When concerned with safety issues related to their care, patients prefer to challenge nurses rather than doctors, according to a study released on April 3, 2008 in the BMJ Specialty Journal Quality and Safety in Health Care. Additionally, women were found to be more assertive in this respect than men.
These findings were determined through a validated survey which inquired about the factors that influenced patients' willingness to ask healthcare professionals questions related to the safety of treatment methods. All 80 respondents had undergone surgery at an inner London teaching hospital, and scored their willingness to ask different professionals different questions. The scale given was as low as 1, indicating they would "definitely not be willing," and as high as 4, stating that they "definitely would be willing." From these data, an average score was calculated and used to search for any statistically significant factors.
Patients were far more likely to pose factual questions to all healthcare professionals, auch as inquiring about the length of their hospital stay. They were less likely to ask questions that could be perceived as challenges to the professional's clinical abilities, such as whether the healthcare professional had washed his or her hands.
They were more willing to direct factual questions to doctors than to nurses (a score of 3.41 versus a score of 3.09.) They were more willing to ask nurses questions that challenged their clinical abilities than doctors (a score of 2.58 compared with 2.39.) However, when doctors pointedly encouraged patients to ask more difficult questions, they were overall more willing to quiz both sets on both safety and quality issues.
The patients who were least willing to quiz any professionals about safety and quality issues were generally male, had lower levels of education, and were unemployed. Women were the most willing to ask questions in general.
Approximately one in ten patients will experience an error in his or her medical treatment while in a hospital. However, it is possible that if patients are more willing to ask their caretakers challenging questions, this rate could fall, according to the authors. They explain: "Patients need to feel they can ask questions that may be perceived as challenging, without causing offence to those involved in their healthcare treatment."
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