Knowledge expectations from the perspective of aged dialysis patients

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1 Knowledge expectations from the perspective of aged dialysis patients Mirkka Rantanen, RDH, MNS-student 1 Tapio Kallio, RN, MNSc 3 Kirsi Johansson, RN, PhD, Coordinator 1,2 Sanna Salanterä,RN, PhD, Professor 1 Heli Virtanen, RN, MNSc, PhD-candidate 1 Helena Leino-Kilpi, RN, PhD, Professor 1,2 1 Department of Nursing Science, University of Turku, Turku, Finland 2 Finnish Post-Graduate School in Nursing Science, Turku, Finland 3 Satakunta Polytechnic, Harjavalta, Finland

2 Background Law of patients' rights and position (785/1992) in Finland Number of patients with chronic kidney disease Numbers of elderly Demanding treatments > patients need knowledge > self-care

3 Conceptual framework The idea of supporting patients' empowerment through patient education Empowerment is a process by which people gain mastery of their own lives (Rappaport 1984) Awareness precedes empowerment (Leino-Kilpi 1999).

4 Supporting patients' empowerment through education To help patients to increase and to develop their knowledge and skills so that they can make decisions about their own health and care for themselves The main outcome of patient education is patients empowerment When patient has knowledge which meets his/her needs, expectations or preferences and which he/she is capable of using (Funnell et al. 1991, Anderson et al. 1995, Feste & Anderson 1995, Leino-Kilpi et al. 1998, 1999, Anderson & Funnell 2005)

5 Empowering patient education Bio-physiological Functional Experiential Social Ethical Financial dimensions of knowledge (Leino-Kilpi et al. 1998, 1999)

6 The aim and research questions The aim of this study was to describe and analyse knowledge expectations of patients on dialysis treatment What knowledge did the patients on dialysis treatment expect? What demographic variables are associated with their knowledge expectations?

7 Material and methods The data were collected with a structured Expected Knowledge of Dialysis Patients-scale The data were collected from dialysis patients from one hospital in one of five hospital districts in Finland during three months period in 2004 The questionnaire were given to 62 patients (response rate 76 %)

8 Results: Participants 47 patients in peritoneal dialysis, hemodialysis or pre-dialysis stage Age (mean=62, SD=13,62) Female 57 % Retired 83 % Hemodialysis treatment 68 %

9 Results: Knowledge expectations Patients expected multidimensional knowledge Scale 1-4 (1=disagree, 4=agree) Bio-physiological (mean 3.2) Functional (mean 3.1) Ethical (mean 3.0) Financial (mean 2.8) Experiential (mean 2.7) Social (mean 2.5) expectations

10 Highest knowledge expectations (scale 1-4) Mean SD Prevention of complications Present state of disease, its process and prognosis Medication Examinations and tests Patients responsibilities in ensuring success of a treatment Possible complications involved in treatment Effect of treatment Patients rights in hospital Knowledge about test results Who inform family about illness and treatment

11 Lowest knowledge expectations (scale 1-4) Mean SD Connecting illness with work, hobbies or social life How to meet the hospital priest Illness effects on sexuality Patient organisations and their work Sickness benefit Rehabilitaion and related costs Illness effects on travelling Knowledge about how to take advantage of earlier experience of hospitalisation Illness effects on appearance How patient documents are kept secret

12 Relationship between age and knowledge expectations p <63 years >63 years mean mean Ethical knowledge (s) ,29 2,78 How can I make my own views and opinions known (v) ,46 2,95 How the responsibilities of the various professional groups involved in my care are defined (v) ,33 2,55 How I can have access to my personal patient document (v) ,21 2,55 (s) sumvariable, (v) variable, scale 1-4

13 Relationship between employment status and knowledge expectations p Retired mean Working life mean Experiential knowledge (s) ,29 2,95 How illness effects on appearance (v) ,79 1,50 How illness effects on sexuality (v) ,42 1,00 Knowledge about how to take advantage of earlier experience of hospitalisation (v) ,86 1,00 Knowledge about to whom to talk about feelings (v) ,29 1,50 (s) sumvariable, (v) variable, scale 1-4

14 Conclusion It is important to ensure that also older patients participate their own treatment More conversational therapy should be given to retired patients

15 Conclusion It is important to tailor the education individually By using EKPD-scale as a tool it is possible to discover the most important knowledge expectations of the patient and so support the empowerment of patients.

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