NANDA Definition: Absence or deficiency of cognitive information related to specific topic
Knowledge deficit is a lack of cognitive information or psychomotor skills required for health recovery, maintenance, or health promotion. Teaching may take place in a hospital, ambulatory care, or home setting. The learner may be the patient, a family member, a significant other, or a caregiver unrelated to the patient. Learning may involve any of the three domains: cognitive domain (intellectual activities, problem solving, and others); affective domain (feelings, attitudes, beliefs); and psychomotor domain (physical skills or procedures). The nurse must decide with the learner what to teach, when to teach, and how to teach the mutually agreed-on content. Adult learning principles guide the teaching-learning process. Information should be made available when the patient wants and needs it, at the pace the patient determines, and using the teaching strategy the patient deems most effective. Many factors influence patient education, including age, cognitive level, developmental stage, physical limitations (e.g., visual, hearing, balance, hand coordination, strength), the primary disease process and other comorbidities, and sociocultural factors. Older patients need more time for teaching, and may have sensory-perceptual deficits and/or cognitive changes that may require a modification in teaching techniques. Certain ethnic and religious groups hold unique beliefs and health practices that must be considered when designing a teaching plan. These practices may vary from "home remedies" (e.g., special soups, poultices) and alternative therapies (e.g., massage, biofeedback, energy healing, macrobiotics, or megavitamins in place of prescribed medications) to reliance on an elder in the family to coordinate the plan of care. Patients with low literacy skills will require educational programs that include more simplified treatment regimens, simplified teaching tools (e.g., cartoons, lower readability levels), a slower presentation pace, and techniques for cueing patients to initiate certain behaviors (e.g., pill schedule posted on refrigerator, timer for taking medications).
Although the acute hospital setting provides challenges for patient education because of the high acuity and emotional stress inherent in this environment, the home setting can be similarly challenging because of the high expectations for patients or caregivers to self-manage complex procedures such as IV therapy, dialysis, or even ventilator care in the home. Caregivers are often overwhelmed by the responsibility delegated to them by the health care professionals. Many have their own health problems, and may be unable to perform all the behaviors assigned to them because of visual limitations, generalized weakness, or feelings of inadequacy or exhaustion.
Deficient Knowledge This care plan describes adult learning principles that can be incorporated into a teaching plan for use in any health care setting.
Defining Characteristics:
- Questioning members of health care team
- Verbalizing inaccurate information
- Inaccurate follow-through of instruction
- Denial of need to learn
- Incorrect task performance
- Expressing frustration or confusion when performing task
- Lack of recall
Related Factors:
- New condition, procedure, treatment
- Complexity of treatment
- Cognitive/physical limitation
- Misinterpretation of information
- Decreased motivation to learn
- Emotional state affecting learning (anxiety, denial, or depression)
- Unfamiliarity with information resources
Expected Outcomes
- Patient demonstrates motivation to learn.
- Patient identifies perceived learning needs.
- Patient verbalizes understanding of desired content, and/or performs desired skill.
