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Background <p>Dentofacial deformity is a common and significant oral health issue, which comprehensively affects patients’ quality of life. Orthognathic surgery is a well-established treatment for moderate to severe dentofacial deformities. However, surgical correction is not always elected by patients. Drawing on the Health Belief Model and Shared Decision‑Making as theoretical frameworks, this study systematically synthesized qualitative evidence on patients’ decision-making experiences regarding orthognathic surgery, with the aim of helping them achieve informed preferences.</p> Methods <p>A comprehensive search was conducted across PubMed MEDLINE, Ovid MEDLINE, Embase, CINAHL, Scopus, ProQuest, Web of Science, Cochrane Library, SinoMed, CNKI, Wanfang, and VIP, from inception to 2 August 2024. Study screening, quality appraisal, data extraction and synthesis were all conducted by two researchers under the guidance of the JBI manual for evidence synthesis. The GRADE-CERQual approach was used to assess the confidence in each synthesized finding.</p> Results <p>A total of 14 studies met the inclusion criteria, including 332 participants alongside 2601 online posts and tweets. All 80 extracted findings were classified into 14 categories and subsequently integrated into 4 synthesized findings: initial intention: inner drivers and self-reconstruction; evaluating pathways: ideal visions versus practical constraints; confirming pathways: role of social networks; decision timing: why now? The confidence in the synthesized findings was moderate, moderate, moderate, and low, respectively.</p> Conclusions <p>Patients with dentofacial deformities experience a complex decision-making process that extends beyond clinical factors. This study proposes the Double-Helix Interactive Decision-Making Model, in which patients’ individual beliefs and social contexts interact continuously throughout this process. It also provides a preliminary conceptual framework for patient decision aids. We advocate a shift in clinical practice from technical execution to decision-making empowerment.</p> Trial registration <p>PROSPERO CRD42022372729.</p>

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Elective orthognathic surgery: a meta-synthesis of patients’ decision-making experiences

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年7月29日

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  • Qing He,
  • Jing Wang,
  • Teng Li,
  • Yayun Wang,
  • Min Liu,
  • Min Zhang,
  • Yongai Zhang

摘要

Background

Dentofacial deformity is a common and significant oral health issue, which comprehensively affects patients’ quality of life. Orthognathic surgery is a well-established treatment for moderate to severe dentofacial deformities. However, surgical correction is not always elected by patients. Drawing on the Health Belief Model and Shared Decision‑Making as theoretical frameworks, this study systematically synthesized qualitative evidence on patients’ decision-making experiences regarding orthognathic surgery, with the aim of helping them achieve informed preferences.

Methods

A comprehensive search was conducted across PubMed MEDLINE, Ovid MEDLINE, Embase, CINAHL, Scopus, ProQuest, Web of Science, Cochrane Library, SinoMed, CNKI, Wanfang, and VIP, from inception to 2 August 2024. Study screening, quality appraisal, data extraction and synthesis were all conducted by two researchers under the guidance of the JBI manual for evidence synthesis. The GRADE-CERQual approach was used to assess the confidence in each synthesized finding.

Results

A total of 14 studies met the inclusion criteria, including 332 participants alongside 2601 online posts and tweets. All 80 extracted findings were classified into 14 categories and subsequently integrated into 4 synthesized findings: initial intention: inner drivers and self-reconstruction; evaluating pathways: ideal visions versus practical constraints; confirming pathways: role of social networks; decision timing: why now? The confidence in the synthesized findings was moderate, moderate, moderate, and low, respectively.

Conclusions

Patients with dentofacial deformities experience a complex decision-making process that extends beyond clinical factors. This study proposes the Double-Helix Interactive Decision-Making Model, in which patients’ individual beliefs and social contexts interact continuously throughout this process. It also provides a preliminary conceptual framework for patient decision aids. We advocate a shift in clinical practice from technical execution to decision-making empowerment.

Trial registration

PROSPERO CRD42022372729.