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Journal of Occupational Rehabilitation

, Volume 25, Issue 1, pp 240–255 | Cite as

Measures of Patients’ Expectations About Recovery: A Systematic Review

  • Shanil EbrahimEmail author
  • Cindy Malachowski
  • Mostafa Kamal el Din
  • Sohail M. Mulla
  • Luis Montoya
  • Sheena Bance
  • Jason W. Busse
Review

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.

Keywords

Recovery expectations Patient beliefs Return to work expectations Measurements Systematic review 

Notes

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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Copyright information

© Springer Science+Business Media New York 2014

Authors and Affiliations

  • Shanil Ebrahim
    • 1
    • 2
    • 3
    • 4
    Email author
  • Cindy Malachowski
    • 5
  • Mostafa Kamal el Din
    • 2
  • Sohail M. Mulla
    • 1
  • Luis Montoya
    • 6
  • Sheena Bance
    • 7
  • Jason W. Busse
    • 1
    • 2
    • 8
  1. 1.Department of Clinical Epidemiology and BiostatisticsMcMaster UniversityHamiltonCanada
  2. 2.Department of AnesthesiaMcMaster UniversityHamiltonCanada
  3. 3.Stanford Prevention Research Center, Department of MedicineStanford UniversityStanfordUSA
  4. 4.Department of Anaesthesia and Pain MedicineHospital for Sick ChildrenTorontoCanada
  5. 5.Department of Rehabilitation ScienceUniversity of TorontoTorontoCanada
  6. 6.University Health NetworkTorontoCanada
  7. 7.Department of Applied Psychology and Human DevelopmentOntario Institute for Studies in EducationTorontoCanada
  8. 8.The Michael G. DeGroote Institute for Pain Research and CareMcMaster UniversityHamiltonCanada

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