Stirling J, Latchford G, Morris D O, Kindelan J, Spencer R J, Bekker H L
Institute of Health Sciences, University of Leeds, 15 Hyde Terrace, Leeds LS2 9LT, UK.
J Orthod. 2007 Jun;34(2):113-27; discussion 111. doi: 10.1179/146531207225022023.
Few studies have explored decisions about orthognathic treatment (OGT) from the patient's perspective. This study describes the factors associated with the patient's decision to have or not have orthognathic treatment, and assesses whether the process can be considered to be informed decision making.
A cross-sectional survey employing both interview and questionnaire methods, conducted in four OGT services in Yorkshire.
Participants were patients aged over 16 years, either making an OGT decision over a 6-month period or had made their treatment choice 18-42 months prior to the study start date in 2003.
Questionnaires assessed patient demographics, dental history and psychopathology (anxiety, satisfaction with self, body satisfaction, facial appearance); interviews explored patients' reasons for, and experiences of, orthognathic treatment.
Of 138 patients approached, 61 participated (mean age 25 years, 66% female). Psychopathology scores were within the normal range. The thematic content analysis of interview transcripts found: reasons given for having OGT were to improve the 'bite', as well as gaining a more normal facial appearance; most patients reported the service information was satisfactory, but about half made negative comments, with some reporting staff communications made them feel worse; knowledge of OGT risks and benefits was poor; patients had strong emotions about their facial appearance and the orthognathic treatment they received, which did not seem to be addressed by current practice.
Some OGT patients do not appear to be making informed decisions about their treatment. They seem to have unmet needs in relation to support for their decision making, and managing the emotional effects of undergoing and adjusting to treatment. The implications for information provision, assessment and support during treatment are discussed.
很少有研究从患者角度探讨正颌治疗（OGT）的决策。本研究描述了与患者决定接受或不接受正颌治疗相关的因素，并评估该过程是否可被视为知情决策。
采用访谈和问卷调查方法在约克郡的四个正颌治疗服务机构进行的横断面调查。
参与者为16岁以上的患者，他们在6个月内做出正颌治疗决策，或在2003年研究开始日期前18 - 42个月做出了治疗选择。
问卷评估患者的人口统计学特征、牙科病史和精神病理学情况（焦虑、自我满意度、身体满意度、面部外观）；访谈探讨患者接受正颌治疗的原因及经历。
在138名被邀请的患者中，61名参与（平均年龄25岁，66%为女性）。精神病理学得分在正常范围内。对访谈记录的主题内容分析发现：接受正颌治疗的原因是改善“咬合”以及获得更正常的面部外观；大多数患者表示服务信息令人满意，但约一半患者给出负面评价，一些患者称工作人员的沟通让他们感觉更糟；对正颌治疗风险和益处的了解不足；患者对自己的面部外观和接受的正颌治疗有强烈情绪，而当前的治疗实践似乎并未解决这些问题。
一些正颌治疗患者似乎没有对其治疗做出知情决策。他们在决策支持以及应对治疗和适应治疗的情绪影响方面似乎有未满足的需求。讨论了治疗期间信息提供、评估和支持的意义。
