A longitudinal evaluation of psychosocial changes throughout orthognathic surgery

Abstract

BackgroundJaw correction surgery can cause significant psychosocial impacts on patients. This prospective study investigated the longitudinal changes of psychosocial characteristics of patients with dentofacial deformities after jaw correction surgery and the factors that predict the psychological resilience in Hong Kong Chinese undergoing jaw correction surgery.MethodsA longitudinal cohort study was conducted on 92 Hong Kong Chinese patients (32 males, 60 females; mean age = 24.75 ± 5.65 years), who had jaw correction surgery as treatment for their dentofacial deformities, from 1st June 2011 to 30th June 2015. Self-completed psychological inventories including Brief Symptom Inventory, Life Orientation Test, and the Adult Trait Hope Scale were used to measure distress, optimism, and hope levels respectively. Patients completed the inventories in five time points: the surgical consent signing day (usually two to three months before the surgery) (T1); one day before operation (T2), first to second post-operative week (T3), third post-operative month (T4) and sixth post-operative month (T5).ResultsLatent class growth analysis revealed two outcome trajectory classes: a resilience trajectory (n = 45, 48.9%) and a chronic dysfunction trajectory (n = 14, 15.2%). Another 33 (35.9%) showed erratic trajectory patterns that would not be classified into any categories. The psychological distress levels of patients in the resilience trajectory group, on average, were below the clinical threshold of the Brief Symptom Inventory at all time points. However, the opposite result was obtained for patients in the chronic dysfunctional group. Patients exhibiting a resilience trajectory pattern, when compared to those showing a chronic dysfunction pattern, had higher optimism (t(57) = 3.69, p < .0001) and hope (t(57) = 2.46, p < .05) levels at T1. Logistic regression analyses were conducted to compare the relative power of optimism and hope levels at T1 to predict resilience or chronic dysfunctional group membership. A test of the full model against a constant only model was statistically significant (χ2(2) = 24.096, p < .01). Preoperative baseline optimism (B = —.276, p < .05) but not hope (B = —.25, ns) was a significant variable to classify the outcome trajectories for psychological distress.ConclusionsMost patients were resilient to dentofacial deformities jaw correction surgery. About 15% exhibited a chronic distress pattern. An optimistic view about the surgery may enhance resilience. Pre-surgical counselling or educational sessions to facilitate a realistic positive outlook about the operation would be beneficial.

Traumatic Distress of COVID-19 and Depression in the General Population: Exploring the Role of Resilience, Anxiety, and Hope

“…Snyder operationalised hope as a cognitive goal-oriented process relying on the perception that goals can be met [37]. Research shows that hope can contribute to improved physical and mental well-being [38] and facilitate adjustment when dealing with stressors e.g., [39]. Hope has been identified as a protective factor against depression symptoms associated with negative life events [40,41], natural disasters [42], psychiatric disorders [43,44] and chronic illness [45].…”

Assent for Orthognathic Surgery: Features, Challenges, and Benefits

“…There is a definitive moment when assent or consent is legally obtained, usually by signature. Suen et al (2018) found this moment, which in their study was 2 to 3 months prior to surgery, to be the most psychologically distressing time for patients compared to the day before surgery and at 3 time points postoperatively. This was attributed by the researchers to a lack of psychological preparation to learn the surgical details, which could perhaps have been ameliorated by a more continuous patient–physician dialogue.…”

“…Perhaps patients should also be screened for an externalized locus of control, excessive field dependence, impulsive decision-making, and lack of formal operations. Suen et al (2018) have suggested measuring preoperative optimism and hope as predictors of postoperative resilience. As mentioned, conceptions of "possible selves" are a strong predictor of patient satisfaction and could also be usefully evaluated (Meade and Inglehart, 2010).…”

Effects of sex, age, choice of surgical orthodontic treatment, and skeletal pattern on the psychological assessments of orthodontic patients

“…Some studies have concluded that children aged 14 or 15 years are as competent as adults 17 , 18 . Typically, in surgical orthodontic treatment, pre-surgical orthodontic treatment is initiated after the adolescent growth spurt, and the surgery is usually planned after the skeletal growth has stabilized at age 17–18 years 19 , 20 . In this study, the youngest age of patients who planned orthodontic treatment and chose surgical orthodontics was 14 years.…”