The challenge of a better life for the chronic patient

Therapeutic patient education

Therapeutic education of patient.

The classic medical identity is associated to the belief that the medical activity is mainly to diagnose and consequently treat. If these two actions are key elements in the acute disease, it changes when follow-up of chronic disease is mentioned, where management of symptoms requires “other knowledge” out of the medical science. This knowledge comes from human sciences: doctor-patient communication, patient pedagogy, patient psychology. Its role is to catalyze the medical action, to keep the medication compliance, to improve treatment adhesion. This pedagogical roles of the professionals are not substitutes for the medical activity, but its center of action.
Patient education is a health care practice relatively new, which has progressively being integrated in the management of patients with chronic diseases. It represents the expression of a change to a conception of health where the patient is able to be his own doctor for a given period.
Conversely to health education, therapeutic patient education is aimed by definition to a chronic disease for which learning competences and health behavior are needed to survive. Motivation for learning and the way it happens are influenced by the life context, the degree of acceptance of disease, and the abilities. It is a particular type of learning which requires and adapted pedagogy.
Following WHO: “therapeutic patient education is a continuous process which is integrated within the care and centered on the patient. It comprises organized activities in sensibilisation, information, learning, and psycho-social accompanying related to the disease, prescribed treatment, care, hospitalization, other related care institutions and the patient behavior in health and disease state. It considers to help the patient and their close companions to understand the disease and treatment, to cooperate with the educational professional, to live as healthy as possible, and keep or improve the quality of life. Education should accomplish that the patient was able to adquire the necessary resources to manage optimally his life with disease.”

Patient education is the learning by the patient and health professional of “dependency management”, it is another expression of human learning, singular of an unfavorable environment. It represents a true challenge for professionals and a new vision for the health models. It implies knowledge and methodology and it constitutes a challenge for “the art to cure”.

(*) Doctor Juana María Román. Académico Numerario de la Real Academia de Medicina de las Islas Baleares. Presidente de la Asociación Balear Asma.