Table 3 Quotations: Knowledge and education

A. Superficial level of knowledge

I don't really know what these different pills do for me. (P3)

I'm assuming these people know what they're doing. They're not doing this for nothing. They must have good reasons, and they tell me, "Hang on there, you're doing all right. Keep it up." So I do. I don't question them. Very little, if any. I probably wouldn't know what they were talking about if they started to explain it all, and what's the point of that? (P12)

Q: What do you think Coumadin is doing for you and your health?

A: It makes the blood sticky, I believe, or thins it. I really don't know.

Q: Do you know why they added the Coumadin?

A: No idea.

Q: It doesn't much matter to you?

A: It doesn't matter to me.

Q: Everyone's different. Some people like to know all the details.

A: Oh, I couldn't care less, just as long as it keeps me alive. (P17)

I hope it's [warfarin] keeping everything under control... Well, the stroke that I had, I don't feel sick, I don't have any pain, or anything. (P21)

B. Superior knowledge of risks and benefits

A 72-year-old male has a 30 percent chance of having a stroke regardless, but if I didn't take the Coumadin, it would be a 70 percent chance of having one. So I'm taking medication to avoid the stroke. (P14)

Nobody really explained to me in full what Coumadin is all about, but I did some reading about it. I know it's a blood thinner, an anti-coagulant... helps with the atrial fibrillation that I have, because apparently blood stays longer than it should in the atrium, and if it thickens it can go to your brain and you can have a stroke. (P8)

C. Patient education

Q: When you started on the Coumadin, did you receive any education about the medication?

A: Just that the doctor said to me that it's not 100 %, like anything else, but there's less chance [of stroke]. (P16)

I said to the nurses once, "Supposing I stop taking it." They said, "Oh, I wouldn't advise it, you know, because within a month, you'd have the most severe stroke, or it would kill you, one or the other." That scared me.(P3)

Q: Do you remember if you received any educational material about Coumadin?

A: No.

Q: Or any talk about how it works, the benefits?

A: Not that I can remember. I cannot recall that, no.

Q: Any pamphlets, any coloured paper, anything?

A: No.

Q: You don't recall?

A: If I did have, I read it, then I dismissed it... I have an appetite, I can eat and drink, I can sleep, and I still can work. Anything else, to me, is not quite important. It's probably wrong. I should read them and pay more attention. (P15)

Then he [physician] said, "If you go off the Coumadin for your operation, you could get a stroke. You've got a choice: you can either go off the Coumadin or you can stay on it and bleed to death." Not to death, he didn't say that. You'd bleed. The other way, you could have a stroke. That's all he said. So I presume that it could happen. (P9)

Q: Is there any sort of educational material that you would like to see on warfarin?

A: No. I've got a pile of books to read now, and as soon as I start to read, I fall asleep. The pamphlets would fare worse than the books. I don't think that would help. (P12)

Q: Did you have many questions about it at the time [when warfarin was initiated]?

A: No. You see, the darn trouble was that my wife would be sitting there, and I'd say, "She knows what it's all about; tell her." ... When you have a sit-in nurse, you know, I don't worry about that stuff [getting education on the therapy]. (P3)