An Educational Plan for the Newly Diagnoses Multiple Sclerosis Patient

Multiple sclerosis (MS) is a progressive and debilitating disease affecting the central nervous system and impacts nearly 1 million people in the United States (National Multiple Sclerosis Society, n.d., paragraph 1). MS patients, particularly those facing a new diagnosis, require substantial initial and ongoing education to assist in the planning and adjustment to life, making educational planning vital for this patient population (National Multiple Sclerosis Society, n.d.). As today’s patients evolve from passive recipients of healthcare to more empowered and active partners, technology has stepped in to help meet their need for unlimited access to information and their desire to be in control of their healthcare decisions (Aria & Archer, 2020; McGonigle & Mastrian, 2022, Robillard et al., 2018).

Advanced Practice Nurse Practitioners (APRNs) must develop, educate, and guide patients through the responsible use of technological sources to ensure the information obtained is credible. Utilizing the nursing process, this paper will illustrate the APRNs role in researching and developing a personalized educational plan for a newly diagnosed MS patient, validating and incorporating technological resources, and teaching the patient how to identify and utilize credible information and tools available on the internet (McGonigle & Mastrian, 2022; Robillard et al., 2018).

Assessment

When developing an effective education plan for the newly diagnosed MS patient, the APRN must begin assessing the patient’s health literacy, preference in learning styles, and motivation for learning. Assessing health literacy and developing an education plan facilitates the provision of information and support regarding the MS diagnosis and treatment, prognosis, and lifestyle adjustments and is imperative to patient empowerment, coping, planning, safety, and overall satisfaction of care (Aria & Archer, 2020, National Multiple Sclerosis Society, n.d.).

Informed patients with higher health literacy levels have better health outcomes, are more involved in their healthcare management, and report higher patient satisfaction rates. Those with low health literacy levels tend to have a more difficult time grasping provider-provided information, recognizing negative symptoms and knowing when to report them, and being challenged to distinguish between credible and non-credible sources (McGonigle & Mastrian, 2022; Win et al., 2016).

Diagnosis

Newly diagnosed MS patients will face various challenges and lifestyle adjustments requiring substantial support and education to adjust to their chronic illness (The Multiple Sclerosis Society, n.d.). Initial nursing diagnoses may include Deficient Knowledge, Powerlessness/Hopelessness, Risk for Ineffective Coping, and more patient-specific physical concerns, including Fatigue, Impaired Urinary Elimination, and Ineffective Airway Clearance. Identifying the nursing diagnosis sets the foundation for the APRN to identify patient problem-specific goals and develop the evaluation of progress towards goal attainment (The Multiple Sclerosis Society, n.d.; Walton, 2016).

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Planning

Once patient literacy and learning preferences are determined and specific nursing diagnoses are selected, the APRN must find and assign credible and valid resource options that best meet the patient’s educational needs. Generally, the information provided through government agencies, medical schools, and significant professional or non-profit organizations is considered good medical information (McGonigle & Mastrian, 2022; Volk & Obeid, 2019; Win et al., 2016). Additionally, many healthcare organizations have worked alongside their providers to develop their own approved education information, which may be found in the facility in brochures or handouts connected to the patient’s EMR and are considered credible and valid information sources (McGonigle & Mastrian, 2022).

Finally, the National Library of Medicine (2017) provides a framework to challenge the validity of online information beneficial to both healthcare providers and patients. Specific questions should be asked when evaluating internet sources. Who runs the site, what is the site’s purpose, who pays for the site, is the high information quality, and how does the website use personal information?

Once credible resources are identified, the APRN must choose the best educational tool to meet the patient’s individual needs. Online brochures and information from the health care organization’s collaborative electronic education portal, personalized and printed from the patient’s electronic medical record (EMR) and reviewed at patient appointments, are one approach. Improved from bulk published brochures which carry printing costs and become quickly outdated as medical discovery and resources change, online resources, either from approved patient education available through the facility or found and vetted independently, can be edited and personalized before printing, documented through the patient EMR, and referenced again at the patient’s convenience (McGonigle & Mastrian, 2022; Win et al., 2016).

Although these may provide valuable information, reviewing this information during a visit and answering questions takes substantial time and attention, often a luxury for the APRN. Additionally, patients report preferring more dynamic and interactive ways of learning and tend to retain more information when more actively involved in education (McGonigle & Mastrian, 2022; Win et al., 2016).

Providing a more hands-on and interactive experience for the patient, group education, both in-person or via online meeting options, utilizes visual presentations and interactive discussions to build on specific patient experiences. These group education opportunities, appealing to various levels of expertise, encourage patients to ask questions and contribute to their learning, providing education and connectedness with peers experiencing a similar medical path (Win et al., 2016). This option also offers the organization a way to market its health services by showcasing its specialists and resources, blending patient support and marketing health services.

With the growth of online meeting options, patients can access these meetings conveniently without leaving home, which is increasingly valuable with disease progression; however, some patients may find it challenging to share in a group, hindering their participation and limiting the benefit gained from participation. This circles back to the importance of the initial educational assessment (McGonigle & Mastrian, 2022).

Finally, providing a list of approved online resources, support groups, and organizations provides the patient the instant gratification of information many patients need and can help patients wanting to know more about chronic conditions, treatments, etc., on their own time. With 80% of internet users reporting utilization of the internet for obtaining health information, it is reasonable to conclude that many MS patients will seek answers to questions and ongoing connection with resources through internet searches, corporate websites, social media, and other technological options (McGonigle & Mastrian, 2022; Robillard et al., 2018, p. 1). Having approved resources available as questions, concerns, and support needs arise is empowering and informative for the patient (McGonigle & Mastrian, 2022). Additionally, educating the patient on the distinction between credible and non-credible sources encourages a critical eye when consuming online information and is vital to understanding their diagnosis and treatment plan (McGonigle & Mastrian, 2022; Robillard et al., 2018; Volk et al., 2019).

Implementation

For this example, the MS patient’s educational assessment reveals they are a motivated learner, are technologically savvy, have a high health literacy level, and are eager to gain more insight into their new MS diagnosis. They report feeling overwhelmed and fear they will have more questions once they leave their appointment. Although a combination of tools will be utilized, the provider recognizes that this patient, being comfortable with technology and eager to learn, is likely to use the internet to understand and answer questions regarding their diagnosis and find support after they leave this appointment.

Building from this learning preference, the educational plan will prioritize training to distinguish between credible and non-credible online information through an online tutorial and suggest activities through websites recommended based on the previously mentioned credibility criteria (McGonigle & Mastrian, 2022). Prioritizing the National Multiple Sclerosis Society (n.d) website as the technological tool for this plan, specific tasks, readings, videos, and program enrollment are recommended to facilitate engagement, interaction, and learning through the patient’s learning preference: online learning at their own pace.

Evaluation

The ongoing evaluation of learning allows for adjusting the evolving education plan based on the patient’s changing needs. Positive learning behaviors include asking appropriate questions based on suggested online activities, initiating and sharing learning with the APRN at follow-up appointments, and completing other goals associated with the nursing diagnosis (Walton. 2016). Reports of decreased anxiety, evidence of health-seeking behaviors, and compliance with the treatment plan also suggest that learning objectives are met (see Table 1 for sample education plan).

Conclusion

In a time when technology has increased the accessibility of health information and its use in educational planning, APRNs must recognize and be prepared to educate patients on the benefits and disadvantages of various technologically supported tools and prepare patients to sift through the endless amount of health-related information available to them (McGonigle & Mastrian, 2022; Volk et al., 2019). This paper exhibits one example of the APRNs utilization of the nursing process to develop an education plan for the newly diagnosed MS patient utilizing online tools tailored to the individual needs and expectations of today’s technologically savvy patients.

References

Aria, R. & Archer, N. (2020). An online mobile/desktop application for supporting sustainable            chronic disease self-management and lifestyle change. Health Informatics Journal, 26(4).  2860-2876. https://doi.org/10.1177/1460458220944334

McGonigle, D. & Mastrian, K. G. (2022). Nursing informatics and the foundation of knowledge (5th ed.). Jones and Bartlett Learning, LLC.

National Library of Medicine. (2018). Evaluating health information: A tutorial. MedlinePlus. https://medlineplus.gov/webeval/EvaluatingInternetHealthInformationTutorial.pdf

National Multiple Sclerosis Society. (n.d.). MS prevalence. National Multiple Sclerosis Society.

https://www.nationalmssociety.org/About-the-Society/MS-PrevalenceRobillard, J.M.,

Robillard, J.M., Jun, J. H., Lai, J., & Feng, T. L. (2018). The QUEST for quality online health

information: Validation of a short quantitative tool. BMC Medical Informatics and

            Decision Making, 18(87). 1-15. https://doi.org/10.1186/s12911-018-0668-9

Volk, R. & Obeid, N. (2019). What can we do about Dr. Google? Using the electronic medical

record (EMR) to prescribe reliable patient education. Journal of the Medical Library

            Association, 107(4). 606-608. https://doi.org/10.5195/jmla.2019.774

Walton, B. G. (2016). Developing a nursing IQ-Part II: The expertise of nursing process. Ohio Nurses

            Review, 91(5). 24-34.

Win, K. T., Hassan, N. M., Oinas-Kukkonen, H., & Probst, Y. (2016). Online patient education

for chronic disease management: Consumer perspectives. Journal of Medical Systems,

            40(18). 1-13. https://doi.org/10.1007/s10916-016-0438-0

 Table 1

Sample Educational Plan for Newly Diagnosed Multiple Sclerosis (MS)

Diagnosis	Resources	Validity Check	Objective/Planning	Implementation/Intervention	Evaluation
Deficient Knowledge	National Institute of Health MedlinePlus https://medlineplus.gov/webeval/EvaluatingInternetHealthInformationTutorial.pdf	Federal government website; recommended by healthcare organizations	Patient will be able to decipher between credible and non-credible health information	Complete tutorial	Patient able to produce 3 examples of credible sources and resources they have utilized for information gathering and support
Deficient Knowledge	National Muscular Sclerosis Society https://www.nationalmssociety.org/	Non-profit, endorsed by and contributed to by healthcare professionals, contact information easy to find, recently updated in 2022, purpose in line with the mission to educate and support, privacy policy easy to find	Patient will report basic knowledge of MS including S/S	Read and review ‘What is MS?’ and watch ‘What is MS’ video.  Reviews ‘Living Well with MS’.	Pt completion and asks appropriate questions regarding information covered;                      Pt reports decreased anxiety and stress regarding new MS diagnosis;             Pt lists 3 goals related to Living Well with MS
Deficient Knowledge	National Muscular Sclerosis Society https://www.nationalmssociety.org/	-See above-	Patient will participate in information acquisition from recommended website list	Create a profile on the MS Society website and	Patient creating a profile on the MS Society website     Patient will demonstrate health seeking behaviors (diet and activity modifications, safety, medication compliance, etc.)

 

 

Deficient Knowledge	National Muscular Sclerosis Society https://www.nationalmssociety.org/	-See above-	Patient will utilize virtual programs available to them to gain further knowledge regarding their MS journey.	Enroll in ‘New to MS: Navigating Your Journey’ virtual programming	AEB completion of Virtual Program AEB task completion and asking appropriate questions
Risk of Ineffective Coping	National MS Society Community Facebook (FB) Group https://www.facebook.com/groups/nationalmssocietycommunity	Affiliated through the National MS Society and moderated by healthcare professionals, although posts are dated, and authors noted, there is no guarantee that member positions are credible. Individual sources must be verified.	Patient will connect with others with MS for support	Follow the National MS Society Community (FB) Group	AEB pt enrollment and engagement with FB group through thread replies and posts
	National Muscular Sclerosis Society https://www.nationalmssociety.org/	-See above-	Patient will be able to identify resources available to them	Review “Society Information and Resources for People Affected by MS” printed handout	AEB lists 3 resources available to them from the recommended resources list