Patient education literature and help seeking behaviour: perspectives froman evaluation in the United Kingdom

Decisions by patients upon when to use health care services are a major inf luence on the consumption of health care resources. Patient education - oft en based upon written information on how to identify symptoms of common ill nesses, when to seek help and how to self-treat - is an increasingly popula r strategy to rationalise demand. A large body of literature, in evaluating the impact of such written information, has though overlooked the possessi on or acquisition of comparable publications by respondents in the course o f the studies.. This study attempted to overcome this limitation in conside ring the impact of a prominent patient education booklet that makes referen ce to over 40 common ailments. Questionnaire data from a cohort sample of r esidents (n = 495) in an area within which the booklet was circulated and t hat from a comparison area (n = 509) suggests that such literature exerts a modest influence in orienting patients towards " appropriate" self-referra l and self-care behaviour. Reasons for this limited impact emerged however in semi-structured interviews with a sub-sample of respondents (n = 85). Th ese data show that understanding of the way in which written advice for pat ients is perceived has to focus upon the ways in which diverse sub-populati ons process and attribute meaning to " official" and "unofficial" sources o f advice. More fundamentally, the increasingly sophisticated and specialise d nature of medical and scientific knowledge may be distancing expert knowl edge from individuals and society such that "lay" responses to "expert" adv ice now reflect a continuing process of risk assessment, trust or the withh olding of trust. (C) 2000 Elsevier Science Ltd. All rights reserved.