Scandcleft randomised trials of primary surgery for unilateral cleft lip and palate: 10. Parental perceptions of appearance and treatment outcomes in their 5-year-old child

Heli�vaara, Arja; Johannessen, Emma Christine; Boysen, Betty Marie; Pedersen, Nina Helen; Heliovaara, Arja; Feragen, Kristin Billaud; Semb, Gunvor; Lohmander, Anette; Havstam, Christina; Lundeborg, Inger; Nyberg, Jill; Bradbury, Eileen; Bogh-Nielsen, Joan; Eyres, Philip; Rumsey, Nichola

Abstract

© 2017 Acta Chirurgica Scandinavica Society. Background and aim: Few studies have explored children’s emotional and behavioural reactions to cleft surgery and treatment-related stress. The objective was to investigate parents’ evaluations of appearance and treatment outcomes in their 5-year-old child with unilateral cleft lip and palate (UCLP), and their perceptions of how their child was coping with treatment, comparing this information with recorded postsurgical complications. Design: Three parallel group randomised clinical trials were undertaken as an international multicentre study by 10 cleft teams in five countries: Denmark, Finland, Sweden, Norway, and the UK. Methods: Three different surgical procedures for primary palatal repair were tested against a common procedure in the total cohort of 448 children born with a non-syndromic UCLP. A total of 356 parents completed the Scandcleft Parent Questionnaire, and 346 parents completed the Cleft Evaluation Profile. Results: The results indicated that the majority of parents were satisfied with cleft-related features of their child’s appearance. Further, most children coped well with treatment according to their parents. Nevertheless, 17.5% of the children showed minor or short-term reactions after treatment experiences, and 2% had major or lasting difficulties. There were no significant relationships between parent perceptions of treatment-related problems and the occurrence of post-surgical medical complications. Conclusions: Most parents reported satisfaction with their child’s appearance. However, treatment-related problems were described in some children, urging cleft centres to be aware of potential negative emotional and behavioural reactions to treatment in some young children, with a view to preventing the development of more severe treatment-related anxiety. Trial registration: ISRCTN29932826.

• Journal Article Type: Article
• Acceptance Date: Oct 26, 2016
• Online Publication Date: Feb 20, 2017
• Publication Date: Feb 20, 2017
• Deposit Date: Feb 21, 2017
• Publicly Available Date: Feb 20, 2018
• Journal: Journal of Plastic Surgery and Hand Surgery
• Print ISSN: 2000-656X
• Publisher: Taylor & Francis
• Peer Reviewed: Peer Reviewed
• Volume: 51
• Issue: 1
• Pages: 81-87
• DOI: https://doi.org/10.1080/2000656X.2016.1254642
• Keywords: parent satisfaction, cleft, appearance, treatment anxiety, visible difference
• Public URL: https://uwe-repository.worktribe.com/output/899130
• Publisher URL: http://dx.doi.org/10.1080/2000656X.2016.1254642
• Additional Information: Additional Information : This is an Accepted Manuscript of an article published by Taylor & Francis in Journal of Plastic Surgery and Hand Surgery on 20th February 2017, available online: http://dx.doi.org/10.1080/2000656X.2016.1254642http://www.tandfonline.com/10.1080/2000656X.2016.1254642.
• Contract Date: Feb 21, 2017