Department of Communication Sciences and Disorders, Long Island University Brooklyn, Brooklyn.
Department of Biobehavioral Sciences, Teachers College, Columbia University, New York, NY.
J Craniofac Surg. 2021;32(8):2802-2807. doi: 10.1097/SCS.0000000000007988.
Although a number of international cleft organizations and cleft professionals in low- and middle-income countries (LMICs) have built and supported comprehensive cleft care and speech therapy models to address the shortage of speech services in LMICs, the specific speech needs of individuals with cleft lip and palate (CLP) in such countries remain unknown. The objective of this study was to evaluate the barriers to accessing speech services for patients with CLP as well as the resources and models of speech services that are currently available for individuals with CLP in LMICs, with the goal of better understanding the needs of this population.
Qualitative and quantitative methods consisted of Smile Train partner surveys that were distributed June 25th to July 31st, 2018 worldwide. Surveys were distributed through Smile Train's online medical database, Smile Train Express, which every Smile Train partner uses to report their Smile Train sponsored treatment outcomes. A total of 658 Smile Train partners responded to the surveys. Respondents included surgeons, speech therapists, orthodontists, administrators and nurses who represented non-governmental organizations, hospitals (private or public), hospital groups, and private clinics.
Results indicated that lack of resources, including access to local speech providers and language materials, as well as financial constraints such as patient travel and speech treatment costs, are the most commonly reported barriers to accessing speech services across all geographic regions surveyed.
Improving access to CLP speech services in LMICs may require strategies that address lack of speech providers, language materials, and financial constraints.
尽管一些国际唇腭裂组织和中低收入国家（LMICs）的唇腭裂专业人员已经建立并支持了全面的唇腭裂护理和言语治疗模式，以解决 LMICs 中言语服务的短缺问题，但这些国家的唇腭裂患者的具体言语需求仍不清楚。本研究的目的是评估唇腭裂患者获得言语服务的障碍，以及目前 LMICs 中唇腭裂患者可用的言语服务资源和模式，旨在更好地了解这一人群的需求。
定性和定量方法包括 Smile Train 合作伙伴调查，该调查于 2018 年 6 月 25 日至 7 月 31 日在全球范围内分发。调查通过 Smile Train 的在线医疗数据库 Smile Train Express 分发，每个 Smile Train 合作伙伴都使用该数据库报告他们由 Smile Train 赞助的治疗结果。共有 658 名 Smile Train 合作伙伴对调查做出了回应。受访者包括外科医生、言语治疗师、正畸医生、行政人员和护士，他们代表非政府组织、医院（私立或公立）、医院集团和私人诊所。
结果表明，缺乏资源，包括获得当地言语提供者和语言材料的机会，以及患者旅行和言语治疗费用等经济限制，是所有调查地区报告的获得言语服务的最常见障碍。
改善 LMICs 中唇腭裂患者的言语服务获取可能需要采取策略来解决言语提供者、语言材料和经济限制的缺乏问题。
