Professor and Head, Department of Dental and Prosthetic Surgery, Tata Memorial Hospital, Homi Bhabha National Institute, Mumbai, India.
Professor and Head, Department of Psychiatry, GS Medical College, Parel, Mumbai, India.
J Prosthet Dent. 2022 Dec;128(6):1398-1404. doi: 10.1016/j.prosdent.2021.03.017. Epub 2021 May 11.
Loss of facial organs and subsequent rehabilitation affects a patient's psychological status. Understanding the perceived psychosocial aspects of quality of life among patients with missing organs and after prosthetic rehabilitation is essential, but studies that quantify this aspect are lacking.
The purpose of this clinical study was to develop and validate a psychosocial perception scale and compare psychosocial perception before and after the prosthetic rehabilitation of a missing facial part.
A psychosocial perception scale was developed to quantitatively measure the perceived psychosocial aspects of quality of life among patients with extraoral defects. The instrument was translated in the Hindi and Marathi Indian languages by using a forward and backward translation method. Depending on the responses obtained from the patients in the interview about the interpretation and ease of understanding, the questionnaire was modified and further pilot testing conducted. In the first phase, validation of the questionnaire was carried out with internal consistency, interdomain correlation, and intraclass correlation assessed by using the Cronbach α, Pearson correlation, and test retest reliability. Construct validity was established by the exploratory factor analysis. In the second phase, 32 participants were evaluated for their psychosocial response before and 3 months after prosthetic rehabilitation. Responsiveness and change in the domains scores of the psychosocial perception scale were studied by using the Wilcoxon signed-rank sum test (α=.05).
The Cronbach α for internal consistency of overall psychosocial perception was .855 and .809 in the pretreatment and post-treatment visits consecutively. Most of the domains in the psychosocial perception scale had a Pearson correlation (r)>0.40. The domain of esthetics had r=0.84(confidence interval: .43-0.95), indicating good intraclass correlation. The domains of esthetics (P<.005), function (P<.005), positive emotions (P<.005), negative emotions (P=.011), and social and personal relationship P=.003) of the psychosocial perception scale showed statistically significant improvement in the scores after prosthetic intervention and had excellent (r>0.90) intraclass correlation.
The psychosocial perception scale was a reliable tool to assess the patient response toward the prosthetic rehabilitation of extraoral defects. Positive improvements in the domains score (esthetics, function, positive emotions, and social and personal relationship) contributed to better perception after prosthetic rehabilitation.
面部器官的缺失及其后续康复会影响患者的心理状态。了解缺失器官患者和修复体康复后的生活质量的感知心理社会方面至关重要，但缺乏量化这一方面的研究。
本临床研究旨在开发和验证一种心理社会感知量表，并比较缺失面部部位修复体康复前后的心理社会感知。
开发了一种心理社会感知量表，以定量测量口腔外缺损患者生活质量的感知心理社会方面。该工具通过正向和反向翻译方法翻译成印地语和马拉地语。根据患者在访谈中对解释和理解难易程度的反应，对问卷进行了修改并进一步进行了预试验。在第一阶段，通过 Cronbach α、Pearson 相关性和测试-再测试可靠性评估了问卷的内部一致性、域间相关性和组内相关性。通过探索性因子分析建立了结构效度。在第二阶段，对 32 名患者在修复体修复前和修复后 3 个月进行了心理社会反应评估。使用 Wilcoxon 符号秩和检验（α=.05）研究了心理社会感知量表各领域评分的反应性和变化。
总体心理社会感知的内部一致性 Cronbach α 在治疗前和治疗后连续就诊时分别为.855 和.809。心理社会感知量表的大多数领域的 Pearson 相关性（r）>0.40。美学领域的 r=0.84（置信区间：.43-0.95），表明组内相关性良好。美学（P<.005）、功能（P<.005）、积极情绪（P<.005）、消极情绪（P=.011）和社会和个人关系（P<.005）领域的评分在修复体干预后有统计学显著改善，并且具有极好的（r>0.90）组内相关性。
心理社会感知量表是评估口腔外缺损修复体患者反应的可靠工具。领域评分的积极改善（美学、功能、积极情绪和社会和个人关系）有助于修复体康复后更好的感知。
