School of Health and Social Care, Bournemouth University, Dorset, UK.
Health Expect. 2013 Jun;16(2):143-54. doi: 10.1111/j.1369-7625.2011.00706.x. Epub 2011 Jun 17.
Patients' as well as doctors' expectations might be key elements for improving the quality of health care; however, previous conceptual and theoretical frameworks related to expectations often overlook such complex and complementary relationship between patients' and doctors' expectations. The concept of 'matched patient-doctor expectations' is not properly investigated, and there is lack of literature exploring such aspect of the consultation.
The paper presents a preliminary conceptual model for the relationship between patients' and doctors' expectations with specific reference to back pain management in primary care.
The methods employed in this study are integrative literature review, examination of previous theoretical frameworks, identification of conceptual issues in existing literature, and synthesis and development of a preliminary pragmatic conceptual framework.
A simple preliminary model explaining the formation of expectations in relation to specific antecedents and consequences was developed; the model incorporates several stages and filters (influencing factors, underlying reactions, judgement, formed reactions, outcome and significance) to explain the development and anticipated influence of expectations on the consultation outcome.
The newly developed model takes into account several important dynamics that might be key elements for more successful back pain consultation in primary care, mainly the importance of matching patients' and doctors' expectations as well as the importance of addressing unmet expectations.
患者和医生的期望可能是提高医疗保健质量的关键因素;然而,先前与期望相关的概念和理论框架往往忽略了患者和医生期望之间这种复杂而互补的关系。“匹配的医患期望”这一概念尚未得到充分研究,也缺乏探索咨询中这一方面的文献。
本文提出了一个初步的概念模型,用于描述患者和医生期望之间的关系,特别针对初级保健中的背痛管理。
本研究采用综合文献回顾、检查先前的理论框架、确定现有文献中的概念问题以及综合和发展初步实用概念框架的方法。
开发了一个简单的初步模型,解释了与特定前因和后果相关的期望形成;该模型包含了几个阶段和过滤器(影响因素、潜在反应、判断、形成的反应、结果和意义),以解释期望的发展及其对咨询结果的预期影响。
新开发的模型考虑了一些重要的动态因素,这些因素可能是初级保健中更成功的背痛咨询的关键要素,主要是匹配患者和医生期望的重要性以及解决未满足期望的重要性。