The Effect of Nursing Care Provided to Turkish Mothers of Infants Born With Cleft Lip and Palate on Maternal Attachment and Self-efficacy: A Quasi-Experimental Study

Early Follow-up of Parents by a Specialized Cleft Nurse After the Birth of an Infant with Cleft lip and/or Palate

OBJECTIVE

To document the impact of early follow-up by specialized cleft nurses (SCNs) to families of infants with cleft lip and/or cleft palate (CL/P).

DESIGN

Prospective inclusion of a control group, which received standard care alone, followed by an intervention group, which in addition received early SCN follow-up.

SETTING

The cleft lip and palate team at a University hospital.

PARTICIPANTS

70 families (69 mothers and 57 fathers); control group (n = 38); intervention group (n = 32).

INTERVENTION

SCNs offered a consultation at the maternity ward and follow-ups by phone or face-to-face at one, three, eight weeks and six months after birth.

OUTCOME MEASURES

Use of Internet-Questionnaire, Quality of discharge teaching scale (QDTS), Post discharge coping difficulty scale (PDCDS), Response on follow-up by health professionals.

RESULTS

Infants in the intervention group were admitted less frequently to a Neonatal Intensive Care unit (NICU); 21.9% vs 51.4%, P = .012. Parents in the intervention group used internet for cleft-related reasons less frequently (74.6% vs 85.9%), P = .112 and the mothers benefitted less from cleft-related activity on the internet (P = .013). The intervention group reported higher mean score for satisfaction with total cleft care (P = .001). There were no significant group differences regarding mean total score for discharge teaching (P = .315) and coping difficulties (P = .919).

CONCLUSION

Early follow-up by a SCN with expertise in cleft care is highly valued by parents. Closer cooperation between the cleft team and health professionals at birth hospitals and Child health centers is necessary for optimal follow-up.

Parental Stress, Infant Feeding and Well-being in Families Affected by Cleft Lip and/or Cleft Palate: The Impact of Early Follow-up

OBJECTIVE

To document the impact of early follow-up by specialized cleft nurses (SCNs) provided to families affected by cleft lip and/or palate (CL/P) and the status of parental stress, infant feeding and well-being.

DESIGN

Prospective inclusion of a control group, which only received standard care, followed by an intervention group that also received early SCN follow-up.

SETTING

The cleft lip and palate team at Oslo University Hospital, Norway.

PARTICIPANTS

Seventy families (69 mothers and 57 fathers) distributed into an intervention group (n = 32) and a control group (n = 38).

INTERVENTION

SCNs provided a consultation at the maternity ward and a follow-up conversation by phone or face-to-face at scheduled times for six months.

OUTCOME MEASURES

Parental Stress Index (PSI), Perceived Stress Scale (PSS-14), feeding questionnaire, survey of infant diets, weight percentiles.

RESULTS

The mothers reported higher stress scores than the fathers, but in the control group only in the PSI parent domain at T2 and T3 (P = .007, P = .018). Infants in the intervention group used pacifiers less frequently than in the control group (55.2% vs. 81.1%, P = .023). Otherwise, no significant differences were found between the groups. Overall, the infants received less breast milk than norms.

CONCLUSION

Contextual strategies for early follow-up of families affected by clefts need to be developed, with an emphasis on involving fathers and those parents reporting elevated stress and/or feeding difficulties. There is a need for diagnosis-specific guidelines about the use of pacifiers as well as collaboration between the health professionals involved to increase breastmilk feeding.

The effect of nursing care and follow-up for mothers of infants undergoing congenital heart surgery: a quasi-experimental study

Improvements in congenital heart surgery have resulted in an increasing number of infants surviving, but there remain concerns about home care and difficulties experienced by mothers. This study was designed to evaluate the effect of nursing care and follow-up for the mothers of infants undergoing congenital heart surgery on anxiety, care burden, and self-efficacy. The study was designed as a quasi-experimental study with a pre-test and post-test control group design. The study included 40 mothers whose infants had undergone congenital heart surgery. Nursing care was provided to the mothers of the infants included in the study group through a total of six home follow-ups until the third month after surgery, guided by the North American Nursing Diagnosis Association and Nursing Diagnosis System and Nursing Interventions Classification. Data were collected through Care Needs Identification Form, Spielberger's State-Trait Anxiety Inventory, Zarit Burden Interview, and Parental Self-efficacy Scale. The mean State-Trait Anxiety Inventory and Zarit Burden Interview scores for the mothers in the intervention group decreased, while the mean Parental Self-efficacy Scale scores increased as the follow-up progressed and it was determined that by the third month, the difference between the mothers in the intervention group and those in the control group in terms of post-test State-Trait Anxiety Inventory, Zarit Burden Interview, and Parental Self-efficacy Scale had become statistically significant. Providing appropriate nursing care practices to the mothers of the infants had undergone congenital heart surgery in home setting has the potential to decrease the problems experienced by the mothers.

Differences in specific concerns perceived by parents of children with cleft lip and/or palate based on the types of cleft

BACKGROUND

Parents of children with cleft lip and/or palate (CL/P) have concerns including guilt and worry. Differences in concerns by cleft type is, however, under-researched.

AIM

To compare differences in perceived concerns among parents of children with CL/P by cleft type, adjusting for children's gender and age.

DESIGN

Cross-sectional study conducted in an outpatient centre, assessing psychological status of 171 parents of children aged <12 with CL/P using 12 items.

RESULTS

Across cleft types, 'I am worried about whether the child's teeth will be straight' was the most strongly perceived concern (70.8%). After adjusting for gender and age, logistic regression showed significant differences in type of CL/P for (eg) 'I am worried that the child's appearance will not be beautiful', associated with CL over CP (OR = 0.07, 95% CI: 0.02-0.26) and CLP over CP (8.52, 3.23-22.50);' 'I am concerned about my child being able to speak well', associated with CP (3.12, 1.07-9.11) and CLP (5.69, 2.43-13.33) over CL, and 'I am worried that the child could suffer due to his/her appearance', associated with CL over CP (0.08, 0.02-0.29) and CLP over CP (10.07, 13.78-27.36).

CONCLUSIONS

Parents' concerns were influenced by cleft type.

Validity and reliability of the Family Empowerment Scale for parents of children with cleft lip and/or palate

BACKGROUND

Empowerment is recognized as a crucial concept in strengthening the position of parents in healthcare services. This study aimed to evaluate the validity and reliability of the Turkish Family Empowerment Scale (FES).

METHODS

This methodological study was conducted between January and March 2021, with 348 family members actively caring for their children in the age group of 0-18 years with cleft lip and/or palate (CL/P). The English FES was translated into Turkish using back translation and modified so that it is generic and convenient for all families. The construct validity, internal validity, internal consistency, and split-half test reliability and responsiveness of the Turkish FES were examined.

RESULTS

The original FES structure with three factors (family, health services provided to the child and community participation) and 34 items was verified in Turkish culture. This obtained structure can explain 66% of the variance of the relevant concept. Scores of parents ranged between 34 and 170 points. Increasing scores indicated a positive significance regarding family empowerment. The Cronbach's α reliability coefficient of the scale was calculated as 0.976.

CONCLUSION

The study findings and the goodness-of-fit values indicated that the FES and its Turkish version are a valid and reliable measurement instrument to be used in Turkish culture.

The effect of combined education on the knowledge and care and supportive performance of parents with children with cleft lip and palate: A clinical trial study

Cleft lip and palate is a major problem that disrupts the child's family life. The present study aimed to investigate the effect of combined education on the knowledge and care and supportive performance of parents with children with cleft lip and palate. This is a clinical trial study was conducted on 40 parents referring to hospitals. The data were collected using the demographic information questionnaire, the questionnaire of parental knowledge and care supportive performance questionnaire and analyzed using descriptive and analytical tests. After education the intervention group, the mean score of parents' care and supportive knowledge significantly increased in the intervention group as compared to the control group. There was also a significant difference in the mean score of parents' care-supportive performance between the two groups (P < 0.001). It is recommended to use the combined education as an effective method to increase knowledge and performance in parents of children with cleft lip and palate.

Parental response to the feeding behavior problems in children with cleft lip and palate: A systematic review

OBJECTIVE

To assess and analyze the global status of parental responses to feeding problems in patients with cleft lip and palate (CLP) and to provide recommendations for future research.

DESIGN

A priori protocol was formulated according to PRISMA guidelines and registered. The predefined search strategy was used in established search engines up to July 27, 2020 without any restriction of language or year of publication. Studies evaluating the parental responses to feeding problems in patients with CLP were included. The data extraction was performed with a self-designed form, and risk of bias (ROB) was assessed.

RESULTS

Out of 27 identified papers, eight studies could be included. Most were from Europe, conducted between 1994 and 2020, and had utilized valid and reliable questionnaires. The included studies showed moderate or low ROB. The majority of the studies reported parental dissatisfaction with the knowledge provided. The presence of anxiety and low self-esteem among parents was also highlighted.

CONCLUSIONS

There was general consensus regarding lack of medical advice and support for CLP families, along with the presence of anxiety and low self-esteem among parents. Well-designed studies from different regions of the world must be conducted in the future for an accurate global picture to be presented.