Purpose: In health state valuations the public fails to anticipate adaptation-- they neglect to consider their capability of making the best of a situation. But do people who actually have a new disability consider adaptation in making forecasts?
Method: Patients who had recently had colostomy surgery (n=67) and patients who had recently had amputation surgery (n=56) received a survey at three different time points. The surveys consisted of measurements of physical and psychological well-being (quality of life, satisfaction with life, general health, physical functioning, activities, activities outside, calm/peacefull, energy, downhearted, embarrassed). Some items asked patients to predict how they would feel at the next survey time point—and to remember how they felt at the previous survey time point.
Result: From the predictions and actual valuations of the different well-being scales we find a clear pattern. Patients expected to improve on most well-being domains over time. In general, they overpredicted the amount of improvement. For example, colostomy patients at baseline predicted that their general health at the second wave would be significantly higher than their current general health at baseline ((M = 3.13 vs. 2.78, p < .05), and this prediction was significantly higher than their actual reported health at the second wave (M = 3.13 vs. M = 2.83, p < .05). Looking at recall, we find a similar pattern. Patients tend to think they are better off now than they were previously, and they underestimate their well being at the prior time points.
Conclusion: Patients who are in a situation to which they can adapt are overly optimistic in terms of predictions, and overestimate adaptation in their recollections. This is in contrast to what might be expected from the past literature on affective forecasting and may have implications for how treatment decisions are discussed.
Candidate for the Lee B. Lusted Student Prize Competition