Department of Prevention and Oral Rehabilitation, School of Dentistry, Federal University of Goias, Goiania, Goias, Brazil.
J Oral Rehabil. 2009 Dec;36(12):909-15. doi: 10.1111/j.1365-2842.2009.02018.x. Epub 2009 Oct 27.
The aim of the study was to explore partially edentulous patients' reasons for choosing or refusing prosthodontic treatment with removable partial dentures (RPD), fixed partial dentures (FPD) and implant partial dentures (IPD). Clinical and oral health-related quality of life measures were collected from 165 partially edentulous patients undergoing treatment. Patients' preferences were recorded and reasons for choosing or refusing treatments were measured with 32 questions using a five-point Likert scale. Descriptive statistics, chi-square and multiple logistic regression were used to compare patients' preferences according to clinical variables. Discriminant analysis was used to examine the impact of each reason for a patient's decision to choose or refuse treatment options. Results showed that older patients (P < 0.001) and with greater oral-related quality of life impacts (P < 0.05) were more likely to choose RPD. IPD were preferred by patients with higher education levels (P < 0.01). Discriminant functions revealed that the desire to have a fixed or removable denture had great impact on preferences. Removal of tooth structure was the main reason for refusing FPD and financial cost had a great impact on refusing IPD. Overall agreement between observed patients' decisions and those predicted by the discriminant function was >90% for all treatments. Reasons vary greatly among patients, and the role of individual perception of potential reasons for treatment selection was the most important determinants of patients' decisions. The main reasons for choosing or refusing treatments focused in this study can be used to guide shared decision-making, providing treatments that better match patients' expectations and desires.
本研究旨在探讨部分无牙颌患者选择或拒绝可摘局部义齿（RPD）、固定局部义齿（FPD）和种植体局部义齿（IPD）修复的原因。从 165 名接受治疗的部分无牙颌患者中收集了临床和口腔健康相关的生活质量指标。记录了患者的偏好，并使用五点 Likert 量表通过 32 个问题来衡量选择或拒绝治疗的原因。使用描述性统计、卡方检验和多元逻辑回归来比较根据临床变量的患者偏好。判别分析用于检查患者选择治疗方案的决定的每个原因的影响。结果表明，年龄较大的患者（P < 0.001）和口腔相关生活质量影响较大的患者（P < 0.05）更倾向于选择 RPD。更高学历的患者更倾向于选择 IPD（P < 0.01）。判别函数显示，对固定或可摘义齿的渴望对偏好有很大影响。去除牙体结构是拒绝 FPD 的主要原因，而经济成本对拒绝 IPD 有很大影响。对于所有治疗方法，观察到的患者决策与判别函数预测之间的总体一致性均>90%。患者之间的原因差异很大，个体对治疗选择潜在原因的感知作用是患者决策的最重要决定因素。本研究关注的选择或拒绝治疗的主要原因可用于指导共同决策，提供更符合患者期望和愿望的治疗。
