Pediatric craniofacial surgery and parental attitudes.

A prospective study was designed to explore the effects of attitudes of parents who have children affected with craniofacial deformities. The study focuses on the child's craniofacial deformity and its effect upon the child's mental well being. The effect of surgical reconstruction of the deformity upon these parental attitudes was evaluated as well. The parent actively involved in the child's in- and outpatient care was enrolled in the study (N = 24). The evaluation protocol was administered prior to the surgery and postoperatively at 2 weeks, 3 months, and 1 year. For the majority of these parents, having a child with an obvious facial deformity did not make them less accepting of the children or their childrearing responsibilities. These parents expected the affected children to have positive self-esteem. This was the case for the majority of the children. There was no evidence to suggest that the affected children had a negative impact on the family structure. The child's disfigurement was rarely portrayed in parental drawings of the family, and the affected child could not be distinguished from other siblings. In spite of these positive findings, a majority of older children had significant behavioral problems. The parental attitudes were affected variably and transiently by the event of surgical reconstruction. Most attitudes returned to the preoperative baseline within the year of study.