Psychosocial predictors of high-risk patients undergoing orthognathic surgery.
The purpose of this analysis was to identify a set of predictor variables that are prospectively related to postsurgical outcomes. Specifically, psychosocial characteristics were sought to predict postsurgical outcomes. The 5 Revised Symptom Checklist-90 (SCL-90-R) scales, the neuroticism score of the Eysenck Personality Inventory (EPI), the psychosocial domain score from the Sickness Impact Profile (SIP), and 4 scales from the Oral Health Status Questionnaire (OHSQ) were used as the predictors. A total of 31 male and 86 female subjects participated in this multicenter randomized trial, which compared rigid and wire fixation. Data were collected prior to placement of orthodontic appliances, 1 to 2 weeks presurgery, and at 1 week, 8 weeks, 6 months, and 2 years after surgery. Baseline oral health was used as an indicator of postsurgical oral health functioning. A path analytic model of influences on presurgical oral health was estimated (R2 = 0.43). The results suggest that presurgical screening of demographic characteristics (age, sex, and ethnicity), oral health (the OHSQ), quality of life issues (SIP), and personality features (SCL-90-R), accounts for 23% to 39% of the variance in postsurgical oral health outcomes. The path analysis conducted suggests that a patient's age, ethnicity, gender, and elevated scores on the EPI have indirect effects on postsurgical health. As determined by a 2-stage least squares regression model, 3 variables--the patient's presurgical oral health (per the OHSQ), pre- and postsurgical Global Severity Index (GSI) score from the SCL-90-R, and the psychosocial scale score from the SIP--were found to have a statistically significant impact on postsurgical outcomes. Additionally, the GSI, SIP, and OHSQ are reliable measures in predicting oral health outcomes.
Scott
A A
AA
Department of Pediatrics, University of Texas Health Science Center at San Antonio 78284-7792, USA. Scottaa@uthscsa.edu
Hatch
J P
JP
Rugh
J D
JD
Rivera
S M
SM
Hoffman
T J
TJ
Dolce
C
C
Bays
R A
RA
D000328:Adult; D005163:Factor Analysis, Statistical; D005260:Female; D006305:Health Status Indicators; D006801:Humans; D019248:Jaw Fixation Techniques; D016018:Least-Squares Analysis; D008297:Male; D008312:Malocclusion, Angle Class II / Q000523:psychology / Q000601:surgery*; D019186:Mandibular Advancement / Q000379:methods / Q000523:psychology*; D010555:Personality Inventory; D011237:Predictive Value of Tests; D011446:Prospective Studies; D011569:Psychiatric Status Rating Scales; D012044:Regression Analysis; D015203:Reproducibility of Results; D012307:Risk Factors; D018434:Sickness Impact Profile; D016896:Treatment Outcome