| OBJECTIVE:Measure the levels of state-trait anxiety,resilience and quality of life in patients with dentofacial deformities before and after orthognathic surgery,analyze the factors influencing state-trait anxiety,resilience and quality of life,to explore the role of state-trait anxiety and resilience on quality of life,and the buffering effect of resilience on state-trait anxiety and quality of life.METHODS:Subjects of this study were dentofacial deformity patients with preoperative orthodontics completed who were admitted to Peking University Hospital of Stomatology for treatment from September 2019 to September 2020.Informed consent was obtained from the participants for this study.All patients completed a set of statistical questionnaires assessing oral health-related quality of life,anxiety levels,psychological resilience,and basic patient profile on the day of hospitalization,and consequently at postoperative two weeks(T2),three months(T3),and six months(T4)follow-up period.The questionnaires used were Orthognathic Quality of Life Questionnaire(OQLQ),State-Trait Anxiety Inventory(STAI),and the Psychological Resilience Scale(ConnorDavidson Resilience scale(CD-RISC 10).The ANOVA,t-test and pearson correlation analysis were applied to analyze the level of resilience,state-trait anxiety and quality of life of the patients,and to explore the relationship between the variables.RESULTS:Total of 212 preoperative patients and 96 complete follow-up patients were included in this study.The age of the patients(n=96)ranged from 18 to 42 years(Mean±SD:26.02±5.75),with a median of 25 years.There were 26 male and 70 female cases.(1)The total preoperative population of patients with dentofacial deformities had a state anxiety score of 40.5±10.47 for men and 42.28 ± 8.89 for women,and a trait anxiety score of 43.91 ± 8.99 for men and 44.69± 10.15 for women,There was no difference in preoperative state anxiety(t=0.61,p>0.05)and higher level of trait anxiety(t=2.47,p<0.05)in male patients with dentofacial deformities compared to the domestic norm,and both state and trait anxiety were higher in females compared to the norm(t=4.14,p<0.05;t=4.37,p<0.05).The SAI and TAI scores of the postoperative period in the sample of 96 cases were lower compared to preoperative scores,the difference had statistic significance(p<0.05).There were no statistically significant differences in state anxiety and trait anxiety among patients with different personality traits(p>0.05).(2)The preoperative resilience scores of patients with dentofacial deformities were 28.81±6.60;the resilience scores differences among patients with different personality traits had no statistic significance(p>0.05);Psychological resilience scores improved postoperatively,with a statistically significant difference between T1 and T4 only(p=0.02)..(3)The preoperative quality of life scores of patients with dentofacial deformities were 37.77±8.49,including 20.56±6.86 for social function,11.31±4.06 for oral function,9.84±3.70 for aesthetic perception,and 16.61±3.35 for facial aesthetics;Except for education,no statistically significant differences were found in the quality of life scores of patients classified by different personality traits(p>0.05);the quality of life and its’ four sub-dimensions scores gradually decreased,the quality of life level gradually increased from T1 to T4,and the difference between T1 and T4 was statistically significant(p=0.02);(4)According to Pearson correlation analysis and multiple linear regression or one-dimensional linear regression analysis,there was a correlation between patients’resilience level,state-trait anxiety level and quality of life level(p<0.05).Resilience level and state-trait anxiety level were predictors of quality of life level after surgery;resilience level was predictor of state-trait anxiety level.(5)State anxiety scale screens people with low quality of life in T3 and T4 with cutoff values of 34.5 and 33.5,respectively;The Trait Anxiety Scale screens for low quality of life in T2,T3,and T4 with cutoff values of 43.5,42.5,and 33.5,respectively;psychological resilience scale screens people with low quality of life in T3 and T4 with cutoff values of 31.5 and 23.5 points.CONCLUSIONS:The level of state-trait anxiety in patients with dentofacial deformities improved postoperatively compared with preoperative levels,and the level of resilience and quality of life increased postoperatively compared with preoperative levels;there was a significant correlation between the two variables of state-trait anxiety,psychological resilience and quality of life.State-trait anxiety is negatively associated with quality of life,and psychological resilience is positively associated with quality of life;the level of psychological resilience and state-trait anxiety of patients were predictors of postoperative quality of life.Psychological resilience levels are negatively correlated with state anxiety and trait anxiety,and can reduce the response level of state anxiety,and psychological resilience buffered anxiety and surgical trauma.STAI and CD-RISC 10 scales can be used as screening scales for people with low quality of life after orthognathic surgery. |
