Kok, Xiu Ling Florence; Ryan, Fiona S; Gwilliam, Jamie; Sayers, Mark; Cunningham, Susan J; (2024) A qualitative study of preoperative anxiety in orthognathic patients: The patient perspective. American Journal of Orthodontics and Dentofacial Orthopedics 10.1016/j.ajodo.2024.08.007. (In press).

Text A qualitative study of pre-operative anxiety in orthognathic patients. The patient perspective.pdf - Accepted Version Access restricted to UCL open access staff until 28 September 2025. Download (421kB)

Abstract

INTRODUCTION: Increased preoperative anxiety may have an adverse impact on the patient experience. This qualitative study therefore aimed to explore those factors affecting anxiety in the approach to orthognathic surgery. METHODS: A total of 28 orthognathic patients who had completed their presurgical orthodontic treatment and were within 8 weeks before their surgery underwent one-to-one in-depth interviews. The interviews explored their experience in the preoperative period, with the focus on aspects relating to anxiety. Interviews were audio-recorded and transcribed verbatim, and data were then analyzed using a thematic framework approach. RESULTS: Eight themes and associated subthemes were identified. The first theme related to time and described the approach to the surgery and the transience of the side effects. The second theme discussed control and how the need for control may affect anxiety; the third focused on fear related to the surgery and the element of "the unknown." The fourth theme highlighted the importance of trust between patients and clinicians, whilst the fifth focused on information and its delivery, which was crucial for managing uncertainty. The sixth theme centered on expectations about the surgery and the patient's ability to cope, and the seventh discussed coping strategies that were effective in alleviating anxiety. The final theme focused on the benefits of a strong, effective support system in reducing anxiety. No distinct typologies emerged from the data. Recommendations for consideration by clinicians are presented. CONCLUSIONS: The findings provide a novel insight into the multifactorial nature of preoperative anxiety in orthognathic patients and also highlight the important role of the clinical team in creating a supportive environment to help reduce patient anxiety.

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