Pittman Joseph W, Bennett M Elizabeth, Koroluk Lorne D, Robinson Stacey G, Phillips Ceib L
Department of Orthodontics, School of Dentistry, University of North Carolina, Chapel Hill, NC.
Department of Orthodontics, School of Dentistry, University of North Carolina, Chapel Hill, NC.
Am J Orthod Dentofacial Orthop. 2017 Jun;151(6):1065-1072. doi: 10.1016/j.ajodo.2016.10.036.
A deeper and more thorough characterization of why patients do or do not seek orthodontic treatment is needed for effective shared decision making about receiving treatment. Previous orthodontic qualitative research has identified important dimensions that influence treatment decisions, but our understanding of patients' decisions and how they interpret benefits and barriers of treatment are lacking. The objectives of this study were to expand our current list of decision-making dimensions and to create a conceptual framework to describe the decision-making process.
Discussion boards, rich in orthodontic decision-making data, were identified and analyzed with qualitative methods. An iterative process of data collection, dimension identification, and dimension refinement were performed to saturation. A conceptual framework was created to describe the decision-making process.
Fifty-four dimensions captured the ideas discussed in regard to a patient's decision to receive orthodontic treatment. Ten domains were identified: function, esthetics, psychosocial benefits, diagnosis, finances, inconveniences, risks of treatment, individual aspects, societal attitudes, and child-specific influences, each containing specific descriptive and conceptual dimensions. A person's desires, self-perceptions, and viewpoints, the public's views on esthetics and orthodontics, and parenting philosophies impacted perceptions of benefits and barriers associated with orthodontic treatment.
We identified an expanded list of dimensions, created a conceptual framework describing the orthodontic patient's decision-making process, and identified dimensions associated with yes and no decisions, giving doctors a better understanding of patient attitudes and expectations.
为了在接受正畸治疗方面进行有效的共同决策，需要对患者寻求或不寻求正畸治疗的原因进行更深入、更全面的描述。以往的正畸定性研究已经确定了影响治疗决策的重要维度，但我们对患者的决策以及他们如何理解治疗的益处和障碍仍缺乏了解。本研究的目的是扩展我们当前的决策维度列表，并创建一个概念框架来描述决策过程。
识别并使用定性方法分析富含正畸决策数据的讨论板。进行数据收集、维度识别和维度细化的迭代过程，直至达到饱和状态。创建一个概念框架来描述决策过程。
54个维度涵盖了与患者接受正畸治疗决策相关讨论的观点。确定了10个领域：功能、美观、心理社会效益、诊断、财务、不便之处、治疗风险、个人因素、社会态度和儿童特定影响，每个领域都包含具体的描述性和概念性维度。一个人的愿望、自我认知和观点、公众对美观和正畸的看法以及育儿理念会影响对正畸治疗相关益处和障碍的认知。
我们确定了一个扩展的维度列表，创建了一个描述正畸患者决策过程的概念框架，并确定了与接受或不接受治疗决策相关的维度，使医生能更好地理解患者的态度和期望。
