Al-Moghrabi Dalya, Colonio Salazar Fiorella Beatriz, Johal Ama, Fleming Padhraig S
1 Centre for Oral Bioengineering, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK.
2 College of Dentistry, Princess Nourah bint Abdulrahman University, Riyadh, Saudi Arabia.
J Orthod. 2019 Sep;46(3):212-219. doi: 10.1177/1465312519851196. Epub 2019 May 31.
To explore factors influencing adherence to vacuum-formed retainer wear over a minimum period of four years.
A qualitative study based on a randomised controlled trial assessing the effectiveness of orthodontic retainers.
Institute of Dentistry, Queen Mary University of London.
Fifteen participants wearing vacuum-formed retainers for at least four years.
One-to-one semi-structured interviews were undertaken on a criterion-based purposive sample of participants wearing vacuum-formed retainers. The interviews were audio-recorded, transcribed verbatim and analysed using Framework Methodology.
High self-reported levels of adherence in the early stages of retention were linked to a desire to maintain orthodontic outcomes and the negative perception of potential post-treatment changes. However, adherence typically reduced over time due to a combination of factors including the negative impact of retainers on quality of life and pragmatic issues related to retainer wear. Network support was found to be important in the short and long term, with instances of self-directed wear and negative beliefs concerning the importance of retainer wear and predisposition to post-treatment changes. Lack of follow-up appointments and immaturity of participants prompted independent decisions to cease retainer wear.
Six key influencers of prolonged adherence with vacuum-formed retainer wear were identified. Future strategies to improve adherence should account for these while also being responsive to time elapsed since debond and patient age.
探讨影响佩戴真空成型保持器至少四年的依从性的因素。
一项基于随机对照试验的定性研究，评估正畸保持器的有效性。
伦敦玛丽女王大学牙科学院。
15名佩戴真空成型保持器至少四年的参与者。
对佩戴真空成型保持器的参与者进行基于标准的目的抽样一对一的半结构化访谈。访谈进行录音，逐字转录，并使用框架方法进行分析。
自我报告的在保持早期阶段的高依从性水平与维持正畸效果的愿望以及对治疗后潜在变化的负面认知有关。然而，由于多种因素的综合作用，包括保持器对生活质量的负面影响以及与佩戴保持器相关的实际问题，依从性通常会随着时间的推移而降低。发现网络支持在短期和长期都很重要，存在自我指导佩戴以及对佩戴保持器的重要性和治疗后变化易感性的负面信念。缺乏随访预约和参与者的不成熟促使他们独立决定停止佩戴保持器。
确定了长期坚持佩戴真空成型保持器的六个关键影响因素。未来提高依从性的策略应考虑到这些因素，同时也要对脱粘后的时间和患者年龄做出反应。
