Stock Nicola Marie, Costa Bruna, White Paul, Rumsey Nichola
Centre for Appearance Research, University of the West of England, Bristol, United Kingdom.
Applied Statistics Group, University of the West of England, Bristol, United Kingdom.
Cleft Palate Craniofac J. 2020 Jan;57(1):88-98. doi: 10.1177/1055665619862457. Epub 2019 Aug 4.
Despite the potential psychological impact of a diagnosis of cleft lip and/or palate (CL/P) on parents, few large-scale studies currently exist. Utilizing data extracted from The Cleft Collective Birth Cohort Study, the current study aimed to examine the psychological impact of the diagnosis on parent and family functioning and to identify risk and/or protective factors contributing to parental adjustment in order to inform future psychological intervention.
Parent-reported questionnaire data were extracted for 1163 parents (644 mothers and 519 fathers). Outcome measures included the PedsQL-Family Impact Module, the Perceived Stress Scale, the Hospital Anxiety and Depression Scale, and a condition-specific tool designed by the Psychology Clinical Excellence Network.
Overall, findings suggest that parents adjust well to the diagnosis. Factors found to be protective against psychological distress for both mothers and fathers included a positive life orientation, satisfaction with health care, and relationship satisfaction. Close friendships were also protective against depression in mothers. Risk factors for mothers included the presence of a prior mental health condition, and stressful life events during pregnancy. Risk factors for fathers included being older at the time of conception, and recently being absent from work.
Findings suggest a need for appropriate psychological screening of both parents following a diagnosis of CL/P and emphasize the importance of coordinated multidisciplinary care for psychological health. Preventative models of intervention to strengthen familial relationships and build resilience require further investigation.
尽管唇腭裂（CL/P）诊断对父母可能产生心理影响，但目前大规模研究较少。本研究利用从唇腭裂集体出生队列研究中提取的数据，旨在探讨该诊断对父母及家庭功能的心理影响，并确定有助于父母适应的风险和/或保护因素，以为未来的心理干预提供参考。
提取了1163名父母（644名母亲和519名父亲）通过问卷报告的数据。结果测量包括儿童生活质量量表-家庭影响模块、感知压力量表、医院焦虑抑郁量表，以及由心理学临床卓越网络设计的特定疾病工具。
总体而言，研究结果表明父母对该诊断适应良好。对母亲和父亲的心理困扰均有保护作用的因素包括积极的生活取向、对医疗保健的满意度以及关系满意度。亲密的友谊对母亲的抑郁也有保护作用。母亲的风险因素包括既往有心理健康问题，以及孕期有压力性生活事件。父亲的风险因素包括受孕时年龄较大，以及近期缺勤。
研究结果表明，唇腭裂诊断后需要对父母双方进行适当的心理筛查，并强调心理健康协调多学科护理的重要性。加强家庭关系和建立复原力的预防性干预模式需要进一步研究。
