Does the British Orthodontic Society orthognathic DVD aid a prospective patient’s decision making? A qualitative study

Abstract

Objectives: To explore the views of potential orthognathic patients concerning the influence of the BOS Orthognathic DVD in their decision making process.Design: Qualitative, cross sectional study Setting: A UK dental teaching hospital Participants: Patients considering orthognathic treatmentMethods: New patients were recruited from orthognathic clinics following an initial consultation. After an appropriate time to view the DVD, in-depth interviews were conducted with 10 patients (aged 16-48yrs) in their homes. Interviews explored the attitudes and perceptions that influenced the decisions about surgery, with a focus on the role of the DVD in this process. The interviews were transcribed and a framework analysis was undertaken. Results:The main themes identified were the participants' perceptions on the patient stories, use of images, the nature of the DVD itself and its usefulness in the decision making process. Participants reported they were heavily influenced by the patient stories. Virtual animations of surgery were seen as useful; whereas the before and after images of surgery were found to be disorientating. The design of the menu resulted in confusion or information being missed. The DVD was seen as a trusted resource, whereas the Internet was seen as biased, general and sensationalistic. Conclusions:The DVD gives trusted information that patients cannot obtain or process from professional sources or the Internet. If used properly it can have a role in the decision making process, but should be seen within the context of other influences on the patient. This research has highlighted some aspects of the DVD that could be improved upon.

Evidence in Orthodontics related to qualitative research

“… Qualitative and quantitative / Semi-structured interviews / 7 / Adolescents / Adults The results showed that different facial angles and proportions of what is proposed as scientifically aesthetic does not interfere with the results of treatment, provided that the facial perception of the subjects involved meet the standards of normality and accepted by them and those set by society. Flett et al 16 (2014) / United Kingdom / Journal of Orthodontics Explore the views of potentially orthognathic patients considering the influence of a DVD about orthognathic surgery in the decision to perform the procedure. Qualitative / Unstructured interviews / 10 / Adolescents / Adults The DVD provided reliable information that patients do not get or cannot understand from professionals or the internet.…”

How do patients perceive the British orthodontic society online information resource about orthognathic treatment? A qualitative study

“…This qualitative study investigated how patients at different stages of orthognathic treatment perceived "Your Jaw Surgery". In a review of a BOS DVD, Flett et al, (2014) found that the menu could cause confusion. In contrast the OIR was seen as easy to use, with a clear layout and information provided in a straightforward way.…”

“…A lack of practical advice can encourage patients to seek information from other sources, such as Internet discussion boards, which can lead to patient confusion and dissatisfaction (Bhamrah et al, 2015). Flett et al, (2014) investigated how far a British Orthodontic Society (BOS) DVD helped patients to make decisions about orthognathic surgery. The DVD was felt to provide trusted information about orthognathic surgery however, there were some practical issues using the DVD.…”

“…Following this research, the BOS commissioned a working party to design an online information resource (OIR). Previous research suggests that online information about orthognathic surgery is of low quality, biased and not properly evidenced based (Aldairy et al, 2012) and is not always trusted by patients (Flett et al, 2014). The hope was that by embedding the OIR within the BOS website, it would provide provenance to the resource.…”

Randomized controlled trial of a patient decision-making aid for orthodontics

“…Although PDAs are increasingly used in medicine, they are not commonly used in dentistry [8][9][10][11] . This is despite research showing the need to consider patient values and preferences when making decisions about dental treatment and there is evidence that dental patients prefer a collaborative style of decision-making 12,13 .…”