Center for Biobehavioral Health, The Abigail Wexner Research Institute at Nationwide Children's Hospital, Columbus, OH, USA.
Department of Pediatrics, The Ohio State University College of Medicine, Columbus, OH, USA.
Cleft Palate Craniofac J. 2024 Nov;61(11):1784-1802. doi: 10.1177/10556656231181581. Epub 2023 Jun 22.
To determine associations of demographic, morphologic, and treatment protocol parameters with quality of life (QoL), appearance/speech satisfaction, and psychological adjustment.
Observational study utilizing retrospective report of protocol variables and current outcome variables.
Six North American cleft treatment clinics.
Children, ages 8.0-10.99 years, with Cleft Lip ± Alveolus, Cleft Palate, Cleft Lip and Palate, and parents (N = 284).
Pediatric QoL Inventory (PedsQL): Parent, Child, Family Impact Module (FIM); Patient Reported Outcome Measurement Information System (PROMIS); Child Behavior Checklist (CBCL); CLEFT-Q.
Outcome scores were average with few differences by cleft type. Multiple regression analyses yielded significant associations (.05) between socioeconomic status, race, and age at assessment and parent- and self-reported measures. Females had higher PROMIS Depression (β=.20) but lower CBCL Affective (β = -.16) and PROMIS Stigma scores (β= -.24). Incomplete cleft lip was associated with lower PROMIS Depression, and more positive ratings of CLEFT-Q: Nose, Nostril, Lip Scar; CBCL Competence scores, (βs = -.17 to .17). Younger Age at Lip Closure was associated with higher CBCL School Competence (β= -.18). Younger Age at Palate Closure was associated with higher Child PedsQL Total, Physical, Psychosocial QoL, and better CLEFT-Q Speech Function (βs = -.18 to -.15). Furlow Palatoplasty was associated with more CBCL Externalizing Problems (β = .17) higher CBCL Activities (β = .16). For all diagnoses, fewer Total Cleft-Related Surgeries was associated with lower PROMIS Stigma and higher CBCL Total Competence and Activities (βs = -.16 to .15).
Demographic characteristics, lip morphology, and treatment variables are related to later psychological functioning.
确定人口统计学、形态学和治疗方案参数与生活质量（QoL）、外观/言语满意度和心理调整的关系。
利用方案变量和当前结果变量的回顾性报告进行观察性研究。
北美 6 个腭裂治疗诊所。
年龄 8.0-10.99 岁的唇裂伴或不伴牙槽裂、腭裂、唇腭裂患儿及其父母（N=284）。
儿科生活质量问卷（PedsQL）：父母、儿童、家庭影响模块（FIM）；患者报告的结果测量信息系统（PROMIS）；儿童行为检查表（CBCL）；CLEFT-Q。
结果评分平均，不同类型腭裂之间差异较小。多元回归分析显示，社会经济地位、种族和评估时的年龄与父母和自我报告的测量结果之间存在显著关联（.05）。女性的 PROMIS 抑郁得分较高（β=0.20），但 CBCL 情感得分较低（β=-.16），PROMIS 耻辱感得分较低（β=-.24）。不完全性唇裂与 PROMIS 抑郁评分较低以及 CLEFT-Q：鼻、鼻孔、唇瘢痕；CBCL 能力评分（βs=-.17 至.17）呈正相关。唇裂闭合年龄越小，CBCL 学校能力评分越高（β=-.18）。腭裂闭合年龄越小，儿童 PedsQL 总分、生理、心理社会 QoL 越高，CLEFT-Q 语音功能越好（βs=-.18 至-.15）。Furlow 腭裂修补术与更多的 CBCL 外化问题（β=0.17）和更高的 CBCL 活动（β=0.16）有关。对于所有诊断，总的腭裂相关手术次数越少，PROMIS 耻辱感越低，CBCL 总分能力和活动得分越高（βs=-.16 至.15）。
人口统计学特征、唇形态和治疗变量与后期心理功能有关。
