Introduction

1. ASSESSING ADULT LEARNING PREFERENCE FOR SUCCESSFUL WOUND CARE IN A COMPREHENSIVE WOUND CENTERRanjita Misra, PhD, CHES1,Lynn Lambert, BS, CWS. CHT3, David Vera2 , Ashley Mangaraj2 , Suchin R Khanna2 ,Chandan Sen,PhD2 1Texas A&M University, College Station, Texas, 2The Ohio State University Comprehensive Wound Center, Columbus Ohio , 3 National Healing Corporation (NHC), Boca Raton, Florida Abstract Results Methods Table 1:Demographics BACKGROUND: Understanding the adult learning principles as well as assessing learning preferences can aid clinicians and health providers in successful plan of care designed to initiate a change in behavior, knowledge, and skills. Patient motivation is also an important pedagogical and andragogical strategy for adult learners.OBJECTIVE: The overall goal of this study was to examine adult patient's learning preference and motivation by gender, age, and race/ethnicity. DESIGN: This retrospective study sample comprised of 1003 patients (72 % whites, 53% females) treated for acute, acute traumatic or chronic wounds at a hospital-affiliated Comprehensive Wound Center in the Midwest.RESULTS: Demographic characteristics indicated 99% adults (mean age = 55.2±17; 29% > 65 years), with low levels of education (48% HS education) and socioeconomic status (17% on Medicaid). The majority of patients indicated their learning preference as explanation (59%) or demonstration (56%) by their health care providers.  Printed materials was preferred by only one-third (34%) of the patients. Use of video and group/class room environment was not favored by 99%. Assessment by a nurse manager showed half (51%) were eager to learn and asked questions (69%). However, 11% were anxious, and 6% were uninterested/confused/uncooperative. Knowledge of their health problems was low to medium by 60% of the patients. Learning preference and motivation varied with females having lower knowledge of health problems, not preferring to ask questions, being anxious, and preferring demonstration/printed materials more than their male peers (p<.05). Minority patients had lower knowledge and preferred explanation by providers. Older patients had lower knowledge, did not ask questions, were more anxious and confused, and not interested to learn. CONCLUSIONS:With the projected demographic changes in the US population (i.e., aging; increase in minorities), knowledge of the adult learning preference and pedagogical strategies will help to improve effective patient and caregiver education.   Sample The sample comprised of 1003 patients (72 % whites, 53% females) treated for acute, acute traumatic or chronic wounds at a hospital-affiliated Comprehensive Wound Center. Demographic characteristics indicated 99% adults (mean age = 55.2±17; 29% > 65 years), with low levels of education (48% HS education) and socioeconomic status (17% on Medicaid). Study site and data collection Data were abstracted from patient charts for the period of 2006 and 2009 from one hospital-affiliated and research-based care at Ohio State University’s Comprehensive Wound Center (CWC) in Columbus Ohio. The CWCs provide advanced care to patients with chronic, non-healing wounds. Six trained research assistants abstracted the data using standardized forms developed for the project. Data collected included patient demographics, clinical history, co-morbid disease states, laboratory test results, and wound factors pertinent to wound care. Measures Patient’s demographics - age, gender, race, health insurance, educational level, diabetes status, and perception of current health status. Learning preference and motivational level was assessed by the nurse case manager and patient progress report at the beginning of their treatment. Completed data collection forms were de-identified and data coded and entered into an SPSS database (SPSS Inc., Chicago, IL). Minorities, females and the elderly patients favored learning by demonstration and explanation by the care team. (p<.05). Minorities and elderly patients were more anxious (p<.05). Females, African American and elderly patient s did not ask questions (p<.05). Females and elderly patients were less eager to learn (p<.05). Figure 1: Motivational levels Introduction Minorities, females and the elderly patients had lesser knowledge of their health problems )p<.05). Chronic wounds represent a major health burden in terms of number of days lost from work, decreased quality adjusted life years and disability adjusted life years. Patient education has been identified essential to chronic disease management and positive healing outcomes. Accordingly, JCAHO mandates all clinics and hospitals to assess patients’ needs and provide patient education. Patients’ motivational levels and learning preferences are important factors for effective patient education. They are part of the learning assessment completed in hospitals and clinics. Patient education in proper self management is considered essential to chronic disease management and positive healing outcomes. s s The majority of patients asked questions and were eager to learn. Discussion and Conclusion • With the projected demographic changes in the US population (i.e., aging; increase in minorities), knowledge of the adult learning preference and pedagogical strategies will help to improve effective patient and caregiver education.   • Providing education using patient’s preferred learning method(s) may lead to improved patient compliance and self-management. • Generally, respondents who are females, minorities, and/or olderhave lesser knowledge of their health problems, do not prefer to ask questions, and favor learning by demonstration or explanation by the care team. • Older patients reported a higher number of hospitalization and # medications taken. They were more likely to be anxious and confused, and not interested to learn that adds to the complexity of care (p<.01). • These age, gender, race-specific data can be used in clinical algorithms in clinician’s offices to serve as “prompts” for the clinician to provide tailored education for patients. Figure 2 : Learning preferences among Patients Participants preferred the learning by explanation and demonstration versus printed materials (p<.001) Purpose The purpose of this retrospective study was to examine adult patients’ learning preference and motivation by gender, age, and race/ ethnicity. Funded by the Ohio State University and National Healing Corporation