Analysis of the psychological situation of adult orthodontic patients
Meng Xiangmin
[Abstract] Objective: To study the psychological status of adult orthodontic patients, to provide a basis for orthodontic preparation and orthodontic treatment, and to find corresponding preventive and curative measures to reduce the incidence of patients’ dissatisfaction with the results. METHODS: The Simple Coping Style Scale (SCWQ) Anxiety Self-Assessment Scale (SAS) and Depression Self-Assessment Scale (SDS) were used to test 50 adult orthodontic patients, while 50 normal individuals were used as the control group. The test was administered before bracket bonding, and the purpose and significance were explained before the test. RESULTS: The SAS and SDS scores of the treatment group were 48.64±13.05 and 43.68±13.52, respectively, with a standard cut-off value of 50, which showed that the treatment group scored significantly higher than the control group. CONCLUSION: Some adult orthodontic patients have significant anxiety and depression. In clinical work, we should learn to correctly identify this type of patients and actively explore psychological treatment methods so that the patients can objectively evaluate the treatment effect and reduce the occurrence of doctor-patient dispute problems. Meng Xiangmin, Department of Dentistry, Ningxia Coal General Hospital [Keywords] Adult orthodontic patients; Simple Coping Style Scale; Anxiety Self-Rating Scale; Depression Self-Rating Scale; Psychological status
Currently, the medical model is changing from the traditional biomedical model to the modern bio-psycho-social medical model. With the rapid development of modern medical technology, solving patients’ functional disorders is no longer the only goal of physicians, and the solution of psychological problems has gradually become one of the important goals of physicians’ work, which has been widely recognized internationally. In developed countries, most people have their own psychiatrist since childhood and go for psychological counseling regularly to solve psychological disorders in time, so as to avoid psychological problems from developing into psychological diseases, and many social celebrities, politicians and business elites are even more so.
Although there have been many studies on the psychological condition of adult orthodontic patients in foreign countries, they are still relatively scattered in China and often lack of systematization and scientificity. The Chinese population has unique socio-historical and cultural traditions and psychological characteristics, and their psychological conditions at the time of disease are significantly different from those of foreign patients. Therefore, the investigation and analysis of the psychological conditions of Chinese adult orthodontic patients can provide an important theoretical foundation and basis for solving the psychological problems of patients, which has important theoretical and practical significance. In view of this, this study selected a set of psychometric scales to investigate 50 orthodontic patients and analyzed the influencing factors associated with the patients’ psychological status to provide a theoretical basis for the future psychological treatment of adult orthodontic patients.
1 Study Subjects and Methods
1.1 Study subjects
The study subjects were adult orthodontic patients admitted to Ningxia Coal General Hospital from May 2006 to March 2008, and all patients were treated by surface tomography and cephalometric film.
Inclusion criteria: patients with significant dental malocclusion (1). This included misalignment of teeth, abnormalities in the dentition of the upper and lower dental arches, variation in the position and morphology of the upper and lower jaws, or incongruent tooth and jaw and craniofacial relationships
1.2 Study tools
1.2.1 General questionnaire
A self-designed general information questionnaire was used, including: gender, age, ethnicity, height, weight, time of deformity, education, occupation, specialty, monthly family income, time of deformity, cause, site of deformity, degree of deformity, degree of desire to change facial appearance, whether timely follow-up, and compliance.
The physicians evaluated the degree of deformity of patients by An’s classification or Mao’s classification.
1.2.2 Simple coping scale
The coping style scale was based on the Simple Coping Style Scale developed by Xie Yaning in 1998 (2), with 20 items, the first 12 items being positive coping factors and the last 8 items being negative coping factors, and the scale was a self-rating scale with multipolar scoring, with four options for each item: not used, occasionally used, sometimes used, and often used (with corresponding scores of 0, 1, 2, and 3). The retest correlation coefficient of the scale was 0.89 and the a-coefficient was 0.90; the a-coefficient of the Positive Coping Scale was 0.89; the a-coefficient of the Negative Coping Style was 0.78. The scale has been widely used at home and abroad and is mainly applicable to evaluate individuals’ coping styles and is representative.
The sample source of the Brief Coping Style Scale includes people of different ages, genders, cultures and occupations in the city. The normative information is: the mean of positive coping latitude is 1.78 with a standard deviation of 0.52; the mean of negative coping latitude is 1.59 with a standard deviation of 0.66.
1.2.3 Self-rated anxiety scale
The Self-Assessment Anxiety Scale (SAS) [3-5] was developed in 1965 as a self-assessment scale. It is used to measure the presence or absence of depressive states and to determine the severity of depression. From the form of scale construction to the specific assessment methods, it is very similar to the Depression Self-Rating Scale (SDS) and is a rather simple clinical tool for analyzing patients’ subjective symptoms. Since anxiety is one of the more common mood disorders in counseling clinics, the SAS has been a common scale for understanding anxiety symptoms in counseling clinics in recent years.
The SAS contains 20 entries, each of which uses four choice items (corresponding scores of 1, 2, 3, and 4): occasionally, sometimes, often, and constantly. The split semi-correlation of the odd and even entries was 0.92. This scale is more frequently used to reflect the patient’s recent psychological situation.
1.2.4 Self-rated depression scale
The Self-Rated Depression Scale (SDS) [6-7] was developed in 1965 as a self-rated scale. It is used to measure the presence or absence of depressive states and to determine the severity of depression. The scale contains 20 entries, each of which uses four choice items (corresponding scores of 1, 2, 3, and 4): occasionally, sometimes, often, and constantly. The odd-even item split-half correlation was 0.92, and the scale has been widely used in psychological research to reflect the patient’s recent psychological situation.
The SDS is a short-range self-assessment scale that is easy to administer and easy to master, and can effectively reflect the symptoms related to depressive states and their severity and changes. The SDS scores are not affected by age, gender, economic status, and other factors.
1.3 Research method
A questionnaire survey was used to apply the Patient General Condition Questionnaire, Simple Coping Style Scale, Self-Rated Depression Scale and Self-Rated Anxiety Scale to investigate the general condition, coping style, depression and anxiety characteristics of the study participants; a purposive sampling method was used to distribute questionnaires face-to-face to adult orthodontic patients who met the inclusion criteria, and the questionnaires were completed by the patients on the spot.
The questionnaire included four components: general condition questionnaire, simple coping style questionnaire, self-rated depression scale, and self-rated anxiety scale. For respondents who have difficulty reading and writing, the investigator will read out the contents of the questionnaire or help to fill it out. After the questionnaires were filled out and collected in person, the data were processed using SPSS 13.0 (statistical software), and the patients’ general condition, the distribution of depressive symptoms’ performance, and the distribution of anxiety symptoms’ performance were tabulated as Table 5-7, respectively, and all independent variables were used to force the independent variables into the regression model, and the important independent variables were screened for statistics to establish the regression equation.