State of the art in research and evaluation

In summary, while the state-of-the-art in research and evaluation in patient education is young and developing, there is increasing sophistication of educational diagnosis and program conceptualization, as well as intervention, experimental design, and measurement. Consistent positive effects on short-term patient knowledge, attitudes, beliefs, and health behaviors have been noted, as well as emerging longer-term changes in health behavior and health outcomes, outcomes, including life style risk factors, morbidity, mortality, and costs of care. It is hoped that future research will continue, with rigorous research design, to examine the effects of educational programs on patient care processes and outcome including functional and health status, mortality, and costs. Such studies are also beginning to emerge in population-based programs, in worksites, and in school health programs. As noted by several investigators, possible adverse effects of patient education need to be investigated and monitored as well (e.g., absenteeism, poor self-concept, anxiety). Factors and processes influencing differential response in individuals and populations need further elucidation, so that the most cost-effective programs can be tailored to specific groups and individuals with specific characteristics.