2018 Orthodontic and Surgical Patient Experience Survey (York)

You have been invited to take part in this survey to improve the quality of care we provide to our patients. Your answers will remain completely anonymous and will not affect any future care or treatment. Thank you for taking the time to complete the survey.

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* 1. Are you?

Male

Female

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* 2. Which category below includes your age?

17 or younger

18-20

21-29

30-39

40-49

50-59

60 or older

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* 3. What were the reasons for having your orthodontic and surgical treatment?

	Strongly Agree	Agree	Undecided	Disagree	Strongly Disagree
To improve my self confidence	To improve my self confidence Strongly Agree	To improve my self confidence Agree	To improve my self confidence Undecided	To improve my self confidence Disagree	To improve my self confidence Strongly Disagree
To improve my looks	To improve my looks Strongly Agree	To improve my looks Agree	To improve my looks Undecided	To improve my looks Disagree	To improve my looks Strongly Disagree
To improve my smile	To improve my smile Strongly Agree	To improve my smile Agree	To improve my smile Undecided	To improve my smile Disagree	To improve my smile Strongly Disagree
To improve my social life	To improve my social life Strongly Agree	To improve my social life Agree	To improve my social life Undecided	To improve my social life Disagree	To improve my social life Strongly Disagree
To straighten my teeth	To straighten my teeth Strongly Agree	To straighten my teeth Agree	To straighten my teeth Undecided	To straighten my teeth Disagree	To straighten my teeth Strongly Disagree
To prevent future problems with my teeth	To prevent future problems with my teeth Strongly Agree	To prevent future problems with my teeth Agree	To prevent future problems with my teeth Undecided	To prevent future problems with my teeth Disagree	To prevent future problems with my teeth Strongly Disagree
To improve my ability to eat	To improve my ability to eat Strongly Agree	To improve my ability to eat Agree	To improve my ability to eat Undecided	To improve my ability to eat Disagree	To improve my ability to eat Strongly Disagree
To improve my speech	To improve my speech Strongly Agree	To improve my speech Agree	To improve my speech Undecided	To improve my speech Disagree	To improve my speech Strongly Disagree

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* 4. Were you ever teased about your appearance?

Yes

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* 5. Were you ever embarrassed about eating in public?

Yes

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* 6. Did you ever have difficulty eating?

Yes

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* 7. Did you ever avoid smiling in photographs?

Yes

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* 8. Were you ever self-conscious about the appearance of your teeth?

Yes

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* 9. Were you ever self-conscious about your facial appearance?

Yes

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* 10. Did you receive any information leaflets on braces?

Yes

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* 11. If yes, did you find these leaflets useful?

Yes, completely

Yes, to some extent

No. If not, why?

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* 12. Did you receive any information leaflets on jaw surgery?

Yes

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* 13. If yes, did you find these leaflets useful?

Yes, completely

Yes, to some extent

No. If not, why?

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* 14. Did you visit the BOS website (www.yoursurgery.com) about braces and jaw surgery?

Yes

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* 15. If yes, did you find the website useful?

Yes, completely

Yes, to some extent

No. If not, why?

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* 16. Do you feel you were given enough information to help you make a decision about having treatment with regard to:

	Strongly Agree	Agree	Undecided	Disagree	Strongly Disagree
Wearing braces	Wearing braces Strongly Agree	Wearing braces Agree	Wearing braces Undecided	Wearing braces Disagree	Wearing braces Strongly Disagree
Duration of treatment	Duration of treatment Strongly Agree	Duration of treatment Agree	Duration of treatment Undecided	Duration of treatment Disagree	Duration of treatment Strongly Disagree
Wearing retainers	Wearing retainers Strongly Agree	Wearing retainers Agree	Wearing retainers Undecided	Wearing retainers Disagree	Wearing retainers Strongly Disagree
Surgery	Surgery Strongly Agree	Surgery Agree	Surgery Undecided	Surgery Disagree	Surgery Strongly Disagree
Possible complications involved with treatment	Possible complications involved with treatment Strongly Agree	Possible complications involved with treatment Agree	Possible complications involved with treatment Undecided	Possible complications involved with treatment Disagree	Possible complications involved with treatment Strongly Disagree

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* 17. Which jaw did you have moved in surgery?

Top jaw

Bottom jaw

Both jaws

Don't know

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* 18. Was your operation cancelled and moved to another date?

Yes

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* 19. Did you have to have a second unplanned operation after your jaw surgery (Reoperation/Revision Surgery)?

Yes

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* 20. What do you feel were the benefits you received from the treatment?

	Strongly Agree	Agree	Undecided	Disagree	Strongly Disagree
Increased my self confidence	Increased my self confidence Strongly Agree	Increased my self confidence Agree	Increased my self confidence Undecided	Increased my self confidence Disagree	Increased my self confidence Strongly Disagree
Improved my facial appearance	Improved my facial appearance Strongly Agree	Improved my facial appearance Agree	Improved my facial appearance Undecided	Improved my facial appearance Disagree	Improved my facial appearance Strongly Disagree
Improved my smile	Improved my smile Strongly Agree	Improved my smile Agree	Improved my smile Undecided	Improved my smile Disagree	Improved my smile Strongly Disagree
Improved my social life	Improved my social life Strongly Agree	Improved my social life Agree	Improved my social life Undecided	Improved my social life Disagree	Improved my social life Strongly Disagree
Straight teeth	Straight teeth Strongly Agree	Straight teeth Agree	Straight teeth Undecided	Straight teeth Disagree	Straight teeth Strongly Disagree
Prevented future problems with my teeth	Prevented future problems with my teeth Strongly Agree	Prevented future problems with my teeth Agree	Prevented future problems with my teeth Undecided	Prevented future problems with my teeth Disagree	Prevented future problems with my teeth Strongly Disagree
Improved my ability to eat	Improved my ability to eat Strongly Agree	Improved my ability to eat Agree	Improved my ability to eat Undecided	Improved my ability to eat Disagree	Improved my ability to eat Strongly Disagree
Improved my speech	Improved my speech Strongly Agree	Improved my speech Agree	Improved my speech Undecided	Improved my speech Disagree	Improved my speech Strongly Disagree

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* 21. Do you still have any of the following problems from your treatment?

	Strongly Agree	Agree	Undecided	Disagree	Strongly Disagree
Difficulty eating	Difficulty eating Strongly Agree	Difficulty eating Agree	Difficulty eating Undecided	Difficulty eating Disagree	Difficulty eating Strongly Disagree
Numbness	Numbness Strongly Agree	Numbness Agree	Numbness Undecided	Numbness Disagree	Numbness Strongly Disagree
Dental problems	Dental problems Strongly Agree	Dental problems Agree	Dental problems Undecided	Dental problems Disagree	Dental problems Strongly Disagree

Other (please specify)

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* 22. Do the problems you have listed in Question 21 effect you on a daily basis?

Yes

Yes somewhat

No problems listed

Please state why

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* 23. Do you feel the Specialist Orthodontist:

	Strongly Agree	Agree	Undecided	Disagree	Strongly Disagree
Listened to what you had to say?	Listened to what you had to say? Strongly Agree	Listened to what you had to say? Agree	Listened to what you had to say? Undecided	Listened to what you had to say? Disagree	Listened to what you had to say? Strongly Disagree
Gave you enough time to fully discuss your treatment?	Gave you enough time to fully discuss your treatment? Strongly Agree	Gave you enough time to fully discuss your treatment? Agree	Gave you enough time to fully discuss your treatment? Undecided	Gave you enough time to fully discuss your treatment? Disagree	Gave you enough time to fully discuss your treatment? Strongly Disagree
Explained the reasons for your treatment in a way that you could understand?	Explained the reasons for your treatment in a way that you could understand? Strongly Agree	Explained the reasons for your treatment in a way that you could understand? Agree	Explained the reasons for your treatment in a way that you could understand? Undecided	Explained the reasons for your treatment in a way that you could understand? Disagree	Explained the reasons for your treatment in a way that you could understand? Strongly Disagree

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* 24. Do you feel the Specialist Surgeon:

	Strongly Agree	Agree	Undecided	Disagree	Strongly Disagree
Listened to what you had to say?	Listened to what you had to say? Strongly Agree	Listened to what you had to say? Agree	Listened to what you had to say? Undecided	Listened to what you had to say? Disagree	Listened to what you had to say? Strongly Disagree
Gave you enough time to fully discuss your treatment?	Gave you enough time to fully discuss your treatment? Strongly Agree	Gave you enough time to fully discuss your treatment? Agree	Gave you enough time to fully discuss your treatment? Undecided	Gave you enough time to fully discuss your treatment? Disagree	Gave you enough time to fully discuss your treatment? Strongly Disagree
Explained the reasons for your treatment in a way that you could understand?	Explained the reasons for your treatment in a way that you could understand? Strongly Agree	Explained the reasons for your treatment in a way that you could understand? Agree	Explained the reasons for your treatment in a way that you could understand? Undecided	Explained the reasons for your treatment in a way that you could understand? Disagree	Explained the reasons for your treatment in a way that you could understand? Strongly Disagree

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* 25. Would you recommend this treatment to other people in your situation?

Yes, completely

Yes, to some extent

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* 26. Which hospital did you have your braces fitted?

Harrogate

Scarborough

York

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* 27. Would you recommend York Hospital to your family and friends?

Yes, completely

Yes, to some extent

If not, why?

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* 28. Would you recommend York Hospital for surgery?

Yes, completely

Yes, to some extent

If not, why?

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* 1. Are you?

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* 2. Which category below includes your age?

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* 3. What were the reasons for having your orthodontic and surgical treatment?

Question Title

* 4. Were you ever teased about your appearance?

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* 5. Were you ever embarrassed about eating in public?

Question Title

* 6. Did you ever have difficulty eating?

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* 7. Did you ever avoid smiling in photographs?

Question Title

* 8. Were you ever self-conscious about the appearance of your teeth?

Question Title

* 9. Were you ever self-conscious about your facial appearance?

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* 10. Did you receive any information leaflets on braces?

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* 11. If yes, did you find these leaflets useful?

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* 12. Did you receive any information leaflets on jaw surgery?

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* 13. If yes, did you find these leaflets useful?

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* 14. Did you visit the BOS website (www.yoursurgery.com) about braces and jaw surgery?

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* 15. If yes, did you find the website useful?

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* 16. Do you feel you were given enough information to help you make a decision about having treatment with regard to:

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* 17. Which jaw did you have moved in surgery?

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* 18. Was your operation cancelled and moved to another date?

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* 19. Did you have to have a second unplanned operation after your jaw surgery (Reoperation/Revision Surgery)?

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* 20. What do you feel were the benefits you received from the treatment?

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* 21. Do you still have any of the following problems from your treatment?

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* 22. Do the problems you have listed in Question 21 effect you on a daily basis?

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* 23. Do you feel the Specialist Orthodontist:

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* 24. Do you feel the Specialist Surgeon:

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* 25. Would you recommend this treatment to other people in your situation?

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* 26. Which hospital did you have your braces fitted?

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* 27. Would you recommend York Hospital to your family and friends?

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* 28. Would you recommend York Hospital for surgery?

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* 29. What, if anything, did we do well?

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* 30. What, if anything, could we do to improve our service in the future?