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Measures of Patients’ Expectations About Recovery: A Systematic Review

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Abstract

Introduction Patients’ expectations regarding their prognosis has been shown to affect recovery. We completed a systematic review to identify measures that assess patients’ expectations of recovery. Methods Eligible studies explored the association between patients’ expectations of recovery, and return to work or claim resolution. We searched electronic databases (MEDLINE and PSYCInfo) from inception to June 21, 2014, bibliographies of eligible studies, relevant systematic reviews and our personal files. Reviewers determined study eligibility and study quality, and completed data extraction. Results Of 14,509 unique citations, 46 studies were eligible with majority of the studies (n = 27; 59 %) rated as low quality, primarily due to substantial missing data and inappropriate adjustment for age, gender and illness severity in their regression models. We identified 5 measures and 41 individual items assessing recovery expectations. Three of seven (43 %) studies using a measure to assess recovery expectations reported psychometric properties, with only one reporting both reliability and construct validity. Only two measures (Expectations of Recovery Scale and the Work-related Recovery Expectations Questionnaire) were externally validated in different populations. Overall, 44 (96 %) studies found that patient recovery expectations was a significant predictor of return to work or sick leave/disability claim resolution. Conclusions Very few studies assessing recovery expectations use a psychometrically valid measure. Current evidence suggests that patients with lower recovery expectations are less likely to resolve their disability claim or return to work versus patients with higher recovery expectations. Further validation of existing measures for assessing patient recovery expectations, or development of a new measure that addresses the limitations of existing ones, is required.

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Acknowledgments

We thank Dr. Gordon Guyatt for his intellectual input. No funds were received for this study. SE is supported by a MITACS Elevate and SickKids Restracomp Postdoctoral Fellowship Awards, CM by a graduate scholarship from the Ontario Mental Health Association, SM by MITACS Accelerate and an Ontario Graduate Scholarship, SB by the Social Sciences and Humanities Research Council and an Ontario Graduate Scholarship, and JWB by a New Investigator Award from the Canadian Institutes of Health Research and Canadian Chiropractic Research Foundation.

Conflict of interest

JWB acts as a consultant to Prisma Health Canada, a private incorporated company funded by employers and insurers that consults on and manages long-term disability claims.

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Authors and Affiliations

  1. Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, ON, Canada

    Shanil Ebrahim, Sohail M. Mulla & Jason W. Busse

  2. Department of Anesthesia, McMaster University, HSC-2U1, 1200 Main Street West, Hamilton, ON, L8S 4K1, Canada

    Shanil Ebrahim, Mostafa Kamal el Din & Jason W. Busse

  3. Stanford Prevention Research Center, Department of Medicine, Stanford University, Stanford, CA, USA

    Shanil Ebrahim

  4. Department of Anaesthesia and Pain Medicine, Hospital for Sick Children, Toronto, ON, Canada

    Shanil Ebrahim

  5. Department of Rehabilitation Science, University of Toronto, Toronto, ON, Canada

    Cindy Malachowski

  6. University Health Network, Toronto, ON, Canada

    Luis Montoya

  7. Department of Applied Psychology and Human Development, Ontario Institute for Studies in Education, Toronto, ON, Canada

    Sheena Bance

  8. The Michael G. DeGroote Institute for Pain Research and Care, McMaster University, Hamilton, ON, Canada

    Jason W. Busse

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  1. Shanil Ebrahim
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Correspondence to Shanil Ebrahim.

Appendices

Appendix 1

See Table 3.

Table 3 Detailed description of eligible studies
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Appendix 2

See Table 4.

Table 4 Items assessing expectations or beliefs regarding recovery
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Ebrahim, S., Malachowski, C., Kamal el Din, M. et al. Measures of Patients’ Expectations About Recovery: A Systematic Review. J Occup Rehabil 25, 240–255 (2015). https://doi.org/10.1007/s10926-014-9535-4

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