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Aim: This review aimed to identify validated self-reported instruments used to measure nurses' competence or attribute(s) of competence in empowering patient education, to describe their development and main content and critically appraise and summarize the quality of the instruments., Design: Systematic review., Data Sources: Electronic databases of PubMed, CINAHL and ERIC were searched from January 2000 to May 2022., Review Methods: Data was extracted following predetermined inclusion criteria. With the support of the research group, two researchers performed data selection and appraised the methodological quality using the COnsensus-based Standards for the selection of health status Measurement INstruments checklist (COSMIN)., Results: A total of 19 studies reporting 11 instruments were included. The instruments measured varied attributes of competence and the contents were heterogenous reflecting the complex nature of both empowerment and competence as concepts. Overall, the reported psychometric properties of the instruments and methodological quality of the studies were at least adequate. However, there was variation in the testing of the instruments' psychometric properties and lack of evidence limited the evaluation of both the methodological quality of the studies and quality of instruments., Conclusion: The psychometric properties of the existing instruments assessing nurses' competence in empowering patient education need to be tested further, and future instrument development should be built on a clearer definition of empowerment as well as on more rigorous testing and reporting. In addition, continued efforts to clarify and define both empowerment and competence on the conceptual level are needed., Impact: Evidence on nurses' competence in empowering patient education and its valid and reliable assessment instruments is scarce. Existing instruments are heterogenous and are often missing proper testing of validity and reliability. These findings contribute to further research on developing and testing the instruments of competence in empowering patient education and strengthening nurses' empowering patient education competence in the clinical practice., (© 2023 John Wiley & Sons Ltd.)

The aim of this descriptive study was to analyze the relationship between the sufficiency and usefulness of patient education from the perspective of people with chronic kidney disease. The goal was to discover whether both sufficiency and usefulness need to be analyzed in the quality evaluation of patient education. Patients undergoing predialysis or home dialysis care in Finland (N = 162) evaluated both the sufficiency and usefulness of patient education provided by nephrology nurses by using parallel structured questionnaires. A strong relationship was found between the sufficiency and usefulness of patient education. The relationship was significant across all dimensions of empowering knowledge, but no systematic association was found between the sufficiency-usefulness relationship and background variables. Depending on the purpose of evaluating patient education, either aspect, that is, sufficiency or usefulness, can be used, but it is not necessary to use both due to their strong inter-correlation. In terms of implications for practice, consideration of both sufficiency and usefulness is important when providing empowering patient education for people undergoing pre- or home dialysis, but only one aspect needs to be evaluated., (© 2020 John Wiley & Sons Australia, Ltd.)

In order to be empowered in different situations related to dialysis care, patients need knowledge. This study describes the knowledge expectations of patients on dialysis treatment (n = 47) and selected background variables. The results indicated that patients expressed moderate knowledge expectations. Most important were the biophysiological, functional, and ethical dimensions of knowledge. The least important were the social and experiential dimensions of knowledge. Patients' age, employment status, dialysis modality, and length of dialysis were positively correlated with knowledge expectations.

Aim: This paper is a report of a study to compare orthopaedic ambulatory surgery patients' knowledge expectations before admission and their perceptions of received knowledge 2 weeks after discharge., Background: Advances in technology and population ageing are driving up the number of ambulatory orthopaedic surgical procedures. Shorter hospital stays present a major challenge for patient education., Methods: A descriptive comparative cross-sectional study (pre- and post-test) design was adopted. The data were collected from 120 consecutive patients in 2004, using the Hospital Patient's Knowledge Expectations Scale and Hospital Patient's Received Knowledge Scale. All patients participated in a preoperative education session given by a nurse., Results: Patients expected more knowledge than they actually perceived that they received on all dimensions except the bio-physiological. They perceived that they received least knowledge about experiential, ethical, social and financial dimensions of knowledge. Knowledge expectations correlated with age and professional education. Perceptions of received knowledge correlated with earlier ambulatory surgery, and both expected knowledge and perceptions of received knowledge were related to the level of basic education., Conclusion: Patients' knowledge expectations are greater than the knowledge they perceived that they receive, and they cannot become empowered if they lack important knowledge. Further research is needed to learn about meeting patients' knowledge expectations.

Objective: A systematic literature review, using a metasummary technique for qualitative studies (n=15) was conducted to describe the nature of empowering discourses between patient and nurse., Methods: Computerised searches from 1995 to October 2005 were conducted on the Ovid Medline database using the keywords empower(*), power(*), resource(*), participat(*), facilitat(*), negotiat(*), communicat(*), interact(*), dialog(*), discours(*), discuss(*), encount(*), conversat(*) and 'nurse-patient relations'. All statements concerning empowering discourse were integrated into 29 abstracted findings. Frequency and intensity effect sizes were then calculated., Results: Empowering discourses vary from study to study. Analysed as a whole, an empowering discourse has specific characteristics and structure. Both patients and nurses have essential roles within this type of discourse and their relationship is characterized by an appreciation of each other's expertise within these roles., Conclusion: The results of this review show empowerment during discourse between patient and nurse has a complex and multifaceted but analysable nature. More research is needed to find systematic methods of empowering discourse., Practice Implications: The results of this study increase nurses' understanding of empowering methods in patient education identifying ways of facilitating patient empowerment.

Objective: Here, the aim is to compare surgical patients' knowledge expectations at admission with the knowledge they received during their hospital stay., Design: The study used a descriptive and comparative design., Setting: The study was conducted on surgical wards at one randomly selected university hospital in Finland., Participants: The sample (n = 237) consisted of surgical patients (traumatological, gastroenterological, urological and heart and thorax surgery) admitted to hospital during a 2-month period in 2003., Methods: The data were collected by two specially developed, parallel questionnaires: Hospital Patients' Knowledge Expectations and Hospital Patients' Received Knowledge. These 40-item instruments used a four-tier response scale and made a distinction between the bio-physiological, functional, experiential, ethical, social and financial dimensions of knowledge. The data were analysed statistically., Results: Surgical patients received less knowledge than they felt they expected on the bio-physiological, functional, experiential, ethical, social and financial dimensions. Their knowledge expectations and the knowledge they received were related to age, gender and level of basic education., Conclusions: The results highlighted the need for improved patient education. Surgical patients expect to receive more knowledge than they actually receive on all dimensions. The most problematic areas in the education of surgical patients are the experiential, ethical, social and financial dimensions of knowledge. In particular, younger patients, female patients and patients with a higher level of education require more attention.

The purpose of this study was to analyze the connections between patient education and health-related quality of life as an outcome variable. Data were collected among surgical hospital patients (n = 237) in Finland. On the basis of the results, there seems to be a positive relationship between received knowledge and health-related quality of life, and as such, the study produced knowledge about one quality indicator in nursing care. More research is needed to explore this connection in greater details.

Aims: This paper presents a systematic review whose aim was to describe the scope and methods of the current literature on preoperative patient education and to identify the effects of this education., Background: Preoperative patient education is a common and important intervention in surgical nursing, yet there is very limited systematic evidence on its precise role., Methods: The Medline, CINAHL, Eric, Psycinfo and Social Sciences Index databases and the Cochrane Library were searched, covering the period from the beginning of each database to April 2003. Studies were included if they concerned adult orthopaedic patients, preoperative nursing patient education and were based on randomized controlled or clinical trials. Meta-analysis was carried out where appropriate., Results: We identified 11 articles involving 1044 participants. Most studies included one experimental and one control group; only two had more than one experimental and control group. The educational interventions varied widely, but the majority were based on written materials alone, or written materials in combination with other teaching methods. The most common outcome measures related to pain, knowledge, anxiety, exercises and length of stay, and the least common to self-efficacy and empowerment. The methodological quality of the studies varied. Almost all reported one or more statistically significant effects. Based on the findings of the meta-analysis, preoperative education appears to have some impacts on patients' anxiety and knowledge levels., Conclusions: The review clearly highlights the need for well-designed, methodologically sound research into the outcomes of patient education. It also points to the need to study patient education from the point of view of empowerment.

Saija Inkeroinen,1 Jenni Koskinen,1,2 Mia Karlsson,3 Taina Kilpi,4 Helena Leino-Kilpi,1,5 Pauli Puukka,1 Ros-Marie Taponen,6 Riitta Tuominen,5 Heli Virtanen1 1Department of Nursing Science, University of Turku, Turku, Finland; 2Hematology and Stem Cell Transplantation Unit, Turku University Hospital, Turku, Finland; 3Kidney Center, Department of Medicine, Turku University Hospital, Turku, Finland; 4Turku City Welfare, City of Turku, Turku, Finland; 5Turku University Hospital, Turku, Finland; 6Abdominal Center Dialysis Unit, Hospital District of Helsinki and Uusimaa, Helsinki, FinlandCorrespondence: Saija InkeroinenDepartment of Nursing Science, University of Turku, Turku, 20014, FinlandTel +358400760698Email saanin@utu.fiPurpose: 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.Patients and Methods: 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.Results: 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.Conclusion: 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.Keywords: chronic kidney disease, hemodialysis, home, patient education as topic, peritoneal dialysis, renal dialysis