Although many hang their hats on quantitative studies and randomized controlled trials, I appreciate qualitative studies. I find the thoughts and perspectives that people have to be quite interesting. Qualititative studies that shed light on what people think are golden insights that can be used to improve delivery of services and outcomes.
What do people expect from services? I can appreciate that this study focuses on perceptions and expectations for orthopaedic surgeons. I believe what was found in this study may overlap into the rehabilitation world.
As I think about the findings, I see areas that we can begin to address at the onset of services.
Patients want hope. For those of us who use FOTO, I think we provide immediate hope. The patient friendly report engages the patient and provides hope.
Patients want to participate. This is a two-fold issue though. They first want to tell their story and be heard. They want to be believed. They want to hear our perspective while at the same time be active in the decision-making process. In rehabilitation, the concept of "participation" requires even more than a discussion. From the below abstract, you will see that patients may have a bit of a passive attitude and want to be "fixed." The nice thing about qualitative studies is that by knowing this bit of information, we can begin ways to formulate our interactions to manage that expectation to begin to favor self-efficacy.
Another aspect is that patients believe that diagnostic testing is required as evidence to indicate the patient's problem. We realize that diagnostic testing does not necessarily correlate with examination findings. We also know that diagnostic testing and diagnostic reports may influence outcomes, potentially negatively. Having insight as to how much patients value diagnostic testing helps with the conversations we have with patients.
The bottom line is that the insights gained from the study can be used with creating a therapeutic alliance.
Below you will find a quick view of the abstract.
Patients' perceptions of care is an important factor in evaluation of health care, in quality assessment, and in improvement efforts. Expectations of assessments or procedures such as surgery have been found to be related to perceptions of outcome as well as satisfaction, and are therefore of interest to both clinicians and researchers. Increased understanding of these patient views is important so that orthopaedic assessments, regardless of who performs them, can be further developed and patient-centred to better meet patients' needs. The purpose of this study was therefore to explore patients' perceptions and expectations of an upcoming orthopaedic consultation.
This was an explorative qualitative study with an inductive approach. Thirteen patients who were referred for orthopaedic consultation were included using a purposeful sampling strategy. Patients participated in individual, semi-structured interviews that were recorded, transcribed verbatim and analysed with qualitative content analysis.
The participants' expressed perceptions and expectations of the upcoming orthopaedic surgeon consultation were classified into 5 categories: Hoping for action, Meeting an expert, A respectful meeting, Participating in the consultation, and A belief that hard facts make evidence. Across the categories, an overarching theme was formulated: Take me seriously and do something! The participants emphasised a desire to be taken seriously and for something to happen, both during the consultation itself and as a result of the orthopaedic consultation. They described a trust in the expertise of the orthopaedic surgeon and stressed the importance of the surgeon's attitude, but still expected to participate in the consultation as well as in the decision-making process.
The study findings illuminate aspects that are important for patients in an orthopaedic consultation. The descriptions of patients' perceptions and expectations can serve to improve patient-clinician relationships as well as to inform the development of new models of care, and a greater understanding of these aspects may improve the patient experience.
BMC Musculoskelet Disord. 2017 Aug 24;18(1):367. doi: 10.1186/s12891-017-1719-6.