Table 1.

Patient education challenges extracted from the review of the literature

Challenges of the CVDs education system
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]