Odell Annika, Bång Angela, Andréll Paulin, Widell Charlotte, Fryklund Henrik, Kallryd Anders, Tygesen Hans, Grip Lars
Department of Cardiology, The Medicine Institute of Sahlgrenska Academy, Gothenburg, Sweden.
Faculty of Caring Science, University of Borås, Borås, Sweden.
Open Heart. 2017 Mar 6;4(1):e000529. doi: 10.1136/openhrt-2016-000529. eCollection 2017.
Clinical decision-making is often based on evidence of outcome after a specific treatment. Healthcare providers and patients may, however, have different perceptions and expectations of what to achieve from a certain healthcare measure.
To evaluate patients' expectations, perceptions and health related quality of life (HRQoL) before a care process including coronary angiography for suspected coronary artery disease and to evaluate the fulfilment of these expectations in relation to established patient reported outcome measures (PROMs) 6 months later. Furthermore, an aim was to try to define meaningful patient reported experience measures (PREMs) in this population.
544 patients planned for coronary angiography completed a newly developed questionnaire to assess expectations and perceptions of treatment, the expectation questionnaire (ExpQ) and two established HRQoL questionnaires together with the established generic Short-Form 36 (SF36) and the disease specific Seattle Angina Questionnaire (SAQ).
Patients had before the intervention, in general, high expectations of improvement after investigation and treatment and there was a positive attitude towards life style changes, medication and participation in decision-making regarding their own treatment. Only, 56.4% of the patients, however, reported fulfilment of treatment expectations. Fulfilment of treatment expectations correlated strongly with improvement in HRQoL after the care process.
To measure patients ´ expectations and fulfilments of these may offer simple and meaningful outcomes to evaluate a healthcare process from a patient ´s perspective. To approach patients' expectations may also strengthen patient involvement in the care process with the possibilities of both higher patient satisfaction and medical results of the treatment.
临床决策通常基于特定治疗后的结果证据。然而，医疗服务提供者和患者对于某项医疗措施的预期效果可能有不同的认知和期望。
评估在包括对疑似冠状动脉疾病进行冠状动脉造影的护理过程之前患者的期望、认知以及健康相关生活质量（HRQoL），并评估6个月后这些期望与既定的患者报告结局指标（PROMs）的符合情况。此外，目的还在于尝试定义该人群中有意义的患者报告体验指标（PREMs）。
544名计划进行冠状动脉造影的患者完成了一份新开发的问卷，以评估对治疗的期望和认知，即期望问卷（ExpQ），以及两份既定的HRQoL问卷，同时还有既定的通用简短健康调查（SF36）和疾病特异性西雅图心绞痛问卷（SAQ）。
总体而言，患者在干预前对检查和治疗后的改善抱有很高期望，并且对生活方式改变、药物治疗以及参与自身治疗决策持积极态度。然而，只有56.4%的患者报告治疗期望得到了满足。治疗期望的满足与护理过程后HRQoL的改善密切相关。
衡量患者的期望及其满足情况可能会从患者角度提供简单且有意义的结果来评估医疗过程。关注患者的期望也可能会加强患者在护理过程中的参与度，从而有可能提高患者满意度和治疗的医疗效果。
