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Chang I. W.; Hung, S. H.; Redman, R. W.; Shedden, K. A.
International Journal of Evidence-Based Healthcare: September 2014
doi: 10.1097/01.XEB.0000455168.56949.b8
Abstracts of Oral Presentations: Evidence Transfer: PDF Only

Background:

Patient satisfaction is a conventional approach for evaluations of healthcare encounters; however, there are several theoretical and methodological concerns in doing so. Affective characteristics of satisfaction survey, ceiling effect and reliability of satisfaction measures were both problematic for satisfaction results. Moreover, actual healthcare experiences may not be reflected on satisfaction surveys, because patients have cognitive involvement while responding to them. A deeper understanding of patient expectations regarding healthcare experience is proposed as a better approach to improve health care delivery.

Objective:

The objectives were to (a) understand patient expectations of surgical outcomes in the Taiwanese population; and (b) understand whether patient expectation changes over time.

Methods:

It is a prospective study with sample drawn from a major hospital in Taiwan. Sampled patients were scheduled for total knee replacement (TKR) in the following week. The time points for data collection were one day before surgery and six weeks after surgery. Expectation questionnaire, SF-36 and WOMAC were three instruments employed.

Results:

A total of 250 and 170 patients were interviewed before and after surgery respectively. Six domains of expectation on TKR outcomes were investigated. Expectations on all domains were high. Principal component analysis revealed the presence of two factors on both time points. An inspection of component plot in rotated space was made to understand the expectation underlying mindsets. Two patterns with different composition were shown at both time points. Multiple linear regression models were established.

Discussion:

Before surgery, patient expectation focused on knee function and interaction with others. After surgery, expectation emphasized on recovery.

Conclusion:

Patient expectations on TKR outcomes were high in general among Taiwanese population. Patient expectations change over time. Two patterns of expectation mindsets were emerged before and after surgery. Functional status and time points were predictors for expectations outcomes. The understanding of patient expectations should serve as a compass for tailoring healthcare interventions.

International Journal of Evidence-Based Healthcare © 2014 The Joanna Briggs Institute

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