Influence of socioeconomic status on psychological distress and treatment satisfaction levels among patients undergoing prosthetic rehabilitation following maxillectomy: An observational study.

Abstract

Aim:The aim of this study was conducted to evaluate the effect of socioeconomic status (SES) on psychological distress and treatment satisfaction levels of patients who underwent maxillectomy and rehabilitation with obturator prosthesis.Settings and Design:Prospective, observational, analytic study.Materials and Methods:Forty-three patients undergoing maxillectomy were enrolled and divided into upper, middle, and lower SES groups, according to the updated Kuppuswamy SES scale. Psychological distress levels were assessed using Hospital Anxiety and Depression Scale (HADS) before maxillectomy (T0) and at 3 weeks after delivery of definitive obturator (T1). Treatment satisfaction levels with obturator prosthesis were assessed using Obturator Functioning Scale (OFS) at T1. HADS and OFS scores were then correlated with the SES of the participants.Results:Out of 43 participants, 7 were lost to follow up. The total number of participants in upper, middle, and lower SES groups was 14, 11, and 11, respectively. Before surgery, there was no significant difference in anxiety levels (P > 0.05) among different SES groups. However, the depression levels were the highest in the lower SES and decreased significantly with increasing SES. Prosthetic rehabilitation led to statistically significant (P < 0.05) fall in the levels of both anxiety and depression assessed at 3 weeks after delivery of prosthesis. The upper SES group was found to be less anxious and depressed compared to middle and lower SES groups after prosthodontic rehabilitation. Treatment satisfaction level was found to be significantly low (P = 0.005) in lower SES group as compared to upper SES group while no difference was found in between the middle SES when compared to higher or lower SES groups.Conclusions:SES has a profound impact on the patient's psychosocial well-being and treatment satisfaction. Patients of lower SES reported with higher psychological distress and lesser treatment satisfaction compared to those belonging to upper SES.