Is A Surgeon's Self-Perceived Level of Anxiety Associated With the Type of Surgical Procedure Being Performed?

Abstract

Background: Surgical procedures result in some level of anxiety for the surgeon. It is unclear if the type of surgical procedure being performed by oral and maxillofacial surgeons influences the self-perceive level of anxiety.

Purpose: The purpose of this study was to measure the association between different oral and maxillofacial surgical procedures and anxiety levels, and to identify procedures associated with the highest level of performance anxiety.

Study design, setting, sample: A retrospective cross-sectional survey was conducted among oral and maxillofacial surgeons in Turkey, distributing surveys electronically via social media platforms, including Instagram and WhatsApp.

Predictor variable: The primary predictor variable was surgical procedure. The procedures were 15 different operations, including simple and complex tooth extraction, impacted mandibular and maxillary canine-premolar extraction, impacted mandibular and maxillary third molar extraction, dental implant surgery, sinus lifting, grafting (simple and complex), cyst operations, Le Fort I surgery, sagittal split ramus osteotomy, genioplasty, and temporomandibular joint (TMJ) surgery.

Main outcome variable: The main outcome variable was self-reported anxiety level during various surgical procedures, assessed using an 11-point Likert scale ranging from 0 (no anxiety) to 10 (extreme anxiety).

Covariates: Covariates included demographics (age and sex), experience (years) and institution type (public universities, private universities, private clinics, private health institutions, and Ministry of Health-affiliated hospitals.) ANALYSES: Normality was tested with the Shapiro-Wilks test. Anxiety scores were compared among categorical variables with more than 2 categories using the Kruskal-Wallis test, and by sex using the Mann-Whitney U test. Statistical significance was indicated by P value < .05.

Results: A total of 154 surveys were distributed, and 96 responses (62.3%) were received and analyzed. Among the respondents, 34 (35.4%) were female and 62 (64.6%) were male. Anxiety levels differed significantly by surgical procedure (P < .001), with the highest mean in TMJ surgery (8.10 ± 2.23) and the lowest mean in simple tooth extraction (1.44 ± 1.86).

Conclusions and relevance: The anxiety levels associated with different oral and maxillofacial surgical procedures vary for surgeons. Developing targeted anxiety management strategies is important, especially for procedures with high anxiety levels, such as TMJ surgery and bilateral sagittal split ramus osteotomy.