Perspectives on research in patient teaching.

Selection of outcome measures needs to go beyond assessment of knowledge gains to include indicators of adherence to the self-care regimen and health outcomes. Because standard didactic approaches are relatively ineffective in fostering participation in self-care, program content should be individualized and may need considerable reinforcement. In studies of program effectiveness, both the experimental and the comparison conditions should be monitored. Although a wide variety of patient, educator, and situational characteristics may mediate program efficacy, a lack of theoretically based studies and insufficient replication precludes generalizable conclusions about these or other aspects of patient teaching.