Measuring patient satisfaction with education using extended reality in orthognathic surgery: Development, validation, and reliability of the 3D orthognathic surgery questionnaire (3DOS-Q)

Abstract

Objectives: The effectiveness of extended reality technologies in improving patient understanding and satisfaction, particularly in orthognathic surgery, remains underexplored. No existing questionnaire specifically assesses patient satisfaction with different 3D model display techniques in this context. Therefore, this research aimed at developing and validating a questionnaire to assess patient satisfaction with preoperative education using 3D models for orthognathic surgery. Methods: Building on a previous questionnaire for trauma patients, an initial questionnaire was developed and adapted for orthognathic surgery patients based on literature and pretesting with patients and specialists (Phase I). The preliminary questionnaire underwent a field psychometric performance test in a randomized controlled trial at three centers specialized in orthognathic surgery (Phase II). Results: Nine patients and six specialists were included (Phase I), which resulted to a preliminary questionnaire consisting of twelve items. A total of 65 patients completed the preliminary questionnaire (Phase II). The final eleven items demonstrated strong psychometric properties, measuring a single distinct factor 4.99, Cronbach's alpha value of 0.87, for the German (α = 0.849) and Dutch (α = 0.836) versions. A Feldt test revealed no significant difference in internal consistency between the two languages (p = 0.401). The items together statistically significantly predicted patient satisfaction (p < 0.001). Conclusion: The final questionnaire has a good validity, total explained variance at 45.5 %. Innovation: The 3DOS-Q demonstrates significant potential as a tool for evaluating patient satisfaction with 3D models, suitable for extended reality technologies, improving patient care, and exploring satisfaction differences across patient groups and display techniques.