RESUMO
INTRODUCTION: Little is known about rates of suicidal ideation and behavior among youth with cleft lip and/or palate (CLP) and other craniofacial conditions. METHODS: Records of patients ages 6 and older who were administered the Columbia-Suicide Severity Rating Scale (C-SSRS) Lifetime Version during routine multidisciplinary cleft or craniofacial team visits between 2019 and 2023 were examined. Demographics information, C-SSRS data, and diagnoses were assessed with statistics including t tests, the Fisher exact test, and odds ratios. RESULTS: A total of 1140 C-SSRS questionnaires across 602 (433 CLP and 169 craniofacial) patients with an average age of 11.2±3.7 years were included. Eighty-four (13.6%) patients endorsed lifetime suicidal ideation, 9 (1.5%) had at least one instance of suicidal behavior, 30 (5.0%) endorsed nonsuicidal self-injury, and 2 (0.3%) engaged in self-injurious behavior. Compared with CLP, those with other craniofacial conditions had similar odds of endorsing suicidal ideation and behavior ( P ≥0.05). Compared with those with isolated cleft palates, CLP had greater odds of endorsing suicidal ideation and behavior, though those differences were not significant ( P ≥0.05). Incidence of suicidality was unchanged before, during, and after the COVID-19 pandemic ( P ≥0.05). Dividing patients by sex or insurance type revealed no difference in suicidality ( P ≥0.05). CONCLUSION: Patients with CLP and craniofacial conditions have a high incidence of suicidal ideation and behavior, though levels are similar between these groups. Suicidality in these patients was not negatively impacted by the COVID-19 pandemic. Early identification of safety risks and psychosocial challenges through regular screening can facilitate connection with appropriate clinical interventions.
Assuntos
Fenda Labial , Fissura Palatina , Ideação Suicida , Humanos , Feminino , Masculino , Criança , Fenda Labial/psicologia , Fissura Palatina/psicologia , Adolescente , COVID-19/psicologia , COVID-19/epidemiologia , Inquéritos e Questionários , Anormalidades Craniofaciais/psicologia , Comportamento Autodestrutivo/psicologia , Comportamento Autodestrutivo/epidemiologiaRESUMO
OBJECTIVE: To assess whether there is an association between an individual's sex and social judgements made by lay persons regarding untreated cleft lip. MATERIALS AND METHODS: Lay individuals over 18 years old were recruited through an application to respond online to two questionnaires: a sociodemographic survey and the Brazilian Version of Lay Persons' Social Judgements about Cleft-lip Scale (B-LSojCleft-S). B-LSojCleft-S comprises 14 items evaluating social judgements made by laypersons concerning different types of untreated cleft lips in teenagers. The 14 items are linked to 8 images featuring untreated cleft lips and 1 image without a cleft (control). Higher scores represented more favourable social judgements. Independent samples t-test, paired, and multiple linear regression were conducted (P < 0.05). The study assessed judgements of untreated cleft lips in male and female adolescents using the B-LSojCleft-S. RESULTS: The mean age of the 217 participants was 37.78 ± 12.39 years, predominantly women (72.7%), married (47.7%), with a monthly income below three minimum wages (35.6%) in the majority of cases. Significantly higher social judgement scores were observed in the control group (no cleft) compared to any type of cleft (P < 0.001), with similar scores obtained for the same types of clefts with female or male images (P > 0.05). The participant's sex is associated with social judgement scores (F [1, 214] = 6.318, P = 0.013; adjusted R2 = 0.024), with females making more favourable judgements than males (P < 0.05). CONCLUSIONS: Individuals with cleft lips receive more negative social judgement scores, regardless of their own sex. Women make better social judgements than men.
Assuntos
Fenda Labial , Julgamento , Humanos , Fenda Labial/psicologia , Feminino , Masculino , Estudos Transversais , Adulto , Fatores Sexuais , Adolescente , Brasil , Percepção Social , Inquéritos e QuestionáriosRESUMO
OBJECTIVE: To understand the experience of young people with orofacial clefts regarding life as an adolescent. METHODS: Descriptive, qualitative study, developed in a Brazilian public and tertiary hospital, a reference center in the care of patients with craniofacial anomalies and related syndromes, between February and April 2019. The sample was defined by theoretical saturation. The following inclusion criteria were established: age between ten and 19 years old and having previously operated on orofacial cleft (lip and/or palate). Individuals with fissure associated with syndromes or other malformations were excluded. Data collection was performed through semi-structured interviews, which were audio recorded and transcribed in full. The trigger element was: how has it been for you to experience your adolescence? For the construction of the results, content analysis was used in the thematic modality. RESULTS: Seventeen adolescents participated. From the speeches, three categories were revealed: interacting socially, feeling supported, and experiencing and facing prejudice. CONCLUSIONS: The biopsychosocial and conflicting complexity that adolescents with orofacial clefts experience was noticed, as well as the importance of receiving support and establishing modalities of situational coping.
Assuntos
Fenda Labial , Fissura Palatina , Pesquisa Qualitativa , Humanos , Fissura Palatina/psicologia , Fenda Labial/psicologia , Adolescente , Feminino , Masculino , Criança , Adulto Jovem , Adaptação Psicológica , Brasil , Entrevistas como AssuntoRESUMO
OBJECTIVE: The aim of this study was to describe coping strategies used by parents of children with cleft palate with or without a cleft (CP ± L) during the early development of their children in El Salvador. DESIGN: Qualitative interviews were completed with 16 parents of children born with CP ± L who were 6 months to 6 years old. Parents were questioned about their emotions and coping during eight time periods: prenatal, birth, social interaction before the first surgery, the beginning of surgeries, social interaction after the first surgery, early childhood education (ECE), speech-language therapy, and formal education. Thematic analysis (TA) was used to identify coping strategies as conceptualized by Lazarus and Folkman (1984). RESULTS: Four major themes emerged: (a) experienced emotions related to diagnosis, (b) interpretations related to the birth of a child with a cleft, (c) seeking and experiencing cleft treatment, and (d) social interaction of the children. During prenatal and birth stages, parents used emotion-focused strategies. A few hours to a week after birth, they used problem-focused strategies, which led them in search of treatment. Some parents used avoidance strategies during periods of social interaction before surgery, ECE, and formal education. Socioeconomic challenges impacted access to speech-language therapy. Sociocultural factors, such as discrimination, religion, and folk beliefs, appeared to influence some of the coping strategies used by parents. CONCLUSIONS: Problem-focused strategies appear to be helpful in seeking surgical treatments. The emotion-focused strategy of avoidance seemed to have adverse effects in minimizing opportunities for social interaction prior to surgery and early education.
Assuntos
Fenda Labial , Fissura Palatina , Criança , Pré-Escolar , Humanos , Fenda Labial/cirurgia , Fenda Labial/psicologia , Fissura Palatina/cirurgia , Fissura Palatina/psicologia , El Salvador , Adaptação Psicológica , Pais/psicologiaRESUMO
OBJECTIVE: The aim of the study was to assess the quality of life (QOL), oral health-related QOL (OHRQOL), temporomandibular disorders (TMDs), and psychological factors in patients with skeletal Class III malocclusion with cleft lip and palate (CLP) and without CLP. DESIGN: Case-control. SETTING: Primary care, institutional practice. PATIENTS: One hundred thirty-six patients with skeletal Class III malocclusion with CLP (n = 68) and without CLP (n = 68). MAIN OUTCOME MEASURES: QOL and OHRQOL were assessed using the World Health Organization Quality of Life-BREF (WHOQOL-BREF) questionnaire and the Oral Health Impact Profile-14 questionnaire, respectively. TMDs and psychological factors were assessed using the Research Diagnostic Criteria for TMD (RDC/TMD). RESULTS: No differences in QOL were found between the groups (P > 0.05). Patients with CLP reported a better OHRQOL (P = 0.025) in the physical pain, physical disability, and psychological disability domains (P < 0.05). Patients with CLP presented with less myofascial pain (OR, 0.28; 95% CI, 0.11-0.71] and other articular conditions (OR 0.24; 95% CI 0.06-0.90]. More patients with CLP reported no chronic pain (P = 0.012). The QOL of patients with CLP with no depression or with no nonspecific physical symptoms including pain (NSPSIP) was better than that of patients without CLP. The OHRQOL of patients with CLP without TMDs or no psychological factors was better than that of patients without CLP. CONCLUSIONS: Patients with skeletal Class III malocclusion who require orthognathic surgery with CLP have better OHRQOL and present with fewer TMDs than those patients without CLP.
Assuntos
Fenda Labial , Fissura Palatina , Má Oclusão Classe III de Angle , Transtornos da Articulação Temporomandibular , Fenda Labial/psicologia , Fenda Labial/cirurgia , Fissura Palatina/psicologia , Fissura Palatina/cirurgia , Humanos , Saúde Bucal , Dor , Qualidade de Vida , Transtornos da Articulação Temporomandibular/psicologiaRESUMO
OBJECTIVE: The purpose of this study was to evaluate the influence of orthodontic treatment on the oral health-related quality of life (OHRQoL) of patients with cleft lip and palate. SEARCH METHODS: Electronic searches were conducted in Pubmed, Scopus, Web of Science, Cochrane Library, VHL, and OpenGrey databases, completed in January 2021. SELECTION CRITERIA: Cross-sectional and longitudinal observational studies that presented an assessment of OHRQoL in cleft patients undergoing orthodontic treatment were included, according to PRISMA guidelines. Contacts via email were made with authors, to clarify inaccuracies or request additional data. DATA COLLECTION AND ANALYSIS: The entire process was accomplished by two authors, in case of disagreement, a third author mediated the discussion until there was a consensus. Risk assessment was performed by the Fowkes and Fulton qualifier, and the quality of evidence, assessed by the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) tool. A meta-analysis was performed considering the domains combined into three large groups (physical, psychological, and social). The questionnaires were standardized as to the scores and their direction. RESULTS: A total of 3822 studies were retrieved. After excluding duplicates, the titles and abstracts of the remaining articles were analysed. Twenty-eight articles were read in full; 13 met the eligibility criteria; 12 articles showed sufficient methodological quality and 7 were included in the quantitative assessment. The included studies were published between 2011 and 2019. The samples comprised 19 to 183 patients of both sexes. GRADE showed low evidence when compared to the control group, sexes, age, and types of cleft and very low evidence among longitudinal articles. CONCLUSIONS: The OHRQoL is lower in orthodontic patients with cleft than in those without. The OHRQoL of patients with cleft undergoing orthodontic treatment is not influenced by gender or age group, considering children and adolescents, but it is influenced by the type of cleft. The OHRQoL of patients with CLP does not undergo significant changes during orthodontic treatment. LIMITATIONS: The variety of instruments for measuring OHRQoL rendered meta-analysis difficult. REGISTRATION: PROSPERO database number CRD42017054764.
Assuntos
Fenda Labial , Fissura Palatina , Adolescente , Criança , Fenda Labial/psicologia , Fissura Palatina/psicologia , Estudos Transversais , Feminino , Humanos , Masculino , Saúde Bucal , Qualidade de VidaRESUMO
BACKGROUND/OBJECTIVES: To evaluate the relationships between individual, environmental, clinical factors and oral health-related quality of life (OHRQoL) in patients with cleft lip and palate (CLP) following orthognathic surgery. MATERIALS AND METHODS: A follow-up study was conducted involving 69 adults with unilateral and bilateral CLP under orthodontic treatment. Interviews and oral examinations were conducted prior to orthognathic surgery (T0) to evaluate age, gender, psychological well-being, dental caries, malocclusion, social support, social networks, family income and education and OHRQoL. All participants were reviewed after 6 months (T1) to re-assess psychological well-being, malocclusion and OHRQoL. Structural equation modeling estimated the associations between the variables. RESULTS: OHRQoL total scores reduced following orthognathic surgery, from 11.7 to 6.9 (P < 0.01). Occlusal characteristics and psychological well-being improved between T0 and T1. In the structural equation modeling, reduction of malocclusion (ß = 0.02) between T0 and T1 directly predicted poor OHRQoL at T1. Improvement of psychological well-being between T0 and T1 was associated with better OHRQoL at T1 (ß = -0.07). Dental caries and malocclusion at T0 were indirectly linked to poor OHRQoL at T1 (ß = 0.02). LIMITATIONS: The short follow-up period of 6 months after orthognathic surgery. CONCLUSIONS/IMPLICATIONS: This represents the first prospective study examining the interrelationships of predictors of OHRQoL in patients with CLP after orthognathic surgery. OHRQoL and psychological well-being improved after orthognathic surgery. Clinical and psychological characteristics were important determinants of OHRQoL. These findings suggest the importance of the biopsychosocial model of health and the patient-centered approach in oral health care in individuals with CLP.
Assuntos
Fenda Labial , Fissura Palatina , Cárie Dentária , Má Oclusão , Cirurgia Ortognática , Adulto , Fenda Labial/psicologia , Fenda Labial/cirurgia , Fissura Palatina/psicologia , Fissura Palatina/cirurgia , Seguimentos , Humanos , Má Oclusão/psicologia , Má Oclusão/cirurgia , Saúde Bucal , Estudos Prospectivos , Qualidade de Vida/psicologia , Inquéritos e QuestionáriosRESUMO
Los niños que padecen enfermedades genéticas son una población vulnerable para desarrollar problemas de salud mental. Una de las anomalías congénitas más frecuentes es la fisura labiopalatina (FLAP). Objetivo: Estudiar el impacto a nivel familiar del diagnóstico de FLAP. Metodología: Alcance exploratorio, de diseño cuantitativo y corte transversal. Se construyó un cuestionario autoadministrado compuesto por un consentimiento informado, un cuestionario de datos sociodemográficos, el Child Behavior CheckList y preguntas abiertas. El muestreo fue intencional y la muestra fue de 42 casos. Resultados: El diagnóstico de una fisura labio palatina es una experiencia difícil en los padres, quienes viven este momento de manera negativa, con tristeza y miedo. Sin embargo, los niños pequeños con FLAP presentan niveles de salud mental similares a la población general.
Children with genetic diseases are a vulnerable population in the development of mental health problems. The cleft lip and palate (FLAP) is one of the most common congenital anomalies. Objective: To study the impact at family level of the FLAP diagnosis. Methodology: Exploratory and quantitative design and cross-sectional scope. A self-administered questionnaire consisting of an informed consent, a sociodemographic data questionnaire, the Child Behavior CheckList and open questions, was constructed. The sampling was intentional and composed by 42 cases. Results: The diagnosis of a cleft palatal lip is a difficult experience in parents, who experience this moment in a negative way, with sadness and fear. Nevertheless, children with FLAP present similar levels of mental health with general populatio.
Assuntos
Humanos , Masculino , Feminino , Lactente , Pré-Escolar , Adulto , Pais/psicologia , Fenda Labial/psicologia , Fissura Palatina/psicologia , Fatores Socioeconômicos , Comportamento Infantil , Saúde Mental , Estudos Transversais , Inquéritos e Questionários , Medo , Tristeza , Consentimento Livre e EsclarecidoRESUMO
We read with great interest the article entitled "Diagnóstico de fisura labio palatina en niños pequeños de Nicaragua: impacto del diagnóstico a nivel familiar". It is well known that children with CL/P are at risk for psychological problems. In this connection, we would like to briefly discuss the finding of the study of Ortega and Vázquez (2018).
Assuntos
Fenda Labial/psicologia , Fissura Palatina/psicologia , HumanosRESUMO
OBJECTIVE: To evaluate the correlation between measures of quality of life and burden in family caregivers of infants with cleft lip and palate and to analyze possible associations between quality of life and sociodemographic variables. METHOD: Exploratory, cross-sectional study conducted in hospital specialized in the treatment of craniofacial anomalies, with caregivers who answered the following data collection instruments: sociodemographic characterization form, World Health Organization Quality of Life - BREF questionnaire and the Burden Interview Scale. The statistical analysis was conducted using the Pearson's Correlation test, the Student's t-test and the ANOVA test with a level of significance of 0.05. RESULTS: 77 caregivers participated in the study. There was an inverse correlation between quality of life and burden in the Physical Health, Psychological, Social Relationships and Environment domains. There was a positive correlation between quality of life and family income in the Environment domain. CONCLUSION: The greater the burden on the caregiver, the lower was their perception of quality of life. Caregivers with higher family income and greater level of education presented a better perception quality of life in the Environment domain.
Assuntos
Cuidadores/psicologia , Fenda Labial/psicologia , Fissura Palatina/psicologia , Qualidade de Vida , Adolescente , Adulto , Fenda Labial/terapia , Fissura Palatina/terapia , Efeitos Psicossociais da Doença , Estudos Transversais , Escolaridade , Feminino , Humanos , Renda , Lactente , Masculino , Pessoa de Meia-Idade , Inquéritos e Questionários , Adulto JovemRESUMO
El labio leporino con o sin paladar hendido se encuentra entre los principales defectos congénitos y afecta aproximadamente 1:700 de los recién nacidos vivos (1). Se considera que la etiología de esta patología es multifactorial, incluyendo una interacción entre factores genéticos y ambientales.
Cleft lip with or without cleft palate is among the major birth defects and affects approximately 1:700 of live newborns (1). The aetiology of this pathology is considered to be multifactorial, including an interaction between genetic and environmental factors.
O lábio leporino com ou sem fissura palatina está entre os principais defeitos congênitos e acomete aproximadamente 1:700 de recém-nascidos vivos (1). A etiologia desta patologia é considerada multifactorial, incluindo uma interacção entre factores genéticos e ambientais.
Assuntos
Humanos , Recém-Nascido , Fenda Labial , Anormalidades Congênitas/psicologia , Fenda Labial/psicologia , Doenças do Recém-NascidoRESUMO
El labio leporino con o sin paladar hendido se encuentra entre los principales defectos congénitos y afecta aproximadamente 1:700 de los recién nacidos vivos (1). Se considera que la etiología de esta patología es multifactorial, incluyendo una interacción entre factores genéticos y ambientales (2,3)
Cleft lip and/or palate (CL/P) are among the most prevalent of all birth defects in human, affecting approximately 1:700 live births(1). The etiology of CL/P is thought to be multifactorial, involving an interaction between genetic and environmental factors (2,3).
A fissura labial e / ou palatina (FL / P) está entre as mais prevalentes de todos os defeitos congênitos em humanos, afetando aproximadamente 1: 700 nascidos vivos (1). A etiologia da CL / P é considerada multifatorial, envolvendo uma interação entre fatores genéticos e ambientais (2,3)
Assuntos
Fenda Labial/psicologia , Patologia Bucal , Adaptação Psicológica , Causalidade , Fissura Palatina/psicologia , Ajustamento EmocionalRESUMO
OBJECTIVE: to correlate spirituality and religiosity with quality of life of adolescents with and without cleft lip and palate. METHODS: cross-sectional and correlational study involving two groups: case group (n = 40) and comparison group (n = 40). The Duke University Religion Index (DUREL) and the World Health Organization Quality of Life Bref were used for data collection. The Mann-Whitney, Chi-Square, Student's t-test and Pearson's correlation tests were used in the statistical analyses, with a significance level of 5% (p ≤ 0.05). RESULTS: organizational religiosity and overall quality of life were significantly higher in the case group (p = 0.031 and p = 0.012, respectively). As for quality of life, the Environment Domain was significantly higher in the case group (p < 0.001). In the correlation between religiosity and spirituality, non-organizational religiosity had a strong correlation (r = 0.62) with organizational religiosity (p < 0.001). In the correlation of religiosity and spirituality with quality of life, only a moderate correlation between spirituality and overall quality of life was identified (r = -0.35, p = 0.026). CONCLUSION: there was no relationship of religiosity and spirituality with quality of life among adolescents with cleft lip and palate for most aspects evaluated.
Assuntos
Fenda Labial/psicologia , Fissura Palatina/psicologia , Religião , Espiritualidade , Adolescente , Fenda Labial/fisiopatologia , Fissura Palatina/fisiopatologia , Estudos Transversais , Feminino , Humanos , Masculino , Qualidade de Vida , Inquéritos e QuestionáriosRESUMO
Introdução: A fissura labiopalatina é a malformação mais frequente da região da cabeça e afeta mais de 10 milhões de pessoas no mundo. O objetivo do estudo foi avaliar a autoestima em pacientes portadores de fissura labiopalatina em acompanhamento no Serviço de Cirurgia Plástica Craniomaxilofacial do Hospital de Clínicas de Porto Alegre, comparando-os com indivíduos não fissurados. Métodos: Estudo transversal contemporâneo, com 160 participantes, sendo 80 pacientes com fissura labiopalatina já submetidos a procedimentos cirúrgicos relacionados à afecção e, como grupo controle, 80 alunos e funcionários da rede pública de ensino. Um questionário para caracterizar o grupo e a escala de autoestima de Rosenberg foram utilizados para a coleta de dados. Resultados: Houve diferença significativa entre os grupos quanto ao estado civil, escolaridade e repetência escolar. Os pacientes com fissura labiopalatina apresentam níveis de autoestima menores em relação a indivíduos não afetados. Dentre eles, os subgrupos dos indivíduos com fissura bilateral, fissura completa, do gênero feminino, classe econômica D/E, baixa escolaridade, situação familiar reconstituída na infância e com resultados não satisfatórios em relação à comunicação, dentição e cicatriz de lábio também mostraram níveis de autoestima menores. Conclusão: Houve relação significativa entre fissura labiopalatina e baixa autoestima.
Introduction: Cleft lip and palate is the most frequent malformation of the head region and affects more than 10 million people worldwide. This study aims at evaluating the selfesteem in patients with cleft lip and palate and comparing that with the self-esteem of non-affected individuals during followup at the Department of Craniomaxillofacial Plastic Surgery of the Hospital de Clínicas of Porto Alegre. Methods: This is a cross-sectional, contemporary study with 160 participants, comprising 80 patients with cleft lip and palate who have already undergone surgical procedures for correcting the condition and 80 non-affected students and employees of the publicschool system as a control group. We used a questionnaire to characterize the group and the Rosenberg self-esteem scale for data collection. Results: There was a significant difference between groups in terms of marital status, schooling, and school retention. Patients with a cleft lip and palate had lower levels of self-esteem than non-affected individuals. Among them, the individuals with bilateral clefts or complete clefts; female gender; economic strata of D/E; low level of schooling; families reconstituted during childhood; and with unsatisfactory results concerning communication, dentition, and lip scar also showed lower levels of self-esteem. Conclusion: There was a significant relationship between cleft lip and palate and low self-esteem.
Assuntos
Humanos , Masculino , Feminino , Criança , Adolescente , Adulto , Pessoa de Meia-Idade , História do Século XXI , Pacientes , Autoimagem , Anormalidades Congênitas , Inquéritos e Questionários , Fenda Labial , Enfermagem , Anormalidades Congênitas/cirurgia , Anormalidades Congênitas/psicologia , Anormalidades Congênitas/reabilitação , Inquéritos e Questionários/normas , Inquéritos e Questionários/estatística & dados numéricos , Fenda Labial/psicologia , Fenda Labial/reabilitação , Fenda Labial/terapia , Enfermagem/métodos , Enfermagem/normasRESUMO
Nonsyndromic cleft lip with or without cleft palate (NSCL±P) compromises oral health, leading to missing or malformed teeth, and hampering oral hygiene. Apart from anatomic damages, NSCL±P also culminates in an impact on the routine quality of life with social privation and psychological embarrassment. OBJECTIVE: To evaluate the impact of NSCL±P on oral health-related quality of life. MATERIAL AND METHODS: The study was classified as exploratory and descriptive, with quantitative approach. Patients with NSCL±P treated between August 2013 and September 2014 at the Cleft Lip and Palate Integral Care Center (CAIF), Curitiba, Brazil, were invited to participate. Age and sex-related data were collected, as well as level of education, financial income, type of orofacial cleft, use of orthodontic and prosthetic appliances, and number of previous orofacial surgeries. Selected patients were asked to answer the Oral Impact on Daily Performance (OIDP) questionnaire designed to measure the impact of oral health on daily performances. RESULTS: The sample was composed of 103 (44.59%) women and 128 (55.41%) men, with mean age of 19.74 ± 10.20 (7-65) years. The OIDP values ranged from 1 to 175 in 114 (49.35%) patients (mean: 22.38), whereas 117 patients (50.65%) presented total OIDP value equal to zero. High negative impact of NSCL±P on daily performances was detected when associated with the female sex (p=0.037). Daily performances related to phonetics (OIDP2; 2.63) and aesthetics (OIDP5; 2.48) presented the highest average values when compared to other daily performances, except OIDP6. The main symptoms and reported oral problems comprised the aesthetic dissatisfaction. CONCLUSIONS: Almost half of the patients evaluated in this study showed negative impact of NSCL±P in the performance of daily activities.
Assuntos
Fenda Labial/fisiopatologia , Fissura Palatina/fisiopatologia , Saúde Bucal , Qualidade de Vida , Atividades Cotidianas/psicologia , Adolescente , Adulto , Idoso , Criança , Fenda Labial/psicologia , Fissura Palatina/psicologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Qualidade de Vida/psicologia , Fatores Sexuais , Perfil de Impacto da Doença , Inquéritos e Questionários , Adulto JovemRESUMO
OBJECTIVES: To investigate the structural and intermediary determinants of health-related quality of life (HRQoL) and oral health-related quality of life (OHRQoL) among adults with cleft lip and/or palate (CL/P). DESIGN AND PARTICIPANTS: A cross-sectional study was conducted with patients enrolled at the referral center for craniofacial anomalies in Manaus, Brazil. Adults aged 18 years or more with nonsyndromic CL/P were selected. MAIN OUTCOME MEASURES: Both HRQoL and OHRQoL were assessed using the 36-item Short-Form Health Survey and the Oral Impacts on Daily Performance, respectively. Individual interviews and oral examinations were conducted to collect data on socioeconomic and demographic characteristics, social ties, health-related behaviors, compliance of CL/P protocol, chronic diseases, type of CL/P, oral clinical measures, and CL/P-related measures. Poisson regression was used to test the association of independent variables with HRQoL and OHRQoL outcomes. RESULTS: The mean age of the 96 participants was 29.4 ± 9.1 years. Low family income, female sex, low social support, type of CL/P, and dental caries were associated with poor HRQoL and poor OHRQoL ( P < .05). Poor HRQoL was also associated with chronic diseases ( P < .05). Adults with low education, low social network, and smokers were more likely to have worse OHRQoL ( P < .05). CONCLUSIONS: Structural and intermediary determinants were related to HRQoL and OHRQoL in adults with CL/P, suggesting the need for interdisciplinary approaches to improve the management of CL/P and intersectoral actions to reduce the impact of social inequalities.
Assuntos
Fenda Labial , Fissura Palatina , Saúde Bucal , Qualidade de Vida , Adulto , Doença Crônica/epidemiologia , Fenda Labial/psicologia , Fenda Labial/terapia , Fissura Palatina/psicologia , Fissura Palatina/terapia , Estudos Transversais , Demografia , Feminino , Comportamentos Relacionados com a Saúde , Humanos , Masculino , Cooperação do Paciente , Fumar/efeitos adversos , Apoio Social , Fatores Socioeconômicos , Inquéritos e QuestionáriosRESUMO
Oral health problems can influence people's Quality of Life (QoL) because of pain, discomfort, limitations, and other esthetics problems, affecting their social life, feeding, daily activities, and the individual's well-being. To compare oral health-related quality of life (OHRQoL) of children with and without oral clefts and their families. 121 children aged from 2 to 6 years, from both sexes, enrolled in the treatment routine of the Pediatric Dentistry Clinics of a Dental School and a Hospital for Cleft Treatment were divided into two groups: Group 1 - children with cleft lip and palate; Group 2 - children without cleft lip and palate. The OHRQoL was assessed using the validated Portuguese version of the Early Childhood Oral Health Impact Scale (B-ECOHIS). The questionnaire was answered individually, only once, at a private place. Mann-Whitney U test was used to verify differences between groups. Spearman's Rho test was used to associate sex and age with quality of life. The level of significance was set at 5% (p<0.05). According to the parents' perception on the OHRQoL of children with and without cleft lip and palate, oral health of children with oral clefts (Group 1) had a statistically significant impact on OHRQoL. The correlation of sex with impact on OHRQoL did not show statistically significant differences. On the other hand, the higher the age the higher the impact on QoL. The group comparison revealed that the cleft lip and palate negatively impacted on OHRQoL of 2 to 6-year-old children and their parents.
Assuntos
Fenda Labial/fisiopatologia , Fissura Palatina/fisiopatologia , Saúde Bucal/estatística & dados numéricos , Qualidade de Vida , Perfil de Impacto da Doença , Fatores Etários , Estudos de Casos e Controles , Criança , Pré-Escolar , Fenda Labial/psicologia , Fissura Palatina/psicologia , Família/psicologia , Feminino , Humanos , Masculino , Fatores Sexuais , Estatísticas não Paramétricas , Inquéritos e QuestionáriosRESUMO
Introduction: Children with congenital anomalies are a vulnerable population in the development of mental health problems. The cleft lip and palate (FLAP) is a structural congenital anomaly. Objective: To study the impact at family level of the FLAP diagnosis. Methodology: Descriptive and quantitative design and cross-sectional scope. A self-administered questionnaire consisting of an informed consent, a sociodemographic data questionnaire, the Child Behavior Checklist and open questions, was constructed. The sampling was intentional and composed by 50 cases. Results: The CBCL 1.5-5 indicated an average of M = 53.60 (SD 23.53) in the general scale of behavioral and emotional problems, M = 14.86 for the internalizing scale, and M = 19.04 for the externalizing scale. Conclusions: The diagnosis of a cleft palatal lip is a difficult experience in parents, who experience this moment in a negative way, with sadness and fear. Preschool children with a diagnosis of cleft lip and palate are a population at risk of developing psychopathological disorders, mainly of the externalizing type.
Introducción: Los niños que padecen enfermedades genéticas son una población vulnerable para desarrollar problemas de salud mental. La fisura labiopalatina (FLAP) es una anomalía congénita de tipo estructural. Objetivo: Estudiar el impacto a nivel familiar del diagnóstico de FLAP. Métodos: Alcance descriptivo, de diseño mixto y corte transversal. Se construyó un cuestionario autoadministrado compuesto por un consentimiento informado, un cuestionario de datos sociodemográficos, el Child Behavior Checklist y preguntas abiertas. El muestreo fue intencional y la muestra fue de 50 casos. Resultados: El CBCL 1.5-5 indicó una media de M=53.60 (DE 23,53) en la escala general de problemas comportamentales y emocionales, M=14,86 para la escala internalizante, y de M=19.04 para la externalizante. Conclusión: El diagnóstico de una fisura labio palatina es una experiencia difícil en los padres, quienes viven este momento de manera negativa, con tristeza y miedo. Los niños en edad preescolar con diagnóstico de fisura labiopalatina son una población en riesgo de desarrollar trastornos psicopatológicos, mayormente de tipo externalizantes.
Assuntos
Fenda Labial/psicologia , Fissura Palatina/psicologia , Pais/psicologia , Perfil de Impacto da Doença , Adaptação Psicológica , Adulto , Lista de Checagem , Transtornos do Comportamento Infantil/psicologia , Pré-Escolar , Fenda Labial/diagnóstico , Fissura Palatina/diagnóstico , Estudos Transversais , Feminino , Humanos , Masculino , Nicarágua , Inquéritos e Questionários , Adulto JovemRESUMO
Abstract Oral health problems can influence people's Quality of Life (QoL) because of pain, discomfort, limitations, and other esthetics problems, affecting their social life, feeding, daily activities, and the individual's well-being. Objective: To compare oral health-related quality of life (OHRQoL) of children with and without oral clefts and their families. Materials and Methods: 121 children aged from 2 to 6 years, from both sexes, enrolled in the treatment routine of the Pediatric Dentistry Clinics of a Dental School and a Hospital for Cleft Treatment were divided into two groups: Group 1 - children with cleft lip and palate; Group 2 - children without cleft lip and palate. The OHRQoL was assessed using the validated Portuguese version of the Early Childhood Oral Health Impact Scale (B-ECOHIS). The questionnaire was answered individually, only once, at a private place. Mann-Whitney U test was used to verify differences between groups. Spearman's Rho test was used to associate sex and age with quality of life. The level of significance was set at 5% (p<0.05). Results: According to the parents' perception on the OHRQoL of children with and without cleft lip and palate, oral health of children with oral clefts (Group 1) had a statistically significant impact on OHRQoL. The correlation of sex with impact on OHRQoL did not show statistically significant differences. On the other hand, the higher the age the higher the impact on QoL. Conclusions: The group comparison revealed that the cleft lip and palate negatively impacted on OHRQoL of 2 to 6-year-old children and their parents.
Assuntos
Humanos , Masculino , Feminino , Pré-Escolar , Criança , Qualidade de Vida , Saúde Bucal/estatística & dados numéricos , Fenda Labial/fisiopatologia , Fissura Palatina/fisiopatologia , Perfil de Impacto da Doença , Família/psicologia , Estudos de Casos e Controles , Fatores Sexuais , Inquéritos e Questionários , Fenda Labial/psicologia , Fissura Palatina/psicologia , Fatores Etários , Estatísticas não ParamétricasRESUMO
Abstract Nonsyndromic cleft lip with or without cleft palate (NSCL±P) compromises oral health, leading to missing or malformed teeth, and hampering oral hygiene. Apart from anatomic damages, NSCL±P also culminates in an impact on the routine quality of life with social privation and psychological embarrassment. Objective To evaluate the impact of NSCL±P on oral health-related quality of life. Material and Methods The study was classified as exploratory and descriptive, with quantitative approach. Patients with NSCL±P treated between August 2013 and September 2014 at the Cleft Lip and Palate Integral Care Center (CAIF), Curitiba, Brazil, were invited to participate. Age and sex-related data were collected, as well as level of education, financial income, type of orofacial cleft, use of orthodontic and prosthetic appliances, and number of previous orofacial surgeries. Selected patients were asked to answer the Oral Impact on Daily Performance (OIDP) questionnaire designed to measure the impact of oral health on daily performances. Results The sample was composed of 103 (44.59%) women and 128 (55.41%) men, with mean age of 19.74 ± 10.20 (7-65) years. The OIDP values ranged from 1 to 175 in 114 (49.35%) patients (mean: 22.38), whereas 117 patients (50.65%) presented total OIDP value equal to zero. High negative impact of NSCL±P on daily performances was detected when associated with the female sex (p=0.037). Daily performances related to phonetics (OIDP2; 2.63) and aesthetics (OIDP5; 2.48) presented the highest average values when compared to other daily performances, except OIDP6. The main symptoms and reported oral problems comprised the aesthetic dissatisfaction. Conclusions Almost half of the patients evaluated in this study showed negative impact of NSCL±P in the performance of daily activities.