Kettle, J.E. orcid.org/0000-0002-2776-1243, Marshman, Z. orcid.org/0000-0003-0943-9637, Winchester, L. et al. (3 more authors) (2021) Patient narratives of orthognathic treatment for facial asymmetry: a qualitative study. British Journal of Oral and Maxillofacial Surgery, 59 (4). pp. 445-453. ISSN 0266-4356
Abstract
To explore patient experiences of orthognathic treatment for facial asymmetry and adaptation to facial changes post-surgery. Design: Qualitative, cross-sectional. Setting: Two UK sites. Participants: Patients after treatment for non-cleft asymmetry. Methods: Patients were identified using patient databases and clinical notes and approached. Individual interviews and photo elicitation were conducted with fifteen patients (aged 19-40 years). These covered experiences prior to treatment, during treatment and post-surgery. Interviews were transcribed and thematic narrative analysis was undertaken. Results: Participants were largely positive about their orthognathic treatment. The following themes were identified: preoperative (becoming aware, negative impacts of asymmetry, committing to treatment, establishing expectations); pre-surgery orthodontics and inpatient experiences (challenges and coping strategies, preparedness, support and shared experiences); postoperative (surgery as ‘worth it’, positive impacts of treatment, adapting to facial change). Undergoing orthognathic surgery was portrayed as a journey, involving recognisable narratives (treatment unfinished, threat of liminality, treatment as resolution, treatment as transformation). Conclusions: Patient experience of facial asymmetry is associated with feeling ‘abnormal’ and has negative impacts. Undergoing orthognathic treatment for facial asymmetry was worthwhile. Having the feeling that something is ‘wrong’ legitimised by clinicians allows patients access to a recognisable treatment narrative (resolution). Orthognathic treatment is also narrated as transformation from ‘normal abnormality’ to being ‘normal’. Nevertheless, challenges associated with treatment can be frustrating, particularly if resolution is hard to envisage. Further psychological input could help to support patients cope with these challenges and the complex process of adapting to facial change.
Metadata
Item Type: | Article |
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Authors/Creators: |
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Copyright, Publisher and Additional Information: | © 2020 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. This is an author produced version of a paper subsequently published in British Journal of Oral and Maxillofacial Surgery. Uploaded in accordance with the publisher's self-archiving policy. Article available under the terms of the CC-BY-NC-ND licence (https://creativecommons.org/licenses/by-nc-nd/4.0/). |
Keywords: | Facial Asymmetry; Narrative; Orthognathic Surgery; Patient Perceptions; Psychosocial |
Dates: |
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Institution: | The University of Sheffield |
Academic Units: | The University of Sheffield > Faculty of Medicine, Dentistry and Health (Sheffield) > School of Clinical Dentistry (Sheffield) |
Funding Information: | Funder Grant number BRITISH ASSOCIATION OF ORAL AND MAXILLOFACIAL SURGEONS nan |
Depositing User: | Symplectic Sheffield |
Date Deposited: | 02 Oct 2020 12:17 |
Last Modified: | 27 Jan 2022 12:49 |
Published Version: | https://www.sciencedirect.com/science/article/pii/... |
Status: | Published |
Publisher: | Elsevier BV |
Refereed: | Yes |
Identification Number: | 10.1016/j.bjoms.2020.09.003 |
Open Archives Initiative ID (OAI ID): | oai:eprints.whiterose.ac.uk:166286 |
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