患者的感知很重要：正畸治疗中的风险沟通和心理社会因素。

Patients' perceptions matter: Risk communication and psychosocial factors in orthodontics.

机构信息

State Key Laboratory of Oral Diseases, National Center for Stomatology and National Clinical Research Center for Oral Diseases, Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China.

Mental Health Center and Psychiatric Laboratory, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, Sichuan, China; Sichuan Clinical Medical Research Center for Mental Disorders, Chengdu, Sichuan, China.

出版信息

Am J Orthod Dentofacial Orthop. 2024 Oct;166(4):393-403.e18. doi: 10.1016/j.ajodo.2024.06.011. Epub 2024 Jul 20.

DOI:10.1016/j.ajodo.2024.06.011

PMID:39033445

Abstract

INTRODUCTION

Effective risk communication is essential for achieving patient-centered oral health care, but the limited understanding of patients' subjective perceptions of orthodontic-related risks hinders this process. This study aimed to investigate adults' awareness, concerns, and risk-avoidance behaviors about long-term orthodontic risks, exploring their relationship with psychosocial factors.

METHODS

We included 498 adult patients (mean age, 27.3 ± 6.8 years; women, 75.5%) during their initial visits to the orthodontic department at a hospital in Chengdu, China. Participants' understanding of orthodontic risks was gauged before and after exposure to the Oral Health Education Comics (OHEC), a specifically designed digital tool. Concurrently, we used logistic regression models to investigate the associations between patients' depression, anxiety, self-esteem, perfectionism, and dentofacial esthetics with risk perceptions.

RESULTS

Approximately 79.5% of participants initially reported low awareness of orthodontic risks, with most knowledge from online sources. Notably, the percentage of participants with high awareness increased to 64.8% after OHEC. The negative facial soft-tissue change was most concerning for participants: 53.4% showed high concerns, and 28.1% showed high avoidance. Furthermore, linear regression indicated positive associations between depression (β = 0.42 [95% confidence interval {CI}, 0.07-0.77]) and anxiety (β = 0.76 [95% CI, 0.35-1.18]) with orthodontic risk concerns, whereas risk avoidance was positively associated with depression (β = 0.62 [95% CI, 0.27-0.97]), anxiety (β = 1.09 [95% CI, 0.68-1.50]), and perfectionism (β = 0.24 [95% CI, 0.02-0.46]).

CONCLUSIONS

Findings emphasize the imperative of streamlined risk communication in orthodontics. By incorporating comprehensible tools such as OHEC and integrating psychosocial evaluations, more refined patient-practitioner communication and psychosomatic-based dental care can be achieved.

摘要

引言

有效的风险沟通对于实现以患者为中心的口腔保健至关重要，但由于对患者对正畸相关风险的主观认知理解有限，这一过程受到阻碍。本研究旨在探讨成年人对正畸长期风险的认知、担忧和规避行为，并探讨其与心理社会因素的关系。

方法

我们纳入了 498 名在成都一家医院正畸科初诊的成年患者（平均年龄 27.3±6.8 岁；女性占 75.5%）。在使用专门设计的数字工具——口腔健康教育漫画（OHEC）进行正畸风险教育前后，评估患者对正畸风险的认知。同时，我们使用逻辑回归模型，调查患者抑郁、焦虑、自尊、完美主义和颜面部美观对风险认知的影响。

结果

约 79.5%的参与者最初报告对正畸风险的认知度较低，主要来自网络来源。值得注意的是，在接受 OHEC 教育后，对正畸风险认知度高的患者比例增加到 64.8%。参与者最关心的是负面的面部软组织变化：53.4%表现出高关注，28.1%表现出高规避。此外，线性回归表明，抑郁（β=0.42[95%置信区间（CI），0.07-0.77]）和焦虑（β=0.76[95%CI，0.35-1.18]）与正畸风险的关注度呈正相关，而风险规避与抑郁（β=0.62[95%CI，0.27-0.97]）、焦虑（β=1.09[95%CI，0.68-1.50]）和完美主义（β=0.24[95%CI，0.02-0.46]）呈正相关。