Associations among state-trait anxiety, resilience, and health-related quality of life in patients with dentofacial deformities: a prospective study

BACKGROUND: This study evaluates resilience changes in dentofacial deformities patients pre- and post-orthognathic surgery, exploring correlations with anxiety and quality of life to identify high postoperative anxiety risk index. METHODS: Data were collected from 96 adults with dentofacial deformities who were undergoing orthognathic surgery at four time points: preoperatively (T1), and at two weeks(T2), three months(T3), and six months(T4) postoperatively, Psychological status and disease-specific quality of life were assessed using the State-Trait Anxiety Inventory (STAI), the Connor-Davidson Resilience Scale (CD-RISC), and the Orthognathic Quality of Life Questionnaire (OQLQ). Receiver operating characteristic (ROC) curve analysis combined with logistic regression was used to identify preoperative factors associated with elevated postoperative anxiety. RESULTS: Pearson correlation analysis indicated that resilience was negatively correlated with state and trait anxiety levels across all four stages (p < 0.01), as well as between preoperative resilience and state-trait anxiety across all postoperative stages (p < 0.01).Additionally, the multiplicative interaction between resilience and trait anxiety statistically significant impacted quality of life scores at T4 (B = 0.02, t = 2.28, p = 0.03).The Connor-Davidson Resilience Scale demonstrated effectiveness in screening patients with high anxiety level after surgery〔95% CI, two weeks 0.75(0.61,0.90), three months 0.71(0.57,0.86), and six months 0.74 (0.59,0.89), p < 0.01〕, with corresponding cut-off values of 24.5, 26.5, and 26.5, respectively. CONCLUSIONS: Resilience may help alleviate trait anxiety to enhance quality of life. Furthermore, the Connor-Davidson Resilience Scale shows potential as a preliminary preoperative screening aid for identifying patients at risk of high postoperative state-trait anxiety levels.