Abstract

Structured ObjectivesTo describe the impact of cleft service centralization on parental perceptions of child outcomes and satisfaction with care from the Cleft Care UK (CCUK) study and compare them to the Clinical Standards Advisory Group (CSAG) study that took place 15 years earlier.Setting and Sample PopulationA subgroup of respondents from a UK multicentre cross-sectional study (CCUK) of 5-year-olds born with non-syndromic unilateral cleft lip and palate.Materials and MethodsData on parents’ perceptions of child self-confidence and their satisfaction with treatment outcomes and service provision were collected via self-report questionnaires. Data were compared with findings from the 1998 CSAG study.ResultsFewer parents in the CCUK study perceived their children as having poor self-confidence than in the 1998 CSAG study (8 and 19%, respectively). At least 81% of parents report satisfaction with the child’s facial features after surgery and 98% report being satisfied with the care received. These results are similar to those reported in 1998. There is no evidence of an adverse impact on families’ ability to attend appointments at the cleft clinic following centralization. Levels of reported problems (around 30%) with attendance were similar to those reported by CSAG.ConclusionCentralization of cleft services appears to have improved parental perceptions of some child outcomes but has made little difference to already high levels of parental satisfaction with cleft care services. Centralization is not associated with an increase in the proportion of families who find it difficult to attend appointments.

Highlights

  • Every year, in the United Kingdom (UK), around 1:700 infants are born with a cleft lip and/or palate [CLP] [1, 2]

  • A cross-sectional questionnaire study was designed to replicate the investigation of child psychology and parental satisfaction undertaken in the 1998 Clinical Standards Advisory Group (CSAG) study

  • The current study has shown that, overall, parents are very satisfied with the provision of cleft services

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Summary

Introduction

In the United Kingdom (UK), around 1:700 infants are born with a cleft lip and/or palate [CLP] [1, 2] This condition is associated with adverse physical outcomes for the child such as poor facial growth and dental anomalies [3, 4] and communication issues such as speech disorders and poor hearing [5,6,7]. Questionnaire items asked about parental perceptions of the child’s selfconfidence, their satisfaction with the child’s facial appearance (teeth, lips, nose, profile, hearing and speech) and with the level of care provided by the cleft service. Nineteen per cent of parents believed that the cleft had a negative impact on their 5-year-old child’s self-confidence, but the vast majority (93%) reported that the care and attention they had received within the cleft service and associated treatment and outcomes were either good or excellent [1]

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