Department of Psychology, Medical School Hamburg, Hamburg, Germany.
Department of Psychosomatic Medicine and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
PLoS One. 2023 Jan 23;18(1):e0280472. doi: 10.1371/journal.pone.0280472. eCollection 2023.
Patients' expectations, as a central mechanism behind placebo and nocebo effects, are an important predictor of health outcomes. Yet, theoretically based generic assessment tools allowing for an integrated understanding of expectations across conditions and treatments are lacking. Based on the preliminary 35-item version, this study reports the development and validation of the Treatment Expectation Questionnaire (TEX-Q), a generic, multidimensional self-report scale measuring patients' expectations of medical and psychological treatments.
The TEX-Q was developed in a validation sample of n = 251 patients undergoing different treatments using exploratory factor analyses and item analyses, as well as analysis of convergent and divergent validity. Confirmatory factor analysis was conducted in an independent sample of n = 303 patients undergoing cancer treatment. Two-weeks test-retest reliability was assessed in n = 28 psychosomatic outpatients.
Factor analyses revealed six theoretically founded stable subscales. The TEX-Q assesses expectations of treatment benefit, positive impact, adverse events, negative impact, process and behavioural control with a total of 15 items. Results for the subscales and the sum score indicated good internal consistency (α = .71-.92), moderate to high test-retest reliability (r = .39-.76) as well as good convergent validity with regard to other expectation measures (r = .42-.58) and divergent validity with regard to measures of generalized expectations (r < .32) and psychopathology (r < .28).
While further validation is needed, the results suggest that the TEX-Q is a valid and reliable scale for the generic, multidimensional assessment of patients' treatment expectations. The TEX-Q overcomes constraints of ad-hoc and disease-specific scales, while allowing to compare the impact of different expectation constructs across conditions and treatments.
患者的期望是安慰剂和反安慰剂效应的核心机制之一，是健康结果的重要预测指标。然而，缺乏基于理论的通用评估工具来综合理解各种情况下和各种治疗方法的期望。本研究基于初步的 35 项版本，报告了治疗期望问卷（TEX-Q）的开发和验证，这是一种通用的、多维的自我报告量表，用于测量患者对医疗和心理治疗的期望。
TEX-Q 是在一个由 n = 251 名接受不同治疗的患者组成的验证样本中开发的，使用探索性因素分析和项目分析，以及分析收敛和发散效度。在一个接受癌症治疗的 n = 303 名患者的独立样本中进行了验证性因素分析。在 n = 28 名身心科门诊患者中评估了两周的重测信度。
因素分析显示了六个基于理论的稳定子量表。TEX-Q 评估治疗获益、积极影响、不良事件、消极影响、过程和行为控制的期望，共 15 个项目。子量表和总分的结果表明，内部一致性良好（α =.71-.92），重测信度中等至高度（r =.39-.76），与其他期望测量（r =.42-.58）具有良好的收敛效度，与广义期望（r <.32）和精神病理学（r <.28）的测量具有良好的发散效度。
虽然还需要进一步验证，但结果表明 TEX-Q 是一种有效的、可靠的通用量表，用于多维评估患者的治疗期望。TEX-Q 克服了特定疾病和特定疾病的量表的局限性，同时允许比较不同治疗方法中不同期望结构的影响。
