A therapeutic education program includes 4 stages
Educational diagnosis is the first stage: this is time used to “take stock” together with the AD patient. For about 45 min, the doctor (or nurse) sits with the patient to discuss their knowledge (evaluation of flare-up severity, treatments used, etc.), any difficulties encountered, future plans, needs, and so on.
1. Establishing an educational diagnosis
- Creating an educational diagnosis most importantly requires mutual trust between the patient and the doctor.
- Emphasis should not be placed only on the symptoms, but the patient should also be allowed to express their experience with eczema, the treatments used and methods of administration; any difficulties encountered, social surroundings, living conditions, plans for the future, etc. The doctor should find out the patient’s expectations from the consultation.
- This interview usually lasts between 45 min and 1 hour. Ask open-ended questions to encourage the patient to express themselves, and use their end-phrases as a springboard to delve deeper into the subject. Provide feedback by paraphrasing as much as possible. The interview also helps evaluate the patient’s level of motivation to change.
- This discussion (in the form of an inventory or checklist) will highlight strengths and weaknesses and precisely identify progress made as well as the patient’s level of motivation to change.
Example of a guide for educational diagnosis of a patient with atopic dermatitis created by Sébastien Barbarot. (Nantes University Hospital, France)
- Tell me about your disease
- What do you think caused your disease?
- Which factors improve and (or) worsen your disease?
- What bothers you the most about the disease?
- What treatment are you using? Do you have any fears where this is concerned?
- How do you apply products? Describe what you do in detail.
- Are there any activities that your disease prevents you from doing?
- How is your everyday life and your relationships?
- How do you react when you need help? Who do you turn to?
- What do you expect from this consultation?