THE ROLE OF EXPECTATIONS IN PATIENTS REPORTS OF POSTOPERATIVE OUTCOMES AND IMPROVEMENT FOLLOWING THERAPY

Outcomes research typically focuses on the technical capabilities asso ciated with treatment that predicts patients' post-therapy outcomes ad justing for health-related factors. Research on the ability of placebo therapy to alter outcomes suggests that a patient's expectations abou t therapy can also influence outcomes. Few studies have examined the e ffects of expectations and their implications for assessing outcomes. This study followed 348 patients who had surgery for benign prostatic hyperplasia. Four hypotheses are tested: whether positive expectations about improvement influence 1) patients' postoperative reports of sym ptoms; 2) their belief that they have improved, 3) their overall healt h after treatment; and 4) whether these effects persist during the yea r following treatment. Using step-wise regression to control for socio demographic and clinical factors, we found positive expectations did n ot appear to strongly influence a patient's report of postoperative sy mptoms or their overall health. However, we found strong support for p ositive expectations increasing the likelihood of reporting they felt better after surgery, even after controlling for symptom changes. This effect persisted throughout the postoperative year. We conclude that positive expectations result in a more optimistic view of improvement after surgery rather than altering reports of outcomes or health.