Briet Jan Paul, Hageman Michiel G J S, Overbeek Celeste L, Mudgal Chaitanya, Ring David C, Vranceanu Ana-Maria
Hand and Upper Extremity Service, Department of Orthopaedic Surgery, Massachusetts General Hospital, Boston, MA.
Hand and Upper Extremity Service, Department of Orthopaedic Surgery, Massachusetts General Hospital, Boston, MA.
Psychosomatics. 2016 Jul-Aug;57(4):401-8. doi: 10.1016/j.psym.2016.02.004. Epub 2016 Apr 12.
The degree to which patients' expectations are met during an office visit consistently correlates with patients' satisfaction, whereas the relationship between previsit expectations and satisfaction varies.
The aim of this pilot study was to preliminarily assess the relationship of psychosocial factors, pain intensity, and magnitude of disability to previsit expectations, met expectations, and satisfaction with medical care in patients with hand and upper extremity conditions in a surgical outpatient clinic.
A cohort of 85 outpatients with upper extremity illnesses indicated their previsit expectations (Patients Intention Questionnaire), degree to which these expectations were met (Expectations Met Questionnaire), level of depressive symptoms (Patient Health Questionnaire-2), confidence about the ability to achieve one's goals in spite of pain (Pain Self-Efficacy Questionnaire), pain intensity (Numerical Rating Scale for pain), disability (Disabilities of the Arm Shoulder and Hand, short version; QuickDASH), and satisfaction with the medical visit (Medical Interview Satisfaction Scale).
Higher previsit expectations were associated with more depressive symptoms, lower pain self-efficacy, higher pain intensity, and fewer years of education. Patients in the low and moderate met expectations categories had significantly more symptoms of depression, fewer years of education, and more pain compared to those in the high-met expectations category. Fewer years of education and higher pain intensity predicted higher previsit expectations and explained 19% of variance.
Psychosocial factors affect both previsit expectations and met expectations during an outpatient visit to a hand surgeon. Met expectations, but not previsit expectations, affect satisfaction.
Prognostic, level II.
在门诊就诊期间患者期望得到满足的程度始终与患者满意度相关，而就诊前期望与满意度之间的关系则有所不同。
这项初步研究的目的是初步评估心理社会因素、疼痛强度和残疾程度与外科门诊手部及上肢疾病患者的就诊前期望、期望达成情况以及医疗护理满意度之间的关系。
一组85名上肢疾病门诊患者表明了他们的就诊前期望（患者意向问卷）、这些期望得到满足的程度（期望达成问卷）、抑郁症状水平（患者健康问卷-2）、尽管疼痛仍对实现目标能力的信心（疼痛自我效能问卷）、疼痛强度（疼痛数字评定量表）、残疾程度（手臂、肩部和手部残疾，简版；QuickDASH）以及对医疗就诊的满意度（医疗访谈满意度量表）。
较高的就诊前期望与更多的抑郁症状、较低的疼痛自我效能、较高的疼痛强度以及较少的受教育年限相关。与期望达成程度高的类别相比，期望达成程度低和中等的类别中的患者有明显更多的抑郁症状、更少的受教育年限以及更多的疼痛。较少的受教育年限和较高的疼痛强度预示着较高的就诊前期望，并解释了19%的方差。
心理社会因素在手部外科门诊就诊期间会影响就诊前期望和期望达成情况。期望达成情况而非就诊前期望会影响满意度。
预后性，二级。
