[Effects of hypnotic and musical relaxation therapy on the treatment of the parents of children with cleft lip and/or palate]

OBJECTIVE

To evaluate the effectiveness of hypnotic and musical relaxation therapy and psychological consultation for parents of children with cleft lip and/or palate (CLP) and to provide a scientific basis of clinical-psychological treatment options.

METHODS

Sixty-six subjects with children with CLP participated in this study. The subjects were randomly assigned to a test group (n = 33) and a control group (n = 33). The test group was treated with hypnotic and musical relaxation therapy; the control group were subjected to psychological consultation. Anxiety and depression states were evaluated by using a self-rating anxiety scale (SAS) and a self-rating depression scale (SDS) before and after treatment was administered.

RESULTS

1) The test group demonstrated a significant decrease in SAS and SDS scores (t = 2.855, P < 0.01; t = 2.777, P < 0.01). The control group showed a significant decrease in the SAS score (t = 1.831, P < 0.05) but failed to show a significant change in the depression score (t = 0.909, P > 0.05). 2) The test group yielded a higher percentage of remission indicated by the SDS scores than the control group (test group = 75.76%; control group = 60.61%; P < 0.05). The test group also displayed a higher percentage of remission indicated by the SAS scores than the control group (test group = 78.79%, test group = 69.70%; P < 0.05).

CONCLUSION

Hypnotic and musical relaxation therapy can more effectively reduce the scores of the anxiety and depression states of the parents of patients with cleft lip and/or palate than psychological consultation.

Parent-Reported Family Functioning Among Children With Cleft Lip/Palate

OBJECTIVE

To examine family functioning related to sociodemographic and clinical characteristics in youth with cleft lip and/or palate (CL/P).

DESIGN

Cross-sectional, multi-site investigation.

SETTING

Six U.S. cleft centers.

PATIENTS/PARTICIPANTS

A diverse sample of 1200 children with CL/P and their parents.

MAIN OUTCOME MEASURE

Parents completed the Family Environment Scale (FES), which assesses three domains of family functioning: cohesion (or closeness), expressiveness (open expression of feelings), and conflict. Demographic and clinical characteristics were also assessed including race, ethnicity, type of insurance, and surgical recommendations.

RESULTS

The FES scores for families seeking team evaluations for their youth with CL/P (mean age = 11.6 years) fall within the average range compared with normative samples. Families receiving surgical recommendations for their youth also had FES scores in the average range, yet families of children recommended for functional surgery reported greater cohesion, expressiveness, and less conflict compared with those recommended for aesthetic surgery (P < .05). For cohesion and expressiveness, significant main effects for race (P = .012, P < .0001, respectively) and ethnicity (P = .004, P < .0001, respectively) were found but not for their interaction. No significant differences were found on the conflict domain. Families with private insurance reported significantly greater cohesion (P < .001) and expressiveness (P < .001) than did families with public insurance.

CONCLUSIONS

Family functioning across domains was in the average range. However, observed differences by race, ethnicity, type of insurance, and surgical recommendation may warrant consideration in clinical management for patients and families.

[Anxiety disorders and influence factors in adolescent patients with cleft lip and palate]

OBJECTIVE

To investigate the anxiety disorders and influence factors that occur in adolescent patients with cleft lip and palate and to provide theoretical foundation for mental intervention.

METHODS

A total of 120 adolescent patients with cleft lip and palate were investigated using a general information questionnaire, the self-rating anxiety scale, and the social support rating scale (SSRS). The influence factors of anxiety disorders were analyzed.

RESULTS

The effective questionnaires were 119. The occurrence rate of anxiety disorder in adolescent patients was 49.6% (59/119), and the occurrence rates of mild, moderate, and severe anxieties were 41.2% (49/119), 7.6% (9/119), and 0.8% (1/119), respectively. The gender, residential area, disease category, family status (one child or no children), and incidence rate of anxiety disorder in patients were statistically different (P<0.05). The SSRS scores of patients with anxiety disorder were lower than those of patients without anxiety disorder (P<0.05). Multiple regression analysis showed that gender and social support were predictive factors of the occurrence of anxiety disorder (R=0.318).

CONCLUSION

A high anxiety disorder rate occurred in adolescent patients with cleft lip and palate. dender and social support were important influencing factors for anxiety disorder. In the after-mental intervention, considerable attention should be given to the anxiety disorders of patients and improve their mental health.

[Anxiety disorders and influence factors in adolescent patients with cleft lip and palate]

OBJECTIVE

To investigate the anxiety disorders and influence factors that occur in adolescent patients with cleft lip and palate and to provide theoretical foundation for mental intervention.

METHODS

A total of 120 adolescent patients with cleft lip and palate were investigated using a general information questionnaire, the self-rating anxiety scale, and the social support rating scale (SSRS). The influence factors of anxiety disorders were analyzed.

RESULTS

The effective questionnaires were 119. The occurrence rate of anxiety disorder in adolescent patients was 49.6% (59/119), and the occurrence rates of mild, moderate, and severe anxieties were 41.2% (49/119), 7.6% (9/119), and 0.8% (1/119), respectively. The gender, residential area, disease category, family status (one child or no children), and incidence rate of anxiety disorder in patients were statistically different (P<0.05). The SSRS scores of patients with anxiety disorder were lower than those of patients without anxiety disorder (P<0.05). Multiple regression analysis showed that gender and social support were predictive factors of the occurrence of anxiety disorder (R=0.318).

CONCLUSION

A high anxiety disorder rate occurred in adolescent patients with cleft lip and palate. dender and social support were important influencing factors for anxiety disorder. In the after-mental intervention, considerable attention should be given to the anxiety disorders of patients and improve their mental health.

Oral Health-Related Quality of Life in Children and Young Adolescent Orthodontic Cleft Patients

OBJECTIVE

To evaluate and compare the oral health-related quality of life (OHRQoL) in Thai patients with cleft lip and palate and to evaluate parents' and their children perceptions.

MATERIAL AND METHOD

Child Oral Health Impact Profile (COHIP) questionnaire was used to evaluate OHRQoL of the patients and parents' perceptions of patients' OHRQoL. The subjects consisted of 140 cleft patients (aged 8-15 years) and their parents who visited the Department of Orthodontics, Khon Kaen University.

RESULTS

COHIP scores in cleft patients were relatively high. No statistically significant differences were found for overall and subscales COHIP scores between gender and age groups (aged 8-11 and 12-15 years) of patients. Comparison among cleft types, overall COHIP and functional well-being subscales scores showed statistically significant differences (p = 0.01 and p = 0.002, respectively). Cleft lip with or without alveolus (CL/A) had higher overall and functional well-being subscale scores than unilateral and bilateral cleft lip and palate patients (CLP). Only self-image subscale scores were statistically significant differences between patients and parents at p<0.001.

CONCLUSION

Young and adolescent patients with cleft lip and palate had generally positive oral health-related quality of life. Impacts of gender and age of patients on OHRQoL were similar CL/A patients had more positive in overall oral health-related quality of life and functional well-being domains than CLP patients did. Parents had higher perceptions of self-image shown by their children than the children themselves.

Evaluation of Facial Appearance among Patients With Repaired Unilateral Cleft Lip and Palate: Comparison of Patient- and Clinician-Ratings of Satisfaction

The objective of this study was to determine the levels of patient-satisfaction on facial and dental appearance compared with clinician ratings. Participants included 61 patients with repaired unilateral cleft lip and palate (UCLP), aged 14-25 years. Raters comprised three cleft team clinicians. A Likert scale was used to assess the levels of satisfaction of the patients themselves and the clinicians. The results revealed that the patients were moderately satisfied with their appearance. Nose was the least satisfactory feature, followed by lip appearance. When compared to the clinician ratings, the patients were less satisfied with their own nose and lip, but more satisfied with teeth. Concerning age, self-assessment did not differ between adolescents and young adults. Females were less likely to be satisfied compared to males, but the difference was not statistically significant. In conclusion, patients with repaired UCLP were moderately satisfied with their facial and dental appearance. Clinician- and patient-opinions were different in some aspects. This study highlights the importance of patient satisfaction as a meaningful treatment outcome assessment, which could lead to an improvement in cleft care to meet the patient expectations.

Psychological impact of visible differences in patients with congenital craniofacial anomalies

BACKGROUND

Patients with craniofacial anomalies often have appearance concerns and related social anxiety which can affect their quality of life. This study assessed the psychological impact of facial and dental appearance in patients with craniofacial anomalies in comparison to a general population control group.

METHODS

The study involved 102 adult patients (51% male) with congenital craniofacial anomalies and 102 controls (49% male). Both groups completed the Nepali version of Derriford Appearance Scale (DAS) and the Psychological Impact of Dental Aesthetic Questionnaire (PIDAQ) in a clinical setting to assess appearance-related distress, avoidance, and anxiety.

RESULTS

There was a significant difference between patients and controls on both PIDAQ (mean score for patients 33.25 ± 9.45 while for controls 27.52 ± 5.67, p < 0.001) and DAS59 scores (mean score for patients 159.16 ± 31.54 while for controls 77.64 ± 6.57, p < 0.001), indicating that patients experienced greater negative psychological impact of living with their appearance (PIDAQ) and more appearance-related distress (DAS) than controls. DAS scores were not associated with gender. There was no association of the place of residence (rural vs. urban) with PIDAQ or DAS59 scores.

CONCLUSIONS

There is a significant psychological impact of altered facial and dental appearance in patients with craniofacial anomalies compared to controls. There was no effect of locality (rural/urban) on the psychological impact of facial and dental appearance in patients.

[Analysis of quality of life of 115 parents with cleft lip and/or palate children]

OBJECTIVE

To investigate the quality of life of cleft lip and/or palate children's parents and discuss the factors to provide the oretical basis for improving the quality of life of these parents and promoting the healthy growth of children with cleft lip and/or palate.

METHODS

A total of 115 parents whose children had cleft lip and/or palate surgery treatment were selected as the experiment group, and another 198 parents (with healthy children having a similar age with those in the experiment group) as the control group. The experiment group was divided into three subgroups according to different types of cleft lip and/or palate: cleft Lip (CL), cleft palate (CP), cleft lip and palate (CLP). The experiment group and the control group were both divided into four subgroups according to age: 0-1, 1-3, 3-6 years old, and more than 6 years old. The experiment group and the control group were both divided into three subgroups according to education: junior middle school and the following, high school and technical secondary school, junior college degree or above. The GQOLI-74 scale was selected to assess the experiment group and the control group. SPSS 16.0 software was used to analyze data.

RESULTS

1) The experiment group had no significant difference with the control group in terms of the overall score and the scores of various children ages. 2) The scores of every item had no significant difference in CL, CP, CLP subgroup (P > 0.05). 3) The quality of life scores and scores of psychological function dimension and social function dimension of parents with 3-6 years old patients were obviously lower than those of parents with more than 6 years old patients (P<0.05). The scores of social function dimension of parents with 0-1, 1-3, 3-6 years old patients were obviously lower than those of parents with more than 6 years old patients (P < 0.05). The other items had no significant difference. 4) The scores of material life dimension and social function dimension of parents with junior college degree or above were higher than those of parents with junior middle school degree and the following (P < 0.05). The scores of social function dimension of parents with high school and technical secondary school degree were higher than those of parents with junior middle school degree and the following (P < 0.05).

CONCLUSION

No difference was observed in the quality of life between cleft lip and/or palate children's parents and normal group. The parents with the low age children with cleft lip and/or palate and low-levels of education need more help and support to improve quality of life.

Clinical outcomes of primary palatoplasty in pre-school-aged cleft palate children in Srinagarind hospital: quality of life

BACKGROUND

Cleft lips and cleft palates are common congenital anomalies, which affects facial appearance, speech, hearing, teeth alignment and other structures. Craniofacial anomalies and speech disorders are crucial problems in the preschool-aged children (5-6 years old), when they start attending school and become more engaged in the community. This condition, which differentiates them from other students, can lead to teasing or mocking which can cause low-self esteem, an inferiority complex, andfoster bad relationships with friends. Missing class in order to receive treatment and other additional care can affect a student's learning, development and overall-quality of life.

OBJECTIVE

The purpose of this research was to study the quality of life in preschool-aged cleftpalate children and satisfaction with their level of speech.

MATERIAL AND METHOD

This was a retrospective, descriptive study. The data were collected by reviewing medical records of patients with cleft lip and cleft palate aged 5-6 years old who underwent operation and treatment with the Tawanchai Center at Srinagarind Hospital. There were 39patients in this study. Data collection was conducted for 5 months (June to October 2013). The research instruments were: (1) General Demographic Questionnaire, (2) Quality of Life Questionnaire with 5 Domains, and (3) the Satisfaction of Speech Questionnaire. The descriptive statistics, percentages and the standard deviation were analyzed in the present study.

RESULTS

The findings revealedfamily information pertaining to CLP treatment and the impact it has on consumption, speech training, hearing test, development, dental treatment, communication skills, participation, referral treatment as well as the quality ofcoordinationfor advanced treatment. The present study revealed that all ofthe aforementioned criteria were met at a high level. Moreover the child's sickness had only a moderate impact on family life. In conclusion, the overall satisfaction was at a very high level.

CONCLUSION

It was concluded that the collaboration of the Tawanchai Cleft Center and the government, as well as with private and non-governmental organizations was exceptional, particularly in regard to providing proper and continuous treatment for patients with cleft lips and/or cleft palate. The findings reflect a good quality of life in the pre-schooled children with cleft lip and cleft palate that received treatment from the Tawanchai Cleft Center at Srinagarind Hospital. Furthermore, the study showed that the problems associated with the condition, only affected the family's lives at a minimal level.

A Relationship between nasolabial appearance and self-esteem in adolescent with repaired cleft lip and cleft palate at Khon Kaen University Cleft Center

OBJECTIVE

To examine levels of self-esteem of adolescents with repaired cleft lip and cleft palate at Khon Kaen University Cleft Center and its correlation with nasolabial appearance.

MATERIAL AND METHOD

Across-sectional survey of 93 adolescents with repaired cleft lip and palate.

RESULTS

A total nasolabial appearance score was 2.8 +/- 0.36 (fair to good). The mean of the total self-esteem score for all respondents was 20.11 +/- 3.27 (maximum 30). There was no-significant correlation between nasolabial appearance and self esteem (Pearson product-moment correlation coefficiency (r) = 0.18, p = 0.08. The self-esteem scores of good, fair and poor appearance were 20.5 +/- 0.98, 19.8 +/- 0.32, 19 +/- 2.09 respectively.

CONCLUSION

The nasolabial appearance of repaired cleft lip and palate not be the only factor but other psychosocialfactors also may play a role in their self-esteem. The analysis of this study found no relationship between self-esteem and appearance.

Prevalence, pattern and perceptions of cleft lip and cleft palate among children born in two hospitals in Kisoro District, Uganda

BACKGROUND

Cleft lip with or without cleft palate is one of the most common congenital anomalies that affect the oro-facial region. The aim of the study was to determine the period prevalence, pattern and perceptions of cleft lip and cleft palate in children born between 2005 and 2010 in two hospitals in Kisoro District, Uganda.

METHODS

The study involved a retrospective review of medical records of mothers who delivered live babies between January 2005 and December 2010 in Kisoro Hospital and St. Francis Hospital, Mutolere in Kisoro District. Key informant interviews of mothers (n = 20) of the children with cleft lip and/or clip palate and selected medical staff (n = 24) of the two hospitals were carried out. The data were analysed using descriptive statistics.

RESULTS

Over the 6 year period, 25,985 mothers delivered live babies in Kisoro Hospital (n = 13,199) and St. Francis Hospital, Mutolere (n = 12,786) with 20 babies having oro-facial clefts. The overall period prevalence of the clefts was 0.77/1,000 live births. Sixty percent (n = 12) of children had combined cleft lip and palate and the same proportion had clefts on the left side of the face. More boys were affected than girls: 13 versus 7. About 45% of mothers were hurt on realizing that they had delivered a child with an oro-facial cleft. Forty percent of mothers indicated that a child with oro-facial cleft was regarded as an outcast. About 91.7% (n = 22) of the medical staff reported that these children were not accepted in their communities. Surgical intervention and psychosocial support were the management modalities advocated for by most respondents.

CONCLUSION/RECOMMENDATIONS

The period prevalence of combined cleft lip and palate in two hospitals in Kisoro District was comparable to some findings elsewhere. Cleft lip and cleft palate are a medical and psychosocial problem in Kisoro District that calls for sensitization and counseling of the families and communities of the affected children. The policy makers need to strategically plan for provision of rehabilitation with feeding obturators to facilitate easy feeding to gain weight before surgical intervention of the affected children.

Reading in subjects with an oral cleft: speech, hearing and neuropsychological skills

OBJECTIVE

To evaluate speech, hearing, and neuropsychological correlates to reading among children, adolescents, and young adults with nonsyndromic cleft of the lip and/or palate (NSCL/P).

METHOD

All testing was completed in a single visit at a Midwestern university hospital. Subjects in both the NSCL/P (n = 80) and the control groups (n = 62) ranged in age from 7-26 years (average age = 17.60 and 17.66, respectively). Subjects completed a battery of standardized tests evaluating intelligence, neuropsychological skills, and word reading. Subjects with NSCL/P also underwent speech assessment, and past audiology records were evaluated.

RESULTS

After controlling for age and socioeconomic status, subjects with cleft performed significantly worse on a test of word reading. For subjects with cleft, word reading deficits were not associated with measures of speech or hearing, but were correlated with impairments in auditory memory.

CONCLUSION

These findings show poorer reading among subjects with NSCL/P compared with those without. Further work needs to focus on correlates of reading among subjects with cleft to allow early identification and appropriate intervention/accommodation for those at risk.

Panel perception of facial appearance of cleft patients generated by use of a morphing technique

OBJECTIVE

Perception of the facial appearance of cleft patients has, until now, been evaluated on the basis of photographs of the patients. Research based on photographs generated by use of a morphing technique has not yet been reported. The purpose of this study was to investigate female and male raters' panel perception with regard to the following: (1) patient age, (2) attractiveness, (3) gender appearance, and (4) likeability of faces of cleft patients generated by the use of a morphing technique.

SETTING

The study was conducted at the Department of Oral, Craniomaxillofacial and Facial Plastic Surgery, University Hospital of Leipzig, Germany.

PATIENTS, PARTICIPANTS

We used photographs of 32 adult German nonsyndromic cleft patients, mean age 18.9 ± 1.3 years, and surveyed 93 students, mean age 25.3 ± 3.2 years, by use of a standardized questionnaire.

RESULTS

All respondents rated the mean age of cleft patients equally in unmorphed and morphed pictures. For all respondents, attractiveness of morphed patient pictures was rated significantly higher than for unmorphed pictures (mean 4.8 ± 1.0 vs. 6.4 ± 2.4; p < 0.001), although significance was reached only if morphed pictures of eight patients were rated. Female respondents rated attractiveness significantly higher than did males, especially for pictures of female patients.

CONCLUSION

Facial morphing of patient pictures is a suitable method for creation of standard cleft faces. Despite the modification of the pictures, the faces generated remain human and assessable by panel members. Perception of faces of cleft patients' depended on raters' gender.

Oral health-related quality of life in non-syndromic cleft lip and/or palate patients: a systematic review

THE OBJECTIVE

To evaluate oral health-related quality of life (OHRQoL) in non-syndromic patients with cleft lip and/or palate (CLP), in comparison to a general non-cleft population.

BASIC RESEARCH DESIGN

Systematic review. A literature search was conducted to identify papers reporting on OHRQoL in cleft samples. Only studies with suitable control groups were included. From each included paper were extracted the study and sample characteristics and results.

MAIN OUTCOME MEASURES

OHRQoL score.

RESULTS

Three papers were chosen according to the preset inclusion and exclusion criteria. All used an OHRQoL generic patient-reported questionnaire with evidence of a development and validation process, with responses recorded on a five-point scale. The results could not be combined for the purposes of meta-analysis due to lack of standardisation. In 2 of the 3 studies, the OHRQoL was found to be significantly lower in the cleft than in the non-cleft samples (in patients 8-18 or 18-65 years of age). The third study, based on a relatively small sample size, could not detect significant differences between cleft and non-cleft individuals.

CONCLUSIONS

Based on the results of the few studies included in the present systematic review, non-syndromic patients with CLP tend to have a lower OHRQoL than a general non-cleft population. This seems to hold true both for children and adults.

Dental anxiety in children with cleft lip and palate: a pilot study

PURPOSE

To investigate the level of dental fear and anxiety of children who have cleft lip and palate (CLP).

MATERIALS AND METHODS

The study was performed at Cukurova University, Faculty of Dentistry. A total of 32 7- to 12-yearold children, 17 of them with CLP (8 girls and 9 boys) and 15 of them without CLP (7 girls and 8 boys) participated in the study. The children were evaluated by using the Facial Image Scale (FIS) and Dental Subscale of Children's Fear Survey Schedule (CFSS-DS) methods. The anxiety state of the children was assessed twice using FIS: first in the dental hospital waiting room (FIS-WR) and after, while sitting in the dental chair (FIS-DC). CFSS-DS was administered to all participants in order to assess the dental anxiety while they were sitting in the dental chair.

RESULTS

According to the FIS results, there was no difference between CLP and control group in the waiting room (P = 0.682). However, the CLP group showed lower scores than the control group while they were sitting in the dental chair (P = 0.030). The FIS scores of the CLP group were significantly higher in the waiting room than while sitting in the dental chair (P = 0.007). In the control group, there was no significant difference between FIS-WR and FIS-DC values (P = 0.664). The total CFSS-DS scores of children with CLP were lower than those of the control group, but these differences were not statistically significant (P > 0.05).

CONCLUSION

Children with CLP showed more anxiety in the FIS-WR than in the FIS-DC, but they showed lower scores than the control group in the FIS-DC. The positive previous experience of meetings with dentists of the CLP children could explain these results. Positive previous experiences with dentists and a short time in the waiting room could be key elements in the care of CLP children.

It's a privilege to smile: impact of cleft lip palate on families

In this article we describe prior cross-sectional and longitudinal research conducted with children who were born with cleft lip and/or palate and their families in the United States and internationally. The findings and clinical implications from different times and cultures are synthesized using the Biopsychosocial Model. Our primary aim is to summarize the attachment styles, cognitive, psychological and social functioning, self-concept, neurological functioning, and speech difficulties prevalent among individuals who are born with cleft lip/palate at different developmental stages (e.g., infancy, toddler, childhood, adolescence). Additionally, bystander reactions to the speech and appearance of individuals coping with cleft lip and/or palate and its effects on the family are described. Finally we examine the diversity of samples from prior clinical research and provide clinical recommendations for more collaborative family-based practice among medical and mental health providers treating families coping with cleft lip and/or palate.

Stress-coping and cortisol analysis in patients with non-syndromic cleft lip and palate: an explorative study

Background

Non-syndromic clefts of the orofacial region occur in approximately 1 per 500 to 2,500 live births, depending on geographical area and ethnicity. It can be supposed that the disruption of the normal facial structure and the long-standing pressure of treatment from birth to adulthood bring about a range of life stressors which may lead to a long-lasting impact on affected subjects throughout their lives. Therefore, the present study aimed to assess different aspects of psychosocial stress in affected individuals.

Methods

The study was divided into two parts: first, the Trier Social Stress Test which involves uncontrollability and high levels of social-evaluative stress under real conditions and second, the query of various aspects of coping with psychosocial stress. The test group consisted of 30 affected adult subjects, and an equally sized control group of unaffected volunteers. Cortisol dysregulation was determined by saliva samples before and after stress induction. Meanwhile, participants were asked to complete the SVF 120 stress-coping questionnaire.

Results

The analysis of saliva samples showed a similar baseline concentration as well as a similar increase in cortisol levels after stress induction for both groups. Subsequently, the decline in cortisol concentrations was significantly faster in the CLP group (course: p<0.001; groups: p = 0.102; interaction: p = 0.167). The evaluation of the stress-coping questionnaire revealed a significantly shorter rumination about a stressful event in individuals with CLP-related malformations (p = 0.03).

Conclusion

We conclude that adults with CLP have significantly better stress-coping strategies than their healthy peers.

Trial Registration

German Clinical Trials Organization DRKS00003466

Quality of life in patients with cleft lip and palate after operation

BACKGROUND

Cleft lip and cleft palate are the most common craniofacial anomalies. Srinagarind Hospital has 150-200 cases each year. The operating process of care, requires continuity of care involving a multidisciplinary team. When the patients go to hospital for an operation they experience pain, limited activity and also food is very different from normal life. When attending school they suffer speech articulation problems and feel shy and isolated, which has a detrimental affect on their life style and quality of life.

OBJECTIVE

The main purpose of the study is to the present study quality of life in patients with cleft lip and palate after operation.

MATERIAL AND METHOD

The present study is descriptive research using qualitative and quantitative approaches. The studied population were patients age 8-18 years old who were admitted at 3C Ward and Outpatient Department, Srinagarind Hospital. 33 patients were interviewed for the quantitative approach. Guideline for in-depth interview with 15 patients were used for the qualitative approach. Quantitative data were analyzed and presented in frequency, percentage and standard deviation. The qualitative data were analyzed through content analysis.

RESULTS

Patients consider their QOL is high level, but in detail they still worry about self concept psychological well-being. From indept interview patients would like to get further treatment to minimize their scar as soon as possible.

CONCLUSION

Patients consider their quality of life as high level, but they would like to get further treatment.

Home visit patients and family with cleft lip and palate

BACKGROUND

The operating process for cleft care, requires continuity of care involving a multidisciplinary team. When the patient goes to hospital to receive surgery, parents and family feel nervous about their children and need to know how to take care of their children afterwards. Some patients will have operations into their teenage years. The scar on their face will give them low self esteem and feelings of isolation. Patients and family need information and encouragement. Home visit should be a good process to convey information and encourage patients and family.

OBJECTIVE

Of this project were to convey information and encourage patients and family and to evaluate patients/family problems and needs as well as to promote networking.

MATERIAL AND METHOD

A team meeting took place to decide about the families to be visited. After selection the family nurse coordinator contacted them by telephone, as well as contacting the primary care unit near to the family and then travelled to visit the family. The collected data was by questionnaire, observation and in-depth interview.

RESULTS

2 families were visited before and after operation, 8 families were visited 2-3 days after operation. The families have better knowledge, more confidence and can take better care of their children. Unfortunately health care professionals in primary care unit were too busy to join with the team.

CONCLUSION

Home visit is a good process to convey information and find patients and family problems/needs because they are more relaxed than in hospital, so can better understand and talk more easily. The families are happy to see the home visit team and are more confident to take care of their children after visit.

An analysis of the frame-content theory in babble of 9-month-old babies with cleft lip and palate

The aim of this study was to examine the consonant-vowel co-occurrence patterns predicted by the Frame-Content theory in 16 nine-month-old babies with unrepaired cleft palate (±cleft lip) and 16 age-matched non-cleft babies. Babble from these babies was phonetically transcribed and grouped according to the intrasyllabic predictions of the theory (labial-central, alveolar-front, and velar-back). Both groups demonstrated the three consonant-vowel co-occurrence patterns predicted by the Frame-Content theory. Other patterns not predicted by the Frame-Content theory emerged as strong patterns as well.

LEARNING OUTCOMES

The reader will be able to: • Describe consonant-vowel co-occurrence patterns produced by babies with and without cleft palate. • Describe vowel inventories of babies with cleft palate. • Identify possible therapy targets for babies with cleft palate.

The effect of cleft lip on adults' responses to faces: cross-species findings

Cleft lip and palate is the most common of the congenital conditions affecting the face and cranial bones and is associated with a raised risk of difficulties in infant-caregiver interaction; the reasons for such difficulties are not fully understood. Here, we report two experiments designed to explore how adults respond to infant faces with and without cleft lip, using behavioural measures of attractiveness appraisal (‘liking’) and willingness to work to view or remove the images (‘wanting’). We found that infants with cleft lip were rated as less attractive and were viewed for shorter durations than healthy infants, an effect that was particularly apparent where the cleft lip was severe. Women rated the infant faces as more attractive than men did, but there were no differences in men and women's viewing times of these faces. In a second experiment, we found that the presence of a cleft lip in domestic animals affected adults' ‘liking’ and ‘wanting’ responses in a comparable way to that seen for human infants. Adults' responses were also remarkably similar for images of infants and animals with cleft lip, although no gender difference in attractiveness ratings or viewing times emerged for animals. We suggest that the presence of a cleft lip can substantially change the way in which adults respond to human and animal faces. Furthermore, women may respond in different ways to men when asked to appraise infant attractiveness, despite the fact that men and women ‘want’ to view images of infants for similar durations.

Communication attitude and speech in 10-year-old children with cleft (lip and) palate: an ICF perspective

Many children born with cleft palate have impaired speech during their pre-school years, but usually the speech difficulties are transient and resolved by later childhood. This study investigated communication attitude with the Swedish version of the Communication Attitude Test (CAT-S) in 54 10-year-olds with cleft (lip and) palate. In addition, environmental factors were assessed via parent questionnaire. These data were compared to speech assessments by experienced listeners, who rated the children's velopharyngeal function, articulation, intelligibility, and general impression of speech at ages 5, 7, and 10 years. The children with clefts scored significantly higher on the CAT-S compared to reference data, indicating a more negative communication attitude on group level but with large individual variation. All speech variables, except velopharyngeal function at earlier ages, as well as the parent questionnaire scores, correlated significantly with the CAT-S scores. Although there was a relationship between speech and communication attitude, not all children with impaired speech developed negative communication attitudes. The assessment of communication attitude can make an important contribution to our understanding of the communicative situation for children with cleft (lip and) palate and give important indications for intervention.

[Malformation of the oral cavity of the foetus, what support is available for parents?]

One of the many questions which parents ask with regard to the malformation of the oral cavity of their child at birth concerns feeding. By answering all the couple's questions, the antenatal consultation aims to prepare the baby's birth and its admission into its family and society.

Development and reliability of the THAICLEFT Quality of Life Questionnaire for children with cleft lip/palate and families

OBJECTIVE

The objective of this study was to develop and test the reliability of the THAICLEFT Quality of Life (QoL) questionnaire for families of children coping with the problems associated with cleft lip/palate (CLP).

MATERIAL AND METHOD

After reviewing the literature on QoL measurements, the THAICLEFT QoL questionnaire was developed. The 27 families registered with the Tawanchai CLP service registry completed the questionnaire.

RESULTS

The Cronbach's alpha, i.e., the internal consistency and reliability, of 24 Quality of Life questionnaires was calculated. Values > 0.7 are considered acceptable and the value of the THAICLEFT QoL questionnaire was 0.861.

CONCLUSION

Using the THAICLEFT QoL questionnaire can help the healthcare provider to support parents and understand whether they are able to care for the patients and their psycho-economic needs.