Educational Aspirations and Expectations of Adolescents in Rural China: Determinants, Mental Health and Academic Outcomes

Educational aspirations and expectations of adolescents have implications for educational and psychological outcomes. This study aimed to determine factors associated with educational aspiration–expectation discrepancies and to examine the associations between the discrepancies and psychological and academic outcomes in rural left-behind children and non-left-behind children aged 14–16 in mainland China. Cross-sectional data from a self-report survey were collected in 2020 among 606 rural students (mean age = 14.85 years) in two public middle schools in Songzi county, Hubei Province. Participants filled in questionnaires measuring their socio-demographic information, educational aspirations and expectations, academic performance, parental and friends’ aspirations, academic self-perception, academic self-regulation, depression, and self-esteem. Results showed that more than half of the participants reported that they felt they were not likely to attain the level of education to which they aspired. Parental migration, academic performance, mother’s educational aspirations for children, and close friends’ educational aspirations were the main factors associated with students’ educational aspiration–expectation discrepancies. Both left-behind children and non-left-behind children whose aspirations exceed expectations were more likely to report lower self-esteem, higher depression, lower academic self-perception, and poorer self-regulation than those without a discrepancy. These findings have implications for families, schools, and policymakers through informing the development of interventions that target positive development in rural youth.

ANCHOR surgeon views of patient selection and expectations for periacetabular osteotomy

Preoperative expectations impact shared decision making and patient satisfaction. Surgeon views of patient selection, expected outcomes and patient expectations after periacetabular osteotomy (PAO) for treatment of acetabular dysplasia have not been defined. We assessed surgeon views of patient selection and expected outcomes after PAO. A sample of experienced PAO surgeons participated in semi-structured phone interviews assessing: (i) factors that determine patient candidacy for PAO; (ii) surgeon expectations for PAO outcomes; (iii) surgeon perceptions of patient expectations for PAO outcomes and (iv) surgeon perceptions of discrepancies in surgeon and patient expectations and approaches for reconciling these discrepancies. Twelve surgeons (77% of PAO-performing ANCHOR surgeons) participated. The factors most commonly mentioned in determining patient candidacy for PAO were: symptoms, radiographic findings, absence of arthritis and age. Only one-quarter of the sample mentioned patient expectations as a factor in determining patient candidacy for PAO. The most common surgeon expectations were: pain reduction, joint preservation, function with activities of daily living and return to desired activities. 58% of surgeons felt that surgeon and patient expectations align most of the time. Common expectation discrepancies included return to unrestricted activities and complete pain relief. Detailed discussion was the most commonly employed strategy to resolve expectation discrepancies. PAO surgeons felt that patient expectations of complete pain relief and return to unrestricted activities were misaligned with their own expectations. Development of an expectations survey may facilitate shared decision making.