Patient's evaluation of dietetic care: testing a cognitive-attitude approach

The study of patients' attitudes is an important subject because the success of many medical programs is linked to it. We have used a cognitive attitude theory -- the Elaboration Likelihood Model (ELM), to study how patients form an evaluation of dietetic care. Respondents answered one questionnaire before (46% response) and one questionnaire after (60% response) their first consultation with a primary care dietitian. Patients rated their pre-test quality expectations and post-test quality evaluations of each of 28 distinctive aspects of care. They also rated the relative importance of each aspect. According to the ELM, people of high motivation and capacity to process information do so in an elaborate way. From this model five hypotheses are derived. Patients who elaborate are assumed to show a more differentiated pattern in (1) their quality expectations, (2) their rating of importance and (3) their quality judgements of distinctive aspects of dietetic care than people who do not elaborate. Furthermore, they are expected to show (4) a weaker association between quality expectation and quality judgement, and (5) relatively more extreme quality judgements. The three first hypotheses are accepted, the evidence of the last two is still inconclusive.