https://orcid.org/0000-0001-5044-5540
![Sample our Health and Social Care journals, sign in here to start your FREE access for 14 days]({"type":"image" , "src" : "/sda/5938/TOC-Subject-Sample-2021-Health-Social-Care.jpg"})
ABSTRACT
Patients’ expectations are among the most frequently studied psychological prognostic factors in total knee and hip arthroplasty (TKA/THA). So far, however, evidence on the effect of patients’ preoperative expectations on surgery outcome is inconclusive. Heterogeneity of expectation constructs and the use of psychometrically not evaluated measurement instruments have constituted major obstacles for the integration of the current literature. Using a theory-based model of expectation constructs , this meta-analysis set out to disentangle the conflicting results in the current literature. Systematic literature searches yielded k = 46 studies (N = 10,465) that reported associations of preoperative expectations with postoperative pain, functioning and disability, and satisfaction. Random effects meta-analysis revealed a robust small association (r = .16; 95% CI .13, .19) between patients’ positive preoperative expectations and better postoperative outcomes. This effect did not differ between THA and TKA, different outcome categories and different follow-up periods. Studies using psychometrically evaluated expectation measures reported significantly higher effects (r = .19; 95% CI .16, .22). Whether this effect varies among different expectation constructs remains unclear. High-quality studies using validated, multidimensional expectation measures are needed to further understand the role of different expectation constructs in THA and TKA surgery.
Acknowledgements
The authors would like to thank Julia Koß and Marie Mylord for their valuable support during the data collection process.
Disclosure statement
Dr. Neubauer is employed as head of innovation at VAMED Gesundheit Holding Deutschland GmbH (private German Health Care Provider running several rehabilitation hospitals and other health care facilities). Dr. Ebert has served as a consultant to/on the scientific advisory boards of Sanofi, Novartis, Minddistrict, Lantern, Schoen Kliniken, Ideamed and German health insurance companies (BARMER, Techniker Krankenkasse) and a number of federal chambers for psychotherapy. Dr. Ebert is a stakeholder of HelloBetter – GET.ON institute for health training online, which aims to implement scientific findings related to digital health interventions into routine All other authors declare no conflict of interest.
Data availability statement
The data and analysis code used in this manuscript are publicly available at the Open Science Framework: https://osf.io/nsf6w/ (DOI 10.17605/OSF.IO/NSF6W)