Background: Studies regarding patient comprehension have mainly focused on discharge instructions and information, and few studies are available on patients’ comprehension of their treatment while hospitalized. The standards for patient-centered communication by The Joint Commission and the New York State Patients’ Bill of Rights, state that patients should be informed participants in their own health care. In order to adequately adhere to these benchmarks, patients need to understand their situation and comprehend the information that they receive as inpatients.
Methods: Patients (n=35) rated their knowledge and difficulty of understanding on a five-point scale and gave descriptive statements about four domains: diagnosis, greatest health threat/concern, hospital admittance, and treatment plan. Descriptive statements were rated, on a five-point scale, for concordance with their medical chart. Demographics of: age, gender, and education level; and the healthcare engagement factors of: primary care visit frequency and family involvement were also recorded.
Concordance scores and knowledge ratings of three or less were interpreted as indicating comprehension deficits, or the perception of comprehension deficits, respectively. Meaningful difficulty of understanding was interpreted as a difficulty of understanding rating of three or more. Contingency Analysis was performed to evaluate how these measurements correlate with demographics and healthcare engagement factors.
Results: There were noticeable differences in comprehension deficits between education levels particularly for Treatment Plan and Greatest Health Threat/Concern. For genders, Hospital Admittance and Greatest Health Threat/Concern had the greatest differences in comprehension deficits, also, women were more likely to have difficulty of understanding for Hospital Admittance. The age range 66-78 reported the least perception of comprehension deficits and difficulty of understanding for Greatest Health Threat/Concern. Additionally, neither patient perception of comprehension deficits or difficulty of understanding, influenced comprehension deficits.
For those with comprehension deficits, “High School or GED Educated,” individuals were less likely to have difficulty of understanding, the age range 66-78 perceived comprehension deficits least often, and higher frequency of primary care visitation correlated to decreased perception of comprehension deficits and difficulty of understanding. For individuals without comprehension deficits, women were more likely to perceive comprehension deficits. In both cases, the age range 66-78 reported difficulty of understanding least often.
Conclusions: The results suggest that demographics and healthcare engagement factors impact patient comprehension. The patient experience is complicated and further work is required to develop a robust explanation of comprehension deficits in patients, and interventions to help alleviate these deficits.