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People Factors
Does how you recover depend on how you think you'll recover?

At a glance:
Many studies have found that a patient's expectations will influence how well they actually recover. This review summarises the evidence from these studies.
This review of many pieces of research shows that a person's expectations about recovery makes a difference to the outcome.

This does not mean the condition is less real, or that the physical problem is not a condition that needs to be dealt with.  It indicates that when people expect to do well, they are more likely to do so.

If a person expects to do well they are less worried about the problem.  They are more likely to remain engaged with everyday activities and be positive about their abilities.  In turn, this tends to make those around them more positive and optimistic.

When a person is negative they tend to become fearful and withdraw.  This can have a poor effect on their relationships with others.  They are less likely to remain active and to return to work.  They may become distressed and this can cause other emotional problems.

Make sure that you have realistic expectations about your condition.  Whilst we learn from the experience of others, make sure you are not hearing about people with unusual problems, or worrying unnecessarily.  Get the best advice about your condition and develop confidence in what you can do to manage the situation.
This review shows that a person's expectations regarding their health have an influence on the outcome.  A positive partnership, where people understand their condition and feel supported by their employer to return to activity will produce the best results. 
Good explanations and clear advice are fundamental to helping people remain active and return to work.  Misunderstandings about musculoskeletal
Involving the muscles and the skeleton. This term includes the limbs, neck, shoulders and back. 'Musculoskeletal problem' refers to many different conditions that can affect the tendons, muscles and related structures.
 problems are common.  People can become fearful, worried about their job prospects, and develop negative expectations about their recovery.

Providing people with solid and comprehensive advice about the natural history of the condition encourages realistic expectations.  It is also important people are given good advice about what they can do to help themselves.  That they are encouraged to be active and re-integrate with daily activities promptly. 
Encourage employees to develop positive and realistic expectations about their condition.  Claims managers can support this approach by recommending people talk to their treating practitioners
treating practitioner
A health professional that treats patients. In return to work this may include doctors, physiotherapists, chiropractors, osteopaths, psychologists, masseurs, etc.
 and get the best advice about their problem.

Employees may need to have a number of discussions about their condition over a period of time.  Long-term health problems can affect a person's ability to function and do their job, and in turn this can make them more distressed.  Addressing the person's issues and helping them find a positive path forward is a positive contribution to their well-being and return to work.
Original Article, Authors & Publication Details:
Michael V. Mondloch1, Donald C. Cole1,3 and John W. Frank1,2,3,4 : (2001)

Does how you do depend on how you think you'll do? A systematic review
systematic review
A comprehensive review of research studies in a particular area. The review follows guidelines to ensure the studies included are valid.
 of the evidence for a relation between patients' recovery expectations and health outcomes.
CMAJ Canadian Medical Association Journal, 165(2):174-179.

1Institute for Work and Health, Toronto, Ont.
2Department of Public Health Sciences, University of Toronto, Toronto, Ont.
3Department of Family and Community Medicine, University of Toronto, Toronto, Ont.
4Population Health Program, Canadian Institute for Advanced Research, Toronto, Ont.
Background, Study Objectives, How It Was Done:
Doctors have known for a long time that a patient's beliefs and expectations can influence how much they actually improve after an illness.  

In this review, the researchers collected evidence on this topic from a research database
Store of information (e.g. published research articles). Information can be retrieved by searching (e.g. for key words, authors, or titles).
 and found 45 relevant studies that have been performed over the last few decades. They evaluated whether the studies had been properly conducted and whether they gave convincing evidence (for example by checking for bias and ensuring that factors that could make the results inaccurate had been taken into account). 16 studies met these requirements. The researchers then compared and summarised the findings of these studies.
Study Findings:
The sixteen studies that provided good evidence were consistent with each other. They each showed that a patient's expectations do indeed influence their recovery.

         Six studies found that patients' beliefs and expectations have a large influence on how well they recover
         Five studies found that patients' beliefs and expectations have a moderate effect
         Four studies showed that patients' beliefs and expectations have a small effect
         No studies showed that patients' beliefs and expectations have no effect

The different studies showed that a patient's expectations have an influence on a broad range of conditions including low-back pain, obesity, heart disease, alcoholism, benign prostate tumours and psychiatric conditions. They also showed that expectations influence recovery after surgery and psychological
Refers to a person's perceptions, thought processes, emotions, personality and behaviour. Psychologists can treat mental health problems.
 adjustment after abortion. The effect of patients' expectations on their recovery tended to be smaller in patients with psychiatric conditions than in other conditions.

Expectations were found to influence the recovery of all patients, regardless of differences in things like the severity of their condition, their social position or their mental and physical health.
This review shows that how well a patient believes they will recover influences how well they actually do.

Previous research shows that thoughts and expectations can trigger biological changes in the body. A patient's beliefs also affect their motivation and behaviour, including the level to which they seek treatment and follow advice. Expectations influence a patient's level of anxiety, and affects how they perceive their symptoms.

It is very important, therefore, that patient's expectations are clarified and that they are given appropriate information and reassurance (without giving false hope.) Patients' expectations can be shaped by previous experiences, the experiences and opinions of others and their level of social support.  
PubMed Abstract
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