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C.K. Pager, P.J. McCluskey; Patient expectations, understanding & outcome as determinants of satisfaction in cataract surgery . Invest. Ophthalmol. Vis. Sci. 2004;45(13):283.
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Purpose:The purpose of this study is, firstly, to document patients’ pre–operative expectations for post–operative outcomes; and secondly, to measure the relative contribution of patient understanding, expectations, outcome, and expectation–outcome disparity in determining patient satisfaction. Methods:121 patients were surveyed just before and one month after surgery regarding their understanding of the procedure, satisfaction with their vision, and both current & expected visual function for each of the items on the VF–14 scale. Results:60% of patients expected to achieve a perfect VF–14 score. The average expected VF–14 score was 96.6, compared against 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 did correlate with satisfaction, when controlling for other factors only achievement–expectation disparity was independently predictive. Conclusions:This study provides support for the expectation–outcome disparity model of patient satisfaction. Further, it highlights the highly unrealistic expectations harbored by cataract patients, and emphasizes the importance for clinicians to control their patients’ expectations. Controlling patient expectations may be more effective than improving patients’ post–operative outcome in terms of maximizing patient satisfaction.
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