published_or_final_version / Social Work / Master / Master of Social Work

published_or_final_version / Dentistry / Master / Master of Dental Surgery

Thesis (MSocialWork)--Stellenbosch University, 2002. / ENGLISH ABSTRACT: In this study an explorative and a descriptive design has been implemented with the aim of obtaining knowledge, insight, and understanding of the psycho-social implications of a cleft lip and/or cleft palate for the individual child as well as the family. The motivation for this study was a result of the lack of knowledge on the psycho-social adjustments of an individual/child with a cleft lip and/or cleft palate and his/her family. The researcher became conscious of this lack during a full preliminary inquiry and this lack has been confirmed by the Department of Social Work as well as the Department of Maxillo-Facial-and Oral Surgery at Tygerberg Hospital. The aim of this study is therefore to create guidelines concerning social welfare interference in families after the birth of a baby with a cleft lip and/or cleft palate, in order to improve psycho-social functioning. The literature study included occurrence and incidence, embryological development, etiology of cleft lip and/or cleft palate as well as the psycho-social implications for the individual/child and the family. The medical aspects, namely the etiological and embryological development of cleft lip and/or cleft palate only serves as a background for the medical social worker that forms part of the interdisciplinary team of a cleft palate/lip clinic. This research focuses primarily on the psycho-social implications of a cleft lip and/or cleft palate on the individual/child as well on the family. The literature study also included the theoretical perspectives which determine the social worker's task and the system and strength perspective has been focused on. These perspectives have been implemented according to the development-aimed approach. The researcher decided to involve ten pre-school children with congenital deformity, between the ages of one month to six years as well as their mothers, who are from the service area of the Tygerberg Hospital in the research. The study was determined by a combination of qualitative as well as quantitative research methods, namely structured interviews as well as structured questionnaires. The results of this research confirmed the results of the literature study to a great extent, namely that individuals/children with a congenital deformity, as well as their families, are a highrisk group for psycho-social problems. These psycho-social problems indicate relationship problems in the family, cognitive problems for the individual/child as well as social adjustment problems for the individual/child and the family. Therefore the results gave an indication of what the content of intervention programmes for this target group should be. The recommendations focused on three areas, namely general recommendations concerning prenatal clinics where the cleft lip and/or cleft palate should be identified, general recommendations concerning guidelines for the social worker before intervention in the target group starts and recommendations with the aim of creating guidelines for social welfare intervention, in order to limit the psycho-social implications on the individual/child. The recommendations include further research in order to address society's ignorance concerning cleft lip and/or cleft palate. This research should focus on the development of social welfare programmes which, by primary prevention, aim at improved informing the society of this deformity. / AFRIKAANSE OPSOMMING: 'n Verkennende sowel as 'n beskrywende ontwerp is in hierdie studie geïmplementeer ten einde kennis, insig en begrip oor die psigo-sosiale implikasies van 'n gesplete lip en/of verhemelte vir individu/kind sowel as die gesin te verkry. Die motivering vir hierdie studie het na vore gekom weens die leemte rakende kennis oor die psigo-sosiale aanpassings van 'n individu/kind met 'n gesplete lip en/of verhemelte en sy/haar gesin. Die navorser het van hierdie leemte bewus geword tydens 'n volledige voorondersoek en hierdie leemte is deur die Departement Maatskaplike Werk sowel as die Departement Kaak- en Mondchirurgie te Tygerberg Hospitaal bevestig. Die doel van hierdie studie is dus om riglyne daar te stel ten opsigte van maatskaplike intervensie met gesinne ná die geboorte van 'n baba met 'n gesplete lip en/of verhemelte, ten einde psigo-sosiale funksionering te verbeter. Die literatuurstudie het die voorkoms en insidensie, embriologiese ontwikkeling, etiologie van gesplete lip en/of verhemelte sowel as die psigo-sosiale implikasies vir die individu/kind en die gesin ingesluit. Die mediese aspekte, naamlik die etiologiese en embriologiese ontwikkeling van gesplete lip en/of verhemelte dien slegs as agtergrond vir die geneeskundige maatskaplike werker wat deel vorm van die interdissiplinêre span van 'n gesplete verhemelte/lip kliniek. Hierdie navorsing fokus primêr op die psigo-sosiale implikasies van gesplete lip en/of verhemelte op die individu/kind sowel as op die gesin. Die literatuurstudie het ook die teoretiese perspektiewe wat die maatskaplike werker se taak rig, ingesluit en daar is op die sisteem- en sterkteperspektief gefokus. Hierdie perspektiewe is aan die hand van die ontwikkelingsgerigte benadering geïmplementeer. Daar is besluit om tien voorskoolse kinders met kongenitale deformiteit, dus tussen die ouderdomme van een maand tot ses jaar sowel as hul moeders, wat vanuit die Tygerberg Hospitaal se diensarea afkomstig is, by die ondersoek te betrek. Die ondersoek is deur 'n kombinasie van kwalitatiewe sowel as kwantitatiewe navorsingsmetodes, naamlik gestruktureerde onderhoude sowel as gestruktureerde vraelyste, gerig. Die resultate van hierdie ondersoek het tot 'n groot mate die bevindinge van die literatuurstudie bevestig naamlik dat individue/kinders met 'n kongenitale deformiteit, sowel as hul gesinne, 'n hoë risikogroep vir psigo-sosiale probleme is. Hierdie psigo-sosiale probleme dui byvoorbeeld op verhoudings-probleme in die gesin, kognitiewe probleme vir die individu/kind sowel as sosiale aanpassingsprobleme vir die individu/kind en die gesin aan. Die resultate het dus 'n aanduiding gegee van wat die inhoud van intervensieprogramme vir hierdie teikengroep behoort te wees. Die aanbevelings het op drie areas gefokus naamlik algemene aanbevelings ten opsigte van voorgeboorteklinieke waar gesplete lip en/of verhemelte geïdentifiseer moet word, algemene aanbevelings ten opsigte van riglyne vir die maatskaplike werker voordat intervensie met die teikengroep begin en algemene aanbevelings ten einde riglyne daar te stel vir maatskaplike intervensie, sodat die psigo-sosiale implikasies op die individu/kind beperk word. Die aanbevelings sluit in verdere navorsing ten einde die onkunde van die samelewing ten opsigte van gesplete lip en/of verhemelte aan te spreek. Hierdie navorsing moet fokus op die ontwikkeling van maatskaplikewerk-programme wat deur primêre voorkoming die samelewing beter aangaande die deformiteit inlig.

The present study explored the effect of the birth of a child with a cleft lip and palate on family functioning within the context of family systems theory. Five families, each with a child who was born with a cleft lip and palate, were included in the study. The five couples were all married and they were the biological parents of their children whose ages ranged from two months to five years. All five sets of parents were initially interviewed together and then had separate individual interviews where the Family Assessment Measure-III was administered. The results reflected each family's distinctive patterns of interaction and how they adapted to the birth of a child with an orofacial cleft. Factors found to affect family functioning included: External support systems, individual coping skills, family rules and boundaries, open communication and cohesion among family members. / Psychology / M. A. (Psychology)

The present study explored the effect of the birth of a child with a cleft lip and palate on family functioning within the context of family systems theory. Five families, each with a child who was born with a cleft lip and palate, were included in the study. The five couples were all married and they were the biological parents of their children whose ages ranged from two months to five years. All five sets of parents were initially interviewed together and then had separate individual interviews where the Family Assessment Measure-III was administered. The results reflected each family's distinctive patterns of interaction and how they adapted to the birth of a child with an orofacial cleft. Factors found to affect family functioning included: External support systems, individual coping skills, family rules and boundaries, open communication and cohesion among family members. / Psychology / M. A. (Psychology)