title: Patients' Expectations Predict Surgery Outcomes: A Meta-Analysis.
abstract: BACKGROUND
  Several studies indicate that patients' presurgical expectations can influence postsurgical health outcome.
  
  
  OBJECTIVE
  To estimate the potential for clinical exploitation of this association, a meta-analysis of prospective studies which assess the association between patients' presurgical expectations and postsurgical quality of life is applied to accumulate the overall effect.
  
  
  METHODS
  We searched the databases MEDLINE, CENTRAL, and PsychINFO for English- and German-language articles published from 1980 until December 2013. Additionally, manual searches of bibliographies of retrieved articles and relevant reviews were conducted. Prospective studies measuring presurgical expectations and postsurgical quality of life in patients aging 18-65 were selected. Correlations between presurgical expectations and postsurgical quality of life were extracted or provided by the authors.
  
  
  RESULTS
  The search yielded 21 prospective studies (including 2611 patients undergoing surgery) with a follow-up period ranging from 1 week to 13 years. The pooled correlations were 0.369 (95% confidence interval (CI), 0.264 to 0.466; P for heterogeneity <0.001; random-effects model) for overall quality of life (11 studies), 0.126 (95% CI, 0.079 to 0.172; P for heterogeneity = 0.63; random-effects model) for physical quality of life (12 studies), and 0.208 (95% CI, 0.113 to 0.299; P for heterogeneity <0.001; random-effects model) for mental quality of life (12 studies), indicating low to moderate associations between presurgery patients' expectations and postsurgery quality of life.
  
  
  CONCLUSIONS
  These results confirm the importance of patients' expectations in the prediction of postsurgical outcomes and underline the necessity to optimize these expectations in order to improve postoperative quality of life.
authors.affiliation: Department of Clinical Psychology and Psychotherapy, Philipps-University Marburg, Gutenbergstr. 18, 35032, Marburg, Germany. charlotte.auer@staff.uni-marburg.de.
authors.forename: Charlotte J
authors.initials: CJ
authors.lastname: Auer
authors.affiliation: Department of Clinical Psychology and Psychotherapy, Philipps-University Marburg, Gutenbergstr. 18, 35032, Marburg, Germany.
authors.forename: Julia A
authors.initials: JA
authors.lastname: Glombiewski
authors.affiliation: Department of Clinical Psychology and Psychotherapy, Philipps-University Marburg, Gutenbergstr. 18, 35032, Marburg, Germany.
authors.forename: Bettina K
authors.initials: BK
authors.lastname: Doering
authors.affiliation: Department of Clinical Psychology and Psychotherapy, Philipps-University Marburg, Gutenbergstr. 18, 35032, Marburg, Germany.
authors.forename: Alexander
authors.initials: A
authors.lastname: Winkler
authors.affiliation: Department of Clinical Psychology and Psychotherapy, Philipps-University Marburg, Gutenbergstr. 18, 35032, Marburg, Germany.
authors.forename: Johannes A C
authors.initials: JA
authors.lastname: Laferton
authors.affiliation: Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand.
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Broadbent
authors.affiliation: Department of Clinical Psychology and Psychotherapy, Philipps-University Marburg, Gutenbergstr. 18, 35032, Marburg, Germany. rief@staff.uni-marburg.de.
authors.forename: Winfried
authors.initials: W
authors.lastname: Rief
mesh_terms: D001294:Attitude to Health; D006801:Humans; D063868:Patient Outcome Assessment; D059035:Perioperative Period / Q000523:psychology*; D011446:Prospective Studies; D011788:Quality of Life; D013514:Surgical Procedures, Operative / Q000523:psychology*
keywords: Expectations; Health beliefs; Quality of life; Surgery