Outcome Expectancies, Functional Outcomes, and Expectancy Fulfillment for Patients with Shoulder Problems

Objectives: This study was conducted to evaluate the relationship among patient outcome expectancies, perceived shoulder function changes, and perceptions of expectancy fulfillment. Methods: Patients (n = 199) treated for shoulder problems at one orthopedic surgeon's office completed a baseline...

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Bibliographic Details
Published in:Medical care 2004-02, Vol.42 (2), p.139-146
Main Authors: Kimberly J. O'Malley, Roddey, Toni S., Gartsman, Gary M., Cook, Karon F.
Format: Article
Language:English
Subjects:
Adolescent
Adult
Aged
Aged, 80 and over
Arm Injuries - therapy
Chronic diseases
Demography
Female
Follow-Up Studies
Health outcomes
Humans
Linear Models
Male
Medications
Mental health outcomes
Middle Aged
Multivariate Analysis
Outcome Assessment (Health Care)
Pain
Patient Satisfaction - statistics & numerical data
Physical therapy
Recovery of Function
Shoulder
Shoulder - surgery
Shoulder Injuries
Statistical variance
Surgical specialties
Texas
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Summary:Objectives: This study was conducted to evaluate the relationship among patient outcome expectancies, perceived shoulder function changes, and perceptions of expectancy fulfillment. Methods: Patients (n = 199) treated for shoulder problems at one orthopedic surgeon's office completed a baseline survey comprised of measures of outcome expectancies, shoulder function, health status, and demographics. At 1 month, 2 months, and 3 months, patients completed a mailed follow-up survey comprised of all baseline measures except demographic variables. At 3 months, a measure of expectancy fulfillment was added. A general linear modeling approach was used to assess the significance and effect size of 1) outcome expectancies on changes in shoulder function; and (2) outcome expectancies, shoulder function changes, and their interaction on perceptions of expectancy fulfillment. Results: Outcome expectancies significantly predicted changes in shoulder function and accounted for 10% of the variance in functional improvement. The improvement difference between patients with high expectancies compared with those with low expectancies was clinically relevant (4.57 points), as it was greater than the minimal clinically important difference (3.02 points). Outcome expectancies and shoulder function changes significantly predicted patients' perceptions of fulfilled expectancies, but their interaction was not statistically significant. Conclusions: Results highlight the importance of patient expectancy in medical encounters. The findings suggest the need for interventions targeting patient expectancies such as including discussions about expectancy in patient-physician negotiations of therapeutic plans. Results also underscore the need for the development of better measures of outcome expectancies and expectancy fulfillment.
ISSN:0025-7079
1537-1948
DOI:10.1097/01.mlr.0000108766.00294.92