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E-Patient Counseling Trial (E-PACO): Computer Based Education versus Nurse Counseling for Patients to Prepare for Colonoscopy

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Preferences, predictions and patient enablement: a preliminary study.

Carl J Brusse¹, Laurann E Yen

¹Australian Primary Health Care Research Institute, The Australian National University, Building 63, corner of Mills & Eggleston Roads, Acton 0200 ACT, Australia. carl.brusse@anu.edu.au

BMC Family Practice

|August 15, 2013

Summary

This study found no significant link between patient expectation fulfillment and consultation quality, as measured by the Patient Enablement Instrument (PEI). The findings suggest patient preferences and predictions for outcomes do not reliably predict enablement.

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Area of Science:

Healthcare Quality
Patient-Centered Care
General Practice Research

Background:

Patient enablement is often seen as a more objective measure of consultation quality than patient satisfaction.
The relationship between patient expectations and enablement, and the distinction between expectation as preference versus prediction, remain underexplored.

Purpose of the Study:

To assess the feasibility of measuring the relationship between expectation fulfillment and patient enablement.
To measure the difference between patient expectation as preference and patient expectation as prediction.

Main Methods:

A questionnaire study involving 67 patients across three Australian General Practices.
Recorded patient preferences and predictions for outcomes pre-consultation.
Measured Patient Enablement Instrument (PEI) and actual outcomes post-consultation; analyzed concordance between expectations and outcomes against PEI.

Main Results:

No statistically significant relationship was found between preference-outcome concordance and PEI, or prediction-outcome concordance.
Observed trends suggested a weak positive correlation between PEI and greater discordance (counter to expectations).
Concordance between preferred and predicted outcomes was lower than concordance with actual outcomes.

Conclusions:

The relationship between expectation fulfillment (as preference or prediction) and patient enablement remains uncertain.
The lack of agreement between preference and prediction highlights the need to clearly define 'patient expectation' in study designs.