Title : Anxiety, depression, and health-related quality of life in patients with congenital microtia after ear reconstruction surgery A cross-sectional study
Abstract:
This study aimed to evaluate the levels of anxiety, depression, and health-related quality of life (HRQoL) in patients with congenital microtia after ear reconstruction surgery and identify influencing factors of HRQoL. A cross-sectional study was conducted in 152 patients with congenital microtia (aged 8–18 years) who underwent ear reconstruction at a tertiary hospital in Shanghai from April 2023 to September 2024. The assessment tools, including the Numeric Rating Scale, the Hospital Anxiety and Depression Scale, and the Pediatric Quality of Life Inventory Version 4.0 Generic Core Scales, were used to assess postoperative pain intensity, anxiety symptoms, depression symptoms and HRQoL. Multiple linear regression analysis was performed to explore the factors affecting HRQoL. Post-operatively, 21.7% (33/152) of patients with congenital microtia reported anxiety symptoms, and 17.8% (27/152) reported depressive symptoms. The mean total HRQoL score was 67.40 ± 11.00, significantly lower than healthy controls (86.52±9.80, p < 0.001). Anxiety and depression showed moderate negative correlations with total HRQoL score (r = -0.433 and -0.486, respectively, p < 0.001). Univariate analysis showed that residence, hearing status of the deformed ear, surgery type, pain score, anxiety and depression symptom were associated with HRQoL in patients with congenital microtia after ear reconstruction surgery (p < 0.05). Multivariate analysis identified rural residence, stage ? surgery, higher pain scores, and depressive symptoms were significantly associated with low HRQoL (p < 0.05). Patients with congenital microtia experienced significant psychological distress and a decline in quality of life after ear reconstruction surgery. Anxiety, depression, pain, and sociodemographic factors were associated with the patients' HRQoL. These findings emphasized the need for integrated care models to improve mental health and quality of life. Future precision intervention measures should prioritize psychological evaluation, pain management, and personalized support to optimize patient well-being.
