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Title: Instruments for patient education: Psychometric evaluation of the expected knowledge (EKHP) and the received knowledge of hospital patients (RKHP)
Authors: Leino-Kilpi, Helena 
Inkeroinen, Saija 
Cabrera, Esther 
Charalambous, Andreas 
Fatkulina, Natalja 
Katajisto, Jouko K. 
Sigurdardottir, Árún K. 
Sourtzi, Panayota 
Suhonen, Riitta A. 
Zabalegui-Yárnoz, Adelaida 
Valkeapää, Kirsi 
Major Field of Science: Medical and Health Sciences
Field Category: Health Sciences
Keywords: Empowerment;Nursing;Patient education as topic;Patient participation;Patient-centered care;Surveys and questionnaires
Issue Date: 2020
Source: Journal of Multidisciplinary Healthcare, 2020, vol. 13, pp. 1481 - 1505
Volume: 13
Start page: 1481
End page: 1505
Journal: Journal of Multidisciplinary Healthcare 
Abstract: Purpose: In patient education, there is a need for valid and reliable instruments to assess and tailor empowering educational activities. In this study, we summarize the process of producing two parallel instruments for analyzing hospital patients’ expectations (Expected Knowledge of Hospital Patients, EKhp) and received knowledge (Received Knowledge of Hospital Patients, RKhp) and evaluate the psychometrics of the instruments based on international data. In the instruments, six elements of empowering knowledge are included (bio-physiological, functional, experiential, ethical, social, and financial). Patients and Methods: The original Finnish versions of EKhp and RKhp were tested for the first time in 2003, after which they have been used in several national studies. For international purposes, the instruments were first translated into English, then to languages of the seven participating European countries, using double-checking procedure in each one, and subsequently evaluated and confirmed by local researchers and language experts. International data collection was performed in 2009–2012 with a total sample of 1,595 orthopedic patients. Orthopedic patients were selected due to the increase in their numbers, and need for educational activities. Here we report the psychometrics of the instruments for potential international use and future development. Results: Content validities were confirmed by each participating country. Confirmatory factor analyses supported the original theoretical, six-dimensional structure of the instruments. For some subscales, however, there is a need for further clarification. The summative factors, based on the dimensions, have a satisfactory internal consistency. The results support the use of the instruments in patient education in orthopedic nursing, and preferably also in other fields of surgical nursing care. Conclusion: EKhp and RKhp have potential for international use in the evaluation of empowering patient education. In the future, testing of the structure is needed, and validation in other fields of clinical care besides surgical nursing is especially warranted.
ISSN: 1178-2390
DOI: 10.2147/JMDH.S271043
Rights: © Leino-Kilpi et al. This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at and incorporate the Creative Commons Attribution.
Type: Article
Affiliation : University of Turku 
Turku University Hospital 
University of Pompeu Fabra 
Sechenov University 
Cyprus University of Technology 
Klaipeda University 
Vilnius University 
University of Akureyri 
Akureyri Hospital 
National and Kapodistrian University of Athens 
Turku Welfare Division 
Hospital Clinic of Barcelona 
Universitat de Barcelona 
Finnish Defense Research Agency 
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