Noble L M, Douglas B C, Newman S P
Unit of Health Psychology, Department of Psychiatry and Behavioural Sciences, University College London, UK.
Soc Sci Med. 2001 Apr;52(7):985-98. doi: 10.1016/s0277-9536(00)00210-0.
The article reviews literature concerning patients' expectations of psychiatric care. Early research (pre-1980) is outlined, followed by a systematic review of 21 studies fulfilling specific inclusion criteria from 1980 onwards. Overall, patients expected to improve as a result of psychiatric treatment, and had higher expectations of the helpfulness of psychological and combined treatments than other interventions. Few studies considered expectations of the process of psychiatric care or determinants of expectations. The majority of studies focused on examining the relation between expectations and outcomes. There were indications that expectations of improvement were linked to clinical outcomes, although the relationship appeared to be complex. There was also some evidence that when expectations of the process of care were incongruent with the service provided, outcomes were poorer. The findings of studies in the systematic review were generally congruent with earlier work (pre-1980), although expectations of improvement appeared to be higher in the later studies. Interventions to prepare patients for what to expect were found to have beneficial effects on attendance, satisfaction and the accuracy of expectations about the process of psychiatric care. Future research should focus on developing valid and reliable measures for use in different settings, and on determining the mechanism by which expectations may relate to outcomes, including clinical outcomes, attendance and satisfaction.
本文回顾了有关患者对精神科护理期望的文献。概述了早期研究（1980年之前），随后对1980年起符合特定纳入标准的21项研究进行了系统综述。总体而言，患者期望通过精神科治疗得到改善，并且对心理治疗和联合治疗的有效性期望高于其他干预措施。很少有研究考虑对精神科护理过程的期望或期望的决定因素。大多数研究集中于考察期望与结果之间的关系。有迹象表明改善期望与临床结果相关，尽管这种关系似乎很复杂。也有一些证据表明，当对护理过程的期望与所提供的服务不一致时，结果会更差。系统综述中的研究结果总体上与早期工作（1980年之前）一致，尽管后期研究中改善期望似乎更高。为患者做好预期准备的干预措施被发现对就诊率、满意度以及对精神科护理过程期望的准确性有有益影响。未来的研究应侧重于开发在不同环境中使用的有效且可靠的测量方法，并确定期望可能与结果（包括临床结果、就诊率和满意度）相关的机制。
