**3. Health education: the dialectic between professionals and patients**

Worldwide, citizens' participation in health issues has gained relevance, as has the recognition that it is important to invest in each citizen's ability to make informed decisions about their health throughout their life trajectory.

The current Health System is anchored on a patient-centred model of care, a model that focuses on patients' needs, concerns and subjective experience of illness. The first agent to play an active role is precisely the patient. The new role advocated for those seeking healthcare is that of a person who collaborates with healthcare professionals on decisions related to their health and evaluates the results achieved [27, 32].

Patient education is established in a dialectic between health professionals and the patient/caregiver. Different health professionals are involved in this process, but, in this particular case, the nurse's role stands out as particularly important. Health education and patient education are at the core of nursing practice. Nurses make a difference by helping patients and their families to maintain their health, while sharing knowledge, clarifying daily issues, and training patients/caregivers to cope with illness [33].

The teaching-learning process occurs due to an unmet need. This implies that both, professional and patient, establish a dialogue. The latter indicates to the former, implicitly or explicitly, what their learning needs, preferences and conditions are and, based on this information, both outline teaching and/or training plan that meets the outlined goals [27].

The holistic philosophy of nursing care gives nurses a crucial role in patient education. It is precisely within this framework that the key principles that characterise patient education are highlighted: involvement, knowledge, values, and preferences. This ends up objectively and subjectively delimiting the horizons of the new millennium, whose starting point is the investment in the person, promoting the development of their talents and abilities and the opportunity to practice them. The ultimate goal is to prepare the patient/caregiver for his or her return to family and society [27].

From this perspective, it is important to identify the contributions of education to patient self-efficacy.

The literature shows multiple benefits resulting from patient teaching-learning, such as the reduction of anxiety, the patient's satisfaction with health care, the reduction of the incidence of complications, and the accountability for self-care. It is a process that promotes high degrees of skills and multiple functional versatility, enhancing autonomy, creativity, and empowerment [34–36].

On the other hand, through education and training, it is possible to promote adjustment and adaptability to the new condition. Success results from the promotion of its potential benefits and positive reinforcement. It is evident that the dialectics established between the nurse and the patient/caregiver will tend to positively reinforce the learning and, consequently, promote the development of competencies, knowledge, skills and abilities. However, it is necessary to consider other requirements, such as continuity and follow-up to avoid possible paradoxical effects, especially unlearning and non-adherence to long-term care [37].

For some authors, people are always looking for an opportunity to learn cognitive (knowledge) and instrumental daily living skills that will enable them to cope with new situations, of which illness and hospitalisation fall into this situation.

The absence of health education during the patient's hospitalisation contributes to their dissatisfaction with the health system [37].

Despite the predictable coexistence of the various benefits of patient education promoted by nurses in health organisations, other factors submerge and condition the implementation of the intervention or its effectiveness, such as the shortage of nurses, work overload, organisational culture and low rates of patient compliance [38].

While it is expected in the new system that people will care more for themselves, the efficiency of teaching resources to ensure that learning is adequate and makes patients and carers competent and confident to 'care at home' has not been fully ensured [30].

In fact, the greater or lesser success of any health education process may be related to the way education programmes are designed and administered in different health institutions. Little is known about how this process is carried out by health professionals. This implies the evaluation of possible deviations, in order to try to maintain congruence between the professionals involved in this process [30].

For the author, inhomogeneity may lead to risks for the patient, such as confusion or loss of self-confidence. What seems to be clear in the literature is that this process does not occur in a similar way.

This fact led to the creation of a mnemonic to assist nurses in developing an educational program. This method helped these professionals not to forget any of the steps of the educational process and to develop the process in a systematic and standardised way. This approach proved to be effective and efficient as it increased the nurses' knowledge and behaviours in patient education [39].

The education programme starts at the beginning, but during the process, steps are omitted that can make a difference in the results obtained, which means that the suppression of any step can lead to the established objectives not being achieved. Therefore, training is considered a key element for the professionals' proficiency in this field [30].

In fact, nurses' education is a decisive factor for the success of teaching. It is not only about the positive impact of education on patient experience, but also on clinical outcomes: decreased length of hospital stay, decreased symptoms, increased levels of knowledge and improved levels of patient satisfaction [40, 41].

There is a consensus in the literature that patient education is beneficial to both parties, patients and healthcare, but for education to be effective healthcare professionals need resources and skills to provide it [38, 40].

As a personal development factor, education should be seen as an active component in disease management, which does not seek a simple transmission of knowledge, disconnected from the daily life and the patient's needs, but rather as a means to create synergies that allow professionals to accompany and respond to the patients' demands with existing capacities.

This will be achieved, in part, by adopting the same 'tailored education programme'. As the literature shows great variability in teaching programmes for groups of patients similar in terms of pathology and socio-demographic characteristics, it is difficult to reproduce them in different settings [42, 43].

The evaluation of the effectiveness and efficiency of these programmes is also made more difficult due to the heterogeneity of the programmes and the conditions of their implementation, such as the size of the sample, studies carried out in a single centre - which does not allow the generalisation of results—the variability of measurement instruments - often validated only for that study—among other factors.

*The Dialogue between the Patient's Educational Needs and the Knowledge Transmitted by Nurses… DOI: http://dx.doi.org/10.5772/intechopen.103891*

Nurses face an important challenge: to create a unifying model in their organisations that support a teaching approach based on systematic, integrated, and collaborative learning. A model that allows for its replication in similar contexts.

One of the advantages of such an approach is that with the introduction of technology it is increasingly easy to share models and trends across organisations to educate the patient.

What is understood from what has been said so far is that health education is understood as an essential part to achieve health outcomes such as the empowerment of the patient/caregiver in disease management.

Nurses have a vital role in the teaching-learning process and the hospital, as an organisation committed to developing the acquisition of skills and knowledge, is a privileged space where, individually or in groups, patients and caregivers learn to effectively manage their health condition and act on the factors that influence it.

An integrated and holistic strategy, based on patients' needs, is crucial for the patient education process. In order to better understand this process and, above all, to capture in the literature the education programmes developed for renal transplant patients due to their relevance to our practice, we have analysed the various studies targeting this population and explored the different types of programmes developed around which we will reflect.
