title: What do patients with strabismus expect post surgery? The development and validation of a questionnaire.
abstract: OBJECTIVE
  To develop and validate a short questionnaire to assess patients' expectations about outcomes post strabismus surgery.
  
  
  METHODS
  Questionnaire items were extracted from previous literature and reviewed by a multidisciplinary team. A cross-sectional study was then undertaken with 220 adult patients due to undergo strabismus surgery. Participants completed the 17-item questionnaire. Scale structure was explored using principal component analysis (PCA), and the subscales analysed in relation to demographic and clinical characteristics and psychosocial well-being in order to establish validity.
  
  
  RESULTS
  PCA revealed a 3-factor solution for the Expectations of Strabismus Surgery Questionnaire (ESSQ): (a) intimacy and appearance-related issues, (b) visual functioning, (c) social relationships. This 3-factor solution explained 59.30% of the overall variance in the ESSQ. Internal consistency, content and nomological and concurrent validity were considered acceptable.
  
  
  CONCLUSIONS
  Patients with strabismus have high expectations about their postsurgical outcomes. This questionnaire provides a useful tool to assess the expectations patients have about their surgery, whether these expectations change over time and how they impact on postsurgical outcomes.
authors.affiliation: School of Health Sciences, City University London, London, UK Community Health Newham, East London Foundation Trust, London, UK.
authors.forename: Hayley
authors.initials: H
authors.lastname: McBain
authors.affiliation: Department of Strabismus and Neuro-ophthalmology, Moorfields Eye Hospital NHS Foundation Trust, London, UK.
authors.forename: Kelly
authors.initials: K
authors.lastname: MacKenzie
authors.affiliation: Department of Strabismus and Neuro-ophthalmology, Moorfields Eye Hospital NHS Foundation Trust, London, UK.
authors.forename: Joanne
authors.initials: J
authors.lastname: Hancox
authors.affiliation: Department of Strabismus and Neuro-ophthalmology, Moorfields Eye Hospital NHS Foundation Trust, London, UK UCL Institute of Ophthalmology NIHR Biomedical Research Centre for Ophthalmology, London, UK.
authors.forename: Daniel G
authors.initials: DG
authors.lastname: Ezra
authors.affiliation: Department of Strabismus and Neuro-ophthalmology, Moorfields Eye Hospital NHS Foundation Trust, London, UK.
authors.forename: Gillian G W
authors.initials: GG
authors.lastname: Adams
authors.affiliation: School of Health Sciences, City University London, London, UK.
authors.forename: Stanton P
authors.initials: SP
authors.lastname: Newman
mesh_terms: D000328:Adult; D000368:Aged; D001008:Anxiety Disorders; D003430:Cross-Sectional Studies; D003866:Depressive Disorder; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009801:Oculomotor Muscles / Q000601:surgery; D013508:Ophthalmologic Surgical Procedures; D017063:Outcome Assessment, Health Care; D017060:Patient Satisfaction; D011184:Postoperative Period; D011446:Prospective Studies; D011788:Quality of Life / Q000523:psychology*; D015203:Reproducibility of Results; D018434:Sickness Impact Profile; D013285:Strabismus / Q000523:psychology* / Q000601:surgery*; D011795:Surveys and Questionnaires
keywords: Cosmesis; Treatment Surgery