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PubMed1993

Alcohol-related expected effects and the desirability of these effects for Swedish college students measured with the Alcohol Expectancy Questionnaire (AEQ).

The Alcohol Expectancy Questionnaire (AEQ) was administered to 400 Swedish college students to explore their alcohol-related expectancies in relation to different background variables and their rated desirability of these expected effects. For each item in the AEQ, subjects further rated to what degree the specified effect was desirable. Results indicated that men and high consumers had stronger expectancies and rated these effects as more desirable than did women and low consumers. Regardless of background variables significant positive correlations between expected effects of alcohol and the desirability of these effects were found. The strength of expectancies and the corresponding desirability ratings were both separately positively correlated with drinking habits. The discussion was focused on expectancies as causes of drinking.

Adolescent↗

PubMed1997

Regional patterns of disability-free life expectancy and disability-adjusted life expectancy: global Burden of Disease Study.

BACKGROUND: Information on non-fatal health outcomes of disease and injury has been largely neglected in health planning because of the conceptual and definitional complexity of measuring morbidity and disability in populations. One of our major objectives was to quantify disability for inclusion in health policy debates. We analysed these health outcomes in terms of disability-free life expectancy (DFLE) and disability-adjusted life expectancy (DALE). METHODS: Published and unpublished data were systematically reviewed to estimate the incidence, prevalence, and duration of 483 disabling sequelae of 107 diseases and injuries. To ensure internal consistency of these estimates, a software programme (DISMOD) was applied many times until consistent parameters were identified. The severity of disability, on a scale of 0 (perfect health) to 1 (death), was measured in a deliberate manner by the person-trade-off method. Spearman's and Pearson's correlation coefficients were used to measure disability weights among groups. Prevalence of seven classes of disability was back-calculated from the distribution of each disabling sequela across disabilities. Prevalence for each class of disability for different age-sex groups was used to calculate seven forms of DFLE and DALE based on Sullivan's method. FINDINGS: Prevalence of most disability classes is highest in sub-Saharan Africa and lowest in established market economies. Low-severity disabilities (class I and class II) are the most common. The expectation at birth of class I disability ranges from 6.5 years in established market economies to 14.7 years in sub-Saharan Africa, and for class II disabilities, from 8.5-18.4 years. DFLE varies significantly among regions: DFLE for class I disabilities at birth ranges from 9.9 years in sub-Saharan Africa to 47.7 years in established market economies for females and DFLE for class V disabilities ranges from 43.4 years for men in sub-Saharan Africa to 74.8 years for women in established market economies. The proportion of expected life span at birth lived with disability adjusted for severity, varies from about 8% in established market economies to 15% in sub-Saharan Africa, with little difference between men and women. In high-income regions, nearly 90% of expected disability is due to non-communicable diseases and most of the remainder to injuries. In poorer regions, almost half of expected disability is due to communicable diseases and injuries. INTERPRETATION: The higher proportion of lifespan spent disabled in high-mortality populations is consistent with the compression of morbidity hypothesis. The threshold definition of disability used substantially affects the results of DFLE, DALE, which incorporates severity weights for disabilities, is a useful summary measure of the burden of disability and mortality.

Adolescent↗

PubMed1998

Mental health expectancy--the European perspective: a synopsis of results presented at the Conference of the European Network for the Calculation of Health Expectancies (Euro-REVES). Medical Research Council Cognitive Function and Ageing Study Group.

The increase in life expectancy observed over the last decade has particular relevance for mental health conditions of old age, such as dementia. Although mental disorders have been estimated to be responsible for 60% of all disabilities, until recently population health indicators such as health expectancies have concentrated on calculating disability-free life expectancy based on physical functioning. In 1994, a European Network for the Calculation of Health Expectancies (Euro-REVES) was established, one of its aims being the development and promotion of mental health expectancies. Such indicators may have an important role in monitoring future changes in the mental health of populations and predicting service needs. This article summarizes the proceedings and recommendations of the first European Conference on Mental Health Expectancy.

Aged↗

PubMed1998

[Active life expectancy, life expectancy and ADL in Japanese elderly].

The purpose of the present Study is to analyze the incidence of loss of active life and death rates over a 36 month period in elderly people living a home, to attempt to determine relationships of index of ADL for bed ridden elderly to incidence and expectancies of active life loss, for life and active life. The definition of loss of activities was as follows: Long term (over six months) medication at home, long term (over six months) admission to hospital or intermediate institute for elderly, admission to nursing home or death. Subjects were 6,883 people living at home in Ogi, Sage prefecture, aged 70 years or older. A total of 6,753 people could be followed up for thirty six months, with 287 people having long term medication at home, 389 people having long term admission in hospital or intermediate institute for elderly, 45 people were admission to nursing home and of these groups defined as experiencing, 490 people were died of all subjects, 746 deaths were observed. The main results were as follows: (1) Annual mortality rate was 5.4% for males, 3.0% for females, and annual rate of active life loss was 7.1% for males, 6.0% for females. Life expectancy for the 70-74 year group was 13.7 years for male, 17.9 years for female, and active life expectancy for the 70-74 year group was 12.0 year for males, 13.9 years for females. The difference between life expectancy and active life expectancy was 1.7 years for male, 4.2 years for female, which can be considered the average length of term requiring care. (2) From the relation between scale of active daily living for the handicapped elderly and the life expectancies of life and active life by Cox proportional hazard model analysis of survival, controlling for age and sex, five categories of classification for active daily living for a handicapped elderly were developed: 1-very healthy with abilities for using transportation (train and bus); 2-abilities of moving in the neighborhood by oneself; 3-abilities of moving in the neighborhood with help; 4-Chair-bound, 5-Bed-bound.

Activities of Daily Living↗

PubMed1998

Expectancy challenge and drinking reduction: process and structure in the alcohol expectancy network.

Expectancies' mediational (control) role in alcohol consumption has been supported by both correlational and experimental evidence (J. Darkes & M. S. Goldman, 1993; M. S. Goldman, P. E. Greenbaum, & J. Darkes, 1997; L. Roehrich & M. S. Goldman, 1995). This study assigned participants (n = 54) to 1 of 2 expectancy challenges targeting the expectancy dimensions of either arousal or sociability identified by B. C. Rather and M. S. Goldman (1994), or to a no-treatment control, to examine the relationship of the structure and process of change in alcohol expectancies. Both challenges resulted in reduced consumption and expectancies immediately posttreatment and 6 weeks later after a short "booster" session. These results may reflect the lack of "discrete" expectancy structure and provide further support for the exploration of these methods as a possible prevention strategy.

Adult↗

PubMed1995

Patient expectations: what do primary care patients want from the GP and how far does meeting expectations affect patient satisfaction?

There is growing recognition of the importance of patients' expectations in general practice. This study aimed to investigate the types of expectations adult primary care patients have prior to consulting the GP, and how far meeting expectations is associated with increased satisfaction. Patients (n = 504) attending general practitioners (n = 25) at 10 London general practices were included in the study. The Patients Intentions Questionnaire (PIQ) was administered prior to the consultation to investigate patients' expectations and the Expectations Met Questionnaire (EMQ) was administered after the consultation to find out what the patient reportedly obtained. Satisfaction with the consultation was also measured using the Medical Interview Satisfaction Scale (MISS). The results of a principal components analysis of PIQ item scores indicated that the most wanted items were for 'explanation of the problem'. There was less desire for 'support' or 'tests and diagnosis'. Many of the 'support' items could potentially be provided to all patients, yet a proportion of patients reported not receiving these items from the GP. The results of one-way ANOVAs revealed that patients with greater numbers of their expectations met reported significantly higher satisfaction with the consultation than those with lower numbers met. The PIQ and EMQ could be potentially useful self-audit tools for use by general practitioners and trainee GPs.

Adolescent↗

PubMed2003

Expect the best, prepare for the worst: surgeon and patient expectation of the outcome of primary total hip and knee replacement.

A cross-sectional study of 100 surgeons and 370 patients awaiting primary total hip or knee replacement was carried out. Oxford hip or knee score questionnaires were sent to the surgeons and patients. They were asked to predict the level of symptoms expected 6 months following surgery. The Oxford scores derive a value of 12-60, with a greater score indicating worsening symptoms. The mean pre-operative score was 45.12 for the hip patients and 42.96 for the knee patients, and the patients expected this to drop to 23.70 and 25.66, respectively, 6 months' postoperatively. This was a significant difference for both groups. The surgeons expected the patients to have a mean postoperative score of 20.91 for the hip group and 22.19 for the knee group. The surgeons' scores were significantly lower than those from the patients. There was a significant difference between the patients' and surgeons' expectations of the results of total knee and hip replacement surgery. The surgeons expected better results than the patients. We believe that this is the first study that directly compares surgeon and patient expectations of lower limb arthroplasty.

Adult↗

PubMed1994

Alcohol expectancies in early adolescents: predicting drinking behavior from alcohol expectancies and parental alcoholism.

The current study examined the role of alcohol expectancies and parental alcoholism in prospectively predicting alcohol consumption and consequences among early adolescents. We examined whether personal effects expectancies would predict "problem" alcohol use outcomes and if social effects expectancies would predict "normal" alcohol consumption. Although confirmatory factor analytic techniques showed considerable overlap between personal and social effects expectancies, we found evidence to suggest that distinctiveness between these constructs may increase at higher levels of alcohol consumption. Regression analyses supported the utility of alcohol expectancies in prospectively predicting alcohol consequences over and above pre-existing alcohol consumption, and parental alcoholism. However, there was no consistent support for the hypothesis that personal and social effects expectancies predicted different types of drinking outcomes, possibly because of the young age of the current sample.

Adolescent↗

PubMed1991

Expected gains in life expectancy from various coronary heart disease risk factor modifications.

BACKGROUND: Despite much evidence that modifying risk factors for coronary heart disease can decrease morbidity and mortality, little is known about the impact of risk-factor modification on life expectancy. METHODS AND RESULTS: We used the Coronary Heart Disease Policy Model, a state-transition computer simulation of the US population, to forecast potential gains in life expectancy from risk-factor modification for the cohort of Americans turning age 35 in 1990. Among 35-year-old men, we projected that the population-wide increase in life expectancy would be about 1.1 years from strict blood pressure control, 0.8 years from smoking cessation, 0.7 years from reduction of serum cholesterol to 200 mg/dl, and about 0.6 years from weight loss to ideal body weight. For women, reducing cholesterol to 200 mg/dl would have the greatest estimated impact-a gain of 0.8 years-whereas smoking cessation, blood pressure control, or weight loss would yield population-wide gains of 0.7, 0.4, and 0.4 years, respectively. Gains for 35-year-old individuals having a given risk factor are greater. We estimate that, on average, male smokers would gain 2.3 years from quitting smoking; males with hypertension would gain 1.1-5.3 years from reducing their diastolic blood pressure to 88 mm Hg; men with serum cholesterol levels exceeding 200 mg/dl would gain 0.5-4.2 years from lowering their serum cholesterol level to 200 mg/dl; and overweight men would gain an average of 0.7-1.7 years from achieving ideal body weight. Corresponding projected gains for at-risk women are 2.8 years from quitting smoking, 0.9-5.7 years from lowering blood pressure, 0.4-6.3 years from decreasing serum cholesterol, and 0.5-1.1 years from losing weight. Eliminating coronary heart disease mortality is estimated to extend the average life expectancy of a 35-year-old man by 3.1 years and a 35-year-old woman by 3.3 years. CONCLUSIONS: Population-wide gains in life expectancy from single risk-factor modifications are modest, but gains to individuals at risk can be more substantial.

Adult↗

PubMed1996

[Sex differential in life expectancy at birth in Japan: (2) trends in sex differential in life expectancy at birth from 1920 to 1990].

Sex differentials in life expectancy at birth in Japan are analyzed for the period 1920 to 1990. The results show that there was a general increase in differences in mortality by sex over time. "The sex differential in age-specific death rate in 0-4 year age group (particularly age 0) explained most of the sex differential in life expectancy at birth before 1947. After 1950, the age group of 60-79 played a major role in the sex differential in life expectancy at birth. It is noteworthy that female mortality exceeded male mortality in age groups of 2-41 before 1930. Consequently, excess of female mortality reduced the sex differential in life expectancy at birth at that period. As for the sex differential in mortality rates by causes of death, tuberculosis, pregnancy and childbirth related disease exerted a great influence...before 1940. Recently, malignant neoplasms, heart diseases, cerebrovascular diseases, and accidents [have] become leading contributors to the sex differentials in life expectancy at birth." (SUMMARY IN ENG)

Age Factors↗

PubMed2005

Patient expectations regarding eye care: development and results of the Eye Care Expectations Survey (ECES).

OBJECTIVE: To develop an instrument (the Eye Care Expectations Survey [ECES]) that can identify and quantify the expectations of patients visiting eye care providers. METHODS: A total of 202 patients attending 4 ophthalmology practices affiliated with Duke University Eye Center enrolled in the study. All participants completed the pilot version of the ECES, which was developed through a review of the expectations literature and a multicondition focus group process. Factor analysis of patients' responses was used to identify the performance characteristics of the ECES. RESULTS: Factor analysis yielded factors that describe 4 distinct types of expectations: patient involvement in eye care, interpersonal manner, information about diagnosis and prognosis, and communication and clinical competence. These 4 factors explained 89% of the total variance. The factor analysis identified a subset of 27 questions (of the original 37) to represent the 4 factors. Estimates of internal consistency and test-retest reproducibility indicate that the ECES is reliable. In addition, tests of association with clinical variables support the construct validity of the survey. The psychometric properties of the ECES were influenced by the severity of the underlying eye condition as well as other demographic and clinical variables, including the patient's rating of his or her own vision, best corrected visual acuity, sex, education, race, and household income. CONCLUSIONS: Based on this cross-sectional study, the 27-item ECES appears to be a useful tool for better understanding patients' expectations regarding eye care.

Attitude to Health↗

PubMed1996

Pain expectancies, pain, and functional self-efficacy expectancies as determinants of disability in patients with chronic low back disorders.

This study tested the relative predictive power of self-efficacy expectations of physical capabilities (functional self-efficacy [FSE]), expectations of pain, and expectations of reinjury on physical function in chronic back patients. Before behavioral assessment of function, 85 patients rated their abilities to perform essential job tasks (FSE) and the likelihood that their performances would be accompanied by pain and reinjury. Partial correlations revealed that FSE was significantly related to function when reinjury and pain were partialed out. Neither reinjury nor pain expectancies correlated significantly with function when FSE was partialed out. Further support for an FSE approach came from regression analyses that found pain intensity, gender, and FSE--not expected pain or reinjury--related consistently with physical performance. Thus, performance-specific cognitions may have greater explanatory power over disability than pain-specific ones.

Activities of Daily Living↗

PubMed1993

Effect of temporal focus on the recall of expectancy-consistent and expectancy-inconsistent information.

This research examined the impact of temporal focus on the recall of information that is consistent or inconsistent with an expectation. A consistent pattern of results across 4 experiments indicates that when Ss' expectations are temporally unfocused, better memory for consistent information is observed. In contrast, when expectations are focused in time--that is, Ss know when the relevant events are likely to occur--recall for consistent and inconsistent information is more balanced. Experiment 4 tied these recall findings to the amount of processing devoted to consistent and inconsistent events. When expectations were temporally unfocused, processing time and recall was greater for the confirmatory information. When expectations were temporally focused, more equivalent processing time and recall of consistent and inconsistent information was observed. Discussion centers on the role of temporal focus as a determinant of whether an event is one-sided or two-sided.

Adult↗

PubMed2001

Do situational expectations produce situational inferenes? The role of future expectations in directing inferential goals.

Little is known about the conditions that lead observers to adopt different inferential goals in the context of their everyday lives. Four studies examined whether future expectations created situational inferential goals. In 2 quasiexperimental studies, students made more situational inferences for targets in their expected future careers. In 2 experiments, situational expectations were manipulated, and participants made more situational inferences when they expected to be in the same situation as the target. This tendency was stronger when observers devoted minimal cognitive effort to their inferences, suggesting that when observers have situational expectations, making situational inferences is less effortful than making dispositional inferences.

Adolescent↗

PubMed1992

Differential effects of voluntary expectancies on reaction times and event-related potentials: evidence for automatic and controlled expectancies.

Expectancy has been used to explain the effects of stimulus sequences both on reaction times (RTs) and on the P300 component of the human event-related potential. However, there are conflicting views about the control obtainable over these underlying expectancies. We compared the effects of voluntary expectancies for stimulus changes or repetitions in random tone series on RTs and the P300. Ss responded according to either stimulus identity (Experiment 1) or stimulus sequence (Experiment 2). In both experiments RTs were strongly affected by event expectedness. P300 amplitude, on the other hand, was affected (as a trend) only in Experiment 2. The results suggest that there are at least 2 types of "expectancy", one that is largely automatic and inflexible, reflected in P300 amplitude, and a second, controlled process that is reflected mainly in RT. The latter type of expectancy appears to affect processing stages beyond stimulus evaluation and classification.

Arousal↗

PubMed2007

First-time mothers' expectations of parenthood: What happens when optimistic expectations are not matched by later experiences?

Becoming a parent is a major developmental transition of adulthood. Individuals often have optimistic expectations about parenthood, yet this transition also presents a number of challenges. The authors investigated whether new parents have overly optimistic expectations about parenthood and, if they do, how this influences their adjustment to this role. The sample consisted of 71 first-time mothers who completed questionnaires during pregnancy and at 4 months postpartum. The study assessed women's expectations of caring for their infant and the influence parenthood would have on their well-being and their relationships with others. Most women's expectations were matched or exceeded by their parenting experiences. However, where experiences were negative relative to expectations, there was greater depression symptomatology and poorer relationship adjustment.

Adaptation, Psychological↗

PubMed2004

Combined expectancy effects are modulated by the relation between expectancy cues.

Studies of combined expectancies have shown that spatial cueing effects are reduced on trials on which participants have to respond with an unexpected motor response. In the first two experiments the range of reduced expectancy effects is examined. Advance knowledge of the likely response was combined in a trial-by-trial procedure with modality cueing, object cueing, and task cueing. Effects of modality cueing were reduced on trials on which the target requested an unexpected response. However, effects of object cueing as well as effects of task cueing were unaffected by response cueing. Comparing experiments revealed that different types of cues were used in different experiments. To test the effect of type of cue on the interaction of expectancies the third experiment combined spatial cueing with response cueing. When integrated cues were used that cued the likely target location by an arrow and the likely response by an arrow too, spatial cueing effects were reduced on trials with unexpected responses. However, spatial cueing effects remained unaffected by response cueing when separated cues were used consisting in a word cueing the response and an arrow cueing target location. An account for the modulation of combined expectancies by the relation between cues is suggested in terms of the adjusted expectancy model.

Adult↗

PubMedDate not supplied

Childbirth education classes: expectant parents' expectations.

One hundred clients (43 fathers, 57 mothers), of whom 50 had enrolled in childbirth education classes but had not yet attended and 50 who had attended and were parents of a healthy infant, were surveyed to find out what clients expect to gain from attending childbirth education classes. Responses of preclass and postdelivery male and female clients were compared using content analysis and chi-square statistics. Results suggest that interest followed pregnancy chronology, fathers expected to learn facts, mothers expected to learn coping strategies, and both expected to learn breathing, relaxation, and infant care techniques. Although clients felt that more time should have been spent on the majority of topics, 64% of mothers and 53% of fathers said that the classes had met their expectations.

Adult↗