1
|
Vasthare R, Lim Y R A, Bagga A, Nayak PP, Bhat B, S S. The phenomenological approach in dentistry - a narrative review. Int J Qual Stud Health Well-being 2024; 19:2341450. [PMID: 38634343 PMCID: PMC11028029 DOI: 10.1080/17482631.2024.2341450] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Accepted: 04/06/2024] [Indexed: 04/19/2024] Open
Abstract
PURPOSE Phenomenology is a branch of philosophy that focuses on human lived experience. Illness including dental diseases can affect this living experience. Within the dental literature, there is very little reported on the use of phenomenology compared to other healthcare sciences. Hence, the aim was to review the literature and provide an overview of various applications of phenomenology in dental research. METHODS This study was a narrative review using literature in the last 10 years identified by web-based search on PubMed and Scopus using keywords. A total of 33 articles that were closely related to the field and application in dentistry were included. The methodology, main results, and future research recommendations, if applicable, were extracted and reviewed. RESULTS The authors in this study had identified several areas such as orofacial pain and pain control research, dental anxiety, dental education, oral healthcare perceptions and access, living with dental diseases and dental treatment experience in which the phenomenological method was used to gain an in-depth understanding of the topic. CONCLUSIONS There are several advantages of using the phenomenological research method, such as the small sample size needed, the diverse and unique perspective that can be obtained and the ability to improve current understanding, especially from the first-person perspective.
Collapse
Affiliation(s)
- Ramprasad Vasthare
- Department of Public Health Dentistry, Manipal College of Dental Sciences, Manipal Academy of Higher Education, Manipal, India
| | - Arron Lim Y R
- Department of Orthodontics, National University of Malaysia, Bangi, Malaysia
| | - Aayushi Bagga
- Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Australia
| | - Prajna P. Nayak
- Department of Public Health Dentistry, Manipal College of Dental Sciences, Manipal Academy of Higher Education, Manipal, India
| | - Bhargav Bhat
- Department of Public Health Dentistry, Manipal College of Dental Sciences, Manipal Academy of Higher Education, Manipal, India
| | - Sahana S
- Department of Public Health Dentistry, Manipal College of Dental Sciences, Manipal Academy of Higher Education, Manipal, India
| |
Collapse
|
2
|
Bogart KR, Bryson BA, Harcourt D. Disclosing the obvious: Psychosocial implications of (not) explaining facial differences. Body Image 2023; 46:91-102. [PMID: 37247489 DOI: 10.1016/j.bodyim.2023.04.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Revised: 04/22/2023] [Accepted: 04/26/2023] [Indexed: 05/31/2023]
Abstract
Although the disclosure of invisible stigmatized identities has been frequently researched, little work has examined disclosure of facial differences (FD), in which stigma is often highly visible. People with FD are frequently expected by others to disclose or explain their condition. Qualitative work indicates that people with FD have a range of disclosure approaches from agentic disclosure (feeling obliged to disclose), autonomous nondisclosure (choosing not to disclose or to disclose only to certain people), and autonomous disclosure (choosing to openly disclose). The purpose of the present study was to validate these disclosure approaches in a large international sample, examine their frequency of use, and test their relationship to psychosocial outcomes using validated measures. English-speaking participants (n = 288) with 33 different types of FD completed an online survey of disclosure approaches and psychosocial outcomes (i.e. anxiety, depression, self-esteem, stigma, job satisfaction, and relationship self-concept). Participants disclosed to 59 % of the people they knew. Selective and indiscriminate disclosure were the most frequently used and recommended approaches. As predicted, autonomous disclosure was associated with more positive psychosocial outcomes than agentic (non)disclosure and autonomous nondisclosure. Findings from this study can support disclosure autonomy, and thus positive psychosocial outcomes, among people with FD.
Collapse
Affiliation(s)
- Kathleen R Bogart
- School of Psychological Science, Oregon State University, Corvallis, OR 97331, USA.
| | - Brooke A Bryson
- Department of Psychology, Texas State University, San Marcos, TX 78666, USA
| | - Diana Harcourt
- Centre for Appearance Research, University of the West of England, Coldharbour Lane, Bristol BS16 1QY, UK
| |
Collapse
|
3
|
Stepp WH, Stein EJ, Canfarotta MW, Wood J, Vandoros E, Stein M, Daniel R, Shockley WW, Clark JM, Drake AF. Body Dysmorphic Disorder in Adult Patients With an Orofacial Cleft: An Unseen Psychological Burden. Laryngoscope 2023; 133:818-821. [PMID: 36054769 DOI: 10.1002/lary.30378] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2022] [Revised: 07/14/2022] [Accepted: 08/12/2022] [Indexed: 11/07/2022]
Abstract
OBJECTIVES Facial dysmorphic disorder (FDD), a variant of body dysmorphic disorder, occurs when individuals are preoccupied with perceived defects in their facial appearance. Cleft lip and/or palate (CL/P) requires many clinical interventions and has significant psychological impacts on a patient's perception of appearance. This study identified psychological burdens related to living as an adult with CL/P and characterizes the degree of FDD symptoms in an adult craniofacial population. METHODS This was a prospective, single-center, cross-sectional case-control study using semi-structured interviews and symptom assessments at a university-based craniofacial center. Patients without CL/P undergoing non-cosmetic facial surgery were recruited as controls (n = 20). Patients with an orofacial cleft (n = 30) were recruited from medical and dental providers at the University of North Carolina. Body Dysmorphic Disorder-Yale Brown Obsessive Compulsive Scale (BBD-YBOCS) scores were collected from a control population and patients with CL/P to assess FDD severity. RESULTS Demographic factors such age, biological sex, and ethnicity had no significant impact on FDD symptom scores. Patient with CL/P were more likely to have significant FDD symptoms (BDD-YBOCS greater than 16) than patients without CL/P (OR 10.5, CI95 2.7-41.1), and had a mean difference in FDD symptoms scores of 10.04 (p < 0.0001; CI95 5.5-14.6). Patients with CL/P seen by a mental health provider in the past 3 months had 3-fold lower overall FDD symptom scores (OR 0.081; CI95 0.0085-0.77). CONCLUSIONS Adults with CL/P would benefit from treatment for cleft-specific needs and psychological support as they face unique stressors related to their appearance, including an increase in FDD-associated symptoms. This study emphasizes the importance of recognizing psychological symptoms and providing ongoing multidisciplinary care to adults with CL/P. LEVEL OF EVIDENCE 3; Individual case-control study Laryngoscope, 133:818-821, 2023.
Collapse
Affiliation(s)
- Wesley H Stepp
- Department of Otolaryngology, University of North Carolina, School of Medicine, Chapel Hill, North Carolina, U.S.A
| | - Eva J Stein
- Department of Otolaryngology, University of North Carolina, School of Medicine, Chapel Hill, North Carolina, U.S.A
| | - Michael W Canfarotta
- Department of Otolaryngology, University of North Carolina, School of Medicine, Chapel Hill, North Carolina, U.S.A
| | - Jeyhan Wood
- University of North Carolina Craniofacial Center, University of North Carolina, School of Dentistry, Chapel Hill, North Carolina, U.S.A.,Department of Surgery, University of North Carolina, School of Medicine, Chapel Hill, North Carolina, U.S.A
| | - Eva Vandoros
- Department of Otolaryngology, University of North Carolina, School of Medicine, Chapel Hill, North Carolina, U.S.A
| | - Margot Stein
- University of North Carolina Craniofacial Center, University of North Carolina, School of Dentistry, Chapel Hill, North Carolina, U.S.A
| | - Renie Daniel
- University of North Carolina Craniofacial Center, University of North Carolina, School of Dentistry, Chapel Hill, North Carolina, U.S.A.,Department of Oral and Maxillofacial Surgery, University of North Carolina, School of Dentistry, Chapel Hill, North Carolina, U.S.A
| | - William W Shockley
- Department of Otolaryngology, University of North Carolina, School of Medicine, Chapel Hill, North Carolina, U.S.A
| | - Joseph Madison Clark
- Department of Otolaryngology, University of North Carolina, School of Medicine, Chapel Hill, North Carolina, U.S.A
| | - Amelia F Drake
- Department of Otolaryngology, University of North Carolina, School of Medicine, Chapel Hill, North Carolina, U.S.A.,University of North Carolina Craniofacial Center, University of North Carolina, School of Dentistry, Chapel Hill, North Carolina, U.S.A
| |
Collapse
|
4
|
Adult Cleft Patients: An Exploration of Functional Needs and Treatment Barriers. J Craniofac Surg 2023; 34:332-336. [PMID: 35984002 DOI: 10.1097/scs.0000000000008931] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Accepted: 07/07/2022] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND Management of cleft lip and palate has been well characterized in pediatric patients, but limited data exist regarding the long-term functional outcomes of cleft patients once they reach adulthood. MATERIALS AND METHODS An institutional, cross-sectional survey of adult patients with a history of cleft lip and/or palate was performed. The survey recorded patient characteristics, concerns, and barriers to care. Patient-reported outcome measures were assessed using the Nasal Obstruction Symptom Evaluation Scale, Epworth Sleepiness Scale, Mandibular Function Impairment Questionnaire, and the CLEFT-Q Speech Modules. RESULTS A total of 63 patients (18.2%) participated in the survey. The mean patient age was 43.7 years (median: 41 y, range: 19-93 y), and the most common diagnosis was cleft lip and palate (51%) followed by isolated cleft palate (35%) and isolated cleft lip (14%). A subset of patients scored with moderate to severe dysfunction on each outcome measure including the Nasal Obstruction Symptom Evaluation Instrument (59%), Epworth Sleepiness Scale (7%), and Mandibular Function Impairment Questionnaire (13%). Respondent scores on the CLEFT-Q Speech modules demonstrated a bimodal distribution with lower scores in a significant subset of patients with cleft palate and cleft lip and palate. Many respondents (41%) were interested in clinical evaluation but cited barriers to seeking treatment including financial barriers (35%) or lack awareness of clinical options (27%). CONCLUSIONS Many cleft patients have persistent needs or concerns in adulthood, especially regarding speech and nasal breathing. Systemic barriers pose challenges to these patients undergoing clinical evaluation.
Collapse
|
5
|
Niinomi K, Ueki S, Fujita Y, Kitao M, Matsunaka E, Kumagai Y, Ike M. Differences in specific concerns perceived by parents of children with cleft lip and/or palate based on the types of cleft. Int J Paediatr Dent 2022; 32:304-313. [PMID: 34358380 DOI: 10.1111/ipd.12886] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/27/2020] [Revised: 07/21/2021] [Accepted: 07/28/2021] [Indexed: 11/30/2022]
Abstract
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.
Collapse
Affiliation(s)
- Kazuteru Niinomi
- Department of Integrated Health Sciences, Graduate School of Medicine, Nagoya University, Nagoya, Japan
| | - Shingo Ueki
- Department of Health Sciences, Faculty of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Yuichi Fujita
- Department of Nursing, School of Nursing, Mukogawa Women's University, Nishinomiya, Japan
| | - Mika Kitao
- Department of Nursing, School of Nursing, Mukogawa Women's University, Nishinomiya, Japan
| | - Eriko Matsunaka
- Department of Nursing, Japanese Red Cross Kyushu International College of Nursing, Munakata, Japan
| | - Yukari Kumagai
- Department of Nursing, Osaka University Dental Hospital, Suita, Japan
| | - Miho Ike
- Department of Nursing, Osaka University Dental Hospital, Suita, Japan
| |
Collapse
|
6
|
Myhre A, Råbu M, Feragen KJB. The need to belong: Subjective experiences of living with craniofacial conditions and undergoing appearance-altering surgery. Body Image 2021; 38:334-345. [PMID: 34087543 DOI: 10.1016/j.bodyim.2021.05.008] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2020] [Revised: 04/08/2021] [Accepted: 05/20/2021] [Indexed: 01/25/2023]
Abstract
The purpose of this study was to better understand how individuals with craniofacial conditions experience living with visible differences and make sense of appearance-altering surgery. We conducted semi-structured qualitative interviews with 11 adults with Goldenhar or Crouzon syndrome. Interviews were analysed using a hermeneutic-phenomenological approach to thematic analysis. Our analysis revealed the following overarching theme, To see myself as other people see me, which encompassed three main themes: a) Striving to fit in, b) Altering the way I look and c) Support from family and friends. The participants' sense of their own appearance seemed to be connected to how they perceived others to evaluate their appearance. All had experienced negative reactions from others. They experienced themselves as different and had a desire to belong. All participants had undergone appearance-altering surgery, hoping that by changing appearance, they would reduce negative reactions and feel more connected to and accepted by other people. The process of undergoing appearance-changing surgery was experienced as challenging, and participants wished for a dialogue with surgeons which included psychological and emotional aspects of changing appearance. A better understanding of how to strengthen positive identity processes and feelings of belongingness should be a key focus of future research.
Collapse
Affiliation(s)
- Anita Myhre
- Centre for Rare Disorders, Division of Paediatric and Adolescent Medicine, Oslo University Hospital, Postboks 4950 Nydalen, 0424, Oslo, Norway.
| | - Marit Råbu
- University of Oslo, Department of Psychology, Postboks 1094 Blindern, 0317, Oslo, Norway.
| | - Kristin J B Feragen
- Centre for Rare Disorders, Division of Paediatric and Adolescent Medicine, Oslo University Hospital, Postboks 4950 Nydalen, 0424, Oslo, Norway.
| |
Collapse
|
7
|
Alighieri C, D'haeseleer E, Bettens K, Bonte K, Vermeersch H, Vermeire N, Claeys M, Sseremba D, Galiwango G, Van Lierde K. Sociodemographics and Quality of Life in Dutch-Speaking Adolescents and Adults With and Without a Cleft Lip and/or Palate. Cleft Palate Craniofac J 2021; 59:S65-S73. [PMID: 34142586 DOI: 10.1177/10556656211024513] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVE To investigate the impact of living with a cleft lip and/or cleft palate (CL/P) on sociodemographic variables, quality of life, aesthetics, life satisfaction, and social distress in Dutch-speaking adolescents and adults. DESIGN Cross-sectional study. PARTICIPANTS Thirty Dutch-speaking participants with a CL/P with a mean age of 26.93 years (SD = 11.69) and an age- and gender-matched control group of 30 participants (19 men and 11 women) without a CL/P with a mean age of 26.87 years (SD = 11.73). MAIN OUTCOME MEASURES Self-reported outcomes of sociodemographics, quality of life, aesthetics, life satisfaction, social distress, and impact of cleft on well-being and functioning. RESULTS No significant differences in educational level, employment, monthly net income, marital status, and having children were found between participants with and without a CL/P. In addition, quality of life, overall aesthetics, life satisfaction, and social distress did not differ between the 2 groups. Among participants with CL/P, there were no gender differences in the influence of their CL/P on daily functioning, well-being, social contacts, family life, applying for a job, work, education, or leisure time. CONCLUSION The findings revealed no differences between participants with and without a CL/P with regard to sociodemographics, quality of life, aesthetics, life satisfaction, or social distress. There were no gender differences in the influence of cleft on well-being and functioning. Longitudinal research can help determine possible fluctuations in the impact of living with a CL/P across the life span.
Collapse
Affiliation(s)
- Cassandra Alighieri
- Department of Rehabilitation Sciences, 26656Ghent University, Corneel Heymanslaan, Ghent, Belgium
| | - Evelien D'haeseleer
- Department of Rehabilitation Sciences, 26656Ghent University, Corneel Heymanslaan, Ghent, Belgium
| | - Kim Bettens
- Department of Rehabilitation Sciences, 26656Ghent University, Corneel Heymanslaan, Ghent, Belgium
| | - Katrien Bonte
- Department of Head and Skin, 26656Ghent University Hospital, Corneel Heymanslaan, Ghent, Belgium
| | - Hubert Vermeersch
- Department of Head and Skin, 26656Ghent University Hospital, Corneel Heymanslaan, Ghent, Belgium
| | - Nele Vermeire
- Department of Rehabilitation Sciences, 26656Ghent University, Corneel Heymanslaan, Ghent, Belgium
| | - Merel Claeys
- Department of Rehabilitation Sciences, 26656Ghent University, Corneel Heymanslaan, Ghent, Belgium
| | - Daniel Sseremba
- Comprehensive Rehabilitation Services in Uganda (CoRSU), Kisubi, Uganda
| | - George Galiwango
- Comprehensive Rehabilitation Services in Uganda (CoRSU), Kisubi, Uganda
| | - Kristiane Van Lierde
- Department of Rehabilitation Sciences, 26656Ghent University, Corneel Heymanslaan, Ghent, Belgium
| |
Collapse
|
8
|
Oka A, Tanikawa C, Isogai Y, Mihara K, Yamashiro T. Evaluation of Facial Appearance-Related Quality of Life in Young Japanese Patients With Cleft Lip and/or Palate. Cleft Palate Craniofac J 2021; 59:S57-S64. [PMID: 34132116 DOI: 10.1177/10556656211023243] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVE (1) To confirm the reliability of a Japanese version of the Youth Quality of Life Instrument-Facial Differences Module (YQOL-FD); (2) to assess the quality of life (QoL) related to facial difference in Japanese youths with cleft lip and/or palate (CL/P) using this instrument; and (3) to examine the QoL differences according to age, sex, and cleft type. DESIGN A cross-sectional study. SETTING Japanese youths with CL/P were recruited through our hospital and asked to complete the YQOL-FD. PARTICIPANTS Sixty-nine Japanese youths (age, 11-18 years) with CL/P. OUTCOME MEASURES The domain scores of stigma, negative consequences, negative self-image, positive consequences, and coping in the YQOL-FD, and the reliability of such scores were evaluated. RESULTS The instrument showed an acceptable internal consistency (Cronbach α = 0.74-0.92) and test-retest reliability (intraclass correlation coefficient = 0.94-0.98), except for the coping domain. The individual's domain scores were spread out from the lowest score to the high scores among all domains, thus indicating the negative and positive impacts of living with facial differences regarding their QoL may vary among individuals with CL/P. All domain scores in the 15- to 18-year-old group were significantly higher than those in 11- to 14-year-old group; there were no significant differences according to sex or cleft type. CONCLUSIONS The instrument showed acceptable reliability, except for the coping domain. There were individual variations in QoL concerning the facial difference among Japanese youths with CL/P as measured by the YQOL-FD, suggesting the importance of individual evaluations. Perceptions were influenced by age, but not sex or cleft type.
Collapse
Affiliation(s)
- Ayaka Oka
- Department of Orthodontics and Dentofacial Orthopedics, Graduate School of Dentistry, 13013Osaka University, Suita, Osaka, Japan
| | - Chihiro Tanikawa
- Department of Orthodontics and Dentofacial Orthopedics, Graduate School of Dentistry, 13013Osaka University, Suita, Osaka, Japan
| | - Yukako Isogai
- Department of Orthodontics and Dentofacial Orthopedics, Graduate School of Dentistry, 13013Osaka University, Suita, Osaka, Japan
| | - Kiyomi Mihara
- Department of Orthodontics and Dentofacial Orthopedics, Graduate School of Dentistry, 13013Osaka University, Suita, Osaka, Japan
| | - Takashi Yamashiro
- Department of Orthodontics and Dentofacial Orthopedics, Graduate School of Dentistry, 13013Osaka University, Suita, Osaka, Japan
| |
Collapse
|
9
|
Longstaff S, Davies K, Benson P. Exploring 10-15-year-old patients' perspectives of fixed orthodontic treatment. J Orthod 2021; 48:110-117. [PMID: 33573439 DOI: 10.1177/1465312520981077] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE To explore and understand young people's perspectives of fixed orthodontic treatment. In particular, understanding how young people perceived and experienced having a fixed appliance and how their experiences can change during their treatment. DESIGN Qualitative study carried out longitudinally. SETTING In-depth qualitative interviews carried out in participants' homes, video diaries recorded by participants when and where they wish. PARTICIPANTS Fifteen patients aged 10-15 years undergoing NHS fixed appliance treatment. METHODS Data were collected by in-depth interviews and video diaries throughout the participants' course of orthodontic treatment. Data were analysed using thematic analysis. RESULTS Young people's friends, family and social media influenced how young people felt about the appearance of their teeth. Young people can perceive negative social judgements are made about them based on the appearance of their teeth; however, the appearance of the brace was not a concern. For some of the young people, the presence of the brace formed a rite of passage throughout adolescence. Pain and discomfort caused by fixed appliances was expected and tolerated and felt normal with time. CONCLUSION Young people's perceptions about appearance are influenced by people around them and social media. The physical feeling of the brace was normalised, although it did affect young people's lives.
Collapse
Affiliation(s)
- Sarah Longstaff
- University Hospitals of Derby and Burton NHS Foundation Trust, Burton on Trent, UK
| | | | - Philip Benson
- Department of Orthodontics, University of Sheffield, Sheffield, UK
| |
Collapse
|
10
|
Paganini A, Moss T, Persson M, Mark H. A gender perspective on appearance-related concerns and its manifestations among persons born with unilateral cleft lip and palate. PSYCHOL HEALTH MED 2020; 26:771-778. [PMID: 32720821 DOI: 10.1080/13548506.2020.1800055] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Cleft lip and palate (CLP) affects a person's facial appearance and can cause appearance-related distress. Appearance-related distress and its manifestations are not fully understood. Women with CLP tend to experience a higher degree of distress as well as undergo more aesthetic revisions than men. The aim of this study was to investigate if self-reported appearance-related gender differences occur among adults born with unilateral CLP using the Derriford Appearance Scale 24 (DAS24). One hundred sixty two consecutive patients, 107 men and 55 women, with unilateral CLP and no associated syndromes treated at the same hospital were asked to answer the DAS24. A mixed methods approach was used to analyse the questionnaires both quantitively and qualitatively. Fifty men and 30 women participated, the results showed that the aspects of appearance considered most disturbing was cleft-related among both genders, most common in regards to the nose. Three themes were found: acceptance, cleft features, and general appearance issues. The quantitative part showed that women reported higher appearance-related social anxiety and avoidance than men. This study demonstrated that appearance-related distress is present in both genders; however, women expressed more distress than men. Moreover, non-cleft as well as cleft features are of importance for self-reported dissatisfaction.
Collapse
Affiliation(s)
- Anna Paganini
- Department of Plastic Surgery, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Tim Moss
- Centre for Appearance Research, Faculty of Health and Applied Sciences, University of the West of England (Bristol), Bristol, UK
| | - Martin Persson
- Faculty of Health Sciences, Kristianstad University, Kristianstad, Sweden
| | - Hans Mark
- Department of Plastic Surgery, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Sahlgrenska University Hospital, Gothenburg, Sweden
| |
Collapse
|
11
|
Hamlet C, Harcourt D. Exploring the Experiences of Adults With Microtia: A Qualitative Study. Cleft Palate Craniofac J 2020; 57:1230-1237. [PMID: 32643387 PMCID: PMC7502977 DOI: 10.1177/1055665620931611] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
OBJECTIVE Microtia is a medically complex condition, with the option of surgery to address hearing and reconstruct the ear. The current study explored adults' experiences of microtia, with a particular focus on the psychosocial impact and experiences of ear reconstruction. The ultimate aim was to identify areas for support and future research that could improve patient care. DESIGN Fifteen adults (12 females) aged between 20 and 62 years took part in semi-structured interviews. Interviews were audio-recorded, transcribed verbatim, and analyzed using inductive thematic analysis. RESULTS Three main themes were identified in the data: microtia as an invisible difference, surgery as a welcome opportunity, and living well with microtia. Participants had incorporated microtia into their self-concept and did not report a lasting negative impact on their lives. However, some psychosocial challenges were reported, including anxiety about showing their ears (even after reconstruction), disclosing their diagnosis to romantic partners, surgical decision-making, and feeling unsupported in the work environment. CONCLUSION Individuals with microtia may benefit from psychosocial interventions to increase confidence, access to support for treatment decision-making, and guidance around disclosing microtia to employers.
Collapse
Affiliation(s)
- Claire Hamlet
- Centre for Appearance Research, University of the West of England, Bristol, United Kingdom
| | - Diana Harcourt
- Centre for Appearance Research, University of the West of England, Bristol, United Kingdom
| |
Collapse
|
12
|
Matsunaka E, Kumagai Y, Ike M, Takano S, Kogo M. Decision-making process to undergo surgery among adolescent patients with cleft lip and/or palate. Jpn J Nurs Sci 2020; 17:e12342. [PMID: 32390343 DOI: 10.1111/jjns.12342] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2019] [Revised: 02/19/2020] [Accepted: 03/29/2020] [Indexed: 12/30/2022]
Abstract
AIM As patients with cleft lip and/or palate grow older, the main decision-making process for treatment is likely to shift from a parent-centered to a patient-centered process. However, many adolescent patients have difficulty in treatment decision-making. This study aimed to clarify the decision-making process regarding undergoing surgery among adolescent patients with cleft lip and/or palate. METHODS Participants were adolescent patients with cleft lip and/or palate aged 14-18 years who were admitted to a hospital in Japan for surgery. Fourteen patients (six boys, eight girls) and their parents agreed to participate in this study. Data were collected in face-to-face semi-structured interviews. Data were analyzed qualitatively with inductive content analysis. RESULTS Fifteen categories were classified into three themes for adolescent patients' decision-making processes regarding undergoing surgery. The three themes were: (a) a doctor's recommendation for surgery, (b) psychological conflict about surgery, and (c) a final decision about surgery. CONCLUSION This study's findings suggest that adolescent patients with cleft lip and/or palate were not adequately involved in the decision-making process before undergoing surgery. Medical staff need to explain other treatment options, the risks and benefits of surgery with materials and methods that adolescent patients can understand as part of "a doctor's recommendation for surgery." Medical staff and parents need to encourage adolescent patients to communicate their preferences and values to reduce patients' "psychological conflict about surgery" and adolescent patients' intentions should be considered in "a final decision about surgery."
Collapse
Affiliation(s)
- Eriko Matsunaka
- Department of Nursing, Japanese Red Cross Kyushu International College of Nursing, Fukuoka, Japan
| | - Yukari Kumagai
- Nursing Department, Osaka University Dental Hospital, Osaka, Japan
| | - Miho Ike
- Nursing Department, Osaka University Dental Hospital, Osaka, Japan
| | - Sachiko Takano
- Nursing Department, Osaka University Dental Hospital, Osaka, Japan
| | - Mikihiko Kogo
- Department of Oral and Maxillofacial Surgery 1, Graduate School of Dentistry, Osaka University, Osaka, Japan
| |
Collapse
|
13
|
Saving Face: Patient Strategies to Reduce Stigma and Barriers to Effective Decision-Making Among Children With Cleft Lip. J Craniofac Surg 2020; 31:1608-1612. [PMID: 32371692 DOI: 10.1097/scs.0000000000006520] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
Facial differences associated with cleft lips are often stigmatizing and can negatively impact psychosocial development and quality of life. However, little is known regarding patients' responses to societal expectations of appearance, or how these responses may impact utilization of revision surgery. Thus, patients with cleft lips at least 8 years of age (n = 31) were purposively sampled for semi-structured interviews. After verbatim transcription, first cycle coding proceeded with a semantic approach, which revealed patterns that warranted second cycle coding. The authors utilized an eclectic coding design to capture deeper meanings in thematic analysis. Additionally, survey data from a separate study were examined to evaluate participants' interest in improving appearance. Three major themes emerged, all of which reflected a desire to "save face" when interacting with society: (1) Cultural Mantras, which included societal mottos that minimized the importance of appearance; (2) Toughening Up, wherein the participants downplayed the difficulty of having a cleft; and (3) Deflection, wherein the participants took pride in facial features unrelated to their clefts. Despite these efforts to "save face," 78% of participants expressed interest in improving their appearance in the separate survey data.In conclusion, children with cleft lips try to "save face" when interacting with society by depreciating appearance, making light of clefts, and focusing on non-cleft related features. Paradoxically, many desired improvements of their appearance in an earlier survey. Awareness of these coping strategies is critical, as they may negatively impact surgeon-patient communication and inhibit patients from expressing interest in revision surgery.
Collapse
|
14
|
Ardouin K, Hare J, Stock NM. Emotional Well-Being in Adults Born With Cleft Lip and/or Palate: A Whole of Life Survey in the United Kingdom. Cleft Palate Craniofac J 2020; 57:877-885. [PMID: 31906694 DOI: 10.1177/1055665619896681] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023] Open
Abstract
Objectives: Previous research with adults born with cleft lip and/or palate (CL/P) has identified a range of concerns regarding mental health and quality of life, concluding that overall emotional functioning is poorer compared to the general population. The aim of the current study was to build on this previous work by investigating the self-reported emotional well-being of adults born with CL/P in the United Kingdom. Design: An online, mixed methods survey was designed by the Cleft Lip and Palate Association in collaboration with the Centre for Appearance Research at the University of the West of England. A total of 207 eligible responses were received between July and October 2018. Qualitative data were analyzed using inductive content analysis, while quantitative data were analyzed using descriptive statistics and independent t tests. Results: Almost half of the sample reported a diagnosis of a mental health condition. Scores on standardized measures indicated significantly lower global self-worth, higher levels of fear of negative appearance evaluation, and lower self-perceived job competence compared to normative data. Scores of overall body esteem were in line with the general population. Most participants had not received psychological support from their regional CL/P team and 41% were unaware of their entitlement to treatment from the National Health Service. Conclusions: Individuals with CL/P may be at risk of emotional distress persisting into adulthood. The integration of routine psychological support from an early age is highly recommended, as is information for young adults about to complete routine treatment. Comprehensive psychological screening for adults returning to the service later in life is also strongly advised.
Collapse
Affiliation(s)
- Kenny Ardouin
- Cleft Lip and Palate Association, London, United Kingdom
| | - Jess Hare
- National Cleft Surgical Service for Scotland, Queen Elizabeth University Hospital, Glasgow, United Kingdom
| | - Nicola Marie Stock
- Centre for Appearance Research, University of the West of England, Bristol, United Kingdom
| |
Collapse
|
15
|
Connolly KA, Kurnik NM, Truong TA, Muller C, Beals PH, Singh DJ, Beals SP. Long-Term Outcomes for Adult Patients With Cleft Lip and Palate. J Craniofac Surg 2019; 30:2048-2051. [PMID: 31524752 DOI: 10.1097/scs.0000000000005932] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
The purpose of this study was to evaluate a single center's experience with adult patients who had cleft lip, cleft palate, or both. The authors aimed to identify common long-term needs in this patient population and evaluated the relationship of team-based care in meeting those needs. To do so, the authors retrospectively reviewed chart records from a single private practice and tertiary referral cleft center for all patients who were ≥15 years of age and who had a history of clefts of the lip or palate, or both, from January 1, 2013, to June 30, 2014. The authors compared the concerns of the patients who received cleft-team-based care by a single, multidisciplinary cleft team; multiple multidisciplinary cleft teams; or no formal cleft team. The authors analyzed data for 142 patients. The most common patient concerns were lip aesthetics (64%), nose aesthetics (61%), septal deviations (47%), nasal obstruction (44%), malocclusion (32%), oronasal fistulas (29%), and speech (21%). Oronasal fistulas were more commonly reported in the group of patients who had care by multiple teams (42.9%; P < .001). Malocclusion was more commonly reported in the group of patients who had care by multiple teams (50%; P = .001). The authors found that adult patients who have undergone rehabilitation for cleft lip and palate appear to have a common set of long-term needs. Multidisciplinary cleft-team-based care appears to be the most effective way to address these needs.
Collapse
Affiliation(s)
| | - Nicole M Kurnik
- Division of Plastic and Reconstructive Surgery, Mayo Clinic Hospital
| | - Tuan A Truong
- Division of Plastic and Reconstructive Surgery, Mayo Clinic Hospital
| | | | | | - Davinder J Singh
- Barrow Cleft and Craniofacial Center.,Division of Plastic and Reconstructive Surgery at Phoenix Children's Hospital, Phoenix, AZ
| | | |
Collapse
|
16
|
Rosenberg J, Albert M, Aspinall C, Bautista S, Bellucci CC, Edwards TC, Heike CL, Mecham SH, Patrick DL, Stueckle L, Kapp-Simon K. Parent Observations of the Health Status of Infants With Clefts of the Lip: Results From Qualitative Interviews. Cleft Palate Craniofac J 2019; 56:646-657. [PMID: 30092661 PMCID: PMC6368886 DOI: 10.1177/1055665618793062] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVE To explore, using semistructured qualitative interviews, parent observations of their infant's health as they relate to having a cleft lip or cleft lip and cleft palate (CL±P) and/or associated treatments. DESIGN Cross-sectional, qualitative study across 3 sites. SETTING Parents were recruited from 3 academic craniofacial centers. Most interviews were conducted over the telephone, audio-recorded, and transcribed. PARTICIPANTS Forty-one parents (31 English-, 10 Spanish-speaking) were interviewed. Parents had a child ages 1 to 35 months diagnosed with CL±P. MAIN OUTCOME MEASURE(S) Twelve domains reflecting infant health and well-being, likely affected by a CL±P and/or associated treatments, were identified from clinical experience and literature review. Study investigators conducted semistructured interviews based on 12 identified domains. After transcripts of the interviews were reviewed, our multidisciplinary team selected illustrative quotes from each domain that reflected consistent observations made by parents. RESULTS Parents' responses covered all 12 domains. Specifically, parents discussed the domain of feeding most frequently, followed by observations about sleep, development, comfort, breathing, and vocalization. CONCLUSIONS We found that parents of infants with clefts provided caregiver-centered language useful in describing their daily observations. No additional domains of infant health were noted by parents. We will use these observations and language to develop and validate a parent-reported observation diary that can augment assessments of the impacts of interventions on infants who are receiving care for CL±P.
Collapse
Affiliation(s)
- Janine Rosenberg
- University of Illinois Hospital and Health Sciences System, Chicago, IL, USA
| | | | | | - Suzel Bautista
- University of Illinois Hospital and Health Sciences System, Chicago, IL, USA
| | | | | | | | | | | | | | | |
Collapse
|
17
|
Omeje UK, Owobu T, Agbara R. Social impact of cleft lip repair on married adults: an uncommon finding from a semi-urban African settlement. Br J Oral Maxillofac Surg 2019; 57:242-245. [PMID: 30850222 DOI: 10.1016/j.bjoms.2019.02.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2018] [Accepted: 02/18/2019] [Indexed: 11/18/2022]
Abstract
An orofacial cleft may have an appreciable psychosocial impact on patients that could affect their social lives, including the choice of who they marry. We retrospectively reviewed the impact of repair of cleft lip on marriage in adult patients in our institution by questioning a group of patients treated from July 2009-June 2017. There were 120 adult patients who had cleft lips repaired, of whom 17 (14%) patients changed their marital status. The mean (SD) ages of the 17 were 32 (1), range 20-41, years. Five of the 17 were men, and 12 women, with a male:female ratio of 0.4: 1. All 17 patients confirmed that the unrepaired cleft affected the choice of who they initially married. After repair, the five male patients married additional wives (one wife each (n=4), and two wives (n=1)). Of the 12 female patients all divorced their spouses, but only nine had remarried at the time of the study. We conclude that unrepaired cleft lip in an adult in our environment may affect the choice of partner. This choice may be altered if facial aesthetics improve after repair of the cleft.
Collapse
Affiliation(s)
- Uchenna Kelvin Omeje
- Department of Oral and Maxillofacial Surgery, Aminu Kano Teaching Hospital, Kano, Nigeria; Department of Dental and Maxillofacial Surgery, Federal Medical Center, Nguru, Yobe State, Nigeria.
| | - Thomas Owobu
- Department of Dental and Maxillofacial Surgery, Federal Medical Center, Nguru, Yobe State, Nigeria
| | | |
Collapse
|
18
|
Morzycki A, Wong A, Hong P, Bezuhly M. Assessing Attentional Bias in Secondary Cleft Lip Deformities: An Eye-Tracking Study. Cleft Palate Craniofac J 2018; 56:257-264. [PMID: 29742362 DOI: 10.1177/1055665618775728] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVE Using a well-established measure of attention, we aimed to objectively identify differences in severity between types of simulated secondary cleft lip deformities. DESIGN Volunteer participants viewed a series of images of a child digitally modified to simulate different secondary unilateral cleft lip deformities (long lip, short lip, white roll/vermilion disjunction, and vermilion excess), a lip scar with no secondary deformity, or a normal lip. Eye movements were recorded using a table-mounted eye-tracking device. Dwell times for 7 facial regions (eyes, nose, mouth, left ear, right ear, scar, and entire face) were compared. PARTICIPANTS Forty-six naive adults (25 male; mean age 25.5 years) were recruited from our local university community. MAIN OUTCOME The primary outcome of the study was cumulative dwell time between facial regions (eyes, nose, mouth, left ear, right ear, scar, and entire face). RESULTS Participants spent significantly more time focused on the upper lip regions in patients with simulated secondary deformities relative to those who did not ( P < .01). Severe short lip deformities resulted in longer fixation times than severe long lips ( P < .05). Participants spent less time focused on the eye region in the presence of a secondary lip deformity ( P < .05). When total facial fixation time was assessed, short lip deformities resulted in the greatest duration dwell time ( P < .001). CONCLUSIONS This study presents objective data to support the concept that observers show varying degrees of attentional bias to the lip region depending on the type and severity of the simulated secondary cleft lip deformity.
Collapse
Affiliation(s)
- Alexander Morzycki
- 1 Faculty of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Alison Wong
- 2 Division of Plastic and Reconstructive Surgery, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Paul Hong
- 3 Division of Otolaryngology, Dalhousie University, Halifax, Nova Scotia, Canada.,4 Department of Surgery, IWK Health Centre, Halifax, Nova Scotia, Canada
| | - Michael Bezuhly
- 2 Division of Plastic and Reconstructive Surgery, Dalhousie University, Halifax, Nova Scotia, Canada.,4 Department of Surgery, IWK Health Centre, Halifax, Nova Scotia, Canada
| |
Collapse
|
19
|
Nicholls W, Selvey LA, Harper C, Persson M, Robinson S. The Psychosocial Impact of Cleft in a Western Australian Cohort Across 3 Age Groups. Cleft Palate Craniofac J 2018; 56:210-221. [PMID: 29649370 DOI: 10.1177/1055665618769660] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Management of a cleft of the lip and/or palate (CL/P) involves a multidisciplinary team approach lasting from birth to potentially postskeletal maturity. This condition is complex, with both medical and psychosocial implications that may place individuals with a cleft at higher risk of developing psychosocial problems. METHODOLOGY A self-administered questionnaire was completed by a sample from the Western Australian cleft population comprising 3 age groups: child (n = 100), adolescent (n = 101), and adult (n = 158). RESULTS Public speaking, being photographed, special relationships, and participation in school were identified as the areas most impacted by having a cleft. Hearing and speech were reported to have a higher importance than facial and dental appearance. Participants rated support given to them by their parents as the most important, with high ratings for treatment providers. For teasing, the impact of cleft was significantly higher among participants with cleft lip and palate for both the adolescent and adult age groups. There was little significant difference by gender across the variables, which suggests that males are just as likely to require support as females. CONCLUSION The impact of a cleft across multiple psychosocial domains needs to be recognized and addressed as part of craniofacial team care across age groups.
Collapse
Affiliation(s)
- Wendy Nicholls
- 1 Princess Margaret Hospital Dental/Cleft Lip and Palate Unit, Perth, Western Australia, Australia
| | - Linda A Selvey
- 2 Curtin University, Perth, Western Australia, Australia
| | - Craig Harper
- 3 Private Consultancy, Perth, Western Australia, Australia
| | | | | |
Collapse
|
20
|
Nicholls W, Harper C, Robinson S, Persson M, Selvey L. Adult-Specific Life Outcomes of Cleft Lip and Palate in a Western Australian Cohort. Cleft Palate Craniofac J 2018; 55:1419-1429. [PMID: 29620916 DOI: 10.1177/1055665618768540] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND People with a cleft of the lip and/or palate (CL/P) differ from their peers due to their facial appearance, hearing and speech difficulties, and the significant time spent attending appointments and recovering from surgical interventions. These differences may impact life outcomes including occupation, income, education, relationships, psychosocial health issues, and lifestyle choices. METHODOLOGY A self-administered questionnaire was posted to 338 former and current patients of the Cleft Lip and Palate Unit of Princess Margaret Hospital (PMH), Perth, Western Australia. RESULTS Completed questionnaires were returned by 158 former and current patients. In comparison to the Australian Bureau of Statistics, study participants attained equivalent highest education levels, full-time annual income levels, occupational categories, employment rates, and home ownership levels. They did not marry later and demonstrated positive health-related lifestyle behaviors. However independent living was significantly delayed, and the number of romantic relationships, marriages, and children was lower, with separation/divorce rates also being lower. A key finding was that 78% of participants self-reported that they experienced at least 1 psychosocial health issue and more than half experienced anxiety and/or depression. CONCLUSION When comparing the sociological outcomes for the study participants, the psychosocial outcomes were the areas of most concern. Further investigation is required to determine the causes for the high self-reported rates of anxiety and/or depression found in this study.
Collapse
Affiliation(s)
- Wendy Nicholls
- 1 Dental Department/Cleft Lip and Palate Unit, Princess Margaret Hospital for Children, Perth, Western Australia, Australia
| | - Craig Harper
- 2 School of Computing, Curtin University, Perth, Western Australia, Australia
| | - Suzanne Robinson
- 3 School of Public Health, Curtin University, Perth, Western Australia, Australia
| | - Martin Persson
- 4 Centre for Appearance Research, University of West England, Bristol, United Kingdom
| | - Linda Selvey
- 3 School of Public Health, Curtin University, Perth, Western Australia, Australia
| |
Collapse
|
21
|
Feragen KB, Stock NM. Factors affecting subjective appearance evaluations among patients with congenital craniofacial conditions: An application of Cash's cognitive-behavioural model of body image development. Body Image 2018; 24:124-136. [PMID: 29414145 DOI: 10.1016/j.bodyim.2017.12.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2017] [Revised: 11/16/2017] [Accepted: 12/19/2017] [Indexed: 12/11/2022]
Abstract
Satisfaction with appearance is of central importance for psychological well-being and health. For individuals with an unusual appearance, such as congenital craniofacial anomalies (CFA), appearance evaluations could be especially important. However, few, if any papers have presented a comprehensive synthesis of the factors found to affect subjective satisfaction with appearance among children, adolescents, and adults born with a CFA. Further, only a handful of craniofacial studies have applied psychological theories or models to their findings, resulting in an overall lack of guidance for researchers in the field. This paper summarises the literature pertaining to satisfaction with appearance among those affected by CFAs, and examines the extent to which Cash's cognitive-behavioural model of body image development (2012) fits with this literature. Given the overlap between factors of interest in the field of CFAs, and in the area of body image more broadly, a closer collaboration between the two research fields is suggested.
Collapse
Affiliation(s)
| | - Nicola Marie Stock
- 'Scar Free Foundation Research Fellow' at the 'Centre for Appearance Research and The Cleft Collective', University of the West of England, Frenchay Campus, Coldharbour Lane, Bristol, BS16 1QY, United Kingdom.
| |
Collapse
|
22
|
Stock NM, Feragen KB, Rumsey N. Adults’ Narratives of Growing up with a Cleft Lip and/or Palate: Factors Associated with Psychological Adjustment. Cleft Palate Craniofac J 2018; 53:222-39. [DOI: 10.1597/14-269] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Background Growing up with a cleft lip and/or palate presents a number of challenges for those affected and their families. Understanding why some individuals cope well while others struggle is key to psychological research in this field. A better appreciation of the factors and processes that contribute to psychological adjustment to cleft lip and/or palate (CL/P) from the patient perspective would be of value to both researchers and clinicians. Design Qualitative data elicited from individual interviews with 52 adults born with CL/P. Result Inductive thematic analysis identified three main themes: “background” factors (age, gender, sexual orientation, culture, additional conditions, socioeconomic status, and adoption), “external” factors (treatment autonomy, familial coping and support, salience, public understanding, psychological input, and peer support), and “internal” psychological factors (perceptions of difference, noticeability and teasing, social confidence, internalization of beauty ideals, valence, expectations of treatment, responding to challenges, social comparisons, acceptance, faith, dispositional style, and recognition of strengths and positive growth). Conclusions The number and breadth of factors identified in this study are testament to the importance of psychology in the field of CL/P and may offer guidance in relation to developing and assessing the value of psychological interventions. There is a clear role for psychologists in tackling appearance-related concerns, designing materials, supporting patient decision making, and improving social interaction, as well as providing specialist psychological support. The findings illustrate the potential degree of individual variation in perspectives and offer insight into the conflicting results found within current literature.
Collapse
Affiliation(s)
- Nicola Marie Stock
- Centre for Appearance Research, University of the West of England, Bristol, United Kingdom
| | | | - Nichola Rumsey
- Centre for Appearance Research, University of the West of England, Bristol, United Kingdom
| |
Collapse
|
23
|
Liddle MJ, Baker SR, Smith KG, Thompson AR. Young Adults’ Experience of Appearance-Altering Orthognathic Surgery. Cleft Palate Craniofac J 2017; 55:238-247. [DOI: 10.1177/1055665617726533] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Objective: To gain an experiential account of the processes of change associated specifically with orthognathic surgery. Design: A qualitative design was used. Semistructured interviews were carried out with 7 participants approximately 1 week before and 6-8 weeks after surgery. The data were analyzed using interpretative phenomenologic analysis (IPA). Setting: Participants were recruited from a NHS Dental Hospital. Participants: Patients aged 16 to 25 years scheduled to undergo orthognathic surgery on both the upper and lower jaws were purposively sought to participate. Seven participants aged between 18 and 25 years and who had undergone a bimaxillary osteotomy completed interviews (5 females and 2 males). Results: Themes were identified in connection with the overall journey of treatment being a rite of passage; the treatment’s role in raising awareness about the anomalies in appearance; the initial shock at the changes that followed surgery; the uncertainty about treatment; the impact of actual negative reactions of others; and the role of significant others in the decision-making process. Conclusions: Participants described undergoing a much more complex process of adjustment to change in appearance than has been identified elsewhere within the literature, and the study highlights the nuanced fashion in which both medical and parental communication influence patient expectation and experience of surgery. There is a need to improve communication between clinicians, families, and young adults seeking orthognathic surgery. Further studies are needed to investigate the processes associated with seeking to change facial appearance resulting from other forms of dentofacial condition.
Collapse
Affiliation(s)
- Morna J. Liddle
- Clinical Psychology Unit, Department of Psychology, University of Sheffield, Cathedral Court, United Kingdom
| | - Sarah R. Baker
- School of Clinical Dentistry, University of Sheffield, Claremont Crescent, Sheffield, United Kingdom
| | - Keith G. Smith
- School of Clinical Dentistry, University of Sheffield, Claremont Crescent, Sheffield, United Kingdom
| | - Andrew R. Thompson
- Clinical Psychology Unit, Department of Psychology, University of Sheffield, Cathedral Court, United Kingdom
| |
Collapse
|
24
|
Hamlet C, Harcourt D. Response to “Older Adults’ Experiences of Living with Cleft Lip and Palate: A Qualitative Study Exploring Ageing and Appearance”. Cleft Palate Craniofac J 2017; 54:368. [PMID: 27115563 DOI: 10.1597/15-352] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Affiliation(s)
- Claire Hamlet
- Centre for Appearance Research, University of the West of England, Bristol, United Kingdom
| | - Diana Harcourt
- Centre for Appearance Research, University of the West of England, Bristol, United Kingdom
| |
Collapse
|
25
|
Searle A, Neville P, Waylen A. Psychological growth and well-being in individuals born with cleft: An application of self-determination theory. Psychol Health 2017; 32:459-482. [DOI: 10.1080/08870446.2016.1275630] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Aidan Searle
- School of Oral and Dental Sciences, University of Bristol, Bristol, UK
| | - Patricia Neville
- School of Oral and Dental Sciences, University of Bristol, Bristol, UK
| | - Andrea Waylen
- School of Oral and Dental Sciences, University of Bristol, Bristol, UK
| |
Collapse
|
26
|
Jones BA, Buchanan H, Harcourt D. The experiences of older adults living with an appearance altering burn injury: An exploratory qualitative study. J Health Psychol 2016; 22:364-374. [DOI: 10.1177/1359105315603473] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Advances in medical treatment mean more older people are living with burn injuries. However, little is known about experiences and support needs of this group. Interpretative Phenomenological Analysis of semi-structured interviews with 10 burn survivors aged 51–71 years identified four themes: time and adjusting to an altered appearance; living with a visible difference in the eyes of others; me, myself and I; importance of maintaining appearance. Adjusting to burns was a long process. Participants discussed feeling isolated, needing information about how ageing impacts on scars and maintaining a socially acceptable appearance. Implications for care and further research are discussed.
Collapse
|
27
|
Stock NM, Feragen KB. Psychological adjustment to cleft lip and/or palate: A narrative review of the literature. Psychol Health 2016; 31:777-813. [DOI: 10.1080/08870446.2016.1143944] [Citation(s) in RCA: 66] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
|
28
|
Roberts RM, Neate GM, Gierasch A. Implicit attitudes towards people with visible difference: findings from an Implicit Association Test. PSYCHOL HEALTH MED 2016; 22:352-358. [DOI: 10.1080/13548506.2016.1163399] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
|
29
|
Lee DC, Adetayo OA. Letter to the Editor. Cleft Palate Craniofac J 2016; 54:245. [PMID: 26907207 DOI: 10.1597/15-342] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Affiliation(s)
| | - Oluwaseun A Adetayo
- Division of Plastic Surgery and Cleft-Craniofacial Center Albany Medical College and The Bernard & Millie Duker Children's Hospital at Albany Medical Center 50 New Scotland Avenue, MC-190 Albany, New York 12208 E-mail
| |
Collapse
|
30
|
Kumar A, Kalliainen LK. Cleft Lip Surgical Intervention in Resource Constraint Settings: A Case Report. Health (London) 2016. [DOI: 10.4236/health.2016.85050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
|
31
|
Kovrazhkina EA, Starikova NV, Nadtochiy AG, Gubskiy LV, Panov VO, Volkova KN. Neurologic disturbances in children with cleft lip and cleft palate. Zh Nevrol Psikhiatr Im S S Korsakova 2016; 116:76-82. [DOI: 10.17116/jnevro20161163276-82] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
|
32
|
Stock NM, Feragen KB, Rumsey N. “It Doesn't All Just Stop at 18”: Psychological Adjustment and Support Needs of Adults Born with Cleft Lip and/or Palate. Cleft Palate Craniofac J 2015; 52:543-54. [DOI: 10.1597/14-178] [Citation(s) in RCA: 57] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
Background Cleft in the lip and/or the palate (CL/P) is considered to be a lifelong condition, yet relatively little is known about the long-term outcomes for patients. Existing literature is largely outdated and conflicted, with an almost exclusive focus on medical aspects and deficits. Objective To explore the psychological adjustment and possible support needs of a large number of adults born with CL/P from their own perspective. Design Fifty-two individual telephone interviews eliciting qualitative data. Results Qualitative analysis identified five themes. Participants reported a range of challenges in relation to discharge from the service, additional surgery as an adult, social and romantic relationships, higher education, vocational achievement, and access to psychological support. The findings imply that most adults with a cleft adjust well to these challenges and report many positive outcomes. For a minority of patients, issues attributed to the cleft may continue to cause distress in adulthood. Conclusions Adults with CL/P may require psychological support, information about the heritability of cleft, signposting and referrals from nonspecialists, support regarding further treatment, and opportunities to take part in research and activities. New issues arising in adulthood, such as entering the workplace, forming long-term relationships, and starting a family, may warrant both further investigation and additional support. Further work is needed to identify the factors that contribute to psychological distress and resilience, as well as the timing of particular points of risk and opportunity for personal growth.
Collapse
Affiliation(s)
- Nicola Marie Stock
- Centre for Appearance Research, University of the West of England, Bristol, United Kingdom
| | | | - Nichola Rumsey
- Centre for Appearance Research, University of the West of England, Bristol, United Kingdom
| |
Collapse
|