scholarly journals The Comparison of Patient Satisfaction after “Surgery First” and Conventional Orthognathic Surgery: An Original Research

2017 ◽  
Vol 7 ◽  
pp. 123-129 ◽  
Author(s):  
Pritam Mohanty ◽  
Swati Saraswata Acharya ◽  
Nivedita Sahoo ◽  
Sushila Sah ◽  
Sanjeeb Kumar Sahu
Keyword(s):  
Patient Satisfaction ◽  
Orthognathic Surgery ◽  
Rating Scale ◽  
Common Factor ◽  
Original Research ◽  
Analog Scale ◽  
Facial Esthetics ◽  
Point Rating Scale ◽  
Surgery First ◽  
Open Question

Aims and Objectives We evaluated the factors which affect patient satisfaction and their expectations toward “surgery first” and conventional orthognathic surgery. Materials and Methods Questionnaires consisting of 17 questions were given to the subjects postoperatively who had undergone Le fort 1 maxillary superior impaction for skeletal gummy smile correction with conventional orthognathic surgery and “surgery first” approach. Eleven-point rating scale based on a (visual analog scale; 0 = poor; 10 = excellent) were used to answer six questions. Ten closed-form questions were also included as well as one open question for “further remarks.” Results Nineteen patients (12 females, 07 males; mean age, 23.4 ± 4.9 [standard deviation] years) gave their consent to participate in the study. The intention to undergo surgery only for esthetics was noted in 42.11% of patients; only improvement of chewing function in 21.05% and both in 36.84%. Conclusion The most common factor for patient satisfaction after “surgery first” and conventional orthognathic surgery was facial esthetics, but masticatory function and even psychological aspects should be considered equally when planning surgery. The patient satisfaction was more in “surgery first” than conventional orthognathic surgery. The timing of treatment and immediate results are important factors toward patient satisfaction.

Surgery-first or orthognathic surgery approach: Psychosocial and physical changes

2016 ◽  
Vol 33 (S1) ◽  
pp. S147-S147
Author(s):  
E. Gambaro ◽  
C. vecchi ◽  
C. Gramaglia ◽  
A. Losa ◽  
M. Giarda ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Orthognathic Surgery ◽  
Orthodontic Treatment ◽  
Short Form ◽  
Self Esteem ◽  
Care Quality ◽  
Surgical Approaches ◽  
Facial Esthetics ◽  
Surgery First

IntroductionTwo surgical approaches exist for malocclusion: in the surgery-first approach the orthognathic surgery precedes the orthodontic treatment, treating facial esthetics first and then occlusion, whereas in the conventional approach (the orthodontics-first approach) the orthodontic treatment precedes the orthognathic surgery, treating occlusion first and then facial esthetics. The advantages of the surgery-first approach include the fact that patient's dental function, and facial esthetics are restored and improved soon after the beginning of treatment. Moreover, the entire treatment lasts only 1 to 1.5 years or less and orthodontic management is easier to achieve.AimsOur study aims to compare patients undergoing surgery-first or orthognathic surgery approach as for as self-esteem, satisfaction with their appearance in the pre- and postoperative care, quality of life and psychosocial changes, are concerned.MethodsWe recruited 50 patients undergoing surgery-first or orthognathic surgery approach at SC Maxillo-Facciale of Novara between October 2014 and December 2017. Assessment were performed at baseline (T0) and at follow-up (T1: 5 weeks; T2: 5–6 months), with Rosenberg Self-Esteem Scale (RSES), Temperament and Character Inventory (TCI: only at T0), Short Form Health Survey 36 (SF-36), Beck Depression Inventory (BDI-II), Resilience Scale for Adult (RSA), Psychosocial Impact of Dental Aesthetics Questionnaire (PIDAQ), Oral Health Impact Profile (OHIP-14).ResultsData collection is still ongoing. We expect to find a better quality of life and higher self-esteem in patients undergoing surgery first approach.ConclusionSatisfaction is crucial for patients’ adherence to treatment and to avoid revolving door. Clinical implications will be discussed.Disclosure of interestThe authors have not supplied their declaration of competing interest.

scholarly journals Modern Surgery-First Approach Concept in Cleft-Orthognathic Surgery: A Comparative Cohort Study with 3D Quantitative Analysis of Surgical-Occlusion Setup

2019 ◽  
Vol 8 (12) ◽  
pp. 2116 ◽  
Author(s):  
Hyung Joon Seo ◽  
Rafael Denadai ◽  
Betty Chien-Jung Pai ◽  
Lun-Jou Lo
Keyword(s):  
Orthognathic Surgery ◽  
Quantitative Data ◽  
Treatment Time ◽  
Therapeutic Modality ◽  
Computer Assisted ◽  
Multidisciplinary Teams ◽  
Anterior Teeth ◽  
Facial Esthetics ◽  
Surgery First ◽  
Intercanine Distance

Despite the evident benefits of the modern surgery-first orthognathic surgery approach (reduced treatment time, efficient tooth decompensation, and early improvement in facial esthetics), the challenge of the surgical-occlusion setup acts as a hindering factor for the widespread and global adoption of this therapeutic modality, especially for the management of cleft-skeletofacial deformity. This is the first study to assess three-dimensional (3D) quantitative data of the surgical-occlusion setup in surgery-first cleft-orthognathic surgery. This comparative retrospective study was performed on 3D image datasets from consecutive patients with skeletal Class III deformity who had a unilateral cleft lip/palate (cleft cohort, n = 44) or a noncleft dentofacial deformity (noncleft cohort, n = 22) and underwent 3D computer-assisted single-splint two-jaw surgery by a single multidisciplinary team between 2014 and 2018. They received conventional orthodontics-first or surgery-first approaches. 3D quantitative characterization (linear, angular, and positional measurements) of the final surgical-occlusion setup was performed and adopted for comparative analyses. In the cleft cohort, the occlusion setup in the surgery-first approach had a significantly (all p < 0.05) smaller number of anterior teeth contacts and larger incisor overjet compared to the conventional approach. Considering the surgery-first approach, the cleft cohort presented significantly (all p < 0.05) larger (canine lateral overjet parameter) and smaller (incisor overjet, maxillary intercanine distance, maxillary intermolar distance, ratio of intercanine distance, and ratio of intermolar distance parameters) values than the noncleft cohort. This study contributes to the literature by providing 3D quantitative data of the surgical-occlusion setup in surgery-first cleft-orthognathic surgery, and delivers information that may assist multidisciplinary teams to adopt the surgery-first concept to optimize cleft care.

scholarly journals The Effects of Humanized Psychological Nursing Model in General Surgery Nursing

2021 ◽  
Vol 5 (4) ◽  
pp. 98-102
Author(s):  
Guifeng Xue ◽  
Huafang Yi ◽  
Ping Xue ◽  
Wenmin Sun
Keyword(s):  
Patient Satisfaction ◽  
General Surgery ◽  
Rating Scale ◽  
Nursing Intervention ◽  
Control Group ◽  
Study Group ◽  
Clinical Effects ◽  
Analog Scale ◽  
Nursing Services ◽  
Hamilton Anxiety Rating Scale

Objective: To analyze and comprehensively study the clinical effects of humanized psychological nursing model in general surgery nursing. Methods: The study period was from January 2018 to December 2020. A sample of 200 patients who were admitted to The Second People’s Hospital of Taizhou City for general surgery were selected. Random lottery grouping was used to divide the subjects into a study group and a control group. The sample within each group was n=100. The patients in the control group were provided with conventional general surgery nursing plan whereas the patients in the study group received the same nursing plan but with addition of the humanized psychological nursing model. The indicators of the two groups were compared and analyzed. Results: Comparing the scores from Hamilton Anxiety Rating Scale (HAMA) and Hamilton Depression Rating Scale (HAMD) after nursing intervention, postoperative visual analog scale (VAS), hospital stay, and patient satisfaction with the nursing services between the two groups, the study group was better (P < 0.05). Conclusion: The implementation of humanized psychological nursing model in general surgery nursing had a significant effect in which there were improvements in regard to the patients’ mental state and their satisfaction with the nursing services. Hence, it is worthy of promotion.

scholarly journals Clinicians’ Knowledge and Attitudes About Delirium Detection and Management

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 519-520
Author(s):  
Priyanka Shrestha ◽  
Erica Husser ◽  
Diane Berish ◽  
Long Ngo ◽  
Marie Boltz ◽  
...  
Keyword(s):  
Rating Scale ◽  
P Value ◽  
Clinical Implementation ◽  
Chi Square ◽  
Response Options ◽  
Knowledge And Attitudes ◽  
Point Rating Scale ◽  
Life Threatening ◽  
Strongly Agree ◽  
High Level

Abstract Delirium is a serious and potentially life-threatening problem, but it remains clinically under-recognized. Various factors contribute to this under-recognition, including limited understanding of delirium, insufficient training and application of delirium assessments, potential stigma for the patient and increased workload for the clinician. As a part of an NIH funded study testing a rapid two-step delirium identification protocol at two hospitals in the U.S. (one urban and one rural), clinicians completed a 12-item survey to assess their knowledge and attitudes about delirium and their confidence in preventing and managing delirium. Survey response options followed a 5-point rating scale (strongly disagree, disagree, undecided, agree, strongly agree). The sample for this analysis included 399 clinicians (MDs=53; RNs=235; CNAs=111). Chi-square was used to test for group differences between clinician types. Less than half of the clinicians reported agreeing with the statement, “delirium is largely preventable” (MDs: 47%; RN: 44%; CNA: 41%, p-value=0.021). MDs and RNs indicated a high level of confidence in recognizing delirium while CNAs endorsed lower levels of confidence (MDs: 87%; RN: 81%; CNA: 65%, p-value=0.001). All types of clinicians reported lower confidence in managing delirium (MDs: 29%; RN: 36%; CNA: 44%, p-value=0.117). 47% of CNAs and 37% of RNs agreed there is a need for additional training in caring for persons with delirium while only 21% of MDs agreed (p = 0.031). Understanding how different types of clinicians think and feel about delirium will inform training and communication initiatives, clinical implementation, and research on best practices for delirium identification and management.

scholarly journals Lumbar Disc Herniation and Preoperative Modic Changes: A Prospective Analysis of the Clinical Outcomes After Microdiscectomy

2021 ◽  
pp. 219256822097608
Author(s):  
Dinesh Kumarasamy ◽  
Shanmuganathan Rajasekaran ◽  
Sri Vijay Anand K. S ◽  
Dilip Chand Raja Soundararajan ◽  
Ajoy Prasad Shetty T ◽  
...  
Keyword(s):  
Patient Satisfaction ◽  
Back Pain ◽  
Clinical Outcomes ◽  
Lumbar Disc Herniation ◽  
Disc Herniation ◽  
Rating Scale ◽  
Lumbar Disc ◽  
Modic Changes ◽  
P Value ◽  
Functional Scores

Study design: Prospective comparative cohort study. Objectives: The study aims to elucidate the relationship between Modic endplate changes and clinical outcomes after a lumbar microdiscectomy. Methods: Consecutive patients undergoing microdiscectomy for lumbar disc herniation (LDH) were prospectively studied. Pre-operative clinical and radiological parameters were recorded. The pain was assessed by Numeric pain rating scale (NPRS), and functional assessment by Oswestry Disability Index (ODI). Minimal clinically important difference (MCID) in outcome was calculated for both the groups. Complications related to surgery were studied. Follow-up was done at 6 weeks, 3 months, 6 months and 1 year. Mac Nab criteria were used to assess patient satisfaction at 1 year. Results: Out of 309 patients, 86 had Modic changes, and 223 had no Modic changes. Both groups had similar back pain (p-value: 0.07) and functional scores (p-value: 0.85) pre-operatively. Postoperatively patients with Modic changes had poorer back pain and ODI scores in the third month, sixth month and 1 year (p-value: 0.001). However, MCID between the groups were not significant (p-value: 0.18 for back pain and 0.58 for ODI scores). Mac Nab criteria at 1 year were worse in Modic patients (p-value: 0.001). No difference was noted among Modic types in the pre-operative and postoperative pain and functional outcomes. Four patients in Modic group (4.7%) and one patient in the non-Modic group (0.5%) developed postoperative discitis (p-value: 0.009). Conclusions: Preoperative Modic changes in lumbar disc herniation is associated with less favorable back pain, functional scores and patient satisfaction in patients undergoing microdiscectomy.

Effects of Onabotulinum Toxin A on Gait in Parkinson’s Disease Patients with Foot Dystonia

2021 ◽  
pp. 1-6
Author(s):  
Pei Huang ◽  
Yuan-Yuan Li ◽  
Jung E. Park ◽  
Ping Huang ◽  
Qin Xiao ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Botulinum Toxin ◽  
Gait Analysis ◽  
Rating Scale ◽  
Analog Scale ◽  
Toxin A ◽  
Timed Up And Go ◽  
Balance Test ◽  
Onabotulinum Toxin A

ABSTRACT: We investigated the effects of botulinum toxin on gait in Parkinson’s disease (PD) patients with foot dystonia. Six patients underwent onabotulinum toxin A injection and were assessed by Burke–Fahn–Marsden Dystonia Rating Scale (BFMDRS), visual analog scale (VAS) of pain, Timed Up and Go (TUG), Berg Balance Test (BBT), and 3D gait analysis at baseline, 1 month, and 3 months. BFMDRS (p = 0.002), VAS (p = 0.024), TUG (p = 0.028), and BBT (p = 0.034) were improved. Foot pressures at Toe 1 (p = 0.028) and Midfoot (p = 0.018) were reduced, indicating botulinum toxin’s effects in alleviating the dystonia severity and pain and improving foot pressures during walking in PD.

scholarly journals P121 The efficacy of treatment interventions on fatigue in adolescents with juvenile idiopathic arthritis: a literature review

Rheumatology ◽  
2021 ◽  
Vol 60 (Supplement_1) ◽  
Author(s):  
Sebastian Moshtael ◽  
Sonia Khanom ◽  
Janet E McDonagh
Keyword(s):  
Quality Of Life ◽  
Juvenile Idiopathic Arthritis ◽  
Young People ◽  
Rating Scale ◽  
Outcome Measure ◽  
Therapeutic Interventions ◽  
Current Evidence ◽  
Original Research ◽  
Qualitative Synthesis

Abstract Background/Aims  Fatigue has been reported by young people and professionals alike as a major challenge for people living with juvenile idiopathic arthritis (JIA) . It remains unclear as to how therapeutic interventions impacts on this major symptom. The aim of this review was to determine the current evidence for the effectiveness of therapeutic interventions, non- pharmacological and pharmacological, on improving fatigue in adolescents with JIA. Methods  Three electronic databases (MEDLINE, EMBASE, PsycINFO) were searched from 2000 to Feb 2020; in addition to manual searches. Articles were eligible for inclusion if they (i) were original research papers, (ii) had fatigue as a primary outcome measure (iii) included adolescents (10-25 years) and (iv) were available in the English language. Results  Of the 3,142 records identified, 31 underwent full text assessment and 4 studies were included in the qualitative synthesis including 2 from the Netherlands, 1 Germany, and 1 from Canada. The total number of participants across the 4 studies was 824. Three were randomised controlled trials of nonpharmacological interventions and one was a cohort study from a national drug registry including older adolescents JIA (mean: 19-years). Measurement tools included the Paediatric Quality of life multidimensional fatigue scale, (2 studies), the Checklist for Individual Strength CIS-20 (1 study), a numeric rating scale (1 study). In one study a visual analogue scale for energy level was also utilised. In 2 studies baseline prevalence of fatigue was reported as 60% and 76% respectively. Significant reduction in fatigue was observed in all three nonpharmacological studies. In the registry study, fatigue was noted to be prevalent in spite of the disease being in inactive or minimally active on biologic therapy. In 3 studies the relationship between health-related quality of life and fatigue was highlighted and showed a decreased quality of life in fatigued young people. Conclusion  Fatigue is a significant problem in JIA during adolescence and influences quality of life. Improvements in fatigue with non-pharmacological interventions have been reported. However, at present, data is insufficient to conclusively decide which treatment intervention is most efficacious in treating fatigue in young people with JIA. Fatigue should be considered as an important outcome measure for the management of JIA in future evaluations of interventions. Disclosure  S. Moshtael: None. S. Khanom: None. J.E. McDonagh: None.

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