The psychological and social implications of patient motivation and satisfaction with orthgnathic surgery

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Scott, Anthony A.
Krause, Frank H.
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Thesis (D. Ed.)
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The purpose of this study was to validate a set of predictor variables which identify perspective orthognathic surgical patients who may be poor surgical risks. The predictive qualities of four MMPI scales, two Bloom Sentence Completion scales, and seven Dental Inventory scales were used to identify presurgical, orthognathic patients who were likely to express postsurgical dissatisfaction.All variables were considered jointly to assess their significance in predicting surgical satisfaction versus dissatisfaction. Subsequently, a minimal set of predictors, which accounted for a significant proportion of the criterion variance, were derived by using factor analysis.A nonrandomized, pretest-posttest design with a one-way, multivariate analysis of variance yielding a Hotelling T square statistic was used. A discriminate analysis of variance was used as a follow-up to the Hotelling T square to note those variables which caused the differences between the means.This study was conducted at a large military teaching and research hospital in Southwest Texas. Patients used in this study were identified during routine dental examinations or were referred by their dentists. Eighty-nine subjects participated in the research project. All subjects were between the ages of 15 and 50 with a mean age of 23.7. They were all volunteers and received their surgery in the same hospital by the current staff of oral surgeons. All subjects were informed that the psychological evaluation was an integral part of the oral surgery evaluation.Upon admission to the hospital the patient received the scheduled surgery and underwent 8 weeks of routine postoperative care. Prior to being discharged from the hospital the patient was readministered the MMPI, Bloom Sentence Completion, and the Dental Inventory. The 8-week period was chosen for postoperative testing because patients were medically cleared to resume normal functioning at that time.A statistically significant difference between the four MMPI scores on the results of the orthognathic surgery variable was evident when comparing satisfied versus dissatisfied patients (F = 3.020, P 0.028). Additionally, there was a multilinear relationship among the presurgical test and the level of postsurgical satisfaction.Factor analysis rendered a minimal set of predictor variables which proved practical in identifying satisfied from dissatisfied patients.Considering the limitations of the study and the above-mentioned results, it can be concluded that a minimal set of predictor variables could be effective in helping surgeons screen out those patients who have the potential of being poor surgery risks.