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01.12.2012 | Research | Ausgabe 1/2012 Open Access

Health and Quality of Life Outcomes 1/2012

Systematic review: Do patient expectations influence treatment outcomes in total knee and total hip arthroplasty?

Zeitschrift:
Health and Quality of Life Outcomes > Ausgabe 1/2012
Autoren:
Tsjitske M Haanstra, Tobias van den Berg, Raymond W Ostelo, Rudolf W Poolman, Ilse P Jansma, Pim Cuijpers, Henrica CW de Vet
Wichtige Hinweise

Electronic supplementary material

The online version of this article (doi:10.​1186/​1477-7525-10-152) contains supplementary material, which is available to authorized users.
An erratum to this article is available at http://​dx.​doi.​org/​10.​1186/​1477-7525-11-72.

Competing interests

The authors declare that they have no competing interests.

Authors’ contributions

TMH participated in the design of the study, carried out the literature search, selection and evaluation of articles and writing of the review. EPJ carried out the literature search. TB participated in selection and evaluation of articles and revising the manuscript. RWO participated in the design of the study, selection and evaluation of articles and revising the manuscript. RWP participated in the design of the study and revising the manuscript. PC participated in the design of the study and revising the manuscript. HCWV participated in the design of the study and revising the manuscript. All authors read and approved the final manuscript.

Abstract

Objective

This systematic review aims to summarise all the available evidence related to the association between pre-operative patient expectations (outcome expectations, process expectations and self efficacy expectations) and 5 different treatment outcomes (overall improvement, pain, function, stiffness and satisfaction) in patients with total knee or total hip arthroplasty at three different follow-op periods (>6 weeks; >6 weeks- ≤6 months; >6 months).

Methods

English and Dutch language articles were identified through PubMed, EMBASE.com, PsycINFO, CINAHL and The Cochrane Library from inception to September 2012. Articles assessing the association between pre-operative patient expectations and treatment outcomes for TKA/THA in either adjusted or unadjusted analysis were included. Two reviewers, working independently, determined eligibility, rated methodological quality and extracted data on study design, population, expectation measurements, outcome measurements and strength of the associations. Methodological quality was rated by the same reviewers on a 19 item scale. The scores on the quality assessment were taken into account when drawing final conclusions.

Results

The search strategy generated 2252 unique references, 18 articles met inclusion criteria. Scores on the methodological quality assessment ranged between 6% and 79%. Great variety was seen in definitions and measurement methods of expectations. No significant associations were found between patient expectations and overall improvement, satisfaction and stiffness. Both significant positive and non-significant associations were found for the association between expectations and pain and function.

Conclusions

There was no consistency in the association between patients’ pre-operative expectations and treatment outcomes for TKA and THA indentified in this systematic review. There exists a need for a sound theoretical framework underlying the construct of ‘patient expectations’ and consistent use of valid measurement instruments to measure that construct in order to facilitate future research synthesis.
Zusatzmaterial
Additional file 1:Search strategy in PubMed.(DOCX 12 KB)
12955_2012_1054_MOESM1_ESM.docx
Authors’ original file for figure 1
12955_2012_1054_MOESM2_ESM.pdf
Literatur
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