Patient-centered evaluation of orthodontic care: A longitudinal cohort study of children's and parents' attitudes

As health services are adapted to meet consumers' needs, patient-centered e valuation of quality of care as well as informed consent to treatment decis ions become increasingly important concepts in orthodontics. In an attempt to assess the orthodontic service in a region, this study focused on attitu des among children and their parents. The attitudes were recorded both befo re and after the period in which orthodontic treatment is usually carried o ut. Changes in children's and parents' attitudes were applied to measure ou tcome of care, and to evaluate the relevance of informed consent in decisio ns about treatment. Seventy-nine family units were interviewed with the use of questionnaires when the child was 11 years of age and again at 16 years . Both orthodontically treated and untreated subjects were included. Respon ses to questions about satisfaction with dental appearance and desire for t reatment were transformed to a score for orthodontic concern. A significant decrease in the concern score was observed over the 5-year period among th e treated subjects, and the care system apparently identified and provided treatment to the majority of those children concerned at 11 years. Intra-un it disagreement in concern was observed among 25% of the child/parent units at the 11-year stage, whereas at 16 years nearly all units agreed. Informe d consent as a tool to ensure patients' autonomy when decisions about treat ment are made did not appear to be negatively affected by conflicting attit udes between children and their parents.