on preparation for surgery, Johnston and Vogele (1993) concluded that preparation
for surgery in the form of both procedural information (i.e. what will happen) and
behavioural instructions (i.e. how to behave afterwards) resulted in significant benefits
on all outcome variables explored, including mood, pain, recovery, physiological indices
and satisfaction. Although the reasons why pre-operative information is so successful
remain unclear, it is possible that pre-operative information may be beneficial to the
individual in terms of the reduction of anxiety by enabling the patient to mentally
rehearse their anticipated worries, fears and changes following the operation; thus
any changes become predictable. These results therefore suggest that information com-
municated correctly by the doctor or the health professional may be an important part of
reducing the distress following hospitalization or a hospital intervention.THE ROLE OF KNOWLEDGE IN DOCTOR–PATIENT COMMUNICATION
Ley’s approach to doctor–patient communication can be understood within the frame-
work of an educational model involving the transfer of medical knowledge from expert
to layperson (Marteau and Johnston 1990). This traditional approach has motivated
research into health professional’s medical knowledge, which is seen as a product of
their training and education. Accordingly, the communication process is seen as origin-
ating from the health professional’s knowledge base.
Boyle (1970), although emphasizing patients’ knowledge, also provided some
insights into doctors’ knowledge of the location of organs and the causes of a variety of
illnesses. The results showed that although the doctor’s knowledge was superior to that
of the patient’s, some doctors wrongly located organs such as the heart and wrongly
defined problems such as ‘constipation’ and ‘diarrhoea’. It has also been found that
health professionals show inaccurate knowledge about diabetes (Etzwiler 1967;
Scheiderich et al. 1983) and asthma (Anderson et al. 1983). Over recent years, due to
government documents such as Health for All and the Health of the Nation, primary care
team members are spending more time on health promotion practices, which often
involve making recommendations about changing behaviours such as smoking, drinking
and diet. Research has consequently examined health professionals’ knowledge about
these practices. Murray et al. (1993) examined the dietary knowledge of primary care
professionals in Scotland. GPs, community nurses and practice nurses completed a
questionnaire consisting of a series of commonly heard statements about diet and were
asked to state whether they agreed or disagreed with them. The results showed high
levels of correct knowledge for statements such as ‘most people should eat less sugar’ and
‘most people should eat more fibre’, and relatively poor accuracy for statements such as
‘cholesterol in food is the most important dietary factor in controlling blood lipid levels’.
The authors concluded that primary health care professionals show generally good
dietary knowledge but that ‘there is clearly an urgent need to develop better teaching
and training in the dietary aspects of coronary heart disease’.84 HEALTH PSYCHOLOGY