Measurement of Health-Related and Oral Health–Related Quality of Life among Individuals with Nonsyndromic Orofacial Clefts: A Systematic Review and Meta-Analysis

Herkrath, Ana Paula Corrêca De Queiroz; Herkrath, Fernando José; Rebelo, Maria Augusta Bessa; Vettore, Mário Vianna

doi:10.1597/13-104

Cited by 71 publications

(54 citation statements)

References 75 publications

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“…The use of mixed models allowed analysis to draw from all available data, although future studies incorporating multiple imputation for multilevel data may be useful. Based on active surgery histories among participants, it is clear that additional follow‐up into young adulthood is needed to fully measure psychological sequelae.…”

Section: Discussionmentioning

confidence: 99%

Resiliency and socioemotional functioning in youth receiving surgery for orofacial anomalies

Ruff

Sischo

Broder

2016

Comm Dent Oral Epid

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Objectives Restorative interventions for cleft lip and palate involve annual evaluations, adjunct treatment, and multiple surgeries. The purpose of this study was to investigate the longitudinal impact of cleft surgery on psychosocial functioning among youth with cleft. Methods Data were derived from a 5-year, multicenter, prospective longitudinal study of children with cleft (N = 1196). Children completed psychological inventories for self-concept, anxiety, depression, mastery, and relatedness. Multilevel mixed-effects models were used to analyze the effects of craniofacial surgery for cleft on psychosocial outcomes over time. Results There were 1196 participants at baseline, of whom 258 (27.5%) received a surgical intervention prior to their 1st follow-up visit. Approximately 78% of participants had cleft lip and palate, and 22% had cleft palate only. Surgery receipt was significantly associated with lower relatedness (β = −1.48, 95% CI = −2.91, −0.05) and mastery (β = −1.32, 95% CI = −2.49, −0.15) scores, although overall scores appeared to increase over time. Surgery was not related to anxiety (β = −0.15, 95% CI = −1.08, 0.79), depression (β = 0.18, 95% CI = −0.65, 1.01), and self-concept (β = −0.84, 95% CI = −1.83, 0.15). The treatment–time interaction was not significant. Significant differences in psychosocial functioning were found across sex, race/ethnicity, and age groups. Conclusions Surgery may have negative short-term impacts on psychosocial functioning, although effects may diminish over time. Given the limited postsurgical follow-up period, long-term change in psychological well-being and the moderating effects of surgery may not be fully realized. Further follow-up of children with cleft through adulthood to explore developmental trajectories of psychosocial functioning in more detail is recommended.

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Section: Discussionmentioning

confidence: 99%

Resiliency and socioemotional functioning in youth receiving surgery for orofacial anomalies

Ruff

Sischo

Broder

2016

Comm Dent Oral Epid

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“…Health- and oral health-related quality of life are aspects of QoL that refer to the effect of (oral) disease/condition and its treatment on various facets of life (e.g., physical functioning, mental health, and social interaction) [5, 6]. QoL has been used in patient-oriented research to evaluate treatment outcomes at the individual level [7]. Yet, little is known about the impact of cleft treatment over time on the QoL and oral health-related quality of life (OHRQoL) of youth with CLP.…”

Section: Introductionmentioning

confidence: 99%

“…While many studies find children and adolescents with CLP appear to have good psychosocial functioning, resilience [8–10], and overall self-concept [11], evidence also suggests that individuals with CLP are at risk of lower OHRQoL and psychosocial well-being [7, 12]. Indeed, differences in QoL emerge when specific aspects of well-being are examined, such as personal and social self-concept [13], academic achievement [14], body image (particularly for girls) [15], and depression [16].…”

Section: Introductionmentioning

confidence: 99%

“…Health disparities have also been found as adolescents with cleft who are without health insurance, ethnic minorities, and those having unmet clinical needs (e.g., surgical recommendations) have lower OHRQoL than their privately insured, white counterparts without a surgical recommendation [18, 20]. This existing research, however, is often cross-sectional, has small samples, fails to control for confounders, deals with different age groupings, and/or often lacks a conceptual framework [7, 11]. Further, these reports often focus on the negative psychological status and fail to incorporate positive aspects of psychosocial functioning and QoL.…”

Section: Introductionmentioning

confidence: 99%

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Oral health-related quality of life in youth receiving cleft-related surgery: self-report and proxy ratings

2016

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Purpose This paper evaluated the impact of cleft-related surgery on the oral health-related quality of life (OHRQoL) of youth with cleft over time. Methods Data were derived from a 5-year, multi-center, prospective, longitudinal study of 1196 youth with cleft lip and/or palate and their caregivers. Eligible youth were between 7.5 and 18.5 years old, spoke English or Spanish, and were non-syndromic. During each observational period, which included baseline, and 1- and 2-year post-baseline follow-up visits, youths and their caregivers completed the Child Oral Health Impact Profile, a validated measure of OHRQoL. Multilevel mixed-effects models were used to analyze the effects of receipt of craniofacial surgery on OHRQoL over time. Results During the course of this study a total of 516 patients (43 %) received at least one surgery. Youth in the surgery recommendation group had lower self- (β = −2.18, p < 0.05) and proxy-rated (β = −2.92, p < 0.02) OHRQoL when compared to non-surgical self- and proxy-rated OHRQoL at baseline. Both surgical and non-surgical youth (β = 3.73, p < 0.001) and caregiver (β = 1.91, p < 0.05) ratings of OHRQoL improved over time. There was significant incremental improvement (time × surgery interaction) in self-reported OHRQoL for youth postsurgery (β = 1.04, p < 0.05), but this postsurgery increment was not seen in the caregiver proxy ratings. Conclusions Surgical intervention impacts OHRQoL among youth with cleft. Youth who were surgical candidates had lower baseline self- and caregiver-rated OHRQoL when compared to non-surgical youth. Youth who underwent cleft-related surgery had significant incremental improvements in self-rated but not caregiver (proxy)-rated OHRQoL after surgery.

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“…in Swedish adults with cleft lip and palate compared to controls. Furthermore, a recently published review and meta‐analysis show that CL/P negatively affects HRQoL in children (2‐ to 18‐year‐olds) and in adults (19‐ to 65‐year‐olds) mainly in psychological health.…”

Section: Introductionmentioning

confidence: 99%

A comparison of health‐related quality of life in 5‐ and 10‐year‐old Swedish children with and without cleft lip and/or palate

Sundell¹,

Törnhage

Marcusson

2016

Int J Paed Dentistry

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Measurement of Health-Related and Oral Health–Related Quality of Life among Individuals with Nonsyndromic Orofacial Clefts: A Systematic Review and Meta-Analysis

Cited by 71 publications

References 75 publications

Resiliency and socioemotional functioning in youth receiving surgery for orofacial anomalies

Resiliency and socioemotional functioning in youth receiving surgery for orofacial anomalies

Oral health-related quality of life in youth receiving cleft-related surgery: self-report and proxy ratings

A comparison of health‐related quality of life in 5‐ and 10‐year‐old Swedish children with and without cleft lip and/or palate

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