title: Irritable bowel syndrome patients' ideal expectations and recent experiences with healthcare providers: a national survey.
abstract: The purpose of this paper is to identify patients' ideal expectations from their healthcare providers. The IBS-Patient Education Questionnaire was developed using focus groups, and was administered to a national sample of IBS patients. Frequencies of item endorsements were obtained. Subgroup analysis was done comparing the responses for patients' ideal expectations of their healthcare providers vs. their experiences with their last provider. Among the 1,242 patients who completed the survey, the mean age was 39.3 years, educational attainment 15 years, 85% female, IBS duration 6.9 years, 1,028 (83%) had seen a physician for IBS in the past, and 92.6% have used the Internet to obtain health information. Among the subjects who have seen a physician for IBS, the most desired qualities of providers were to give comprehensive information (96%), to refer to a source for additional information (95.8%), to answer questions (95.9%), to listen (94.4%), to provide information about IBS studies and medications (94%), and to provide support (88.6%) and hope (82.1%). Importantly, patients' prior experiences with their last healthcare provider differed from their ideal expectations: "provide information" (38.3%); answer questions during the visit (68%), "to listen" (63.8%), and support (47.1%). Patients' ideal expectations from healthcare providers (what patients ideally would like to experience) relate to obtaining information and relationship needs of receiving support and hope. Notably, their prior experiences with recent healthcare providers (what patients perceived actually occurred) were different from their ideal expectations. A better understanding of different types of expectations is necessary in order to construct an effective therapeutic relationship, which is critical for the management of IBS.
  
  
  CONCLUSIONS
  Practice guidelines for IBS should emphasize a better understanding of a patient's expectations and the therapeutic value of patient-provider communication.
authors.affiliation: Center for Digestive Disorders, Boston University School of Medicine, 85 East Concord Street, Boston, MA 02118, USA. albena.halpert@bmc.org
authors.forename: Albena
authors.initials: A
authors.lastname: Halpert
authors.forename: Christine B
authors.initials: CB
authors.lastname: Dalton
authors.forename: Olafur
authors.initials: O
authors.lastname: Palsson
authors.forename: Carolyn
authors.initials: C
authors.lastname: Morris
authors.forename: Yuming
authors.initials: Y
authors.lastname: Hu
authors.forename: Shrikant
authors.initials: S
authors.lastname: Bangdiwala
authors.forename: Jane
authors.initials: J
authors.lastname: Hankins
authors.forename: Nancy
authors.initials: N
authors.lastname: Norton
authors.forename: Douglas A
authors.initials: DA
authors.lastname: Drossman
mesh_terms: D000328:Adult; D005260:Female; D005500:Follow-Up Studies; D006282:Health Personnel / Q000592:standards*; D006801:Humans; D043183:Irritable Bowel Syndrome / Q000523:psychology* / Q000628:therapy; D008297:Male; D010353:Patient Education as Topic / Q000592:standards*; D010817:Physician-Patient Relations; D011785:Quality Assurance, Health Care / Q000379:methods*; D012189:Retrospective Studies; D011795:Surveys and Questionnaires