Table 1 Patient education challenges extracted from the review of the literature

Human resources-related challenges

Patient-related

Illiteracy (CH1) [9, 17]

Patient's paying less attention to the instructor (CH2) [13]

Fear of too much information (CH3) [13]

A misconception or lack of awareness (CH4) [10, 14]

Difficulty of changing lifestyle (CH5) [10, 14]

Patients' lack of understanding about the severity of the disease (CH6) [12]

Difficulty in memorizing information (CH7) [13]

Confusion because of conflicting information (CH8) [10]

Difficulties in facing the disease (CH9) [13, 14]

Age-related cognitive disorder (CH10) [14]

Lack of patients' cooperation (CH11) [14, 17]

The patients' unfavorable status (CH12) [13, 17]

Medical personnel-related

Lack of personnel’s time and long duration of education classes (CH13) [9, 17, 26]

Lack of nurses’ awareness about patient education principles (CH14) [17]

Risk of weakening patient-doctor relationship (CH15) [26]

Society-related challenges

Different culture and language (CH16) [9]

Old population (CH17) [9]

Limited health literacy (CH18) [4]

Comorbidity outbreak (CH19) [9]

System-related challenges

Planning-related

Lack of flexible and dynamic educational plans (CH20) [12, 17]

Relevance of provided education (CH21) [13]

Direct relation between the amount of education and duration of hospitalization (CH22) [12]

Medical advances and increasing amount of transmitted information (CH23) [9]

Uncertainty of patients' understanding of info at the time of discharge (CH24) [13]

Health centers focus on their own desired content (not patients' needs) (CH25) [13, 17]

Lack of recognition of the patients' educational needs (CH26) [17]

Lack of nursing manpower (CH27) [17]

Lack of written educational sources (CH28) [17]

Lack of funding for patient education (CH29) [17]