Department of Plastic and Reconstructive Surgery, Xijing Hospital, Forth Military Medical University, Xi'an, Shaanxi, China.
Medicine (Baltimore). 2024 Aug 23;103(34):e39435. doi: 10.1097/MD.0000000000039435.
Skeletal Class III malocclusion can significantly impact psychological well-being. Although bimaxillary surgery is a well-established corrective intervention, its psychological effects are not fully understood. This study aims to investigate changes in self-esteem, sensitivity to criticism, and social appearance anxiety following surgery to inform targeted nursing interventions for psychological adaptation. This comparative study included 205 participants: 150 patients with skeletal Class III malocclusion who underwent bimaxillary surgery, and a control group of 55 individuals without malocclusion. The malocclusion group had a mean age of 21.99 ± 2.28 years (96 males, 109 females). The control group consisted of department interns with Class I occlusion, normal overjet and overbite, and typical facial appearance, with a mean age of 21.61 ± 2.40 years (26 males, 29 females). Psychological assessments, validated for reliability, measured self-esteem, sensitivity to criticism, and social appearance anxiety before and after surgery. Statistical analyses, including independent sample t tests and one-way ANOVA, were performed to compare outcomes between the groups, with a significance level set at P < .05. Preoperative assessments revealed that patients with skeletal Class III malocclusion had significantly lower self-esteem and higher sensitivity to criticism and social appearance anxiety compared to the control group (P < .05). Postoperatively, there were modest improvements in self-esteem and significant reductions in sensitivity to criticism and social appearance anxiety, though levels of social appearance anxiety remained higher than those in the control group (P < .05). No significant differences in self-esteem and sensitivity to criticism were observed between the surgical and control groups postoperatively (P > .05). Within-group comparisons showed significant improvements in all measures after surgery (P < .05). Bimaxillary surgery positively affects the psychological well-being of patients with skeletal Class III malocclusion, enhancing self-esteem and reducing sensitivity to criticism and social appearance anxiety. However, some psychological concerns persist, indicating a need for targeted nursing interventions to further support these patients' psychological well-being.
骨性 III 类错牙合会显著影响心理健康。虽然双颌手术是一种成熟的矫正干预措施，但它的心理影响尚未被充分了解。本研究旨在探讨手术后自尊、对批评的敏感和社交外表焦虑的变化，以为心理适应提供有针对性的护理干预。这项比较研究包括 205 名参与者：150 名患有骨性 III 类错牙合的患者接受了双颌手术，对照组为 55 名无错牙合的个体。错牙合组的平均年龄为 21.99±2.28 岁（96 名男性，109 名女性）。对照组由科室实习生组成，具有 I 类牙合、正常覆合和覆盖以及典型的面部外观，平均年龄为 21.61±2.40 岁（26 名男性，29 名女性）。经过可靠性验证的心理评估测量了手术前后的自尊、对批评的敏感和社交外表焦虑。采用独立样本 t 检验和单因素方差分析对两组结果进行比较，显著性水平设为 P<0.05。术前评估显示，与对照组相比，骨性 III 类错牙合患者的自尊明显较低，对批评的敏感和社交外表焦虑较高（P<0.05）。术后，自尊略有改善，对批评的敏感和社交外表焦虑显著降低，但社交外表焦虑水平仍高于对照组（P<0.05）。术后手术组和对照组在自尊和对批评的敏感方面无显著差异（P>0.05）。组内比较显示，手术后所有指标均有显著改善（P<0.05）。双颌手术对骨性 III 类错牙合患者的心理健康有积极影响，提高了自尊，降低了对批评的敏感和社交外表焦虑。然而，一些心理问题仍然存在，这表明需要有针对性的护理干预来进一步支持这些患者的心理健康。
