Associations among perceived and objective disease knowledge and satisfaction with physician communication in patients with chronic kidney disease

Abstract

It is likely that patients with chronic kidney disease (CKD) have a limited understanding of their illness. Here we studied the relationships between objective and perceived knowledge in CKD using the Kidney Disease Knowledge Survey and the Perceived Kidney Disease Knowledge Survey. We quantified perceived and objective knowledge in 399 patients at all stages of non-dialysis-dependent CKD. Demographically, the patient median age was 58 years, 47% were women, 77% had stages 3-5 CKD, and 83% were Caucasians. The overall median score of the perceived knowledge survey was 2.56 (range: 1-4), and this new measure exhibited excellent reliability and construct validity. In unadjusted analysis, perceived knowledge was associated with patient characteristics defined a priori, including objective knowledge and patient satisfaction with physician communication. In adjusted analysis, older age, male gender, and limited health literacy were associated with lower perceived knowledge. Additional analysis revealed that perceived knowledge was associated with significantly higher odds (2.13), and objective knowledge with lower odds (0.91), of patient satisfaction with physician communication. Thus, our results present a mechanism to evaluate distinct forms of patient kidney knowledge and identify specific opportunities for education tailored to patients with CKD.

Figures

Figure 1

Graphical summary of perceived knowledge--itemized and overall. The upper graph presents box plots (median in bold line and interquartile range as top and bottom of box) for each Perceived Kidney Disease Knowledge Surve (PiKS) question, with a box plot of the total PiKS summary score at the far right. The box and whisker plots present 0.05 and 0.95 percentiles. The bottom graph presents frequencies of each possible response (1,2,3,or 4) for each PiKS question, with the rightmost distribution representing the distribution of total PiKS survey scores.

Figure 2

The a priori associations between patient characteristics, perceived knowledge, and outcomes. CKD, chronic kidney disease.