EVALUATING PATIENT-CLINICIAN COMMUNICATION INORAL SURGERY. A STUDY OF CALABAR, NIGERIA

Background: Effective communication is vital in oral surgery for patient satisfaction, understanding, and
treatment compliance. This study evaluated the impact of visual aids, digital consent forms, and motivational
interviewing on patient outcomes in Calabar, Nigeria.
Subjects and methods: A quasi-experimental study was conducted over six months at the University of Calabar
Teaching Hospital (UCTH) and General Hospital Calabar, involving 60 patients undergoing oral surgery.
Participants were divided into four groups: (1) control (standard consultation), (2) visual aids, (3) digital consent
form, and (4) motivational interviewing. Patient understanding was assessed using questionnaires before and after
intervention, satisfaction was measured post-consultation, and compliance was tracked for two weeks post-surgery.
Data were analyzed using ANOVA and t-tests.
Results: The visual aids group showed a significant improvement in patient understanding (p < 0.05) and
satisfaction (p < 0.05) compared to the control. The digital consent form group demonstrated higher recall of
surgical information (p < 0.05) and better treatment compliance. Motivational interviewing significantly increased
postoperative adherence and perceived support (p < 0.05). The combination of all three strategies yielded the
highest levels of patient satisfaction and treatment compliance. After 6 months, no significant differences were
found between the two groups in sinus membrane elevation (P = 0.5267) or implant stability (P = 0.5573).
Although bone height increased in both groups, the difference between them was not statistically
significant (P = 0.1713). The Densah group showed a 50% lower risk of sinus membrane perforation
compared to the Osteotome group, but this was not statistically significant (P = 0.5483). Patient-reported
outcomes were similar between groups at both 1 and 2 weeks (P > 0.05), while intragroup analysis showed
a significant improvement in oral health impact profile in both groups (P < 0.0001).
Conclusion: Implementing visual aids, digital consent forms, and motivational interviewing techniques significantly
enhances patient understanding, satisfaction, and compliance in oral surgery. These strategies should be integrated
into routine clinical practice to improve patient outcomes.

1.Barlow, S. W., Houlton, T. G., Mulhall, M. B., Gilligan, A. M., & Smith, A. F. (2018). Illustrated postoperative instructions improve patient compliance and satisfaction: A randomized controlled trial. Journal of Bone and Joint Surgery, 100(12), 1023-1028. https://doi.org/10.2106/JBJS.17.01067

2.Barry, M. J., & Edgman-Levitan, S. (2012). Shared decision making—the pinnacle of patient-centered care. New England Journal of Medicine, 366(9), 780– 781. https://doi.org/10.1056/NEJMp1109283

3.Boyle, P., Kitchener, H., & Sammons, H. (2015). The relationship between communication and patient satisfaction after oral surgery interventions. Journal of Oral and Maxillofacial Surgery, 73(3), 432-438. https://doi.org/10.1016/j.joms.2014.09.029

4.Brom, H., Kouwenhoven, S., & Boeije, H. (2017). Communication strategies in postoperative care: Effects on recovery. Patient Education and Counseling, 100(12), 2279-2285. https://doi.org/10.1016/j.pec.2017.07.002

5.Cascaes, F. F., Auad, S. M., Gouvêa, L. S., Garbin, C. A., & Garbin, A. J. (2014). Effectiveness of motivational
interviewing in improving oral health: a systematic review. Journal of Clinical Periodontology, 41(11), 1046-1056. https://doi.org/10.1111/jcpe.12229

6.Doyle, C., Lennox, L., & Bell, D. (2013). A systematic review of evidence on the links between patient effectiveness. BMJ Open, 3(1), e001570. https://doi.org/10.1136/bmjopen- 2012-001570

7.Epstein, R. M., & Street, R. L. (2011). The values and value of patient-centered care. Annals of Family Medicine,9(2),100-103.https://doi.org/10.1370/afm.1239

8.Glanz, K., Rimer, B. K., & Viswanath, K. (2015). Health behavior: Theory, research, and practice (5th ed.).
Jossey- Bass.

9.Gordon, C. S., Heim, D., & Akers, J. (2016). Motivational interviewing to improve oral hygiene: A systematic review. Community Dentistry and Oral Epidemiology, 44(3), 193-200. https://doi.org/10.1111/cdoe.12201

10. Ha, J. F., & Longnecker, N. (2010). Doctor-patient communication: A review. Ochsner Journal, 10(1), 38-43. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3096184/

11. Heckman-Stoddard, B. M., Donovan, D. M., & DiClemente, C. C. (2014). Motivational interviewing: what it is, how it works, and why it is effective. Comprehensive handbook of psychotherapy, 4(1), 109-126. https://doi.org/10.1037/a0036092

12. Houts, P. S., Doak, C. C., Doak, L. G., & Loscalzo, M. J. (2006). The role of pictures in improving health communication: A review of research on attention, comprehension, recall, and adherence. Patient Education and Counseling,61(2),173-190. https://doi.org/10.1016/j.pec.2005.05.004

13. Kassam-Adams, N., Castillo, L., Garcia-Espana, J. F., & Deatrick, J. A. (2015). Research on the pediatric assent process from 1995 to 2013: a systematic review and qualitative synthesis. Journal of Empirical Research on Human Research Ethics, 10(2), 140- 152. https://doi.org/10.1177/1556264615573267

14. Kassam-Adams, N., Fleisher, C. M., & Kilaru, A. S. (2015). Digital consent: Enhancing informed decision making. American Journal of Bioethics, 15(12),43-45. https://doi.org/10.1080/15265161.2015.1082444

15. Kelly, B., Duff, A., & Kelly, F. (2017). Effective communication in healthcare. Journal of Health Management, 19(3), 285-294.

16. Khadka, R., Pant, S., & Shrestha, A. (2021). Impact of communication on patient satisfaction in oral surgery.
International Journal of Oral Health Sciences, 11(2), 113-118. https://doi.org/10.3126/ijohs.v11i2.37424

17. Kiecolt-Glaser, J. K., McGuire, L., Robles, T. F., & Glaser, R. (2002). Emotions, morbidity, and mortality: New perspectives from psychoneuroimmunology. Annual Review of Psychology, 53(1), 83-107. https://doi.org/10.1146/annurev.psych.53.100901.13521

18. Kobayashi, L. C., Wardle, J., Wolf, M. S., Von Wagner, C., & Ferrer, A. J. (2011). Health literacy mediates the relationship between age and self- efficacy for managing medications. Journal of General Internal Medicine, 26(2), 149–155.

19. Kobayashi, M., Williams, R. A., & Munoz, M. (2011). Visual aids and patient comprehension in oral surgery.
Journal of Dental Education, 75(12), 1535- 1542. https://doi.org/10.1002/j.0022- 0337.2011.75.12.tb05623.x

20. Kruse, C. S., Betancourt,J. R., Ortiz, S. M., Flournoy, R., Schuster, A. L., & (2017). Barriers to the use of mobile health in improving health outcomes for patients with chronic diseases: A systematic review. JMIR mHealth and uHealth, 5(6), e8468. https://doi.org/10.2196/mhealth.7982

21. Kruse, C. S., Bolton, K., & Freriks, G. (2017). The effect of patient portals on quality outcomes and its implications
to meaningful use: A systematic review. Journal of Medical Internet Research, 19(2), e44. https://doi.org/10.2196/jmir.6682

22,Levinson, W., Roter, D. L., Mullooly, J. P., Dull, V. T., & Frankel, R. M. (1997). Physician-patient communication. The relationship with malpractice claims among primary care physicians and surgeons. JAMA, 277(7), 553-559.

23. Miller, W. R., & Rollnick, S. (2013). Motivational interviewing: Helping people change (3rd ed.). Guilford Press.

24. Montazeri, A., Tavousi, M., Rakhshani, F., Azin, S. A., Jahangiri, K., Ebadi, M., & Harirchi, I. (2014). The effect of educational intervention on the attitude of breast cancer patients towards participation in decision making. Patient preference and adherence, 1655. https://doi.org/10.2147/PPA.S73836

25. Montri, A. F., Roman, A., D’Amico, M., & Walsh, T. (2020). Evaluation of electronic informed consent usage
in gynecology. American Journal of Obstetrics and Gynecology,223(6),895-896. https://doi.org/10.1016/j.ajog.2020.05.012

26. Moore, P. M., Rivera Mercado, S., Grez Artigues, M., & Lawrie, T. A. (2018). Communication skills training for healthcare professionals working with people who have cancer. Cochrane Database of Systematic Reviews,(6), CD009431. https://doi.org/10.1002/14651858.CD009431.pub3

27. Neville, A., Forde, K., Streff, M., McAndrew, R., Catic,A. G., Patel, M., & Baker, J. (2020). Using video in oral surgery patient education: Improving preparedness and reducing complexity. Journal of Oral and Maxillofacial Surgery, 78(2), 193–199. https://doi.org/10.1016/j.joms.2019.08.017

28. Neville, S., Lee, A., & Kelly, P. (2020). Enhancing oral surgery patient education with visual aids: A randomized controlled trial. International Journal of Oral and Maxillofacial Surgery, 49(1),88-95. https://doi.org/10.1016/j.ijom.2019.08.011

29.Rollnick, S., Miller, W. R., & Butler, C. (2008). Motivational interviewing in health care: Helping patients change behavior. Guilford Press.

30.Rosenstock, I. M. (1974). Historical origins of the Health Belief Model. Health Education Monographs,
2(4),328-335. https://doi.org/10.1177/109019817400200403

31.Rowbotham, S., Allen, D., & Wood, M. (2013). Improving patient information: a systematic review of the readability of patient information materials International Journal of Pharmacy Practice, 21(4), 219-229. https://doi.org/10.1111/ijpp.12026

32. Street, R. L., Jr, Makoul, G., Arora, N. K., & Epstein, R.M. (2009). How does communication heal? Pathways
linking clinician-patient interaction to health outcomes. Patient Education and Counseling, 74(3),295-301. https://doi.org/10.1016/j.pec.2008.11.015

33. Weinstein, P., Harrison, R., & Benton, T. (2013) Motivating parents to prevent caries in their young children: Results of a randomized trial. Journal of the American Dental Association, 144(3), 279-287. https://doi.org/10.1016/j.adaj.2012.09.017