Attempt of Psychological Analysis of Perioperative Patient with Skeletal Mandibular Prognathism Using Text Mining Approach

Abstract

Anxiety about complications after surgery is a critical factor that heavily influences the patientʼs decision on whether to have orthognathic surgery. Also, we need to grasp the patientʼs pain and anxiety in postoperative management. In nursing research, abstract anxiety is embodied in various ways to help postoperative management. The purpose of this study was to analyze the psychological state using text mining based on a diary written by a patient who had undergone orthognathic surgery. A 24-year-old man was referred to our hospital for orthodontic surgery from a local orthodontic office. We performed sagittal splitting ramus osteotomy followed by nine days of hospitalization including postoperative management. The patient was asked to keep a diary and freely describe changes in mental state and life from the time of entering the operating room to 17 days after the operation. In order to perform qualitative data analysis of the descriptive contents, the text mining software KH-Coder was used to perform morphological analysis, and then the extracted words were classified by cluster analysis and co-occurrence network, respectively. In addition, correspondence analysis was conducted during hospitalization and after discharge, and each characteristic word was read. In the language extracted by morphological analysis, the characteristic words of the diary were “swelling”, “mouth”, “opening”, “big”, and “cheek”. In the cluster analysis, the extracted language was classified into 10 clusters, and in the co-occurrence network, the extracted language was classified into 12 groups. When the classified clusters and groups were interpreted, “opening”, “swelling”, “sleep”, “nasogastric tube”, “pain”, and “surgery” were common. The characteristic words of correspondence analysis were “turning over” and “dinner” in hospitalization and “correcting physician”, “posture”, etc. after discharge from the hospital. Immediately after surgery, consciousness about “nasogastric tube”, “cheek swelling”, “diet”, “pain”, “sleep”, and “opening/closing of mouth” was strong; after discharge, consciousness about “cheek swelling”, “pain” and “opening/closing of mouth” was strong. We found that consciousness of “opening”, “swelling”, “sleep”, “nasogastric tube”, “pain” and “surgery” is strong in the analysis of text mining after orthognathic surgery. Both during hospitalization and after discharge, the patient continued to be conscious of “opening”, “swelling” and “pain”.