No description available.

published_or_final_version / abstract / toc / Clinical Psychology / Master / Master of Social Sciences

No description available.

No description available.

There is no abstract available for this dissertation.

published_or_final_version / Nursing Studies / Master / Master of Nursing

published_or_final_version / Nursing Studies / Master / Master of Nursing

Background: Jaw corrective surgery can cause significant psychosocial impacts on patients. This prospective study aimed to investigate the longitudinal changes of psychosocial characteristics of patients with dentofacial deformities after corrective surgery and the factors that predict the psychological resilience of Hong Kong Chinese undergoing this type of surgery. Materials and Methods: A prospective cohort study was carried out from 1st June 2011 to 31st December 2012 on Hong Kong Chinese patients, who had corrective surgery as treatment for their dentofacial deformities. Self-completed questionnaires, including Brief Symptom Inventory (BSI), Adult Trait Hope Scale (AHS), Hospital Anxiety and Depression Scale (HADS), Life Orientation Test (LOT), Social Avoidance and Distress Scale (SADS) and Satisfaction with Life Scale (SWLS), were administered to each patient at the surgical consent signing date (T1), one pre-operative day (T2), 1-2 post-operative week (T3) and 3rd post-operative month (T4). Psychological outcome trajectories were established using the BSI General Severity index (GSI) at T1, T3 and T4. Five patterns of outcome trajectories were created using specified outcome measures of psychological distress level, including chronic dysfunction, recovery, delayed dysfunction, resilience and others. They were then categorized into two patterns of outcome trajectories (resilience and non-resilience groups) for analysis. Independence sample t-test and logistic regression analyses were conducted to investigate the significance of life orientation level at baseline to predict resilience. Results: 67 participants (23 males, 44 females; mean age 25.6) were recruited in the study. Highest hope level and psychological distress level was noted pre-operatively at the surgical consent signing date. The levels then dropped post-operatively in the first 3 months. No statistically significant difference was noted on the depression and anxiety level, social avoidance and distress level, optimism level and life satisfaction level from pre-operative to post-operative stages. The proportion of the five patterns of outcome trajectories was chronic dysfunction (22.4%), recovery (7.5%), delayed dysfunction (3%), resilience (43.3%) and others (23.8%). The logistic regression analyses showed that the pre-operative baseline optimism level of LOT was a significant predictor on the resilience characteristic of a patient after orthognathic corrective surgery. Conclusion: Patients with dentofacial deformities have high level of hope and equally high level of psychological distress at the surgical consent stage of orthognathic surgery. Their psychological distress and hope levels tend to drop during the first three post-operative months. There is no expected peri-operative change on the depression and anxiety symptoms, social avoidance and distress, optimism level as well as life satisfaction level in these patients. Optimism level can predict the psychological resilience of a Hong Kong Chinese in going through orthognathic surgery. Brief Symptom Inventory (BSI) and Life Orientation Test (LOT) are recommended as preoperative psychological screening tools. / published_or_final_version / Dental Surgery / Master / Master of Dental Surgery

No description available.

Dentofacial deformities have an adverse impact on functional as well as psychological wellbeing. Being highly visible, they may lead to a host of psychological problems particularly in youths and young adults as concerns about bodily identity and integrity are likely to be most prominent. Body image and self-esteem have been noted to play an important role in adjusting to disfigurement. Those who opted for corrective orthognatic surgery with realistic expectations were found to have a higher level of satisfaction with the outcome of the surgery. In contrast, undue and unrealistically positive aspirations towards the surgery are implicated in increased post-operative psychological difficulties. This study aimed to systematically document the variability of psychological adjustment and study the predictors of well-being in individuals with dentofacial deformity after orthognathic surgery. Seventy patients pending to go through orthognathic surgery were recruited from a university based dental hospital. Assessments of the patients’ overall psychological condition and adjustment towards their dentofacial deformity were conducted with standardized questionnaires and compared with similar assessment conducted with control subjects. The patients’ motivations for orthognathic surgery, psychological well-being, as well as expectations on the outcomes of surgery were studied through individually conducted psychological assessment interviews. Patients were re-assessed at 6 and 12 months after surgery on their level of satisfaction toward the outcome of surgery as well as to gauge possible changes in their psychological condition. There was no excess of significant psychopathology in patients with dentofacial deformity compared to the normal control group. However, as predicted, people with dentofacial deformity were more dissatisfied with their facial attractiveness. They also have more problems in interpersonal sensitivity. In the patient group, functional impairment or disability was a lesser concern compared to body image and presentation. Improvement of physical attractiveness was a strong underlying motivation for treatment. Longitudinal data on patients’ level of satisfaction with the treatment outcomes and perceived benefits associated with the improved facial esthetics will be further analyzed in the light of their underlying psychological vulnerabilities or resilience. The results are expected to cast light on factors that may affect patients’ satisfaction with the treatment. The results of the study confirmed that dissatisfaction with facial appearance prompted acceptance of surgery despite its associated discomfort and hazards. The findings of the study are expected to be useful in better informing clinical psychological interventions with aims of enhancing adjustment and forestalling psychological morbidity through early intervention with individuals coping with facial disfigurement. / published_or_final_version / Psychiatry / Doctoral / Doctor of Philosophy