No abstract

During adolescence, romantic relationships are a key developmental milestone. Coupled with the increasing salience of appearance and social acceptance, adolescents with an appearance-altering condition may feel particularly vulnerable when it comes to romantic relationships. This study aimed to explore the prevalence of romantic experiences among adolescents with a cleft lip and/or palate (CL/P), and to investigate how these experiences could be related to depressive symptoms and global self-worth. The study included 661 Norwegian adolescents with CL/P, who were compared to a large national sample. The prevalence of romantic relationships was lower among adolescents with CL/P compared to the reference group, although the overall impact on depressive symptoms and global self-worth appeared to be low. This study is one of few to explore the impact of a congenital visible condition on experiences of romantic relationships and provides preliminary insight into a significant, yet complex topic.

Bodily or physical differences constitute a class of potentially stigmatized characteristics. The existing literature confirms that those with appearance altering or disfiguring conditions ("visible differences") may experience both felt and enacted stigma and seek to conceal their difference. Furthermore, issues relating to the disclosure or revelation of visible difference are frequently cited. The present study used qualitative methods to explore participants' experiences of having disclosed otherwise unknown or hidden visible differences to others and considered these experiences within the context of existing theories of the disclosure of stigmatized characteristics. Semistructured interviews were conducted with 15 participants who had a variety of visible differences. The data were analyzed through inductive thematic analysis with the resultant themes indicating participants' concerns and anxieties related to disclosing their differences, variable levels of agency within, preparation for, and control over the disclosure scenario, the importance of their difference being seen by others, and the personal and interpersonal changes that disclosure could facilitate. In consideration of participants' experiences of the disclosure of visible difference and the applicability of existing models of disclosure to this scenario, a working framework that incorporates the specific issues relevant to the disclosure of visible differences is proposed.

Background There has been a lack of a standardized protocol for collection of patient reported outcomes (PRO) and detection of and indication for psychological treatment in cleft care. The objectives of this paper was to translate Cleft Hearing Appearance and Speech Questionnaire (CHASQ) into eight European languages, to investigate whether levels of PRO in patients with cleft lip and/or cleft palate (CL/P) were comparable across countries and to investigate clinician experience of the instrument. Methods The PRO measure-CHASQ-was translated into Bulgarian, Estonian, Greek, Latvian, Macedonian, Romanian, Serbian and Swedish and implemented with patients in the respective countries. A focus group discussion was conducted to investigate health care professional experience on the use of CHASQ in their clinics. Data was analysed in accordance with the principles of thematic analysis. Results Analysis showed statistically significant differences between countries and groups of diagnosis in CHASQ scores. CHASQ helped clinicians gain patient information and informed on treatment decisions, broadened the clinicians' role as caregivers and was perceived as short and easy to use. Limited time and resources in clinics were limitations in implementing the instrument. Conclusions Translation and utilization of CHASQ facilitated international comparison and cooperation. Linguistically, valid replicas of CHASQ are now available in many European languages. Results from this study show that CHASQ may be used for collection of PRO on patient satisfaction and to spark conversation between clinicians, patients and families. Level of evidence: Not rateable.

The psychological and social impact of hair loss and its ongoing treatment can be considerable. Medical treatments are not always successful, and alternative treatments, such as medical tattooing, are growing in popularity. The aims of this study were to explore adults' motivations, experiences, and self-perceived outcomes in relation to medical tattooing. Individual telephone interviews were conducted with 22 women from the United Kingdom aged 26-67 years who had undergone medical tattooing in the past 5 years related to hair loss. Interviews were transcribed and inductive thematic analysis was performed. Appearance concerns, loss of self-confidence/identity, and the practicalities of daily upkeep were cited as reasons for seeking a semi-permanent solution. Trust in the practitioner and the ongoing costs of tattoo maintenance were important considerations in participants' decision-making process and their overall satisfaction with treatment outcomes. Participants felt the emotional impact of hair loss and the subsequent need for appearancerestoring treatment remains unrecognised. This study provides insight into participants' perceptions of an under-researched and unregulated but widely accessible treatment. Implications for the decision-making process are discussed, and suggestions for health professionals are offered.