Development and Validation of a Brief Four-Component Questionnaire to Identify Patient's Motivation to Undergo Functional Rhinoplasty

Overview

Existing rhinoplasty questionnaires are long and cover overlapping ground, which limits their use during a consultation. This study administered three of them before and after surgery, used statistical analysis to identify the underlying domains, and selected the single strongest question for each.

Sections of note

• Patients completed the Rhinoplasty Outcome Evaluation, the Nasal Obstruction Symptom Evaluation scale, and the Utrecht Questionnaire for Outcome Assessment in Aesthetic Rhinoplasty.
• Assessment points were preoperative and 1, 3, and 12 months after surgery.
• Satisfaction was assessed at postoperative consultations using a five-point Likert scale.
• Principal component analysis identified the main domains covered by the questionnaires; a correlation matrix identified the items loading most strongly on each.
• Four domains emerged: influence of nasal appearance on quality of life, trouble with nasal breathing, subjective perception of nasal appearance, and the wish for modification or alteration.
• The strongest-loading question for each domain was compiled into the four-component questionnaire.
• The authors state the preoperative assessment allows an estimation of the expected outcome. The abstract gives no patient numbers or validation statistics.

What it means for a patient

• Four questions can capture most of what three longer questionnaires measure about why someone wants surgery.
• Motivation splits into breathing, appearance, how appearance affects daily life, and the desire to change it.
• The authors claim the preoperative answers help predict the outcome, though no supporting figures appear in the abstract.
• Limits: no patient count, no reliability or validity statistics, and single-center development.

Why this paper matters

Understanding why a patient wants surgery is the recognized predictor of whether they will be satisfied, but long instruments are impractical in clinic. A four-question version could be used routinely. Whether it predicts outcome as claimed is not demonstrated in this abstract.

Terms

• Principal component analysis: A statistical method that finds the underlying dimensions in a set of questions.
• Domain: A distinct area a questionnaire measures, such as breathing or appearance.
• Factor loading: How strongly a question relates to the domain it belongs to.
• Likert scale: A response scale with ordered options, here five points.
• Functional rhinoplasty: Nasal surgery aimed at breathing as well as appearance.