The Theoretical Basis of Patient Education – Introduction

The goal of patient teaching is to influence behavior change, yet changing habits is extremely difficult for most of us. Health care providers ask patients to make enormous changes in their lives in order to prevent disease and promote health. For example, we ask diabetic patients to lose or maintain weight by staying on a diet 365 days a year, every year, for life. Diabetic patients must also carefully control their intake of dietary fat and cholesterol to decrease their increased risk of heart attacks and stroke. Constant and accurate self-monitoring of blood glucose is required by finger sticks and urine testing. Exercise is part of the treatment as well, but it must be planned to avoid causing elevations or severe drops in blood glucose levels. In addition, the patient must inject insulin several times a day or take oral medications. Self-management of diabetes is very complex, yet we ask ordinary people to take on all these tasks and, at the same time, carry on their normal life of work, school, and social relationships.

Theories that explain human behavior change serve as guidelines for teaching. Theories are a generalized set of rules that can help us find answers for patient learning and motivation, and help predict the consequences of specific health education interventions. The more you know about educational theories, the more tools you will have for building strong, effective patient education interventions.2 Theories that can be applied to patient education come from the disciplines of communication, organizational development, sociology, psychology, and adult education. Theories used for patient teaching include the Health Belief Model, self-efficacy theory, locus of control theory, cognitive dissonance theory, diffusion theory, stress and coping theory, and adult learning theory.

The Health Belief Model