Pradubwong Suteera, Prathanee Benjamas, Patjanasoontorn Niramol
J Med Assoc Thai. 2016 Aug;99 Suppl 5:S36-42.
After surgically correcting deformities in children with cleft lip/palate (CLP), 88% still had speech disorders, resonance disorders, voice abnormalities, and unintelligibility that affected daily life. Accessibility to speech therapy in developing countries is limited. The community-Based Speech Therapy Model is one means of improving communication and quality of life.
To evaluate quality of life and reflections from children, families, and speech assistants (SAs) who participated in Networking of Khon Kaen University Community-Based, Speech Therapy Model (KKUCBSM) in Mahasarakham province.
The model was piloted from March 2014 to February 2015. The Tawanchai Quality of Life questionnaire, General Health Questionnaire (Thai GHQ-12), and open-ended question feedback were used for collecting data June to August 2015. Demographic data were reported as percentages, means, standard deviations, and content analysis of openended questions.
Fourteen children with cleft lip and palate (mean age 5.5 years: 7 boys, 7 girls), 14 caregivers and 6 SAs were recruited for this study. Most caregivers were parents (9 families). Their needs were dental care followed by skills to support child development and skills to improve the children’s speech (score 4.64+0.497, 4.57+0.646, 4.50+0.519, respectively). The score for psychosocial satisfaction vis-a-vis facial appearance was good (3.50+0.760), but for negative result scores, they felt significantly less happy, tired, and hopeless (4.79+0.579). The anxiety score was in the normal range. As a result of interviewing about problems and obstacles before joining, caregivers reported their greatest problems arose from difficulties traveling to join the project (costs were greater than reimbursements and time was insufficient). SAs reported being overworked. Benefits from participation in the project included: children with clefts consistently accessed speech services by SAs in community, caregivers gained good experiences for daily living support and speech correction. SAs gained experiences in speech correction under supervision of Speech and language pathologists (SLPs) that could be used to help other children with speech defects and other patients besides children with clefts.
KKUCBSM for children with CLP was not only the effective way for solving articulation defects, but also improved quality of life in children with CLP.
在对唇腭裂（CLP）患儿进行手术矫正畸形后，88%的患儿仍存在影响日常生活的言语障碍、共鸣障碍、嗓音异常及发音不清问题。在发展中国家，获得言语治疗的机会有限。基于社区的言语治疗模式是改善沟通和生活质量的一种方式。
评估参与孔敬大学基于社区的言语治疗模式（KKUCBSM）在玛哈沙拉堪府项目的儿童、家庭及言语治疗师（SAs）的生活质量及反馈。
该模式于2014年3月至2015年2月进行试点。2015年6月至8月，使用Tawanchai生活质量问卷、一般健康问卷（泰国版GHQ - 12）及开放式问题反馈收集数据。人口统计学数据以百分比、均值、标准差及开放式问题的内容分析形式呈现。
本研究招募了14名唇腭裂患儿（平均年龄5.5岁：7名男孩，7名女孩）、14名照料者及6名言语治疗师。大多数照料者是父母（9个家庭）。他们的需求依次为牙齿护理、支持儿童发育的技能及改善儿童言语的技能（得分分别为4.64 + 0.497、4.57 + 0.646、4.50 + 0.519）。对面部外观的心理社会满意度得分良好（3.50 + 0.760），但对于负面结果得分，他们感到明显不开心、疲惫及绝望（4.79 + 0.579）。焦虑得分在正常范围内。在询问参与前的问题和障碍时，照料者报告他们最大的问题是前往参加项目的交通困难（费用高于报销额度且时间不足）。言语治疗师报告工作负担过重。参与该项目的益处包括：唇腭裂患儿持续获得社区言语治疗师的言语服务，照料者在日常生活支持和言语矫正方面获得良好经验。言语治疗师在言语和语言病理学家（SLP）的监督下获得言语矫正经验，可用于帮助其他言语缺陷儿童及除唇腭裂患儿外的其他患者。
KKUCBSM对唇腭裂患儿不仅是解决发音缺陷的有效方法，还改善了唇腭裂患儿的生活质量。
