title: Expectations of pain and functioning in patients with musculoskeletal disorders: a cross-sectional study.
abstract: Research has suggested that patient expectations are associated with treatment outcome and evolve along with patient communication within the musculoskeletal field. However, few studies have investigated if or how physical medicine and rehabilitation (PMR) consultations affect the attending patients' expectations regarding pain and functional improvement. Hence, the aims of the present study were to compare patient expectations regarding pain and functional improvement before and after a PMR consultation and to assess patient characteristics, including diagnosis, that could perhaps predict changes in expectations.
  
  
  
  The study design was cross-sectional. Eligible participants were first-time patients with neck/back or shoulder complaints who were referred to a PMR outpatient clinic between January and June 2013. Questionnaires (the Patient Shoulder Outcome Expectancies, or PSOE, questionnaire and a numeric rating scale, or NRS) focused on expectations regarding pain and functioning were completed immediately prior to and after a consultation with a PMR specialist.
  
  
  
  In total, 257 patients were included. In total, 24% of the subjects expected a more positive outcome after the PMR consultation compared with before the consultation, while 10% of the subjects exhibited a negative change in expectations. Few patient characteristics other than sick leave were associated with changes in expectations; however, patients with shoulder complaints seemed to be more optimistic than patients with neck/back complaints.
  
  
  
  Expectations can be influenced by a single specialist consultation. Among clinical prognostic factors, only sick leave influenced the change expectations. However, patients with shoulder complaints seemed to be more optimistic than patients with neck/back complaints.
  
  
  
  The study was approved by the Data Protection Office at Oslo University Hospital, 2012/2574. ISRCTN registration: 40963362  (registered retrospectively 12.12.2016).
authors.affiliation: Deparment of Physical Medicine and Rehabilitation, Oslo University Hospital, Oslo, Norway. sjskatte@medisin.uio.no.|Faculty of Medicine, University of Oslo, Oslo, Norway. sjskatte@medisin.uio.no.|, Ullveien 19b, 0791, Oslo, Norway. sjskatte@medisin.uio.no.
authors.forename: Sigrid
authors.identifier: 0000-0002-6667-4468
authors.initials: S
authors.lastname: Skatteboe
authors.affiliation: Deparment of Physical Medicine and Rehabilitation, Oslo University Hospital, Oslo, Norway.|Faculty of Medicine, University of Oslo, Oslo, Norway.
authors.forename: Cecilie
authors.initials: C
authors.lastname: Røe
authors.affiliation: Oslo Centre for Biostatistics and Epidemiology, Research Support Services, Oslo University Hospital, Oslo, Norway.
authors.forename: Morten Wang
authors.initials: MW
authors.lastname: Fagerland
authors.affiliation: Deparment of Physical Medicine and Rehabilitation, Oslo University Hospital, Oslo, Norway.|Department of Pain Management and Research, Division of Emergencies and Critical Care, Oslo University Hospital, Oslo, Norway.
authors.forename: Lars-Petter
authors.initials: LP
authors.lastname: Granan
mesh_terms: D000328:Adult; D000368:Aged; D001416:Back Pain / Q000209:etiology / Q000523:psychology / Q000534:rehabilitation; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009140:Musculoskeletal Diseases / Q000150:complications / Q000523:psychology* / Q000534:rehabilitation*; D019547:Neck Pain / Q000209:etiology / Q000523:psychology / Q000534:rehabilitation; D026741:Physical Therapy Modalities; D020127:Recovery of Function; D012017:Referral and Consultation; D020069:Shoulder Pain / Q000209:etiology / Q000523:psychology / Q000534:rehabilitation; D018582:Sick Leave; D011795:Surveys and Questionnaires; D016896:Treatment Outcome
keywords: Back pain; Musculoskeletal pain; Neck pain; Shoulder pain; Treatment outcome