Expected and actual knowledge of hospital patients

Abstract

A survey in six general hospitals in the Netherlands studied the relationship between cognitions of doctors and nurses concerning the patients' level of knowledge, their reported informative behavior, and the actual level of patients' knowledge. Forty-eight doctors and 442 nurses filled out a questionnaire reporting percentages of patients they would expect to have valid knowledge in each of a number of knowledge fields. The same items were presented to 754 inpatients in the form of questions. Knowledge scores were computed based on the number of correct answers. From the data presented we concluded that about 50% of patients have adequate medical knowledge and knowledge of the hospital environment. On the whole, the actual knowledge of patients agreed with the expectation of doctors and nurses. These expectations were lowest concerning “knowledge of own condition,” the item considered of central importance to the wellbeing of the patient. Analysis of data on the ward level revealed large differences in the relationship between expected and actual knowledge among wards. Particularly in the case of knowledge of the hospital and ward, the expectations exceeded the actual knowledge. In the medical category this applied only to knowledge of anatomy and physiology. The difference was greatest for knowledge of the patients' own condition. We also sought the determinants of expected and actual knowledge and of the discrepancy between them. We found that knowledge expectations of doctors are positively related to a more professional attitude. Among nurses, we found that a more bureaucratic attitude, greater job satisfaction, and less uncertainty in their occupational role correlated with lower expectations. Knowledge expectations of doctors and nurses are not positively related to informative behavior. This conclusion has implications for the theoretical relation between cognitions and behavior of members of the helping professions in the hospital.