title: Psychological care for maxillofacial trauma patients: a preliminary survey of oral and maxillofacial surgeons.
abstract: BACKGROUND
  Psychological morbidities are major complications following maxillofacial injuries. The aim of this study was to assess self-evaluation of oral and maxillofacial surgeons on posttraumatic psychological care.
  
  
  METHODS
  Using a cross-sectional study design, we enrolled a sample of surgeons in 261 oral and maxillofacial surgery (OMFS) departments in the United States, United Kingdom and France. A self-administered e-mail questionnaire was used to evaluate knowledge, attitude and practice of the surgeons regarding psychological problems in maxillofacial injury patients, and their collaboration with psychological personnel. Appropriate descriptive and univariate statistics were computed, and P<0.05 was considered statistically significant.
  
  
  RESULTS
  The response rate was 28.1% (112 of 398), but we included only 100 respondents from 107 OMS units. 60% of the surgeons disclosed a moderate or high level of relevant knowledge. Only 28 OMS departments (26.2%) had intra-service psychological staff (commonly in France [P<0.05]), and five surgeons revealed considerable deficits in access to psychological care. Frequent reasons for patient referral to psychological staff were depression, body dysmorphic disorder, posttraumatic stress disorder, suicidal idea, anxiety and behavioural changes. Eighty-eight surgeons linked patient's non-compliance with changes or difficulties in practice, and 58 surgeons experienced it already.
  
  
  CONCLUSIONS
  Despite several limitations, the results of this study suggest that oral and maxillofacial surgeons have a great interest and experience in posttraumatic psychological problems. Psychological professionals in charge will improve surgical care quality. Well-designed studies with larger sample size are desirable to confirm our results. Ethical issues of maxillofacial trauma care are also discussed.
authors.affiliation: Department of Oral, Craniomaxillofacial and Facial Plastic Surgery, Faculty of Medicine, University Hospital of Leipzig, Nürnberger Strasse 57, Leipzig, Germany. poramate.pitakarnnop@gmail.com
authors.forename: Poramate
authors.initials: P
authors.lastname: Pitak-Arnnop
authors.forename: Christian
authors.initials: C
authors.lastname: Hervé
authors.forename: Jean-Christophe
authors.initials: JC
authors.lastname: Coffin
authors.forename: Kittipong
authors.initials: K
authors.lastname: Dhanuthai
authors.forename: Jacques-Charles
authors.initials: JC
authors.lastname: Bertrand
authors.forename: Jean-Paul
authors.initials: JP
authors.lastname: Meningaud
mesh_terms: D001291:Attitude of Health Personnel; D016009:Chi-Square Distribution; D003430:Cross-Sectional Studies; D005602:France; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008446:Maxillofacial Injuries / Q000150:complications / Q000523:psychology* / Q000601:surgery; D019239:Practice Patterns, Dentists' / Q000706:statistics & numerical data; D011613:Psychotherapy; D012017:Referral and Consultation / Q000706:statistics & numerical data; D013313:Stress Disorders, Post-Traumatic / Q000209:etiology / Q000628:therapy*; D013515:Surgery, Oral / Q000941:ethics / Q000523:psychology / Q000706:statistics & numerical data; D011795:Surveys and Questionnaires; D006113:United Kingdom; D014481:United States