Editorial

This issue illustrates the international relevance of the topics at the core of Health Expectations and demonstrates the array of different methods used to explore shared decision-making, patient-centred care and patient and public involvement. The first three articles highlight the importance of qualitative methods. How people manage allergic rhinitis is explored through a qualitative and observational study as part of a randomized control trial in Australia. The researchers conclude that people on the whole did not and did not wish to rely on medication and that individualized support for selfmanagement can make a difference. The second article documents the development of a guidebook on osteoarthritis. Rather than framing the involvement process as research, Grime and Dudley present this as a collaboration based on sharing qualitative research papers creating a broader understanding than relying lived-experience alone. In the third article, Giacomini et al. explore how university and community-based respondents in Ontario Canada interpret scenarios and options presented in a quantitative resource allocation survey that measured the effects of information types, goods and community sample on peoples’ beliefs about fair resource allocation. They conclude that using a qualitative approach aids in understanding the processes, imagery and principled reasoning behind lay judgments of fair allocation. Decision making in relation to quality links the next three articles. Fader et al. present a ‘shopping’ experiment on how people with incontinence would spend an individual budget. Participants were able to consider trade-offs between different levels of budget and different products. The conclusions suggest that providing an opportunity to control the purchase of their own supplies could improve patient satisfaction and result in a more efficient allocation of funds. Patient perceptions of the quality of primary care services in Greece were explored by Papanikolaou and Zygiaris. They apply an adapted version of SERVQUAL a service quality framework originally developed for a broad range of services such as banking and long-distance telephone services. The findings demonstrate the applicability of SERVQUAL to the measurement of quality in primary care services but also suggest that such generic measures may oversimplify patient’s expectations. Broar, Nieboer and Bal present an ethnographic study of Dutch client participation in quality improvement programmes in mental health. Rather than identifying the exercise of power over clients by service providers, the findings suggest instances of mutual powerlessness as neither professionals nor clients knew how to ensure an involvement process beneficial for all. A more sophisticated approach to understanding power, they conclude is likely to lead to less defensiveness and better outcomes. The importance of conceptual clarity is apparent in the next two articles. Hamrosi et al. used Australian focus-groups to explore needs and expectations relating to written medicines information. They found that this information was particularly important for