エピテーゼによる顔面一部欠損患者の補綴的治療における心理的側面について

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Successful treatmerlt of facial defect patients using an epithetic appliance requires the dentist to pay attention to their physical, biological, and psychological problems. The psychological factors are especially important in Japan. Embarassment is pointed out by many patients as a large factor in rejecting use of an epithesis. These psychological factors are not found in the reports from American and European colleagues. In this study, we compaired some psychological factors in two cases of facial defect patients (Fig. 1 and Tab. 1). Case 1 has been wearing an epithetic appliance for 15 years, while Case 2 rejected use of it. Through evaluating these patients. it became clear that whether or not the patient was self-independent was a very important factor affecting his attitude towards epithesis acceptance. This study was initiated to detemine prospectively whether there was a relationship in facial defect patients between psychological elements and epithesis acceptance. Three assessing methods were employed prior to the treatment, namely YG personality test, MMPI and an interview based on our original protocol. The result of the YG tesd dshowed that the D type patient had a high probability wearing an epithesis (Tab. 2), It was also suggeded that the personality of an epithesis wearer was inclined to be aggressive, dominant, non-nervous and/or they had an inferiority complex (Tab. 3). This personality does not agree with the sensitive and dependent character commonly found among the Japanese. A comparison of usefulness of YG and MMPI for the purpose of predicting the possibility of wearing an epithesis through multiple regression analysis showed that YG was highly dominant (Tab. 3 and 5). We also citrried out an interview based upon our protocol including 32 items to evaluate the pattern of behaviours of facial defect patients in some occasions. Multiple regression anaaysis made it clear that eight items were very useful to foresee the possibility of wearing an epithesis (Tab. 6). The item asking a patient whether he expected a change himself after prostetic rehabilitation had especially significant weight in the prediction. The contrast noted in the arswers to the item between the epithesis wearing group and the non-wearing group 8uggested that the attitude towards the epithetic appliance had already been decided before the treatment started and that a patient who had a negative prediction in his self-image after prosthetic rehabilitation never wore an epithetic appliuce h the end. It was also down that high probability of wearing epithesis was expected in the male and/ or in the patient with no occupation.
日本心身医学会の論文
1985-10-01

エピテーゼによる顔面一部欠損患者の補綴的治療における心理的側面について

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