Coping with a Cleft II: Factors Associated with Psychosocial Adjustment of Adolescents with a Cleft Lip and Palate and Their Parents

2011 ◽  
Vol 48 (1) ◽  
pp. 82-90 ◽  
Author(s):  
Zoe E. Berger ◽  
Louise J. Dalton
Keyword(s):  
Psychosocial Adjustment ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Factors Associated

scholarly journals Fatores de Riscos na Fissura Labiopalatina Não Sindrômica

UNICIÊNCIAS ◽  
2021 ◽  
Vol 24 (1) ◽  
pp. 86-93
Author(s):  
Carla Meliso Rodrigues Silvestre ◽  
Renata Cristina Giroto Ferreira da Silva ◽  
Ageo Mario Candido da Silva ◽  
Walkiria Shimoya Bittencourt ◽  
Yolanda Benedita Abadia Martins de Barros ◽  
...  
Keyword(s):  
Risk Factors ◽  
Environmental Factors ◽  
Literature Review ◽  
Cleft Palate ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
First Trimester ◽  
Human Beings ◽  
Factors Associated ◽  
Narrative Literature Review

As anomalias craniofaciais representam um grupo amplo de malformações congênitas que afetam uma grande proporção da sociedade mundial. Entre essas se encontram as fissuras de lábio e/ou de palato, anomalia orofacial mais frequente entre os seres humanos que ocasionam problemas estéticos e funcionais nos indivíduos afetados.  A etiologia das fissuras labiopalatinas isoladas ou não-sindrômicas é complexa e multifatorial, associadas à fatores hereditários e ambientais. Este estudo teve como objetivo relatar os fatores genéticos e ambientais associados à etiologia desse tipo de malformação, através de uma revisão narrativa de literatura, a partir das bases de dados: PubMed e Scielo. Os descritores utilizados foram: cleft palate AND cleft lip AND etiology AND risk factors. Incluíram-se artigos nos idiomas inglês e português publicados em periódicos nacionais e internacionais acerca da temática da pesquisa. Baseado na revisão de literatura se pode identificar que os fatores ambientais como: fumo, consumo de álcool, consumo de medicamentos, o não uso de suplementação com polivitamínicos e ácido fólico, exposição a agrotóxicos, idade dos genitores podem aumentar a chance de ocorrência das fissuras labiopalatinas. O acompanhamento gestacional durante o primeiro trimestre gestacional se faz necessário, a fim de monitorar os fatores de risco associados com as fissuras labiopalatinas não sindrômicas.   Palavras-chave: Fissura Palatina. Fenda Labial. Etiologia. Fatores de Risco.   Abstract Craniofacial anomalies represent a broad group of congenital malformations that affect a large proportion of world society. Among them are cleft lip and / or palate, the most frequent orofacial anomaly among human beings that cause aesthetic and functional problems in the affected individuals. The etiology of isolated or non-syndromic cleft lip and palate is complex and multifactorial, associated with hereditary and environmental factors. This study aimed to report the genetic and environmental factors associated with the etiology of this type of malformation through a narrative literature review conducted in October 2020, using the PubMed and Scielo databases. The keywords used were cleft palate AND cleft lip AND etiology AND risk factors. Articles in English and Portuguese published in national and international journals about the research theme were included. Based on the literature review, it can be identified that environmental factors such as smoking, alcohol consumption, medication consumption, the non-use of supplementation with multivitamins and folic acid, exposure to pesticides, age of parents can increase the chance of cleft lip and palate occurrence. Gestational monitoring during the first trimester of pregnancy is necessary in order to monitor the risk factors associated with non-syndromic cleft lip and palate.   Keywords: Cleft Palate. Cleft Lip. Etiology. Risk Factors.

Factors Associated With Delay in Cleft Surgery at a Tertiary Children’s Hospital in a Major US Metropolitan City

2021 ◽  
pp. 105566562198950
Author(s):  
Jacqueline Stoneburner ◽  
Naikhoba C. O. Munabi ◽  
Eric S. Nagengast ◽  
Madeleine S. Williams ◽  
Pedram Goel ◽  
...  
Keyword(s):  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Female Gender ◽  
Hispanic Ethnicity ◽  
Delayed Surgery ◽  
Factors Associated ◽  
Children's Hospital ◽  
Children’S Hospital ◽  
Syndromic Diagnosis ◽  
Cleft Surgery

Objective: To identify factors associated with late cleft repair at a US tertiary children’s hospital. Design: Retrospective study of children with CL/P using Children’s Hospital Los Angeles (CHLA) records. Setting: US tertiary children’s hospital. Patients/Participants: Patients undergoing primary CL or CP repair at CHLA from 2009 to 2018. Main Outcome Measures: Proportion of children who had delayed primary CL repair or CP repair using CHLA and American Cleft Palate-Craniofacial Association (ACPA) guidelines and factors associated with late surgery. Results: In total, 805 patients—503 (62.5%) who had CL repair, 302 (37.5%) CP repair—were included. Using CHLA protocol, 14.3% of patients seeking CL repair had delayed surgery. Delay was significantly associated with female gender, non-Hispanic ethnicity, Spanish primary language, government insurance, bilateral cleft, cleft lip and palate (CLP), and syndromic diagnosis. Using ACPA guidelines, 5.4% had delayed surgery. Female gender and syndromic diagnosis were significantly associated with delay and remained significant after adjustment for confounders in multivariate models. For CP repair, 60.3% of patients had delayed surgery using CHLA protocol. Cleft lip and palate diagnosis, complete cleft, syndromic diagnosis, and longer travel distance were significantly associated with delay. Using ACPA guidelines, 28.5% had delayed surgery; however, significant association with patient variables was not consistently observed. Conclusions: Delay in cleft surgery occurs most often for patients seeking CP repair and is associated with female gender, non-Hispanic ethnicity, Spanish language, government insurance, and bilateral CL, CLP, or syndromic diagnoses. Initiatives should aim to optimize cleft surgery delivery for these subpopulations.

scholarly journals Epidemiological features of patients with nonsyndromic cleft lip and/or palate in Western Parana

2016 ◽  
Vol 15 (1) ◽  
pp. 39 ◽  
Author(s):  
Helenara Salvati Bertolossi Moreira ◽  
Renato Assis Machado ◽  
Sibele Nascimento de Aquino ◽  
Ana Lúcia Carrinho Ayrosa Rangel ◽  
Hercílio Martelli Júnior ◽  
...  
Keyword(s):  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
First Trimester ◽  
Vitamin Supplements ◽  
Cross Sectional ◽  
Oral Clefts ◽  
Factors Associated ◽  
Epidemiological Features ◽  
History Of ◽  
First Trimester Of Pregnancy

Aim: : To describe the clinical, demographic and environmental features associated with NSCL/P (nonsyndromic cleft lip and/or palate) patients born in western Parana state, Brazil. Methods: This cross-sectional, observational, retrospective study included 188 patients attended at the Association of Carriers of Cleft Lip and Palate - APOFILAB, Cascavel-Parana, between 2012 and 2014. Information on demographic characteristics, medical and dental histories and life style factors were obtained from records and personal interviews. Results: Among the 188 patients, cleft lip and palate (CLP) was the most frequent subtype (55.8%), followed by cleft lip only (CLO, 25.0%) and cleft palate only (CPO, 19.2%). Caucasian males were the most affected, although no differences among types of cleft were observed. The otorhinolaryngologic and respiratory alterations were the most frequent systemic alterations in NSCL/P patients, and more than 80% of the NSCL/P mothers reported no vitamin supplements during the first trimester of pregnancy. Conclusions: This study revealed that the prevalence of nonsyndromic oral cleft types in this cohort was quite similar to previously reported prevalence rates. Systemic alterations were identified among 23.4% of the patients and patients with CLP were the most affected. History of maternal exposition to environmental factors related to nonsyndromic oral clefts was frequent and most mothers reported no vitamin supplements during the pregnancy. This study highlights the importance of identifying systemic alterations and risk factors associated with NSCL/P in the Brazilian population for planning comprehensive strategies and integrated actions for the development of preventive programs and treatment.

Timeliness of Primary Cleft Lip/Palate Surgery

2009 ◽  
Vol 46 (6) ◽  
pp. 588-597 ◽  
Author(s):  
Cynthia H. Cassell ◽  
Julie Daniels ◽  
Robert E. Meyer
Keyword(s):  
North Carolina ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Health Department ◽  
Vital Statistics ◽  
Local Health ◽  
Factors Associated ◽  
Time Period ◽  
Cleft Lip Palate ◽  
Cleft Surgery

Objective: To examine the timeliness of primary cleft surgery, mean age at which surgery occurred, and factors associated with timely cleft surgery among children with orofacial clefts (OFCs). Design: Retrospective study of children with OFC using North Carolina vital statistics, birth defects registry, and Medicaid files. Participants/Patients: Medicaid-enrolled North Carolina resident children with OFC born from 1995 to 2002. Main Outcome Measures: Proportion of children who underwent primary cleft surgery within 18 months of life, mean age when surgery occurred, and factors associated with timely surgery. Results: 406 children with OFC were continuously enrolled in Medicaid during the first 2 years of life. Overall, 78.1% of children had surgery within 18 months. About 90% of children with cleft lip (CL), 58.0% of children with cleft palate (CP), and 89.6% of children with cleft lip and palate (CLP) received timely cleft surgery; the mean age at which surgery occurred was 5 months. Children whose mothers received maternity care coordination, received prenatal care at a local health department, or lived in the southeastern or northeastern region of the state were more likely to receive timely cleft surgery. Conclusion: Most children with OFC in North Carolina born during this time period received primary cleft surgery within 18 months of life, but this varied by maternal demographics and other factors.

scholarly journals Factors Associated With Psychological Adjustment in Adults With Cleft Lip and/or Palate: Findings From a National Survey in the United Kingdom

2021 ◽  
pp. 105566562110284
Author(s):  
Bruna Costa ◽  
Kenny Ardouin ◽  
Nicola Marie Stock
Keyword(s):  
Psychological Adjustment ◽  
Cleft Lip ◽  
Family Cohesion ◽  
Cleft Lip And Palate ◽  
Treatment Options ◽  
Body Esteem ◽  
The Body ◽  
Life Orientation Test ◽  
Life Orientation ◽  
Factors Associated

Objectives: Research has identified adults born with cleft lip and/or palate (CL/P) to be at risk of poorer psychological outcomes compared to the general population. This study investigated factors that may contribute to positive and negative adjustment in adults born with CL/P. Design: A survey was designed and distributed by the Cleft Lip and Palate Association in collaboration with (University). There were 207 eligible responses (95% completed online) received between July and October 2018. Dependent variables included the Body Esteem Scale for Adolescents and Adults, Harter’s Self Perception Profile for Adults (Global Self-Worth, Social Competence, and Intimacy subscales), the Fear of Negative Appearance Evaluation Scale, and the Revised Adult Attachment Scale. Independent variables were the Revised Life Orientation Test, biodemographic data, and self-reported single-item questions. Results: Factors associated with positive adjustment included reports of a happy childhood, talking about CL/P with family, close friendships, comfort in public spaces, satisfaction with appearance, and a positive life orientation. Psychological distress was associated with a desire for further surgery to improve appearance and/or function. Conclusions: Several factors were identified that may influence psychological adjustment in adults with CL/P. Throughout childhood, family-centered practice to support family cohesion and an open dialogue about CL/P is indicated, as is support for young people to develop social confidence. For adults returning to the cleft service, treatment options for appearance and/or functional concerns should be explored, with access to psychological support when indicated. Interventions to increase optimism, resilience, and self-acceptance may also be warranted throughout the life span.

Coping with a Cleft: Psychosocial Adjustment of Adolescents with a Cleft Lip and Palate and Their Parents

2009 ◽  
Vol 46 (4) ◽  
pp. 435-443 ◽  
Author(s):  
Zoe E. Berger ◽  
Louise J. Dalton
Keyword(s):  
Young People ◽  
Psychosocial Adjustment ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Maternal Mental Health ◽  
Normal Population ◽  
Self Report ◽  
Future Research ◽  
Related Factors ◽  
Adjustment Difficulties

Objective: To explore the nature of psychosocial adjustment in young people with a cleft as well as in their parents, within the framework of Lazarus and Folkman's (1984) transactional model of stress and coping. Design, Participants, Setting: A cross-sectional postal questionnaire design study was used, involving young people aged between 11 and 16 years and their parents. There were 145 families from two cleft services participating in the study. Outcome Measures: Participants completed measures of psychological adjustment, coping, social experiences, satisfaction with appearance, cleft-related factors, and demographic information. Results: Young people with a cleft and their mothers did not report psychosocial adjustment difficulties above that of the normal population. An insufficient number of fathers were recruited for substantive analysis to be conducted using their data. Conclusions: The findings show little evidence of significant psychosocial adjustment difficulties for adolescents with a cleft or for their mothers. The concepts of adjustment, coping, satisfaction with appearance, and maternal mental health in this population are discussed. The results highlight the importance of timely interventions and seeking multiple perspectives in clinical management of a cleft. Questions are raised about the completion of self-report measures for future research in this population.

Factors Associated With Adherence to Nasoalveolar Molding (NAM) by Caregivers of Infants Born With Cleft Lip and Palate

2017 ◽  
Vol 55 (2) ◽  
pp. 252-258 ◽  
Author(s):  
Nick O. Esmonde ◽  
Judah S. Garfinkle ◽  
Yiyi Chen ◽  
William E. Lambert ◽  
Anna A. Kuang
Keyword(s):  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Travel Distance ◽  
Retrospective Case ◽  
Tertiary Referral Center ◽  
Factors Associated ◽  
Female Sex ◽  
Public Payer ◽  
Nasoalveolar Molding ◽  
Continuous Use

Objective: Identify factors associated with adherence to nasoalveolar molding (NAM) therapy. Design: Retrospective case-control study. Setting: Tertiary referral center. Patients, Participants: Infants with cleft lip, with or without cleft palate, referred for NAM. One hundred thirty-five patients met criteria. Main Outcome Measure(s): Adherence to NAM therapy, defined as continuous use of the appliance and attendance of NAM adjustment visits. Results: Female sex (OR = 2.85, 95% CI 1.21-6.74), bilateral cleft (OR = 2.88, 95% CI 1.29-6.46), and travel distance (OR = 1.01, 95% CI 1.00-1.01) were independent predictors of nonadherence. Bilateral clefts (OR = 8.35, 95% CI 2.72-25.64) and public-payer insurance (OR = 3.67, 95% CI 1.13-11.91) for male patients were significantly associated with nonadherence, in our sex-stratified multivariate model. The majority of the families (58%) had public health insurance. Males comprised 77.0% of the cohort. Conclusions: NAM treatment adherence is impaired by bilateral clefts, female sex, increased travel distance, and public insurance. Further studies are warranted to investigate how these factors affect adherence, and to develop interventions to improve adherence in families at risk due to economic or psychosocial barriers.

scholarly journals Aleitamento materno em lactentes com fissura labiopalatina

2018 ◽  
Vol 12 (5) ◽  
pp. 1390
Author(s):  
Armando Dos Santos Trettene ◽  
Thais De Oliveira Maximiano ◽  
Carolina Cantatore Beraldo ◽  
Juliana Campanati Mendonça ◽  
Aline Godoi Luiz ◽  
...  
Keyword(s):  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Cross Sectional Study ◽  
Bottle Feeding ◽  
Chi Square ◽  
Cross Sectional ◽  
Prenatal Health ◽  
Factors Associated ◽  
Nursing Visit ◽  
Chi Square Test

RESUMOObjetivo: identificar fatores associados à adesão ao aleitamento materno em lactentes com fissura de lábio e/ou palato. Método: estudo quantitativo, transversal, com 121 cuidadores de crianças com fissura de lábio e/ou palato. A coleta de dados foi realizada durante a consulta de Enfermagem pré-operatória de queiloplastia e/ou palatoplastia. Os pais/responsáveis responderam a um questionário referente ao recebimento de informações sobre o aleitamento materno recebidas no pré e pós-natal. Para a análise estatística, utilizou-se o teste Qui-quadrado, com significância de 5%. Resultados: o aleitamento materno exclusivo foi observado em 31% (n=38) dos lactentes. Desses, 63% (n=24) foram amamentados por um mês. Entre os fatores para a não adesão ao aleitamento materno prevaleceu a sucção ineficaz (n=45, 37%). Possuir fissura de lábio e palato influenciou negativamente a prática do aleitamento materno (p<0,001), enquanto receber orientações no pré-natal favoreceu a sua adesão (p=0,042). Conclusão: poucos lactentes foram amamentados exclusivamente e por tempo aquém do recomendado. A complexidade da fissura, evidenciada pelo déficit de sucção, influenciou negativamente a adesão ao aleitamento materno, enquanto o recebimento de informações por profissionais de saúde no pré-natal influenciou positivamente. Descritores: Aleitamento Materno; Cuidados de Enfermagem; Fissura Labial; Fissura Palatina; Alimentação Artificial; Enfermagem.ABSTRACTObjective: to identify factors associated with adherence to breastfeeding in infants with cleft lip and / or palate. Method: quantitative, cross-sectional study with 121 caregivers of children with cleft lip and / or palate. Data collection was carried out during the preoperative nursing visit of queiloplasty and / or palatoplasty. The parents / guardians answered a questionnaire regarding the receipt of information about breastfeeding received in the pre- and postnatal care. For the statistical analysis, the chi-square test was used, with significance of 5%. Results: exclusive breastfeeding was observed in 31% (n = 38) of infants. Of these, 63% (n = 24) were breastfed for one month. Among the factors for non-adherence to breastfeeding, ineffective sucking (n = 45, 37%) prevailed. Posterior cleft lip and palate negatively influenced the practice of breastfeeding (p <0.001), while receiving prenatal guidelines favored its adherence (p = 0.042). Conclusion: few infants were breastfed exclusively and for shorter time than recommended. The complexity of the cleft, evidenced by sucking deficit, negatively influenced adherence to breastfeeding, while the receipt of information by prenatal health professionals influenced positively. Descritores: Breast Feeding; Nursing Care; Cleft Lip; Cleft Palate; Bottle Feeding; Nursing.RESUMENObjetivo: identificar factores asociados a la adhesión a la lactancia materna en lactantes con fisura de labio y / o paladar. Método: estudio cuantitativo, transversal, con 121 cuidadores de niños con fisura de labio y / o paladar. La recolección de datos fue realizada durante la consulta de Enfermería preoperatoria de queiloplastia y / o palatoplastia. Los padres / responsables respondieron un cuestionario referente a la recepción de informaciones referentes a la lactancia materna, recibidas en el pre y post-natal. Para el análisis estadístico, se utilizó el testeo Qui-cuadrado, con significancia de 5%. Resultados: la lactancia materna exclusiva se observó en un 31% (n = 38) de los lactantes. De ellos, 63% (n = 24) fueron amamantados por un mes. Entre los factores para la no adhesión a la lactancia materna prevaleció la succión ineficaz (n = 45, 37%). La posesión de fisura de labio y paladar influenció negativamente la práctica de la lactancia materna (p <0,001), mientras que recibir orientaciones en el prenatal favoreció la su adhesión (p = 0,042). Conclusión: pocos lactantes fueron amamantados exclusivamente y por tiempo por debajo de lo recomendado. La complejidad de la fisura evidenciada por el déficit de succión, influenció negativamente la adhesión a la lactancia materna, mientras que la recepción de informaciones por profesionales de salud en el prenatal influenció positivamente. Descritores: Lactancia Materna; Atención de Enfermaría; Labio Leporino; Fisura del Paladar; Alimentación Artificial; Enfermaría.

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