Abstract
ObjectivesThe constructs optimism, pessimism, hope, treatment credibility and treatment expectancy are associated with outcomes of medical treatment. While these constructs are grounded in different theoretical models, they nonetheless show some conceptual overlap. The purpose of this study was to examine whether currently available measurement instruments for these constructs capture the conceptual differences between these constructs within a treatment setting.MethodsPatients undergoing Total Hip and Total Knee Arthroplasty (THA and TKA) (Total N = 361; 182 THA; 179 TKA), completed the Life Orientation Test-Revised for optimism and pessimism, the Hope Scale, the Credibility Expectancy Questionnaire for treatment credibility and treatment expectancy. Confirmatory factor analysis was used to examine whether the instruments measure distinct constructs. Four theory-driven models with one, two, four and five latent factors were evaluated using multiple fit indices and Δχ2 tests, followed by some posthoc models.ResultsThe results of the theory driven confirmatory factor analysis showed that a five factor model in which all constructs loaded on separate factors yielded the most optimal and satisfactory fit. Posthoc, a bifactor model in which (besides the 5 separate factors) a general factor is hypothesized accounting for the commonality of the items showed a significantly better fit than the five factor model. All specific factors, except for the hope factor, showed to explain a substantial amount of variance beyond the general factor.ConclusionBased on our primary analyses we conclude that optimism, pessimism, hope, treatment credibility and treatment expectancy are distinguishable in THA and TKA patients. Postdoc, we determined that all constructs, except hope, showed substantial specific variance, while also sharing some general variance.
Highlights
Growing evidence supports the importance of psychological constructs in predicting outcomes of medical treatment including surgery [1,2,3,4,5,6,7]
The results of the theory driven confirmatory factor analysis showed that a five factor model in which all constructs loaded on separate factors yielded the most optimal and satisfactory fit
A bifactor model in which a general factor is hypothesized accounting for the commonality of the items showed a significantly better fit than the five factor model
Summary
Growing evidence supports the importance of psychological constructs in predicting outcomes of medical treatment including surgery [1,2,3,4,5,6,7]. Much attention has been given to the future oriented constructs ‘optimism’, and ‘hope’ [1,9]. Both these constructs reflect expectancies about one’s future. Substantial empirical work investigating optimism and hope has been done within mental health settings. Evidence suggests these constructs may be related to outcomes in medical treatments like surgery. For example: optimism explains close to 10% of the variance in post-surgical pain after total hip arthroplasty (THA) and total knee arthroplasty (TKA) [13]
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