. This review aimed to examine the existing evidence on the relationship between patient education, health literacy, and self-care in nursing care.
Methods: This review study was conducted through a comprehensive search of the PubMed, Scopus, Web of Science, Google Scholar, SID, and Magiran databases using the keywords Patient Education, Health Literacy, Self-care, Self-management, Nursing, and Nursing Care. Persian and English-language articles investigating patient education, health literacy, or self-care in nursing care were screened according to the predefined inclusion and exclusion criteria and subsequently reviewed.
Findings: The findings indicate that patient education, health literacy, and self-care are three interrelated and central components of nursing care. Effective patient education serves as the first step toward improving health literacy. Enhanced health literacy, through strengthening patients' ability to access, understand, evaluate, and apply health information, facilitates the adoption of effective self-care behaviors. Improved self-care is associated with favorable clinical outcomes, including greater adherence to treatment regimens, more effective disease control, fewer complications, reduced hospital readmissions, and ultimately, improved quality of life. Furthermore, the integration of innovative educational technologies, such as telenursing, mobile health applications, and artificial intelligence, can significantly enhance the effectiveness of patient education and serve as an important facilitator within this continuum of care.
Conclusion: Patient education is one of the most essential professional responsibilities of nurses, and health literacy plays a pivotal role in translating education into effective self-care behaviors. Developing patient-centered educational programs tailored to patients' health literacy levels and incorporating innovative educational technologies can enhance self-care, improve health outcomes, and promote the quality of nursing care.

کلیدواژه‌ها English

Patient education
Health literacy
Self-care
Nursing
Nursing care
Chronic diseases
1.     World Health Organization. Health promotion: health literacy. Geneva: WHO; 2021.
2.     Bastable SB. Nurse as Educator: Principles of Teaching and Learning for Nursing Practice. 6th ed. Burlington (MA): Jones & Bartlett Learning; 2023.
3.     Funnell MM, Anderson RM. Patient empowerment: evolution of a concept and implications for diabetes education. Diabetes Educ. 2020; 46(3): 213-21.
4.     World Health Organization. Noncommunicable diseases. Geneva: WHO; 2023.
5.     Riegel B, Jaarsma T, Strömberg A. A middle-range theory of self-care of chronic illness. Advances in nursing science. 2012; 35(3): 194-204.
6.     American Nurses Association. Nursing: Scope and Standards of Practice. 4th ed. Silver Spring (MD): ANA; 2021.
7.     Nutbeam D, Muscat DM. Health promotion glossary 2021. Health Promot Int 2021; 36(6): 1578-98.
8.     Sentell T, Vamos S, Okan O. Interdisciplinary perspectives on health literacy research around the world: more important than ever in a time of COVID-19. Int J Environ Res Public Health 2020; 17(9): 3010.
9.     Shao Y, Hu H, Liang Y, Hong Y, Yu Y, Liu C, et al. Health literacy interventions among patients with chronic diseases: A meta-analysis of randomized controlled trials. Patient Educ Couns 2023; 114: 107829.
10.  Ferreira PB, Porto IS, Santo FH, Figueiredo NM, Enders BC, Cameron LE, et al. Health education for hospitalized patient in nursing care: a conceptual analysis. Rev Bras Enferm 2021; 75(02): e20200459.
11.  Przybylska D, Borzęcki A, Drop B, Przybylski P, Drop K. Health education as an important tool in the healthcare system. Pol J Public Health 2014; 124(3): 145-7.
12.  Adams RJ. Improving health outcomes with better patient understanding and education. Risk Manag Healthc Policy 2010; 3: 61-72.
13.  Jotterand F, Amodio A, Elger BS. Patient education as empowerment and self-rebiasing. Med Health Care Philos 2016; 19(4): 553-61.
14.  Vahdat S, Hamzehgardeshi L, Hessam S, Hamzehgardeshi Z. Patient involvement in health care decision making: a review. Iran Red Crescent Med J 2014; 16(1): e12454.
15.  Lewis KB, Horvat L. Shared decision making interventions: theoretical and empirical evidence with implications for health literacy. In: Logan RA, Siegel ER, editors. Health Literacy: New Directions in Research, Theory and Practice. Amsterdam: IOS Press; 2017. p. 263-83.
16.  Iriarte-Roteta A, Lopez-Dicastillo O, Mujika A, Ruiz-Zaldibar C, Hernantes N, Bermejo-Martins E, et al. Nurses’ role in health promotion and prevention: a critical interpretive synthesis. J Clin Nurs 2020; 29(21-22): 3937-49.
17.  Pereira AF, Escola JJ, Almeida CM, Rodrigues VM. Health education provided by nurses to children and young people: parents’ assessment. BMC Nurs 2023; 22(1): 287.
18.  Mallonee S, Phillips J, Holloway K, Riggs D. Training providers in the use of evidence-based treatments: a comparison of in-person and online delivery modes. Psychol Learn Teach 2018; 17(1): 61-72.
19.  Hartzler B, Hinde J, Lang S, Correia N, Yermash J, Yap K, et al. Virtual training is more cost-effective than in-person training for preparing staff to implement contingency management. J Technol Behav Sci 2023; 8(3): 255-64.
20.  Alsahli M, Abd-Alrazaq A, Fathy DM, Abdelmohsen SA, Gushgari OA, Ghazy HK, et al. Effectiveness of patients’ education and telenursing follow-ups on self-care practices of patients with diabetes mellitus: cross-sectional and quasi-experimental study. JMIR Nurs 2025; 8(1): e67339.
21.  Ajayi RO, Adeyemi-Benson OS, Adeyemi-Benson OA, Ogunjobi TT. Chronic disease management in families: A public health and biomedicine perspective. Medinformatics 2025: 1-14.
22.  Dunn PJ, Milheim KL. Enhancing informal patient education in nursing practice: A review of literature. J Nurs Educ Pract 2017; 7(2): 18-24.
23.  Vaughn LM, Jacquez F, Baker RC. Cultural health attributions, beliefs, and practices: Effects on healthcare and medical education. The Open Medical Education Journal 2009; 2(1): 64-74.
24.  Nabavian M, Rahmani N, Seyed Nematollah Roshan F, Firouzbakht M. Nurses' experiences of the social stigma caused by the COVID-19 pandemic: a qualitative study. J Res Nurs 2023; 28(2): 104-15.
25.  Nutbeam D, Muscat DM. Advancing health literacy interventions. In: Okan O, Bauer U, Levin-Zamir D, Pinheiro P, Sørensen K, editors. Health Literacy in Clinical Practice and Public Health: New Initiatives and Lessons Learned at the Intersection with Other Disciplines. London: SAGE Publications; 2020. p. 115-27.
26.  Ishikawa H, Yano E. Patient health literacy and participation in the health‐care process. Health Expect 2008; 11(2): 113-22.
27.  Kaphingst KA, Kreuter MW, Casey C, Leme L, Thompson T, Cheng MR, et al. Health Literacy INDEX: development, reliability, and validity of a new tool for evaluating the health literacy demands of health information materials. J Health Commun 2012; 17(Suppl 3): 203-21.
28.  Liu C, Wang D, Liu C, Jiang J, Wang X, Chen H, et al. What is the meaning of health literacy? A systematic review and qualitative synthesis. Fam Med Community Health 2020; 8(2): e000351.
29.  Parnell TA, Stichler JF, Barton AJ, Loan LA, Boyle DK, Allen PE. A concept analysis of health literacy. Nurs Forum. 2019;54(3):315-27.
30.  Kickbusch IS. Health literacy: addressing the health and education divide. Health Promot Int 2001; 16(3): 289-97.
31.  Squiers L, Peinado S, Berkman N, Boudewyns V, McCormack L. The health literacy skills framework. J Health Commun 2012; 17(S3): 30-54.
32.  Karimzadeh-Soureshjani E, Pourhasan F, Simab PA, Saeedi-Boroujeni A. Beyond Genes: The Social Dimensions of Inborn Errors of Immunity. Immunol Genet J 2024; 7(1): 11-23.
33.  Levin-Zamir D, Leung AY, Dodson S, Rowlands G, Peres F, Uwamahoro N, et al. Health literacy in selected populations: Individuals, families, and communities from the international and cultural perspective. Inf Serv Use 2017; 37(2): 131-51.
34.  Burrell DN. Telehealth technologies, disruptions, and health literacy. Health Econ Manag Rev 2024; 5(4): 33-46.
35.  Wilandika A, Pandin MG, Yusuf A. The roles of nurses in supporting health literacy: a scoping review. Front Public Health 2023; 11: 1022803.
36.  Wittenberg E. Health literacy: exploring nursing challenges to providing support and understanding. Nurs Womens Health 2018; 22(1): 53-61.
37.  Godfrey CM, Harrison MB, Lysaght R, Lamb M, Graham ID, Oakley P. Care of self–care by other–care of other: The meaning of self‐care from research, practice, policy and industry perspectives. Int J Evid Based Healthc 2011; 9(1): 3-24.
38.  Tulu SN, Cook P, Oman KS, Meek P, Kebede Gudina E. Chronic disease self‐care: a concept analysis. Nurs Forum 2021; 56(3): 734-41.
39.  Hall C. Theories of nursing, and nursing as. In: Hall C, editor. What is Nursing? Exploring Theory and Practice. 2nd ed. Exeter: Learning Matters; 2011. p. 50.
40.  Hall C. Theory and practice: Understanding the nature of nursing as a caring activity. In: Hall C, editor. What is Nursing? Exploring Theory and Practice. Exeter: Learning Matters; 2013. p. 61-84.
41.  RobatSarpooshi D, Mahdizadeh M, Alizadeh Siuki H, Haddadi M, Robatsarpooshi H, Peyman N. The relationship between health literacy level and self-care behaviors in patients with diabetes. Patient Relat Outcome Meas 2020; 11: 129-35.
42.  Daniati N, Widjaja G, Olalla Gracìa M, Chaudhary P, Nader Shalaby M, Chupradit S, et al. The health belief model's application in the development of health behaviors. Health Educ Health Promot 2025; 9(5): 521-7.
43.  Iovino P, Nolan A, De Maria M, Ausili D, Matarese M, Vellone E, et al. The influence of social support on self-care is mediated by self-efficacy and depression in chronic illness: key findings from the 'SODALITY' observational study. Aging Ment Health 2023; 27(4): 820-8.
44.  Cocchieri A, Pezzullo AM, Cesare M, De Rinaldis M, Cristofori E, D'Agostino F. Association between health literacy and nursing care in hospital: A retrospective study. J Clin Nurs 2024; 33(2): 642-52.
45.  Jamali B, Zare O, Nabavian M, Rezaei F. The prevalence of perceived stress and depression in women facing abortion and related obstetric and non-obstetric risk factors: a cross-sectional study. Reprod Health 2025; 22(1): 50.
46.  Tang YH, Lin CT, Wu LC. Understanding Health Literacy Through Patients' Interpretation of Health Education Leaflets: A Thematic Narrative Review. Health Expect 2025; 28(6): e70479.
47.  Guo F, Zhang X, Lee P. Digital information for patient education. Front Public Health 2023; 11: 1211285.
48.  Esen K, Kolcu M. The relationship between health literacy and self-care management in patients with hypertension attending primary healthcare centers. J Public Health 2024; 32(2): 175-83.
49.  Ong-Artborirak P, Seangpraw K, Boonyathee S, Auttama N, Winaiprasert P. Health literacy, self-efficacy, self-care behaviors, and glycemic control among older adults with type 2 diabetes mellitus: a cross-sectional study in Thai communities. BMC Geriatr 2023; 23(1): 297.
50.  Roshan-Nejad M, Hosseini M, Vasli P, Nasiri M, Hejazi S. Effect of health literacy-based teach-back training on quality of life and treatment adherence in type 2 diabetes: an experimental study. Sci Rep 2025; 15(1): 551.
51.  Dizdarevic-Hudic L, Halilovic E, Brkic S, Loncar D, Jahic NA, Hudic I, et al. The impact of patient education on rehospitalization rate and quality of life in heart failure patients. Int J Cardiovasc Acad. 2025; 11(1): 6-14.
52.  Altayyer MK, Almalki AH, Alkathiri AM, Almalki MS, Aljabri AJ, Alradadi AF, et al. Health literacy and behavioral interventions to improve self-management in chronic disease populations. Rev Diabet Stud 2024; 20(1): 1-8.
53.  Wong AK, Bayuo J, Wong FK. Investigating predictors of self‐care behavior among homebound older adults: The role of self‐efficacy, eHealth literacy, and perceived social support. J Nurs Scholarsh 2022; 54(3): 278-85.
54.  Son H, Han Y. The effect of digital health literacy, self-efficacy on self-care behaviors among community-dwelling elderly: focusing on Gyeongsangbuk-do. Res Community Public Health Nurs 2025; 36(1): 59-72.
55.  Rahmanni N, Nabavian M, Afshar A. Explaining barriers to patient education from nurses' perspective in babol city educational and medical centers - a qualitative content analysis study [in Persian]. Med Educ J 2025; 14: e2.
56.  Bivolaru S, Constantin A, Vlase CM, Gutu C. COPD patients' behaviour when involved in the choice of inhaler device. Healthcare (Basel) 2023; 11(11): 1606.
57.  Anderson CA, Nguyen HA. Nutrition education in the care of patients with chronic kidney disease and end‐stage renal disease. Semin Dial 2018; 31(2): 115-21.
58.  Oakley C, Ream E. Role of the nurse in patient education and engagement and its importance in advanced breast cancer. Semin Oncol Nurs 2024; 40(1): 151556.
59.  Mountain A, Patrice Lindsay M, Teasell R, Salbach NM, de Jong A, Foley N, et al. Canadian stroke best practice recommendations: rehabilitation, recovery, and community participation following stroke. Part two: transitions and community participation following stroke. Int J Stroke 2020; 15(7): 789-806.
60.  Fitzpatrick PJ. Improving health literacy using the power of digital communications to achieve better health outcomes for patients and practitioners. Front Digit Health 2023; 5: 1264780.
61.  Song M, Elson J, Bastola D. Digital age transformation in patient-physician communication: 25-year narrative review (1999-2023). J Med Internet Res 2025; 27: e60512.
62.  Veneri DA, Zdanis K. Are technology-informed methods better than traditional approaches in educating patients? A meta-analysis. Health Educ J 2018; 77(3): 261-76.
63.  Chen H, Xiao S, Wan T, Li G, Peng Y, Wang Z. Application of AI in Hypertension Health Education: Scoping Review. J Med Internet Res 2026; 28: e95596.
64.  Sharma KP, Agrawal R, Mustafa FM, Johar MG, Chohan JS, Alkhayyat A, et al. Transforming Healthcare with Artificial Intelligence: Current Applications and Future Opportunities. Natl Acad Sci Lett 2026: 1-2.
65.  Prajapati M, Kumar S. Virtual reality revolution in healthcare: a systematic review. Health Technol 2025; 15(2): 231-42.
66.  Paterick TE, Patel N, Tajik AJ, Chandrasekaran K. Improving health outcomes through patient education and partnerships with patients. Proc (Bayl Univ Med Cent) 2017; 30(1): 112-3.
67.  Nutbeam D. Health literacy as a public health goal: a challenge for contemporary health education and communication strategies into the 21st century. Health Promot Int 2000; 15(3): 259-67.
68.  Khazaei A, Afshari A, Khatiban M, Borzou SR, Oshvandi K, Nabavian M, Maddineshat M. Perceptions of professional challenges by emergency medical services providers: a qualitative content analysis study. BMC Emergency Medicine 2024; 24(1): 38.
69.  Rahmani N, Roshan FS, Nabavian M, Alipour H. The design and psychometric evaluation of a COVID-19 social stigma questionnaire in nurses. BMC Nurs 2023; 22(1): 464.
70.  Wu T, Yu Y, Huang Q, Chen X, Yang L, Liu S, et al. Current status and implementation strategies of patient education in core outcome set development. Patient Educ Couns 2024; 118: 108027.
دوره 44، شماره 863
هفته 3، تیر
خرداد و تیر 1405
صفحه 819-835

  • تاریخ دریافت 30 تیر 1405
  • تاریخ پذیرش 04 مرداد 1405