An exploratory qualitative study of patients’ perceptions of material risks for Orthognathic Surgery

Mohammed Saed, Sara (2024). An exploratory qualitative study of patients’ perceptions of material risks for Orthognathic Surgery. University of Birmingham. M.Sc.

Preview

Mohammedsaed2024MScByRes_Redacted.pdf
Text - Redacted Version
Available under License All rights reserved.
Download (3MB) | Preview

Abstract

Aim: There are a limited number of publications which have qualitatively investigated the treatment journey and the risk based decision-making process of patients undergoing orthognathic surgery following the Montgomery versus Lanarkshire Health Board (2015) legal ruling. Therefore, the aim of the study is to carry out qualitative research to ascertain the perception of risks during decision-making in a group of patients who have undergone orthognathic surgery. The goal is to improve the consent process of this elective procedure and better tailor this for each individual patient and improve their overall experience.

Design: The aims of this study were to evaluate patients’ perception and their lived experiences qualitatively, using focus groups and one to one interviews.

Methods: Patients who had undergone bimaxillary orthognathic surgery were recruited from review clinics at Birmingham Dental Hospital and School. Recruitment began in September 2021 and was completed by December 2021. All patients were approached by an orthodontic registrar (SMS). Twenty-three participants were initially identified and of those fifteen were interviewed. Ten of the participants interviewed were female and five were male. Ages ranged from twenty-three years to forty-three years old. The range of surgery dates was from October 2017 to December 2019.

Results: Two domains were identified, the first domain investigated perceptions of risk involved in orthognathic surgery. The second domain looked at the impact of orthognathic surgery on patients’ psychosocial well-being and considerations during the consent process. The first domain based on three main themes were identified from the interviews centring on the patient’s perceived risks to orthognathic surgery: sources of information about orthognathic surgery, surgical risk and setting and format of how risks should be presented. For the second domain, again three themes; physical effects of surgery and its impact on patients' psychosocial well-being, non-physical effects of surgery and its impact on patients' psychosocial well-being, and impact of surgery necessitating support.

Conclusions: This study has found that patients need to be informed of the overall experience of the treatment journey, providing realistic and accurate information prior to starting treatment. Previous patients are a valuable source in supporting future patients in the consent process. Clinicians should be aware that what may seem of importance to them may not be the same for patients. Patients should be aware of the pain, swelling, nerve injury, difficulty eating and drinking, and the difficulties that may arise in the initial postoperative recovery period. They should also be given a realistic idea of their final facial appearance. This knowledge may lead to greater patient satisfaction and most importantly mentally prepare these patients to reduce the negative implications on their psychosocial well-being. This research has identified the importance of the patient’s social network, dieticians, and psychologists in the treatment pathway. The findings of this study can inform future quantitative studies in which further research is required to look at how this new setting and format should be employed to improve the consent process for these patients as well as developing a comprehensive list of risks from both a clinicians and patient perspective.

Type of Work:

Thesis (Masters by Research > M.Sc.)

Award Type:

Masters by Research > M.Sc.

Supervisor(s):