THE ROLE OF EXPECTATIONS IN PATIENTS REPORTS OF POSTOPERATIVE OUTCOMES AND IMPROVEMENT FOLLOWING THERAPY
THE ROLE OF EXPECTATIONS IN PATIENTS REPORTS OF POSTOPERATIVE OUTCOMES AND IMPROVEMENT FOLLOWING THERAPY
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DOI：
10.1097/00005650-199311000-00006
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发表时间：
1993-11-01
期刊：
影响因子：
3
通讯作者：
BLACK, NA
中科院分区：
文献类型：
--
作者：
FLOOD, AB;LORENCE, DP;BLACK, NA
结果研究通常侧重于与治疗相关的技术能力，预测患者治疗后与健康相关因素的结果。关于安慰剂治疗改变结果的能力的研究表明，患者对治疗的期望也会影响结果。很少有研究考察预期的影响及其对评估结果的影响。本研究随访了348例因良性前列腺增生手术的患者。检验了四个假设：对改善的积极期望是否影响1)患者术后症状报告；2)他们相信自己已经有所改善；3)他们在治疗后的整体健康状况；4)这些影响是否在治疗后的一年内持续存在。使用逐步回归控制社会人口统计学和临床因素，我们发现积极的期望似乎并没有强烈影响患者对术后症状的报告或他们的整体健康状况。然而，我们发现积极期望的强烈支持增加了报告他们在手术后感觉更好的可能性，即使在控制症状变化之后。这种效果持续到术后一年。我们的结论是，积极的期望导致对术后改善的更乐观的看法，而不是改变结果或健康的报告。
Outcomes research typically focuses on the technical capabilities associated with treatment that predicts patients' post-therapy outcomes adjusting for health-related factors. Research on the ability of placebo therapy to alter outcomes suggests that a patient's expectations about therapy can also influence outcomes. Few studies have examined the effects of expectations and their implications for assessing outcomes. This study followed 348 patients who had surgery for benign prostatic hyperplasia. Four hypotheses are tested: whether positive expectations about improvement influence 1) patients' postoperative reports of symptoms; 2) their belief that they have improved, 3) their overall health after treatment; and 4) whether these effects persist during the year following treatment. Using step-wise regression to control for sociodemographic and clinical factors, we found positive expectations did not appear to strongly influence a patient's report of postoperative symptoms or their overall health. However, we found strong support for positive expectations increasing the likelihood of reporting they felt better after surgery, even after controlling for symptom changes. This effect persisted throughout the postoperative year. We conclude that positive expectations result in a more optimistic view of improvement after surgery rather than altering reports of outcomes or health.