Boundaries around the 'well-informed' patient: the contribution of Schutz to inform nurses' interactions

The aim of this paper is to explore the operation of two different types of knowledge in health care and the position of the nurse to assist in the confluence of knowledge to develop the well-informed patient.

If patients are to be active participants in their care they require useful information. Interactions in contemporary health care mostly involve 'medico-scientific' knowledge, that refers to the 'science' of patients' conditions, as opposed to 'everyday' knowledge, which refers to information that can assist patients in lifestyle matters relating to their condition. THEORETICAL PERSPECTIVE: This paper draws on the work of the 'well-informed citizen' as proposed by Schutz in the analysis of two patient case studies of practices in the acute care setting of the hospital.

Data collection was undertaken through fieldwork, incorporating participant observation and discussions with patients in general medical/surgical areas.

Two patient case studies representative of the findings are analysed. Analysis identifies the predominant use of 'medico-scientific' knowledge to the detriment of 'everyday' knowledge during interactions between patients and all health professionals.

There is predisposition in the acute context to interact in 'medico-scientific' knowledge as opposed to 'everyday' knowledge that does not facilitate a comprehensive understanding by patients of how they can best manage their lifestyle.

Using the notion of Schutz's 'well-informed' citizen this study identifies strategies for nursing staff to capture and explore the development of 'everyday' knowledge that can assist patients to become more informed and improve their health management.