| Glenn - USAEyes.org 2004-12-28, 7:15 pm |
| This article is about cataract surgery, but the study clearly shows
that satisfaction is based upon expectations much more than actual
visual outcomes. Patient expectations of LASIK have been made very
high with marketing and so many people achieving a satisfactory
result.
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Expectations and Outcomes in Cataract Surgery
A Prospective Test of 2 Models of Satisfaction
Chet K. Pager, BMed (Hons), DipEd, MA
Arch Ophthalmol. 2004;122:1788-1792.
Objectives To document patients’ preoperative expectations for
postoperative outcomes. To measure the relative contribution of
patient understanding, expectations, outcome, and expectation-outcome
discrepancy in determining patient satisfaction.
Methods One hundred twenty-one patients were surveyed just before and
1 month after cataract surgery regarding their understanding of the
procedure, satisfaction with their vision, and both current and
expected visual function for each of the items on the Visual Function
Index (VF-14).
Results Sixty percent of patients expected to achieve a perfect VF-14
score. The average expected VF-14 score was 96.1, compared with an
achieved VF-14 score of just 89.8. The most unrealistic expectations
involved driving at night, reading small print, and doing fine
handiwork. Surprisingly, improvement in visual function was not
correlated with satisfaction in vision. While patient understanding,
expectations, and achieved VF-14 score did correlate with
satisfaction, when controlling for other factors, only
achievement-expectation discrepancy was independently predictive.
Conclusions This study provides support for the expectation-outcome
discrepancy model of patient satisfaction. Further, it highlights the
highly unrealistic expectations harbored by patients with cataract and
emphasizes the importance for physicians to control their patients’
expectations. Controlling patient expectations may be more effective
than improving patients’ postoperative outcome in terms of maximizing
patient satisfaction.
Author Affiliation: Department of Clinical Ophthalmology and Eye
Health, university of Sydney, Sydney, Australia.
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Glenn Hagele
Executive Director
Council for Refractive Surgery Quality Assurance
Email to glenn dot hagele at usaeyes dot org
http://www.USAEyes.org
http://www.ComplicatedEyes.org
I am not a doctor.
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