Empowered Health Season 2 Episode 17 – Next Steps in Diagnosis

Patient attitudes influence recovery outcome

Why do some patients recovery quickly while others are slow to improve? This question reminds me of that children’s game where “one of these things is not like the other” except in the case with patients, spotting the differences are much more difficult. Dr. Jason Busse, chiropractic researcher at McMaster University is conducting studies that aim to better identify these variables so that it is easier to distinguish high-risk patients from those who require less intervention.

Dr. Busse’s initial findings uncovered approximately 100 studies identifying dozens of varying factors that play into a patient’s recovery. These factors ranged from things such as age, patient’s education, coping mechanisms and confidence in the healthcare provider. Thirty factors from the studies consistently predicted recovery, 25 factors showed no association to recovery and 60 factors proved inconsistent or lacked evidence to support recovery prediction.

Many of the factors that predict recovery were influenced by patient attitudes. The findings suggest that patient beliefs and confidence in their health play a bigger role in recovery than we initially thought. As Dr. Busse puts it “there is a real potential there is seems for the provider by how they convey their impressions to actually influence [the patient’s] prognosis.”

The team at McMaster wanted to evaluate the role of patient beliefs and attitudes as a predictor to recovery outcome. A research trial followed a group of patients who required surgery to repair a broken leg, all who received standardized care. Patients were asked to complete a survey one month after surgery about their beliefs and attitudes with recovery and were followed for one year. “What we found was there were 27 items in our survey that separated out the group that had recovered and gone back to work versus the group that has not recovered” reports Dr. Busse, “and all of these variables were potentially modifiable.”

This reinforces the importance of the doctor’s role in health as they have the potential to influence the attitudes and behaviours of their patients which could ultimately result in a more favourable patient recovery and sooner return to work. Theoretically, the survey could be given to patients to help gauge their risks and needs. Knowing about these factors can assist health care providers in identifying patients who may require more support with recovery than others. Early intervention with patients who are “high-risk” could ensure a more appropriate course and frequency of treatment. Care could also be better tailored for all patients, depending on their needs detected by the factors.

Ultimately, a survey cannot determine how well you will recover; however, it does provide a meaningful tool to help steer health providers in the correct direction. The key is in the doctor’s interpretation of the factors and their delivery of the information to the patient. Dr. Busse’s research is yet another example of the significance of the doctor/patient relationship.