Date of Award

11-4-2022

Degree Type

Thesis

Degree Name

Master of Health Policy and Management

First Advisor

Dr. Farhan Raza Khan

Second Advisor

Dr. Ashar Malik

Third Advisor

Dr. Bilal Usmani

Department

Community Health Sciences

Abstract

Background: Road traffic accidents (RTAs) are a major cause of maxillofacial injuries. Clinical-stigma inherent to Post-Trauma Stress Disorders (PTSD) in oral maxillofacial (OMF) trauma, can impair the individuals, predominantly aged between 18-45 years. Studies conducted in the USA have revealed significant rate of psychological suffering worldwide, including depression and post-traumatic stress disorder (PTSD). Oral maxillofacial trauma patients are a specific group who could be differentially more affected with PTSD, owing to the trauma affecting their face and jaws. The despair and anxiety could change the way they view their therapy and care. In order to identify the care and treatments needed to assure the overall psychological, bodily, and social well-being of PTSD patients with OMF trauma, it’s imperative to determine their perception of required care.
Objectives: To explore the perceptions/experience of PTSD among patients sustaining OMF injuries. We also assessed the provision of post trauma therapy, counseling or services delivered by the clinicians at the private health care facilities in Karachi, Pakistan Methods: It was a mixed-method study, qualitative exploratory design done amongst patients with oral maxillofacial injuries and cross-sectional descriptive study design amongst the OMF surgeons. For the qualitative part, we conducted 20 interviews from the patients who were treated for oral maxillofacial trauma in the private hospitals of Karachi. Interviews were done face to face within 15-30 days of the surgery. After the interpretation of results, if the patients were diagnosed with PTSD, they were referred to the psychiatric consultation. For the quantitative part, we included 20 doctors who are involved in the treatment and management of PTSD patients after oral and maxillofacial trauma. Normality of the data was assessed using Shapiro-Wilk test. Means and SD of quantitative and frequency distribution of categorical variables were computed. Data was analyzed using Chi-square/ Fisher Exact test. The level of significance was set at 0.05.
Results: Maxillofacial injuries were two to three times higher among males compared to females. Only 45% of PTSD patients are diagnosed by the doctors. And only 20% of the doctors referred PTSD patients to the psychology department for their treatment.
Conclusions: There is a gap between doctor-patient counselling/therapy in the patients with OMF trauma. PTSD should be explored, and appropriate measures taken for the referral and management of such patients.

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1

Last Page

75

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