Hospitalized Patients’ Knowledge of Care

a Systematic Review

Arielle E. Sommer*, Blair P. Golden, Jonna Peterson, Claire A. Knoten, Lyndsey O’Hara, Kevin John O'Leary

*Corresponding author for this work

Research output: Contribution to journalReview article

3 Citations (Scopus)

Abstract

Background: Patients’ comprehension of their medical conditions is fundamental to patient-centered care. Hospitalizations present opportunities to educate patients but also challenges to patient comprehension given the complexity and rapid pace of clinical care. We conducted a systematic review of the literature to characterize the current state of inpatients’ knowledge of their hospitalization, assess the methods used to determine patient comprehension, and appraise the effects of interventions on improving knowledge. Methods: We searched MEDLINE, EMBASE, and the Cochrane Library for articles published from January 1, 1995 through December 11, 2017. Eligible studies included patients under inpatient or observation status on internal medicine, family medicine, or neurology services. We extracted study characteristics (author, year, country, study design, sample size, patient characteristics, methods, intervention, primary endpoints, results) in a standardized fashion. The quality of observational studies was assessed using the NIH Quality Assessment Tool for Observation Cohort and Cross-Sectional Studies and the quality of interventional studies was assessed using adapted EPOC criteria from the Cochrane Collaboration. Results: Twenty-eight studies met the criteria for inclusion, including 17 observational studies and 11 interventional studies. Patient knowledge of all aspects of their hospitalization was poor and patients often overestimated their knowledge. Older patients and those with lower education levels were more likely to have poorer knowledge. Intervention methods varied, but generally showed improvements in patient knowledge. Few interventional studies assessed the effect on health behaviors or outcomes and those that did were often underpowered. Discussion: Clinicians should be aware that comprehension is often poor among hospitalized patients, especially in those with lower education and advanced age. Our results are limited by overall poor quality of interventional studies. Future research should use objective, standardized measures of patient comprehension and interventions should be multifaceted in approach, focusing on knowledge improvement while also addressing other factors influencing outcomes.

Original languageEnglish (US)
Pages (from-to)2210-2229
Number of pages20
JournalJournal of general internal medicine
Volume33
Issue number12
DOIs
StatePublished - Dec 1 2018

Fingerprint

Patient Care
Hospitalization
Observational Studies
Inpatients
Observation
Education
Patient-Centered Care
Health Behavior
Neurology
Internal Medicine
MEDLINE
Sample Size
Libraries
Cross-Sectional Studies
Medicine

Keywords

  • comprehension
  • health knowledge
  • hospitalization
  • patient adherence
  • patient education
  • patient-centered care

ASJC Scopus subject areas

  • Internal Medicine

Cite this

Sommer, Arielle E. ; Golden, Blair P. ; Peterson, Jonna ; Knoten, Claire A. ; O’Hara, Lyndsey ; O'Leary, Kevin John. / Hospitalized Patients’ Knowledge of Care : a Systematic Review. In: Journal of general internal medicine. 2018 ; Vol. 33, No. 12. pp. 2210-2229.
@article{a8da1ec92e6f453cbc08295799cf24e9,
title = "Hospitalized Patients’ Knowledge of Care: a Systematic Review",
abstract = "Background: Patients’ comprehension of their medical conditions is fundamental to patient-centered care. Hospitalizations present opportunities to educate patients but also challenges to patient comprehension given the complexity and rapid pace of clinical care. We conducted a systematic review of the literature to characterize the current state of inpatients’ knowledge of their hospitalization, assess the methods used to determine patient comprehension, and appraise the effects of interventions on improving knowledge. Methods: We searched MEDLINE, EMBASE, and the Cochrane Library for articles published from January 1, 1995 through December 11, 2017. Eligible studies included patients under inpatient or observation status on internal medicine, family medicine, or neurology services. We extracted study characteristics (author, year, country, study design, sample size, patient characteristics, methods, intervention, primary endpoints, results) in a standardized fashion. The quality of observational studies was assessed using the NIH Quality Assessment Tool for Observation Cohort and Cross-Sectional Studies and the quality of interventional studies was assessed using adapted EPOC criteria from the Cochrane Collaboration. Results: Twenty-eight studies met the criteria for inclusion, including 17 observational studies and 11 interventional studies. Patient knowledge of all aspects of their hospitalization was poor and patients often overestimated their knowledge. Older patients and those with lower education levels were more likely to have poorer knowledge. Intervention methods varied, but generally showed improvements in patient knowledge. Few interventional studies assessed the effect on health behaviors or outcomes and those that did were often underpowered. Discussion: Clinicians should be aware that comprehension is often poor among hospitalized patients, especially in those with lower education and advanced age. Our results are limited by overall poor quality of interventional studies. Future research should use objective, standardized measures of patient comprehension and interventions should be multifaceted in approach, focusing on knowledge improvement while also addressing other factors influencing outcomes.",
keywords = "comprehension, health knowledge, hospitalization, patient adherence, patient education, patient-centered care",
author = "Sommer, {Arielle E.} and Golden, {Blair P.} and Jonna Peterson and Knoten, {Claire A.} and Lyndsey O’Hara and O'Leary, {Kevin John}",
year = "2018",
month = "12",
day = "1",
doi = "10.1007/s11606-018-4658-5",
language = "English (US)",
volume = "33",
pages = "2210--2229",
journal = "Journal of General Internal Medicine",
issn = "0884-8734",
publisher = "Springer New York",
number = "12",

}

Hospitalized Patients’ Knowledge of Care : a Systematic Review. / Sommer, Arielle E.; Golden, Blair P.; Peterson, Jonna; Knoten, Claire A.; O’Hara, Lyndsey; O'Leary, Kevin John.

In: Journal of general internal medicine, Vol. 33, No. 12, 01.12.2018, p. 2210-2229.

Research output: Contribution to journalReview article

TY - JOUR

T1 - Hospitalized Patients’ Knowledge of Care

T2 - a Systematic Review

AU - Sommer, Arielle E.

AU - Golden, Blair P.

AU - Peterson, Jonna

AU - Knoten, Claire A.

AU - O’Hara, Lyndsey

AU - O'Leary, Kevin John

PY - 2018/12/1

Y1 - 2018/12/1

N2 - Background: Patients’ comprehension of their medical conditions is fundamental to patient-centered care. Hospitalizations present opportunities to educate patients but also challenges to patient comprehension given the complexity and rapid pace of clinical care. We conducted a systematic review of the literature to characterize the current state of inpatients’ knowledge of their hospitalization, assess the methods used to determine patient comprehension, and appraise the effects of interventions on improving knowledge. Methods: We searched MEDLINE, EMBASE, and the Cochrane Library for articles published from January 1, 1995 through December 11, 2017. Eligible studies included patients under inpatient or observation status on internal medicine, family medicine, or neurology services. We extracted study characteristics (author, year, country, study design, sample size, patient characteristics, methods, intervention, primary endpoints, results) in a standardized fashion. The quality of observational studies was assessed using the NIH Quality Assessment Tool for Observation Cohort and Cross-Sectional Studies and the quality of interventional studies was assessed using adapted EPOC criteria from the Cochrane Collaboration. Results: Twenty-eight studies met the criteria for inclusion, including 17 observational studies and 11 interventional studies. Patient knowledge of all aspects of their hospitalization was poor and patients often overestimated their knowledge. Older patients and those with lower education levels were more likely to have poorer knowledge. Intervention methods varied, but generally showed improvements in patient knowledge. Few interventional studies assessed the effect on health behaviors or outcomes and those that did were often underpowered. Discussion: Clinicians should be aware that comprehension is often poor among hospitalized patients, especially in those with lower education and advanced age. Our results are limited by overall poor quality of interventional studies. Future research should use objective, standardized measures of patient comprehension and interventions should be multifaceted in approach, focusing on knowledge improvement while also addressing other factors influencing outcomes.

AB - Background: Patients’ comprehension of their medical conditions is fundamental to patient-centered care. Hospitalizations present opportunities to educate patients but also challenges to patient comprehension given the complexity and rapid pace of clinical care. We conducted a systematic review of the literature to characterize the current state of inpatients’ knowledge of their hospitalization, assess the methods used to determine patient comprehension, and appraise the effects of interventions on improving knowledge. Methods: We searched MEDLINE, EMBASE, and the Cochrane Library for articles published from January 1, 1995 through December 11, 2017. Eligible studies included patients under inpatient or observation status on internal medicine, family medicine, or neurology services. We extracted study characteristics (author, year, country, study design, sample size, patient characteristics, methods, intervention, primary endpoints, results) in a standardized fashion. The quality of observational studies was assessed using the NIH Quality Assessment Tool for Observation Cohort and Cross-Sectional Studies and the quality of interventional studies was assessed using adapted EPOC criteria from the Cochrane Collaboration. Results: Twenty-eight studies met the criteria for inclusion, including 17 observational studies and 11 interventional studies. Patient knowledge of all aspects of their hospitalization was poor and patients often overestimated their knowledge. Older patients and those with lower education levels were more likely to have poorer knowledge. Intervention methods varied, but generally showed improvements in patient knowledge. Few interventional studies assessed the effect on health behaviors or outcomes and those that did were often underpowered. Discussion: Clinicians should be aware that comprehension is often poor among hospitalized patients, especially in those with lower education and advanced age. Our results are limited by overall poor quality of interventional studies. Future research should use objective, standardized measures of patient comprehension and interventions should be multifaceted in approach, focusing on knowledge improvement while also addressing other factors influencing outcomes.

KW - comprehension

KW - health knowledge

KW - hospitalization

KW - patient adherence

KW - patient education

KW - patient-centered care

UR - http://www.scopus.com/inward/record.url?scp=85053757237&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85053757237&partnerID=8YFLogxK

U2 - 10.1007/s11606-018-4658-5

DO - 10.1007/s11606-018-4658-5

M3 - Review article

VL - 33

SP - 2210

EP - 2229

JO - Journal of General Internal Medicine

JF - Journal of General Internal Medicine

SN - 0884-8734

IS - 12

ER -