Objectives: to understand the psychosocial repercussions experienced by caregiving parents, resulting from care for the child with dysphagic cleft lip and palate. Methods: qualitative study, developed in a tertiary hospital in September 2016. The sample defined by theoretical saturation consisted of seven mothers. Data collection was performed by unstructured interview, being audio-recorded and fully transcribed. Symbolic Interactionism was used as theoretical framework, and Thematic Content Analysis as methodological framework. Results: the following themes emerged: diagnosisimpact and coping; coping with overload and stress; interaction between caregivers as an acceptance and coping strategy; impact on family and social life of caregivers; and curiosity coping, and family and community prejudice. Final considerations: despite the physical and emotional overload, the mother figure plays the main and determining role in care, reflecting the complexity of care.
The psychological and physical health of caregivers of children with cleft lip and palate can be strongly influenced by the child’s condition and behavior, and care required by the treatment. This study’s objective was to identify overload levels among these caregivers. A total of 100 caregivers, whose children were in the perioperative period of cheiloplasty and/or palatoplasty, were interviewed using the Scale Burden Interview. The data were analyzed quantitatively. Moderate and moderate severe burden levels were identified in 43% of the sample. The mothers of children aged around 12 months presented significantly higher overload. The results indicate that children in this developmental stage present greater care demand because they seek autonomy in locomotion, explore objects in their surrounding environment, and continually request communicative and affective-social interaction with their reference to greater attachment (the caregiver), which may have contributed to higher burden.
Family with children affected by genetic factors or teratogenics involving functional, aesthetic and psychological sequels such as cleft lip and palate are vulnerable to several stress levels and need corrective and rehabilitation interventions. This study aimed to investigate the stress levels of fathers and mothers before and after surgical intervention in children with cleft lip and palate. The participants were 14 parents of children diagnosed with Cleft Incisive Transforamen Unilateral and Bilateral Incisive Transforamen of both genders, 21-53 participants of the surgical intervention program at the Hospital de Reabilitação de Anomalias Craniofaciais, Universidade de São Paulo in the city of Bauru, State of São Paulo. The results have allowed us to conclude that the people responsible for patients, patients and parents of the patients with cleft palatal lip, in surgical situation, present higher levels of stress in the period of pre-surgery, with modified quality in the autonomic aspects of the organism, besides bodily significantly unsatisfactory reactions.
The aim of this pilot study was to evaluate the effectiveness of cognitive-behavioral therapy (CBT) and use of amitriptyline, a tricyclic antidepressant, in patients with chronic temporomandibular disorders (TMD). Forty-seven women (mean age = 35.4 years old) with chronic TMD were enrolled in the study and divided into 4 groups: amitriptyline; amitriptyline and CBT; placebo and CBT; and placebo only (control). Patients were managed for 7 consecutive weeks. Follow-up evaluations were done at the 1st, 7th and 11th weeks of treatment. The presence and severity of pain, levels of depression, and quality of life and sleep were measured. Data were analyzed using ANOVA, Chi-square and Cochran tests, considering a significance level of 5%. Improvements were found for all factors considered in the intragroup analysis, although no significant differences were detected among groups. However, at the end of the treatment (11 weeks of follow-up), these positive outcomes persisted only for the women treated with amitriptyline and CBT. The obtained results suggest that the combination of amitriptyline and CBT may be effective in reducing pain and depression levels as well as in improving the quality of life and sleep in patients with chronic TMD.
Objective: To check the knowledge informal caregivers of children with cleft lip and palate acquire about the postoperative care of cheiloplasty and palatoplasty through the use of an educational video. Methods: Randomized clinical trial conducted with 80 caregivers of children with cleft lip and palate, arranged into two groups: experimental (G1) and control (G2). Data collection occurred during the child's hospital stay, in three stages, using a structured questionnaire and an educational video developed and validated for this study.Results: There was evidence of improvement in the acquisition of knowledge about postoperative care in both groups (p <0.001), but it was higher in G1 compared to G2. Conclusion: The educational video was shown to be effective to train caregivers of children with cleft lip and palate after cheiloplasty and palatoplasty. ResumoObjetivo: Verificar o conhecimento adquirido por cuidadores informais de crianças com fissura labiopalatina sobre os cuidados pós-operatórios de queiloplastia e palatoplastia por meio da utilização de um vídeo educativo. Métodos: Ensaio clínico randomizado, realizado com 80 cuidadores de crianças com fissura labiopalatina, dispostos em dois grupos: experimental (G1) e controle (G2). A coleta de dados ocorreu durante o período de hospitalização da criança, em três etapas, utilizando um questionário estruturado e um vídeo educativo construído e validado para o presente estudo. Resultados: Foi evidenciada melhora na aquisição de conhecimento sobre os cuidados pós-operatórios em ambos os grupos (p<0,001), porém, foi maior o G1 em comparação a G2. Conclusão: O vídeo educativo mostrou-se eficaz no treinamento de cuidadores de crianças com fissura labiopalatina em situação pós-operatória de queiloplastia e palatoplastia.
O objetivo deste estudo foi avaliar habilidades neuropsicomotoras e funcionais de crianças que apresentaram, no primeiro ano de vida, história clínica de risco para alterações do desenvolvimento, quanto às áreas motora, cognitiva, lingüística e psicossocial. Foram avaliadas 60 crianças, classificadas em dois grupos: o Grupo Experimental (GI), composto por 30 crianças com idade cronológica variando de zero a dois anos e onze meses, ambos os sexos, tendo história de intercorrências peri, pré e pós-natal e/ou atraso neuropsicomotor; o Grupo Controle (GII), formado por 30 crianças sem história de alterações do desenvolvimento, pareadas quanto ao sexo e idade. Os resultados indicaram que, na comparação entre grupos, (GI e GII), GI apresentou diferença estatisticamente significante nas áreas motora, de linguagem e cognitiva. Na análise da comparação entre áreas, as de maior prejuízo foram a da linguagem e motora, seguido da cognitiva. A área psicossocial foi a menos comprometida e na comparação entre grupos os escores não foram estatisticamente significantes. Isto demonstra a influência dos fatores de risco no processo de desenvolvimento e a importância do acompanhamento precoce às crianças que apresentam histórico de intercorrências.
Objective: to describe the process for building up an educational video on the postoperative cares for primary cheiloplasty and palatoplasty surgeries. Method: a five-step technology elaborated development study (analysis and planning, modeling, implementation, evaluation and distribution) conducted in a public institution specialized in treating cleft lip and palate. Results: the evaluation was carried out by six judges regarding content criticism and criteria of familiarity, plausibility and linguistic clarity. Concordance percentage was 98%, which obtained approval and consent from most of the judges participating in the study. The feature adopted after the judges’ analysis was qualified as a facilitator of the information needed to train caregivers' skills in the specific postoperative condition, and an additional in procedures related to basic health care in the hospital system. The video was completed with 11 minutes and 50 seconds. Conclusion: the educational video proved to be efficient in its constitution and applicability for preparing parents and other children caregivers who live with the need to learn about the postoperative care of cheiloplasty and palatoplasty surgeries.
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