Self-perceived health related quality of life in adolescents with repaired cleft lip and palate

Authors

  • Aparajit Ravikumar Department of Pediatrics, Sri Ramachandra University, Porur, Chennai, Tamil Nadu, India
  • Rajesh Balan Department of Pediatrics, Sri Ramachandra University, Porur, Chennai, Tamil Nadu, India
  • Padmasani Venkatramanan Department of Pediatrics, Sri Ramachandra University, Porur, Chennai, Tamil Nadu, India

DOI:

https://doi.org/10.18203/2349-3291.ijcp20172520

Keywords:

Adolescents, Cleft lip, Quality of life, WHO QOL-BREF

Abstract

Background: Cleft lip and palate is one of the most frequent birth defects and is associated co-morbidities such as facial abnormalities, difficulty in feeding, speech impairments and hearing difficulties. The psychological consequences of this anomaly are often not addressed effectively resulting in silent suffering for these individuals. The dissatisfaction with surgical outcome as well as the stigma and discrimination may affect the quality of life for both patients and their family. The study evaluates the self-perceived quality of life in children with repaired cleft lip/palate.

Methods: Adolescents between the age of 11-18 years who were operated for cleft lip and palate in their early years were administered the WHO QOL-BREF questionnaire and their response were analysed in 4 domains, Physical health, Psychological, Social relationship and environmental.

Results: Among the 46 children enrolled, 29 were boys and 17girls. The mean scores across each domain were as follows: Physical health-68.5, psychological-66, social relationship-88.5 and environmental-79.1.  The psychological stressors frequently encountered were: teasing by their peer group, unattractive physical appearance and dissatisfaction with facial features post-surgery.

Conclusions: Among the 4 domains, the mean value of domain 3 (Social relationship) was the highest-88.5 and the mean value of domain 2 (Psychosocial) is the lowest-66. Continued psychological counselling and support during the turbulent adolescent years will help these children face the challenge of integrating with the society.

References

Hagberg C, Larson O, Milerad J. Incidence of cleft lip and palate and risks of additional malformations. Cleft Palate Craniofac J. 1998;35(1):40-5.

Cassio Eduardo, Raposo- do- Amaral, Evelyn Kuczynski, Nivaldo Alonso: Qualities of Life among children with cleft lips and palates: A Critical Review of Measurement Instruments; Rev. Bras. Cir. Plast. 2011;26(4):639-44.

Ashley Bender: Critical Review: What are the Psychosocial Effects of cleft lip and palate?. 2011.

Nazli Gul Shujaat, Shujaat Hasan Idris, Afzal Sheikh, Sonia Afzal, Maheen Aftab: Relationship between quality of life and psychosocial functioning among children and adolescents with cleft lip and palate. Pakistan oral and dent J. 2014;34:4.

Orlagh Hunt, Donald Burden, Peter Hepper and Chris Johnston: The psychosocial effects of cleft lip and palate: a systemic review. Europ J Orthod. 2005;274-85.

Avinash De Sousa, Shibani Devare and Jyoti Ghanshani: Psychological issues in cleft lip and cleft palate.

WHOQOL-BREF- Introduction, administration, scoring and generic version of the assessment. Field trial version. Programme on mental health. 1996;7-10.

Bull R, Rumsey N. The social psychology of facial disfigurement. J Cross Cult Psychol. 1988;17:99-108.

Lansdown R, Lloyd J, Hunter J. Facial deformity in childhood: severity and psychological adjustment. Child Care Health Dev. 1991;17:165-71.

Bernstein NR, Kapp K. Adolescents with cleft palate: body-image and psychosocial problems. Psychosomatics. 1981;22:697-703.

Loh J, Ascoli M. Cross-cultural attitudes and perceptions towards cleft lip and palate deformities. World Cul Psychi Research Review. 2011;6(2):127-34.

Richman LC, Eliason M. Psychological characteristics of children with cleft lip and palate: intellectual, achievement, behavioral and personality variables. Cleft Palate J. 1982;19:249-57.

Richman LC, Millard T. Brief report: cleft lip and palate: longitudinal behavior and relationships of cleft conditions to behavior and achievement. J Pediatr Psychol. 1997;22:487-94.

Rosanowski F, Eysholdt U. Phoniatric aspects in cleft lip patients. Facial Plast Surg. 2002;18:197-203.

Ramstad T, Ottem E, Shaw WC. Psychosocial adjustment in Norwegian adults who had undergone standardised treatment of complete cleft lip and palate. Part II. Self-reported problems and concerns with appearance. Scand J Plast Reconstr Surg Hand Surg. 1995;29:329-36.

Pillemer FG, Cook KV. The psychosocial adjustment of pediatric craniofacial patients after surgery. Cleft Palate J. 1989;26:201-7.

Lefebvre AM, Munro I. The role of psychiatry in a craniofacial team. Plast Reconstr Surg. 1978;61:564-9.

Jeffery S, Boorman JG. Patient satisfaction with cleft lip and palate services in a regional centre. Br J Plast Surg. 2001;54:189-96.

Rachmiel A, Aizenbud D, Ardekian L, Peled M, Laufer D. Surgically-assisted orthopedic protraction of the maxilla in cleft lip and palate patients. Int J Oral Maxillofac Surg. 1999; 28:9-14.

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Published

2017-06-21

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Original Research Articles