Inkeroinen Saija, Koskinen Jenni, Karlsson Mia, Kilpi Taina, Leino-Kilpi Helena, Puukka Pauli, Taponen Ros-Marie, Tuominen Riitta, Virtanen Heli
Department of Nursing Science, University of Turku, Turku, Finland.
Hematology and Stem Cell Transplantation Unit, Turku University Hospital, Turku, Finland.
Patient Prefer Adherence. 2021 May 27;15:1165-1175. doi: 10.2147/PPA.S304530. eCollection 2021.
Patient education improves health and treatment adherence of patients with chronic kidney disease. However, evidence about the sufficiency of patients' knowledge processed in patient education is limited. The purpose of this study was to evaluate subjective and objective sufficiency of knowledge processed in patient education in dialysis care and treatment.
A cross-sectional study design was used. The sample (n=162) comprised patients in predialysis or home dialysis. All eligible patients during the data collection timeframe (2016-2017) in two university hospital districts in Finland were invited to participate. Subjective sufficiency was evaluated with a structured questionnaire having 34 items divided into six dimensions of empowering knowledge (bio-physiological, functional, social, experiential, ethical, and financial) on a Likert scale (1=not sufficient at all, 4=very sufficient). Objective sufficiency was evaluated with a structured knowledge test with 10 items (score range 0-10, correct=1, wrong/no knowledge=0) based on the multidimensional content of patient education emphasizing bio-physiological dimension.
In subjective sufficiency of knowledge, the mean was 3.27 (SD 0.54). The bio-physiological dimension of empowering knowledge was the most sufficient (mean 3.52, SD 0.49) and the experiential the least (mean 2.8, SD 0.88). In objective sufficiency, the means ranged 5.15-5.97 (SD 2.37-2.68) among patients in different modalities of dialysis care and treatment. The least sufficient objective scores were bio-physiological and functional knowledge. The subjective and objective sufficiency did not correlate with each other.
Patients' knowledge, either subjective or objective, does not seem to be sufficient. Hence, attention should be paid to supporting patients with more personalized knowledge. Furthermore, the relationship between subjective and objective sufficiency needs future consideration, as their non-correspondence was a new discovery.
患者教育可改善慢性肾脏病患者的健康状况及治疗依从性。然而，关于患者教育中所传授知识的充分性的证据有限。本研究旨在评估透析护理与治疗中患者教育所传授知识的主观和客观充分性。
采用横断面研究设计。样本（n = 162）包括透析前或家庭透析患者。邀请了芬兰两个大学医院区在数据收集时间段（2016 - 2017年）内所有符合条件的患者参与。主观充分性通过一份结构化问卷进行评估，该问卷有34个项目，分为增强知识的六个维度（生物生理、功能、社会、经验、伦理和财务），采用李克特量表（1 = 完全不充分，4 = 非常充分）。客观充分性通过一项结构化知识测试进行评估，该测试基于强调生物生理维度的患者教育多维内容，有10个项目（得分范围0 - 10，正确 = 1，错误/无知识 = 0）。
在知识的主观充分性方面，均值为3.27（标准差0.54）。增强知识的生物生理维度最充分（均值3.52，标准差0.49），经验维度最不充分（均值2.8，标准差0.88）。在客观充分性方面，不同透析护理与治疗方式的患者均值在5.15 - 5.97之间（标准差2.37 - 2.68）。客观得分最不充分的是生物生理和功能知识。主观充分性和客观充分性之间没有相关性。
患者的知识，无论是主观的还是客观的，似乎都不充分。因此，应注重为患者提供更具个性化的知识支持。此外，主观充分性和客观充分性之间的关系需要未来进一步研究，因为它们不对应是一个新发现。
