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<p>Syftet med denna studie var att, utifrån vetenskaplig litteratur, beskriva hur föräldrar till barn med läpp-, käk- och gomspalt (LKG) upplevde beskedet och den första tiden efter barnets födelse, samt hur de bemöttes av vårdpersonalen. Litteratursökningen genomfördes i Medline och totalt valdes 15 vetenskapliga artiklar ut till föreliggande studies resultat. Många föräldrar till barn med LKG befinner sig den första tiden efter beskedet i en utsatt situation, deras funderingar kan vara många och behovet av stöd kan vara stort. Föreliggande studie visade att en viktig faktor för föräldrarnas upplevelse och välmående var grundlig information och stöd till föräldrarna, givna av välutbildad och erfaren vårdpersonal och att de inte enbart såg till barnets missbildning utan även till barnets hälsa. Vid sjukhusvistelse borde vårdpersonalen uppmärksamma föräldrars eventuella behov av att få känna sig delaktiga i vården av sitt barn. Prenatal diagnos visade sig ha en positiv inverkan på föräldrarnas upplevelse av att få ett barn med LKG. Betydande för hur föräldrarna upplevde sin nya situation var vårdpersonalens attityd och ordval gentemot dem. Möjlighet till kontakt med psykolog eller kontakt med andra föräldrar till barn med LKG visade sig också betyda mycket för föräldrarna.</p> / <p>The aim of this study was to, from scientific articles, illustrate how parents with children born suffering from cleft lip and palate (CLP) reacted when informed of their childs diagnosis, how they experienced the first time period after the birth and the attitude and support from the caregivers. The 15 scientific articles used were found in Medline. Parents with children with CLP are at first in a vulnerable situation beacuse of their many questions and need of support. The result of this study showed that an important factor for the well-being of the parents was profound information and support from well-educated personnel which not only focused on the malformation of the child but also their health. During the hospitalization the caregivers should observe the possible needs the parents could have and how they could be involved in the care of their own child. Further, the result found that prenatal diagnosis had a positiv affect on the parents experience when having a child with cleft lip and palate. The result also proved that the caregivers attitude and their selection of words towards the parents was very important of how the parents experienced the situation. Another important aspect for the parents experience was the possibilty of contact with psychologist and other parents with children with CLP.</p>

Syftet med denna studie var att, utifrån vetenskaplig litteratur, beskriva hur föräldrar till barn med läpp-, käk- och gomspalt (LKG) upplevde beskedet och den första tiden efter barnets födelse, samt hur de bemöttes av vårdpersonalen. Litteratursökningen genomfördes i Medline och totalt valdes 15 vetenskapliga artiklar ut till föreliggande studies resultat. Många föräldrar till barn med LKG befinner sig den första tiden efter beskedet i en utsatt situation, deras funderingar kan vara många och behovet av stöd kan vara stort. Föreliggande studie visade att en viktig faktor för föräldrarnas upplevelse och välmående var grundlig information och stöd till föräldrarna, givna av välutbildad och erfaren vårdpersonal och att de inte enbart såg till barnets missbildning utan även till barnets hälsa. Vid sjukhusvistelse borde vårdpersonalen uppmärksamma föräldrars eventuella behov av att få känna sig delaktiga i vården av sitt barn. Prenatal diagnos visade sig ha en positiv inverkan på föräldrarnas upplevelse av att få ett barn med LKG. Betydande för hur föräldrarna upplevde sin nya situation var vårdpersonalens attityd och ordval gentemot dem. Möjlighet till kontakt med psykolog eller kontakt med andra föräldrar till barn med LKG visade sig också betyda mycket för föräldrarna. / The aim of this study was to, from scientific articles, illustrate how parents with children born suffering from cleft lip and palate (CLP) reacted when informed of their childs diagnosis, how they experienced the first time period after the birth and the attitude and support from the caregivers. The 15 scientific articles used were found in Medline. Parents with children with CLP are at first in a vulnerable situation beacuse of their many questions and need of support. The result of this study showed that an important factor for the well-being of the parents was profound information and support from well-educated personnel which not only focused on the malformation of the child but also their health. During the hospitalization the caregivers should observe the possible needs the parents could have and how they could be involved in the care of their own child. Further, the result found that prenatal diagnosis had a positiv affect on the parents experience when having a child with cleft lip and palate. The result also proved that the caregivers attitude and their selection of words towards the parents was very important of how the parents experienced the situation. Another important aspect for the parents experience was the possibilty of contact with psychologist and other parents with children with CLP.

The purpose of this study was to evaluate the burden of care (BOC) of two presurgical infant orthopedic (PSIO) protocols used for complete unilateral cleft lip and palate (CUCLP), and to compare aesthetic outcomes with centres not utilizing PSIO. Four samples were collected. Two from the same centre that underwent either traditional infant orthopedics (TIO) or nasoalveolar molding (NAM) and two from centres not employing PSIO. BOC data were collected for the PSIO groups and photos at age 5 were collected for ratings of nasolabial aesthetics. The BOC of NAM was found to be significantly greater than IO for number of visits (9.9 vs. 6.6, (p<0.001)) and days wearing the appliance (127 vs. 112, (p<0.05)). Significant differences in aesthetic ratings were noted amongst the three centres but not between the NAM and TIO groups. Overall, an increased burden of NAM over TIO was detected, without an observable aesthetic improvement.

The purpose of this study was to evaluate the burden of care (BOC) of two presurgical infant orthopedic (PSIO) protocols used for complete unilateral cleft lip and palate (CUCLP), and to compare aesthetic outcomes with centres not utilizing PSIO. Four samples were collected. Two from the same centre that underwent either traditional infant orthopedics (TIO) or nasoalveolar molding (NAM) and two from centres not employing PSIO. BOC data were collected for the PSIO groups and photos at age 5 were collected for ratings of nasolabial aesthetics. The BOC of NAM was found to be significantly greater than IO for number of visits (9.9 vs. 6.6, (p<0.001)) and days wearing the appliance (127 vs. 112, (p<0.05)). Significant differences in aesthetic ratings were noted amongst the three centres but not between the NAM and TIO groups. Overall, an increased burden of NAM over TIO was detected, without an observable aesthetic improvement.

In der vorliegenden Dissertation wurde anhand von 1042 extraoralen Fotos im Profil und en face untersucht, wie sich das Wachstum longitudinal bei 166 gesunden Kindern, je zehn Kindern mit isolierter Gaumenspalte, einseitiger Lippen-Kiefer-Gaumenspalte sowie doppelseitiger Lippen-Kiefer-Gaumenspalte operiert nach dem Leipziger Konzept entwickelt, sowie inwiefern sich die einzelnen Gruppen in verschiedenen Altersstufen voneinander unterscheiden. Dazu wurden pro Gruppe jeweils fünf Jungen und fünf Mädchen kaukasischer Herkunft, geboren in den Jahren 1994 bis 2001, mit einer nichtsyndromalen Spalte ausgewählt, die ab der Geburt über mehrere Jahre hinweg fotografiert wurden. Diese Fotos wurden digitalisiert und denen von Kontrollpatienten gegenüber gestellt. Anhand von Winkeln der klassischen Morphometrie und Grafiken und Statistiken der geometrischen Morphometrie wurden die Veränderungen im Wachstum analysiert und die Kontrollpatienten mit dem Leipziger OP-Konzept verglichen. Es konnte gezeigt werden, dass die geometrische Morphometrie durchaus geeignet ist, das Gesichtswachstum anhand von extraoralen Fotos zu beurteilen. Weiterhin konnte bestätigt werden, dass mit dem Leipziger Konzept zur funktionellen Rehabilitation von Patienten mit Lippen-Kiefer-Gaumenspalten sehr gute Operationsergebnisse und vor allem Langzeitergebnisse erzielt werden können.

The wide variation in infant maxillary morphology and cleft size of children with unilateral cleft lip and palate (UCLP) and isolated cleft palate (CP) raise concerns about their possible influences on treatment outcome. The studies in this thesis aimed to investigate the relation between cleft size in infancy and crossbite at 5 years of age (Paper I); the impact of primary surgery on cleft size and maxillary arch dimensions from infancy to 5 years of age (Paper II); associations between cleft size, maxillary arch dimensions and facial growth in both UCLP and CP children (Paper III); and, to evaluate the relation between infant cleft size and nasal airway size and function in adults treated for UCLP (Paper IV). In homogenously treated groups of children with UCLP and CP, dental casts were used to measure cleft size and maxillary arch dimensions from infancy up to 5 years of age, and for crossbite recording at 5 years. Serial lateral cephalometric radiographs taken between 5 and 19 years of age in the same groups were used to study facial growth. Nasal airway size and function were evaluated by acoustic rhinometry, rhinomanometry, peak nasal inspiratory flow and odour test in a group of adults treated for UCLP. The main findings were: crossbite was a frequent malocclusion at 5 years of age in children with UCLP and large cleft widths at the level of the cuspid points in infancy were associated with less anterior and posterior crossbite in this group (Paper I). Cleft widths decreased after lip closure and/or soft palate closure in both UCLP and CP children. Initially, UCLP children had wider maxillary arch dimensions, but after hard palate closure, the transverse growth was reduced, and at 5 years, they had smaller maxillary arch widths than CP children had (Paper II). Maxillary arch depths and cleft widths in infancy were correlated with maxillary protrusion and sagittal jaw relationships in both UCLP and CP children (Paper III), but cleft width in infancy was not correlated with nasal airway size and function in adults treated for UCLP (Paper IV).

Thesis (M.S.)--University of Wyoming, 2007. / Title from PDF title page (viewed on June 11, 2009). Includes bibliographical references (p. 44-51).

Thesis (M.S.)--University of Michigan, 1997. / Includes bibliographical references.

Thesis (M.D.S.)--University of Hong Kong, 1995. / Includes bibliographical references (leaf 190-217).