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Nowak-Gospodarowicz I, Gospodarowicz M, Rękas M. Factors influencing medical expenditures in patients with unresolved facial palsy and pharmacoeconomic analysis of upper eyelid lid loading with gold and platinum weights compared to tarsorrhaphy. HEALTH ECONOMICS REVIEW 2024; 14:30. [PMID: 38676777 PMCID: PMC11055228 DOI: 10.1186/s13561-024-00506-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Accepted: 04/08/2024] [Indexed: 04/29/2024]
Abstract
There are no standards in diagnostic and therapeutic approaches to eye care in incomplete eyelid closure due to unresolved facial palsy (FP). Loading of the upper eyelid (UELL) with gold weights (GWs) or platinum chains (PCs) is a highly effective procedure for the correction of lagophthalmos. Despite this, the procedure is used infrequently in our country because of the relatively high price of the implant and the lack of reimbursement. The aim of this research was to assess the factors influencing medical expenditures in this group of patients and to analyze utility costs for the UELL procedure with the use of GW and PC compared to tarsorrhaphy.Material and methods The costs of 88 surgical procedures (40 GWs, 11 PCs and 37 tarsorrhaphies) and medical expenditures before and after surgery were calculated based on reporting of materials, staff salaries and the SF-36 questionnaire. Distribution quartiles of the cost per QALY measure (dependent variable) was assessed via an ordered logistic regression model with eight explanatory variables.Results The calculated total cost of the surgery was US$209 for tarsorrhaphy, US$758 for UELL with a GW and US$1,676 for UELL with a PC. Bootstrapped costs per QALY values (CUI) in 88% of cases were below the US$100,000 cutoff. Etiology and duration of facial palsy and presence of Bell's phenomenon were factors that significantly influenced the CUI. Patient gender and age, history of previous eyelid surgery, and presence of corneal sensation were found to be not significant (p > 0.1). Calculated ICER for GW was US$1,241.74/1QALY and ICER for PC was US$13,181.05/1QALY compared to tarsorrhaphy.Conclusions Eye protection in patients with FP should be a crucial element of health policy. Findings suggest UELL procedure with a GW or a PC to be a cost-effective procedure with GW being the most cost-effective.
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Affiliation(s)
- Izabela Nowak-Gospodarowicz
- Department of Ophthalmology, Military Institute of Medicine - National Research Institute, 128 Szaserow St, 04-141, Warsaw, Poland.
| | - Marcin Gospodarowicz
- Institute of Banking, Warsaw School of Economics, Niepodległości 162, 02-554, Warsaw, Poland
| | - Marek Rękas
- Department of Ophthalmology, Military Institute of Medicine - National Research Institute, 128 Szaserow St, 04-141, Warsaw, Poland
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Shamil E, Noriega M, Moin S, Ko TK, Tan DJY, Meller C, Andrews P, Lekakis G. Psychological Aspects of Facial Palsy. Facial Plast Surg 2024. [PMID: 38648794 DOI: 10.1055/s-0044-1782678] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/25/2024] Open
Abstract
This article discusses the psychological effects of facial palsy (FP) in adults. FP is the abnormal functioning of facial muscles resulting from temporary or permanent damage of the facial nerves. Following facial paralysis, patients can develop motor and psychosocial functioning issues impacting quality of life. In addition, real or perceived judgment in social settings of those with FP increases the risk of low self-esteem, anxiety, and depression. Currently, most available research focuses on surgical patients and suggests a lack of psychological support throughout the affliction. A multidisciplinary approach when treating patients with FP can help improve the patient's quality of life.
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Affiliation(s)
- Eamon Shamil
- Department of ENT Surgery, Prince of Wales Hospital, Sydney, Australia
- Department of ENT Surgery, The Royal National ENT Hospital, University College London Hospital NHS Foundation Trust, London, United Kingdom
| | - Maria Noriega
- Department of ENT Surgery, The Royal National ENT Hospital, University College London Hospital NHS Foundation Trust, London, United Kingdom
| | - Sarah Moin
- Department of ENT Surgery, Hillingdon Hospitals NHS Foundation Trust, Uxbridge, United Kingdom
| | - Tsz Ki Ko
- Department of ENT Surgery, Royal Stoke University Hospital, Stoke-on-Trent, United Kingdom
| | - Denise Jia Yun Tan
- Department of ENT Surgery, Royal Stoke University Hospital, Stoke-on-Trent, United Kingdom
| | - Catherine Meller
- Department of ENT Surgery, Prince of Wales Hospital, Randwick, New South Wales, Australia
| | - Peter Andrews
- Department of ENT Surgery, Royal National ENT and Eastman Dental Hospitals, London, United Kingdom
| | - Garyfalia Lekakis
- Department of ENT Surgery, Hôpitaux Iris Sud HIS, Brussels, Belgium
- University Hospitals Leuven, Leuven, BE, Louise Medical Center, Bruxelles, Belgium
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3
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Hitchen R, Woolhouse M, Holch P. Breaking the silence: A qualitative exploration of parental perspectives of children with Goldenhar Syndrome. Heliyon 2024; 10:e24328. [PMID: 38318028 PMCID: PMC10839885 DOI: 10.1016/j.heliyon.2024.e24328] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Revised: 12/15/2023] [Accepted: 01/07/2024] [Indexed: 02/07/2024] Open
Abstract
Background Goldenhar Syndrome is a rare congenital condition, typically characterized by craniofacial abnormalities and vertebral malformations. Due to its rare and complex nature, the etiology is unconfirmed, resulting in parental uncertainty and subsequent emotional sequelae. Clinical manifestations have been researched but few studies have explored parental wellbeing and Quality of Life (QoL). In this qualitative study, we explore parental views of the challenges and lived experience of raising a child with Goldenhar Syndrome. Methods Ten biological parents (five mothers and five fathers), recruited at the Goldenhar UK Conference, took part in audio-recorded, semi-structured interviews. Interviews explored emotional wellbeing, views surrounding causation, support accessed, challenges faced, experience of stigma and future outlooks. Reflexive thematic analysis was employed, and transcripts were subject to deductive and inductive coding. Results Seven themes were identified: support networks (Goldenhar UK), rollercoaster of emotion; gendered coping; uncertainty; societal reactions; coping with challenge and acceptance. Conclusions This is the first-time the life perspectives of parents, raising a child with Goldenhar Syndrome, have been explored via interviews. We have unearthed prominent issues that impact parental QoL including isolation and distress at the point of diagnosis, and throughout the multidisciplinary health journey. We have also established significant indicators of the ongoing QoL challenges faced by young people with Goldenhar Syndrome. Future work is underway exploring these issues further with teenagers, young people and adults with Goldenhar to develop a conceptual framework of their QoL. This will be used to develop a bespoke patient reported outcome (PRO) to give voice to the challenges children and young adults face during their medical journey.
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Affiliation(s)
- Rebecca Hitchen
- Leeds Beckett University, Psychology, School of Humanities and Social Sciences, Portland Building, City Campus, Leeds, LS1 3HE, West Yorkshire, UK
| | - Maxine Woolhouse
- Leeds Beckett University, Psychology, School of Humanities and Social Sciences, Portland Building, City Campus, Leeds, LS1 3HE, West Yorkshire, UK
| | - Patricia Holch
- Leeds Beckett University, Psychology, School of Humanities and Social Sciences, Portland Building, City Campus, Leeds, LS1 3HE, West Yorkshire, UK
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4
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Farzan R, Hosseini SJ, Firooz M, Tabarian MS, Jamshidbeigi A, Samidoust P, Sarafi M, Mahdiabadi MZ, Ghorbani Vajargah P, Mollaei A, Karkhah S, Takasi P, Parvizi A, Haddadi S. Perceived stigmatisation and reliability of questionnaire in the survivors with burns wound: A systematic review and meta-analysis. Int Wound J 2023; 20:3391-3403. [PMID: 37016493 PMCID: PMC10502297 DOI: 10.1111/iwj.14176] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Revised: 03/18/2023] [Accepted: 03/21/2023] [Indexed: 04/06/2023] Open
Abstract
Perceived stigmatisation (PS) can cause different effects on burns survivors such as depression, low self-esteem, body image disturbance, and social anxiety. Current systematic review and meta-analysis aimed to determine the average PS among the burns survivor population and the average reliability of the PS questionnaire (PSQ). A comprehensive systematic search was conducted in various international electronic databases, such as Scopus, PubMed, Web of Science, and Persian electronic databases such as Iranmedex, and Scientific Information Database (SID) using keywords extracted from Medical Subject Headings such as "Stigmatisation", "Burns", "Reliability", and "Questionnaire" from the earliest to February 1, 2023. The COSMIN and the Joanna Briggs Institute (JBI) checklists were applied to evaluate the risk of bias. Data analysis was performed in STATA V.14 and JAMOVI v 2.3.24 software. The analysis consisted of two sections. Firstly, the overall weighted average of PS was calculated based on mean and standard deviation. Then, the reliability average of PSQ was calculated with the reliability generalisation method based on the alpha coefficient, questionnaire items, and sample size of each study. Finally, eight articles were included in the quantitative analysis. The results showed the weighted average of PS was 2.14 (ES: 2.14, 95%CI: 1.77-2.51, Z = 11.40, I2 :97.8%, P < 0.001). The average of PS in the factors of confused/staring behaviour, absence of friendly behaviour, and hostile behaviour was 2.36 (ES: 2.36, 95%CI: 2.05-2.67, Z = 14.86, I2 :92.7%, P < 0.001), 2.13 (ES: 2.13, 95%CI: 1.87-2.39, Z = 16.22, I2 :93.8%, P < 0.001) and 2.07 (ES: 2.07, 95%CI: 1.67-2.47, Z = 10.05, I2 :96.5%, P < 0.001), respectively. The analysis showed that the overall coefficient alpha of the PSQ was 0.88 (ES: 0.88, 95%CI: 0.851-0.910, Z = 58.7, I2 : 95.04%, P < 0.001). Also, the alpha coefficient of factors including confused/staring behaviour, absence of friendly behaviour, and hostile behaviour were 0.847 (ES: 0.847, 95%CI: 0.770-0.924, Z = 21.6, I2 :99.13%, P < 0.001), 0.860 (ES: 0.860, 95%CI: 0.808-0.912, Z = 32.4, I2 :98.02%, P < 0.001) and 0.899 (ES: 0.899, 95%CI: 0.829-0.968, Z = 21.33, I2 : 0.0%, P < 0.001), respectively. In sum, the current study showed that the average PS was 2.14 out of 5 points. Most survivors and parents reported confused/starring behaviour as a common perceived behaviour from different individuals. Also, the average reliability of PSQ was 0.88, and it had acceptable reliability. More studies are required to better judge the level of PS among different age groups. Also, the psychometric properties of PSQ in different cultures are an essential issue.
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Affiliation(s)
- Ramyar Farzan
- Department of Plastic & Reconstructive Surgery, School of MedicineGuilan University of Medical SciencesRashtIran
| | | | - Mahbobeh Firooz
- Department of NursingEsfarayen Faculty of Medical SciencesEsfarayenIran
| | | | - Amirreza Jamshidbeigi
- Student Research Committee, Faculty of Nursing and MidwiferyMashhad University of Medical SciencesMashhadIran
| | - Pirouz Samidoust
- Razi Clinical Research Development Unit, Razi HospitalGuilan University of Medical SciencesRashtIran
| | - Milad Sarafi
- Department of Vascular Surgery, Rasool‐e‐Akram HospitalIran University of Medical SciencesTehranIran
| | | | - Pooyan Ghorbani Vajargah
- Burn and Regenerative Medicine Research CenterGuilan University of Medical SciencesRashtIran
- Department of Medical‐Surgical Nursing, School of Nursing and MidwiferyGuilan University of Medical SciencesRashtIran
| | - Amirabbas Mollaei
- Burn and Regenerative Medicine Research CenterGuilan University of Medical SciencesRashtIran
- Department of Medical‐Surgical Nursing, School of Nursing and MidwiferyGuilan University of Medical SciencesRashtIran
| | - Samad Karkhah
- Burn and Regenerative Medicine Research CenterGuilan University of Medical SciencesRashtIran
- Department of Medical‐Surgical Nursing, School of Nursing and MidwiferyGuilan University of Medical SciencesRashtIran
| | - Poorya Takasi
- Burn and Regenerative Medicine Research CenterGuilan University of Medical SciencesRashtIran
- Department of Medical‐Surgical Nursing, School of Nursing and MidwiferyGuilan University of Medical SciencesRashtIran
| | - Arman Parvizi
- Anesthesiology Research Center, Department of Anesthesiology, Alzahra HospitalGuilan University of Medical SciencesRashtIran
| | - Soudabeh Haddadi
- Anesthesiology Research Center, Department of Anesthesiology, Alzahra HospitalGuilan University of Medical SciencesRashtIran
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Leung KL, Yang JJ, Chen FR, Kim E, Gosman AA. Psychosocial Burden of Pediatric and Adult Patients With Congenital Versus Traumatic Facial Differences: Assessment of Psychiatric Distress and Healthcare Utilization in the United States From 2004 to 2012. Ann Plast Surg 2023; 90:S305-S311. [PMID: 36921336 DOI: 10.1097/sap.0000000000003401] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/17/2023]
Abstract
BACKGROUND Psychiatric distress and its effects on healthcare utilization in pediatric patients with congenital and traumatic facial differences remain poorly understood. This study analyzes the psychosocial burden along with mental health and reconstructive surgery services utilization of this patient population in comparison with adult patients with such facial differences. METHODS The 2004-2012 Medical Expenditures Panel Survey was queried for all patients with facial differences. Socioeconomic variables, Patient Health Questionnaire 2 and Kessler 6 scores, responses from validated screening surveys, and utilization of mental health and reconstructive surgery (ie, plastic surgery and otolaryngology) services were compared between pediatric and adult patients with congenital and traumatic facial differences. RESULTS Children ages 5 to 12 years were more likely to be affected by facial trauma, whereas adolescents aged 13 to 17 years were more affected by congenital facial conditions. Pediatric patients with congenital facial conditions had higher rates of medical care, education, and special therapy utilization ( P < 0.0001), although their facial trauma counterparts used mental health services more often ( P < 0.0001). In adults, more facial trauma patients reported poorer perceived mental health status ( P = 0.01). Among patients with any facial difference, distressed adult patients were less likely to see a reconstructive surgeon even when controlling for socioeconomic variables (0.55 [0.31-0.97], P = 0.04). CONCLUSIONS In the pediatric population, psychosocial considerations should include both age and etiology of facial differences to best optimize care. Among adults with facial trauma, poor mental health may contribute to lower rates of surgical follow-up, highlighting a potential benefit for provision of mental health services earlier for these patient populations.
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Affiliation(s)
- Karen L Leung
- From the Division of Plastic Surgery, Department of Surgery, UC San Diego San Diego, CA
| | - Jason J Yang
- From the Division of Plastic Surgery, Department of Surgery, UC San Diego San Diego, CA
| | - Frank R Chen
- Department of Anesthesiology, Hospital of the University of Pennsylvania, Philadelphia, PA
| | - Erinn Kim
- From the Division of Plastic Surgery, Department of Surgery, UC San Diego San Diego, CA
| | - Amanda A Gosman
- From the Division of Plastic Surgery, Department of Surgery, UC San Diego San Diego, CA
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6
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'Everybody is watching me': A closer look at anxiety in people with facial palsy. J Plast Reconstr Aesthet Surg 2023; 77:408-415. [PMID: 36638757 DOI: 10.1016/j.bjps.2022.11.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Revised: 09/09/2022] [Accepted: 11/16/2022] [Indexed: 11/25/2022]
Abstract
OBJECTIVES Objectives were to evaluate the sociodemographic and disease-related factors, and coping style associated with social interaction and social appearance anxiety in people with unilateral facial palsy. METHODS Medical data were extracted from electronic health records, and participants completed the Social Interaction Anxiety Scale (SIAS), Social Appearance Anxiety Scale (SAAS), and Coping Orientation to Problems Experienced inventory. Associations of SIAS and SAAS scores with sociodemographic and disease variables, and coping were assessed with multiple linear regression. RESULTS Among 111 participants (mean age 58.6 years; 59% women), higher age and greater use of emotion-focused coping were associated with lower SIAS scores, whereas greater use of avoidant coping was associated with higher SIAS scores. Higher age, male sex, and greater use of emotion-focused coping were associated with lower SAAS scores, whereas greater use of avoidant coping was associated with higher SAAS scores. CONCLUSIONS Healthcare providers should understand that women and younger people are more likely to have social appearance concerns and that this is not predicted by the objective severity of facial palsy.
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7
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Siddiqui HP, Sennimalai K, Samrit VD, Bhatt K, Duggal R. Binder's syndrome: A narrative review. SPECIAL CARE IN DENTISTRY 2023; 43:73-82. [PMID: 35654104 DOI: 10.1111/scd.12731] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2021] [Revised: 04/28/2022] [Accepted: 04/29/2022] [Indexed: 01/21/2023]
Abstract
AIM The classical features of Binder's syndrome (BS) have been widely reported, yet there is a lack of information on diagnostic and treatment challenges. Therefore, we aimed to review the literature on various aspects, including the role of a multidisciplinary approach in the management of BS. METHODS A thorough literature search was performed on PubMed, Scopus, Embase, Ovid, Web of Science, EBSCOhost, and Google Scholar using the keywords"Maxillonasal dysplasia", "Maxillonasal dysostosis", "nasomaxillary hypoplasia", "Binder type", "Binder syndrome", "Binder phenotype", and "OMIM 155050". In addition, the articles published in the English language from the inception of the database until June 2021 were considered. RESULTS The search of different databases yielded 958 publications, out of which 145 relevant articles were reviewed. The studies were categorised by year of publication, study design, and theme. Most of the studies were case reports (42%) followed by case series (19%). The most reported topic was based on different surgical techniques (42%). Finally, the results were synthesised into a narrative review. CONCLUSIONS The need for a multidisciplinary approach involving clinicians from different specialities is highlighted. Future research is warranted to develop concrete clinical guidelines for the management of this syndrome.
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Affiliation(s)
- Hamza Parvez Siddiqui
- Division of Orthodontics and Dentofacial Deformities Centre for Dental Education and Research, All India Institute of Medical Sciences, New Delhi, India
| | - Karthik Sennimalai
- Division of Orthodontics and Dentofacial Deformities Centre for Dental Education and Research, All India Institute of Medical Sciences, New Delhi, India
| | - Vilas D Samrit
- Division of Orthodontics and Dentofacial Deformities Centre for Dental Education and Research, All India Institute of Medical Sciences, New Delhi, India
| | - Krushna Bhatt
- Division of Orthodontics and Dentofacial Deformities Centre for Dental Education and Research, All India Institute of Medical Sciences, New Delhi, India
| | - Ritu Duggal
- Division of Orthodontics and Dentofacial Deformities Centre for Dental Education and Research, All India Institute of Medical Sciences, New Delhi, India
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Rasset P, Mange J, Montalan B, Stutterheim SE. Towards a better understanding of the social stigma of facial difference. Body Image 2022; 43:450-462. [PMID: 36345083 DOI: 10.1016/j.bodyim.2022.10.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Revised: 10/10/2022] [Accepted: 10/23/2022] [Indexed: 11/06/2022]
Abstract
Facial difference (FD) is not only an individual experience; it is inherently social, reflecting interactions between social norms and individual attitudes. Often FD is stigmatized. In this paper, we employ a widely used stigma framework, namely the social stigma framework put forth by Pryor and Reeder (2011), to unpack the stigma of FD. This framework posits that there are four forms of stigma: public stigma, self-stigma, stigma by association, and structural stigma. We first discuss the social and psychological literature on FD as it pertains to these various forms of stigma. We then describe coping approaches for FD stigma. Lastly, we delineate evidence-based methods for addressing the various forms of FD stigma, such that future efforts can more effectively tackle the stigma of facial difference.
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Affiliation(s)
- Pauline Rasset
- Laboratoire de Psychologie de Caen Normandie (LPCN EA 7452), Université de Caen Normandie, France.
| | - Jessica Mange
- Laboratoire de Psychologie de Caen Normandie (LPCN EA 7452), Université de Caen Normandie, France
| | - Benoît Montalan
- Centre de Recherche sur les Fonctionnements et Dysfonctionnements Psychologiques (CRFDP EA 7475), Université de Rouen Normandie, France
| | - Sarah E Stutterheim
- Department of Health Promotion, Care and Public Health Research Institute, Maastricht University, Maastricht, Netherlands
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9
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Sezer S, Cup EHC, Roets-Merken LM, Lanser A, Siemann I, Weikamp JG, Mul K, van Engelen BG, Satink T, Voermans NC. Experiences of patients with facioscapulohumeral dystrophy with facial weakness: a qualitative study. Disabil Rehabil 2022; 44:6775-6782. [PMID: 34529524 DOI: 10.1080/09638288.2021.1973122] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
PURPOSE This study focuses on the functional and psychosocial consequences of facial weakness of patients with facioscapulohumeral muscular dystrophy (FSHD) and how they manage their daily lives. MATERIALS AND METHODS We conducted a qualitative study. Sixteen FSHD patients with varying degrees of facial weakness were interviewed using a semi-structured interview guide. Data were analyzed using the constant comparison approach based on the Straussian Grounded Theory. RESULTS Reduced facial expression affected different aspects of a participant's life, which is reinforced by fatigue. Particularly the younger participants described the confrontation with reduced facial expression as upsetting. The unpredictability of the progression of facial weakness makes many participants insecure and concerned. They generally tend to avoid discussing facial weakness with loved ones as well as with strangers. CONCLUSIONS Patients would like the expert teams to shed more light on effective skill training and psychosocial support, especially for the younger patient group. A multidisciplinary approach is needed in addition to programs focusing on the individual aspects of facial weakness. As the experienced psychosocial effect is not commonly equal to the objective degree of facial weakness, we recommend a tailored approach. Finally, these programs should point out the importance of the patient's own ingenuity.Implications for RehabilitationFacial weakness affects both activities and social participation in patients with facioscapulohumeral muscular dystrophy (FSHD), which is reinforced by fatigue.Many participants try to stay down to earth and focus on their ability to self-manage their obstacles regarding facial weakness.Thus, future treatment programs should have a multidisciplinary approach and should point out the importance of the patient's own ingenuity.
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Affiliation(s)
- Sümeyye Sezer
- Department of Neurology, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Edith H C Cup
- Department of Rehabilitation, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Lieve M Roets-Merken
- Radboud Institute for Health Science, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Anke Lanser
- Patient Representative & Chairman FSHD Advocacy Group, Patient Organization for Muscular Disease Spierziekten Nederland, Baarn, The Netherlands
| | - Ietske Siemann
- Department of Medical Psychology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Janneke G Weikamp
- Department of Rehabilitation, Donders Centre for Neuroscience, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Karlien Mul
- Department of Neurology, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Baziel G van Engelen
- Department of Neurology, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Ton Satink
- Department of Occupational Therapy, HAN University of Applied Sciences, Nijmegen, The Netherlands
| | - Nicol C Voermans
- Department of Neurology, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands
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10
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Benedict J. Patient Advocacy in Vascularized Composite Allotransplantation. Front Psychol 2022; 13:943393. [PMID: 35923735 PMCID: PMC9340068 DOI: 10.3389/fpsyg.2022.943393] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2022] [Accepted: 06/21/2022] [Indexed: 11/13/2022] Open
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11
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van de Geest-Buit WA, Rasing NB, Mul K, Deenen JCW, Vincenten SCC, Siemann I, Lanser A, Groothuis JT, van Engelen BG, Custers JAE, Voermans NC. Facing facial weakness: psychosocial outcomes of facial weakness and reduced facial function in facioscapulohumeral muscular dystrophy. Disabil Rehabil 2022:1-10. [DOI: 10.1080/09638288.2022.2092779] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Affiliation(s)
- W. A. van de Geest-Buit
- Department of Neurology, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands
| | - N. B. Rasing
- Department of Neurology, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands
| | - K. Mul
- Department of Neurology, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands
| | - J. C. W. Deenen
- Department of Neurology, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands
| | - S. C. C. Vincenten
- Department of Neurology, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands
| | - I. Siemann
- Department of Medical Psychology, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, The Netherlands
| | - A. Lanser
- Patient Representative and Chairman FSHD Advocacy Group, Patient Organization for Muscular Diseases Spierziekten Nederland, Baarn, The Netherlands
| | - J. T. Groothuis
- Department of Rehabilitation, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands
| | - B. G. van Engelen
- Department of Neurology, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands
| | - J. A. E. Custers
- Department of Medical Psychology, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, The Netherlands
| | - N. C. Voermans
- Department of Neurology, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands
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A Novel Psychological Group Intervention Targeting Appearance-Related Distress Among People With a Visible Disfigurement (Inside Out): A Case Study. COGNITIVE AND BEHAVIORAL PRACTICE 2022. [DOI: 10.1016/j.cbpra.2022.03.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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13
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Rod JE, Oviedo-Trespalacios O, King M. A retrospective registry analysis of the transport-related health burden of wheeled recreational devices in Queensland, Australia. Aust N Z J Public Health 2021; 46:208-215. [PMID: 34648211 DOI: 10.1111/1753-6405.13162] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Revised: 06/01/2021] [Accepted: 08/01/2021] [Indexed: 11/28/2022] Open
Abstract
OBJECTIVE Evaluate injury patterns from wheeled recreational devices (WRD) in the public space and explore risk factors for hospital admission. METHOD A cross-sectional analysis of WRD injury prevalence and risk factors for hospital admissions was conducted using data from the Queensland Injury Surveillance Unit (QISU) database for 2007 to 2017. Descriptive statistics and a log-binomial regression model were used to calculate adjusted relative risk for hospital admission. RESULTS Most WRD injury in the public space was related to stand-alone WRD injury events such as falls, with few reported WRD users being hit by vehicles from 2007 to 2017. Stand-alone WRD injury events had a higher independent risk of hospital admissions when injured in the head/neck/face (RR 2.08, 95%CI 1.6 to 2.8, p<0.001), and when the injury was a fracture (RR 2.57, 95%CI 2.1 to 3.3, p<0.001) or a brain injury (RR 3.19, 95%CI 2.5 to 4.1, p<0.001). CONCLUSION Head, brain and facial injuries and fractures are leading preventable factors for hospital admissions due to WRD injury. These types of injuries generate a preventable burden to the health system. Implications for public health: The results support the need to consider legislation regarding mandatory helmet use for non-motorised WRD when used on public roads and footpaths, while further research is conducted. This strategy could reduce the long-term health outcomes associated with head, face and brain injury in young commuters.
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Affiliation(s)
- J E Rod
- Centre for Accident Research and Road Safety Queensland (CARRS-Q), Queensland University of Technology.,Centre for Future Mobility, Queensland University of Technology
| | - Oscar Oviedo-Trespalacios
- Centre for Accident Research and Road Safety Queensland (CARRS-Q), Queensland University of Technology.,Centre for Future Mobility, Queensland University of Technology
| | - Mark King
- Centre for Accident Research and Road Safety Queensland (CARRS-Q), Queensland University of Technology.,Centre for Future Mobility, Queensland University of Technology
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14
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Abstract
Animal bodies in general and faces in particular show mirror symmetry with respect to the median-sagittal plane, with exceptions rarely occurring. Bilateral symmetry to the median sagittal plane of the body also evolved very early. From an evolutionary point of view, it should therefore have fundamental advantages, e.g., more effective locomotion and chewing abilities. On the other hand, the recognition of bilaterally symmetric patterns is an important module in our visual perception. In particular, the recognition of faces with different spatial orientations and their identification is strongly related to the recognition of bilateral symmetry. Maxillofacial surgery and Dentistry affect effective masticatory function and perceived symmetry of the lower third of the face. Both disciplines have the ability to eliminate or mitigate asymmetries with respect to form and function. In our review, we will demonstrate symmetric structures from single teeth to the whole face. We will further describe different approaches to quantify cranial, facial and dental asymmetries by using either landmarks or 3D surface models. Severe facial asymmetries are usually caused by malformations such as hemifacial hyperplasia, injury or other diseases such as Noma or head and neck cancer. This could be an important sociobiological reason for a correlation between asymmetry and perceived disfigurement. The aim of our review is to show how facial symmetry and attractiveness are related and in what way dental and facial structures and the symmetry of their shape and color influence aesthetic perception. We will further demonstrate how modern technology can be used to improve symmetry in facial prostheses and maxillofacial surgery.
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15
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Keys J, Dempster M, Jackson J, Williams M, Coyle S. The psychosocial impact of losing an eye through traumatic injury and living with prosthetic restoration: A thematic analysis. Acta Psychol (Amst) 2021; 219:103383. [PMID: 34352606 DOI: 10.1016/j.actpsy.2021.103383] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Revised: 07/17/2021] [Accepted: 07/24/2021] [Indexed: 01/08/2023] Open
Abstract
This study aims to explore the psychosocial factors and challenges affecting the lives of those who wear an ocular prosthesis following a traumatic eye injury. Thematic analysis of semi-structured interviews with eight individuals resulted in five themes: emotional devastation in the aftermath; moving forward; fear of negative social evaluation; keeping it normal - protecting self and close others; and threat of injury & blindness. Enucleation or evisceration of an eye causes significant emotional stress. Despite successful prosthetic restoration, many individuals continue to experience ongoing psychosocial challenges, as a consequence of their experiences of visible difference and visual impairment.
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Affiliation(s)
- Joni Keys
- School of Psychology, Queen's University Belfast, University Road, Belfast BT7 1NN, UK
| | - Martin Dempster
- School of Psychology, Queen's University Belfast, University Road, Belfast BT7 1NN, UK.
| | - Jonathan Jackson
- Artificial Eye Service, Belfast Health & Social Care Trust, Shankill Wellbeing and Treatment Centre, 83 Shankill Road, Belfast BT13 1FP, UK
| | - Michael Williams
- School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, University Road, Belfast BT7 1NN, UK
| | - Sinead Coyle
- Artificial Eye Service, Belfast Health & Social Care Trust, Shankill Wellbeing and Treatment Centre, 83 Shankill Road, Belfast BT13 1FP, UK
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16
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Myhre A, Råbu M, Feragen KJB. The need to belong: Subjective experiences of living with craniofacial conditions and undergoing appearance-altering surgery. Body Image 2021; 38:334-345. [PMID: 34087543 DOI: 10.1016/j.bodyim.2021.05.008] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2020] [Revised: 04/08/2021] [Accepted: 05/20/2021] [Indexed: 01/25/2023]
Abstract
The purpose of this study was to better understand how individuals with craniofacial conditions experience living with visible differences and make sense of appearance-altering surgery. We conducted semi-structured qualitative interviews with 11 adults with Goldenhar or Crouzon syndrome. Interviews were analysed using a hermeneutic-phenomenological approach to thematic analysis. Our analysis revealed the following overarching theme, To see myself as other people see me, which encompassed three main themes: a) Striving to fit in, b) Altering the way I look and c) Support from family and friends. The participants' sense of their own appearance seemed to be connected to how they perceived others to evaluate their appearance. All had experienced negative reactions from others. They experienced themselves as different and had a desire to belong. All participants had undergone appearance-altering surgery, hoping that by changing appearance, they would reduce negative reactions and feel more connected to and accepted by other people. The process of undergoing appearance-changing surgery was experienced as challenging, and participants wished for a dialogue with surgeons which included psychological and emotional aspects of changing appearance. A better understanding of how to strengthen positive identity processes and feelings of belongingness should be a key focus of future research.
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Affiliation(s)
- Anita Myhre
- Centre for Rare Disorders, Division of Paediatric and Adolescent Medicine, Oslo University Hospital, Postboks 4950 Nydalen, 0424, Oslo, Norway.
| | - Marit Råbu
- University of Oslo, Department of Psychology, Postboks 1094 Blindern, 0317, Oslo, Norway.
| | - Kristin J B Feragen
- Centre for Rare Disorders, Division of Paediatric and Adolescent Medicine, Oslo University Hospital, Postboks 4950 Nydalen, 0424, Oslo, Norway.
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17
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Zelihić D, Williamson H, Kling J, Feragen KB. "It's tough because I see that it's upsetting her…": A qualitative exploration of parents' perceptions of talking with their adolescents about having a visible difference. Body Image 2021; 38:306-316. [PMID: 34052591 DOI: 10.1016/j.bodyim.2021.05.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2020] [Revised: 05/07/2021] [Accepted: 05/12/2021] [Indexed: 10/21/2022]
Abstract
Many adolescents live with a visible difference that affects their lives in profound ways, but studies investigating parents' perceptions of raising appearance issues during conversations with their adolescent are lacking. As part of a larger study exploring the effectiveness of a web-based intervention (YP Face IT), semi-structured interviews were conducted with 18 parents of adolescents with a visible difference. Thematic analysis revealed four overarching themes: (1) Conversational settings; (2) Understanding adolescents' feelings and thoughts; (3) Providing parental guidance and encouragement; and (4) When the dialogue becomes difficult. Results showed that parents resorted to specific settings when instigating conversations about appearance, such as when their adolescents expressed a need for emotional care, were perceived to be upset, or whilst managing their condition. The choice of setting was also important as some parents generally felt uncomfortable raising appearance issues with their adolescent, for fear of fueling appearance concerns. Results further suggest that open communication can enable parents to stay informed about their adolescent's psychosocial adjustment to a visible difference. These results stress the need to make available support to facilitate open communication about appearance-related topics between parents and adolescents.
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Affiliation(s)
- Deniz Zelihić
- Centre for Rare Disorders, Rikshospitalet, Oslo University Hospital, Norway.
| | - Heidi Williamson
- Centre for Appearance Research, University of the West of England, Bristol, UK
| | - Johanna Kling
- Centre for Rare Disorders, Rikshospitalet, Oslo University Hospital, Norway
| | - Kristin B Feragen
- Centre for Rare Disorders, Rikshospitalet, Oslo University Hospital, Norway
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18
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Barriers to Accessing Medical Care for Hispanic Individuals With Craniofacial Conditions. Plast Surg Nurs 2021; 40:236-243. [PMID: 33259425 DOI: 10.1097/psn.0000000000000351] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
In the United States, having limited access to health care has been an ongoing concern that could cause detrimental effects for minority populations, specifically the Hispanic population. Numerous barriers to accessing health care were identified for both pediatric and adult Hispanic patients who were born with craniofacial conditions. Barriers that were determined to impact Hispanic patients with craniofacial conditions from receiving medical and health services included language and communication, patient-health care provider relationships, socioeconomic status and finances, insurance status, timely access to appointments, citizenship and immigration status, and lack of family and social support. Interventions for these barriers were also proposed to increase support for Hispanic patients. Lamentably, there is scant research that investigates how these barriers affect this special population, despite the limitations that they have in their ability to access health care. In addition, these barriers to treatment have dire consequences for individuals with craniofacial conditions. The findings and proposed interventions discussed in this review article provide measures to minimize these barriers and define ways to benefit Hispanic patients with craniofacial conditions.
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19
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Wanitphakdeedecha R, Sudhipongpracha T, Ng JNC, Yan C, Jantarakolica T. Self-stigma and psychosocial burden of patients with port-wine stain: A systematic review and meta-analysis. J Cosmet Dermatol 2021; 20:2203-2210. [PMID: 33949094 DOI: 10.1111/jocd.14199] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2021] [Revised: 04/26/2021] [Accepted: 04/28/2021] [Indexed: 01/23/2023]
Abstract
BACKGROUND Port-wine stain (PWS) is a congenital malformation that does not resolve spontaneously and can lead to social and self-stigma. However, little is known about how PWS affects the patients' quality of life (QoL) and psychosocial well-being. In this article, we examine the existing empirical evidence on self-stigma caused by PWS. METHODS A systematic review was done using MEDLINE, PubMed, Embase, and Cochrane databases on January 15, 2021 to retrieve all case reports, cohort studies, and clinical trials written in English. The keywords used in this literature search included port-wine stain, quality of life, self-stigma, and social stigma. RESULTS From the 74 initial records, eight articles were quantitative studies that assessed the QoL and self-stigma experienced by PWS patients. With regard to perceived stigma or the patients' understanding of how others think and act toward them, we found that the parents of children with facial PWS tend to have more perceived stigma than the children. For anticipated stigma or expectations of future stigma, young patients with PWS have less or no concern about their skin conditions. In terms of enacted stigma or experiences with discriminatory acts, there were significant differences in the QoL score between patients with facial PWS and those with non-facial PWS. CONCLUSION This study suggests that self-stigma caused by PWS affects young patients and their parents. The parents in particular tend to suffer more than their children from perceived and anticipated stigma. Psychological support and early treatment can improve the livelihoods of young patients and their parents.
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Affiliation(s)
- Rungsima Wanitphakdeedecha
- Department of Dermatology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.,College of Interdisciplinary Studies, Thammasat University, Bangkok, Thailand
| | | | - Janice Natasha C Ng
- Department of Dermatology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Chadakan Yan
- Department of Dermatology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
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20
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Barriers to Accessing Medical Care for Hispanic Individuals With Craniofacial Conditions. Plast Surg Nurs 2021; 40:73-80. [PMID: 32459754 DOI: 10.1097/psn.0000000000000302] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
In the United States, having limited access to health care has been an ongoing concern that could cause detrimental effects for minority populations, specifically the Hispanic population. Numerous barriers to accessing health care were identified for both pediatric and adult Hispanic patients who were born with craniofacial conditions. Barriers that were determined to impact Hispanic patients with craniofacial conditions from receiving medical and health services included language and communication, patient-health care provider relationships, socioeconomic status and finances, insurance status, timely access to appointments, citizenship and immigration status, and lack of family and social support. Interventions for these barriers were also proposed to increase support for Hispanic patients. Lamentably, there is scant research that investigates how these barriers affect this special population, despite the limitations that they have in their ability to access health care. In addition, these barriers to treatment have dire consequences for individuals with craniofacial conditions. The findings and proposed interventions discussed in this review article provide measures to minimize these barriers and define ways to benefit Hispanic patients with craniofacial conditions.
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21
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Milibari DS, Fatani D, Ahmad A, Owaidhah O, AlObeidan SA, Almobarak FA, Malik R. Assessing patient cosmetic satisfaction after glaucoma drainage device surgery for different patch grafts. BMC Ophthalmol 2021; 21:99. [PMID: 33622287 PMCID: PMC7903744 DOI: 10.1186/s12886-021-01864-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2020] [Accepted: 02/11/2021] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND The use of a tissue patch graft is common practice with a glaucoma drainage device (GDD). Patch grafts can be visible in the palpebral fissure and may be cosmetically displeasing for some patients. The aim of this study was to report the cosmetic satisfaction of pericardial, scleral, and corneal patch grafts related to superior GDD surgery. METHODS Baseline clinical data were collected for consecutive patients with glaucoma operated between 2014 and 2019 at two tertiary eye care institutions (for superiorly-placed) Ahmad glaucoma valve implant using sclera, cornea and pericardium patch graft. A patient questionnaire that contained 4 concise questions, with a Likert-scale grading relating to cosmetic satisfaction was administered by a telephone-based interview. Responses and scores for each question were compared across patients who received the three different types of graft. A binominal logistic regression analysis was used to assess the effects of age, gender, type of graft, number of previous ocular surgeries, and final visual acuity to explain differences. RESULTS We included 92 patients who met our inclusion criteria (24 patients received a corneal patch graft, 30 who received sclera and 38 who received pericardium). The mean (±SD) age was 50 (±17.5) years, and the average follow up was 20.7 (± 18.6) months. Regardless of the type of patch graft, most (67-84%) of patients were satisfied with the appearance of their eyes. Patients who received cornea or sclera were more likely to report that their eye looked 'abnormal' by others. Younger age was significantly associated with the response to this question. CONCLUSION Patients are generally satisfied with the appearance of their eye following GDD surgery with each of the patch grafts for superiorly-placed GDDs. Younger patients with cornea or sclera were more likely to report that their eyes looked abnormal.
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Affiliation(s)
- Doaa S Milibari
- Glaucoma Division, King Khaled Eye Specialist Hospital Riyadh, Al Arubah Branch Rd, Riyadh, 11462, Saudi Arabia
| | - Dalal Fatani
- King Saud University Department of Ophthalmology, Riyadh, Saudi Arabia
| | - Abeer Ahmad
- Statistics and Epidemiology, Research Department, King Khaled Eye Hospital, Riyadh, Saudi Arabia
| | - Ohoud Owaidhah
- Glaucoma Division, King Khaled Eye Specialist Hospital Riyadh, Al Arubah Branch Rd, Riyadh, 11462, Saudi Arabia.
| | - Saleh A AlObeidan
- King Saud University Department of Ophthalmology, Riyadh, Saudi Arabia
| | | | - Rizwan Malik
- Glaucoma Division, King Khaled Eye Specialist Hospital Riyadh, Al Arubah Branch Rd, Riyadh, 11462, Saudi Arabia
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22
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Stone A. Facial disfigurement, categorical perception, and the influence of Disgust Sensitivity. VISUAL COGNITION 2021. [DOI: 10.1080/13506285.2020.1870184] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Affiliation(s)
- Anna Stone
- School of Psychology, University of East London, London, UK
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23
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Serializing prosthetic rehabilitations to minimize time for patients with a maxillectomy without dentoalveolar support. J Prosthet Dent 2021; 127:803-806. [PMID: 33454116 DOI: 10.1016/j.prosdent.2020.11.039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Revised: 11/04/2020] [Accepted: 11/05/2020] [Indexed: 11/22/2022]
Abstract
An oral prosthesis can help maintain a sense of normalcy by preserving psychosocial and physiologic function in the aftermath of a maxillary resection. Rehabilitating the resulting defect in a timely manner requires strategic choices in treatment sequencing and prosthetic design. This clinical report describes the process of fabricating a series of removable and implant-retained prostheses to minimize a patient's time without the restoration of critical craniofacial structures.
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24
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Willemse H, Geenen R, Van Loey NE. Reliability and structural validity of the Dutch version of Perceived Stigmatization Questionnaire in adults with burns. Burns 2020; 47:1381-1388. [PMID: 33947597 DOI: 10.1016/j.burns.2020.11.017] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2020] [Revised: 11/25/2020] [Accepted: 11/27/2020] [Indexed: 10/22/2022]
Abstract
OBJECTIVE Burn scars can attract attention from others which can be perceived as stigmatizing behavior with negative psychological consequences. The Perceived Stigmatization Questionnaire (PSQ) is a validated instrument measuring the perception of stigmatization in burn survivors. The objective of this study was to examine the psychometric properties of the Dutch version of the PSQ, specifically its factor structure, reliability, and associations with other relevant constructs. METHOD Patients (N = 220) completed the PSQ at 3 months after burn. The factor structure was examined with explorative (EFA) and confirmatory (CFA) factor analyses at 3 and 12 months after burn, and reliability was examined using Cronbach's alpha. Three months measurements were used to examine associations of the PSQ with 'depressive mood' (Beck Depression Inventory, BDI-II), 'interpersonal relations' and 'body image' (Burn Specific Health Scale-Brief, BSHS-B), and two scales of the Illness Invalidation Inventory (3*I). RESULTS A four factor model showed the best fit to the data. Two factors, 'confused/staring behavior' and 'hostile behavior', were identical to the original PSQ. The third original factor, 'absence of friendly behavior', was now divided into two factors separating absence of friendly behavior of strangers and other people. Internal consistency ranged from .60 to .88. Especially the 'confused/staring behavior' factor was related to the other questionnaire scores. CONCLUSION The current study shows acceptable reliability and structural validity of the Dutch version of the PSQ in a 4-factor solution. Further research into measurement invariance across languages is recommended to establish a uniform multicultural instrument.
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Affiliation(s)
- Heidi Willemse
- Association of Dutch Burn Centres, P.O. Box 1015, 1940 EA Beverwijk, The Netherlands; Department of Clinical Psychology, Utrecht University, P.O. Box 80140, 3508 TC Utrecht, The Netherlands.
| | - Rinie Geenen
- Department of Clinical Psychology, Utrecht University, P.O. Box 80140, 3508 TC Utrecht, The Netherlands
| | - Nancy E Van Loey
- Association of Dutch Burn Centres, P.O. Box 1015, 1940 EA Beverwijk, The Netherlands; Department of Clinical Psychology, Utrecht University, P.O. Box 80140, 3508 TC Utrecht, The Netherlands
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25
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Patients' narratives of orthognathic treatment for facial asymmetry: a qualitative study. Br J Oral Maxillofac Surg 2020; 59:445-453. [PMID: 33451811 DOI: 10.1016/j.bjoms.2020.09.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2020] [Accepted: 09/04/2020] [Indexed: 11/22/2022]
Abstract
To explore patients' experiences of orthognathic treatment for facial asymmetry and their adaptation to facial changes after surgery, we did a qualitative, cross-sectional study of patients after treatment for non-cleft asymmetry at two UK sites. A total of 15 patients aged 19-40 years were approached after being identified using patient databases and clinical notes. Individual and photo-elicitation interviews were conducted covering experiences prior to treatment, during treatment, and after surgery. Interviews were transcribed and thematic narrative analysis undertaken. Participants were largely positive about their orthognathic treatment. The following themes were identified: preoperative (becoming aware, negative impacts of asymmetry, committing to treatment, establishing expectations), pre-surgery orthodontics and inpatient experiences (challenges and coping strategies, preparedness, support, and shared experiences); and postoperative (surgery as 'worth it', positive impacts of treatment, adapting to facial change). Undergoing orthognathic surgery was portrayed as a journey involving recognisable narratives (treatment unfinished, threat of liminality, treatment as resolution, and treatment as transformation). Patients' experiences of facial asymmetry are associated with feeling 'abnormal', and negative impacts, and orthognathic treatment for facial asymmetry is worthwhile. Having the feeling that something is 'wrong' legitimised by clinicians allows patients access to a recognisable treatment narrative (resolution). Orthognathic treatment is also described as transformation from 'normal abnormality' to being 'normal'. Nevertheless, the associated challenges can be frustrating, particularly if resolution is hard to envisage. Further psychological input could help patients cope with these challenges and the complex process of adapting to facial change.
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26
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Gattani S, Ju X, Gillgrass T, Bell A, Ayoub A. An Innovative Assessment of the Dynamics of Facial Movements in Surgically Managed Unilateral Cleft Lip and Palate Using 4D Imaging. Cleft Palate Craniofac J 2020; 57:1125-1133. [PMID: 32419475 PMCID: PMC7594373 DOI: 10.1177/1055665620924871] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
OBJECTIVE Assess facial asymmetry during maximum smile in patients with surgically managed unilateral cleft lip and palate (UCLP), using a dynamic 3-dimensional (3D) imaging (4-dimensional) system. DESIGN Prospective 2 cohort comparative study. METHODS Twenty-five surgically managed UCLP cases and 75 controls at 8 to 10 years of age were recruited. Facial movements during maximum smile were recorded using video stereophotogrammetry at a rate of 60 3D facial images per second. Maximum smile took approximately 3 seconds and generated 180 3D facial images for the analysis. A generic facial mesh which consists of more than 7000 quasi landmarks was used for the assessment of facial asymmetry at 5 key 3D frames representing the pattern of maximum smile. RESULTS Statistically significant differences were seen regarding the magnitude of facial asymmetry between the UCLP group and the noncleft controls. Higher average asymmetry in the UCLP group was seen in the 3D frame midway between maximum smile and rest (frame 4) followed by the frame at peak expression of maximum smile (frame 3). The average magnitude of nasolabial asymmetry of the control group was within 0.5 mm in comparison with the UCLP cases which was about 1.8 mm. CONCLUSION This study provided for the first time, an objective tool for analysis of the dynamics of muscle movements which provided an unprecedented insight into the anatomical basis of the residual dysmorphology. The research demonstrates the limitations of the primary lip repair in achieving symmetrical results and underpins the required refinements to improve the quality of surgical repair of cleft lip.
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Affiliation(s)
- Shyam Gattani
- Glasgow Dental School, School of Medicine, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, United Kingdom
| | - Xiangyang Ju
- Medical Devices Unit, Department of Clinical Physics and Bioengineering, National Health Service of Greater Glasgow and Clyde, United Kingdom
| | - Toby Gillgrass
- Glasgow Dental Hospital & School, Glasgow, United Kingdom
| | - Aileen Bell
- Oral Surgery, Glasgow University Dental Hospital & School, Glasgow, United Kingdom
| | - Ashraf Ayoub
- Scottish Craniofacial Research Group, Glasgow University Dental Hospital & School, School of Medicine, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, United Kingdom
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27
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Nowak-Gospodarowicz I, Różycki R, Rękas M. Quality of Life in Patients with Unresolved Facial Nerve Palsy and Exposure Keratopathy Treated by Upper Eyelid Gold Weight Loading. Clin Ophthalmol 2020; 14:2211-2222. [PMID: 32801632 PMCID: PMC7415438 DOI: 10.2147/opth.s254533] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2020] [Accepted: 07/06/2020] [Indexed: 12/20/2022] Open
Abstract
Background Loading of the upper eyelid with gold weights is a well-established procedure for the correction of paralytic lagophthalmos. There is no reliable research evaluating the results of this treatment from the patients’ viewpoint. Aim The aim of this research was to evaluate quality of life (QOL) domains through two standardized questionnaires (SF-36 and NEI-VFQ39) in patients treated by upper eyelid gold weight loading compared to healthy individuals (the “healthy” group) as well as patients with other ophthalmologic conditions (the “sick” group). Patients and Methods This prospective comparative clinical study of 416 surveys was conducted in 2012–2018. The study group includes 59 people: 40 women, 19 men aged 55.5 ± 17.4 treated with gold weights for corneal complications due to unresolved facial nerve palsy. General QOL was assessed using the SF-36 questionnaire. Eye-related QOL was assessed through the NEI-VFQ39 questionnaire. The results were compared with those obtained in 2 control groups: the “healthy” and the “sick,” 53 individuals each. Results A statistically significant increase in QOL domains was noted in patients with facial nerve palsy after treatment (p<0.001). No statistically significant differences were found in categories defining the Physical Component Score in these patients as compared to those from the “sick” control group (p = 0.95). After surgery, the results of the Mental Component Score were comparable to those in the “healthy” control group (p = 0.51). The eye-related health scores changed significantly after surgery and differed significantly compared to the “sick” control group (p <0.05); however, they did not reach the level of the “healthy” control group (p <0.001). Conclusion Patients with untreated facial nerve palsy had the lowest QOL levels among all individuals involved in this study. Treatment of lagophthalmos by gold weights significantly improved their QOL, with the greatest impact on mental aspects of health.
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Affiliation(s)
| | - Radosław Różycki
- Department of Ophthalmology, Military Institute of Medicine, Warsaw 04-141, Poland
| | - Marek Rękas
- Department of Ophthalmology, Military Institute of Medicine, Warsaw 04-141, Poland
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28
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Saydam SZ, Çüçülayef D, Doğan TN, Crerand CE, Özek M. Social Experiences of Turkish Parents Raising a Child With Apert Syndrome: A Qualitative Study. Cleft Palate Craniofac J 2020; 58:354-361. [PMID: 32744062 DOI: 10.1177/1055665620944761] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVE Apert syndrome is a rare and understudied craniofacial condition with regard to its psychosocial impact on children and their parents. Due to the lack of studies focusing solely on the social experiences of children and families with Apert syndrome, it is difficult to develop interventions and strategies to support well-being and positive adjustment for this particular population. This study addressed this gap by assessing the unique social experiences of parents who are raising their children with Apert syndrome including difficulties they face and strategies they use to cope with challenges. DESIGN Descriptive qualitative study using thematic analysis. PARTICIPANTS Participants included 21 parents of 12 children (aged 1-12 years) with Apert syndrome (9 couples, 2 fathers, and 1 mother) who were recruited from a pediatric neurosurgery unit in Turkey. RESULTS The qualitative analysis yielded four main themes describing the experiences of parents including (1) social challenges; (2) coping with negative reactions; (3) promoting socialization and independence; and (4) sources of strength. CONCLUSIONS Parents reported several challenges, including social stigmatization, and utilized a range of strategies to support both their own and their child's positive adaptation and resiliency, including the use of religion and reliance on their spouses for support. Results offer clinically relevant insights about the strengths and challenges of families coping with Apert syndrome.
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Affiliation(s)
| | | | | | - Canice E Crerand
- Department of Pediatrics, The Ohio State University School of Medicine, Columbus, OH, USA.,Department of Plastic Surgery, The Ohio State University School of Medicine, Columbus, OH, USA.,The Center for Biobehavioral Health, The Abigail Wexner Research Institute at 2650Nationwide Children's Hospital, Columbus, OH, USA
| | - Memet Özek
- Division of Pediatric Neurosurgery, Department of Neurosurgery, 162328Acıbadem University, Altunizade Mahallesi, Yurtcan Sokağı, Üsküdar/İstanbul, Turkey
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Kerr AM, Thompson CM, Rubinsky V. Memorable Messages Parents of Children with Vascular Birthmarks Receive from Others: Implications for Stigma and Identity. HEALTH COMMUNICATION 2020; 35:685-695. [PMID: 30793957 DOI: 10.1080/10410236.2019.1582314] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Parents of children with visible illnesses and physical differences, such as vascular birthmarks (VBs), often fear that their child will be stigmatized by others. Despite their use of various strategies to minimize this stigma, parents still frequently receive comments and questions from others about their child's condition. In the current study, we explore the source, content, and valence of these messages using a memorable messages framework. We also examine how parents react to messages from others and why those messages are considered memorable. To collect data, we administered a cross-sectional online survey through the website and social media pages of a national support group for parents of children with vascular birthmarks. A total of 70 parents completed the survey and, altogether, recalled 92 memorable messages. Our analyses revealed that the significance of the memorable messages coalesced around identity. Specifically, the messages described carried implications for a) participants in terms of their identities as parents, and b) participants' children in terms of their identities as stigmatized individuals. When messages were directed at parents, parents appraised them negatively or positively to the extent that they made parents feel judged or validated as parents of children with VBs. When messages were directed at children, parents appraised them negatively or positively to the extent that they labeled children and their VB as abnormal, unattractive, and undesirable, or accepted and complimented children as unique, special, and beautiful. The current research extends previous research exploring the role of memorable messages in negotiating identity.
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Affiliation(s)
- Anna M Kerr
- Department of Family Medicine, Heritage College of Osteopathic Medicine, Ohio University
| | - Charee M Thompson
- Department of Communication, College of Liberal Arts and Sciences, University of Illinois Urbana Champaign
| | - Valerie Rubinsky
- School of Communication Studies, Scripps College of Communication, Ohio University
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30
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de Macedo Bernardino Í, da Nóbrega LM, da Silva JRC, de Alencar CRB, de Olinda RA, d'Ávila S. Social determinants of health and maxillofacial injuries in children and adolescents victims of violence: A novel GIS-based modelling application. Int J Paediatr Dent 2019; 29:375-383. [PMID: 30582232 DOI: 10.1111/ipd.12461] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2018] [Revised: 12/11/2018] [Accepted: 12/13/2018] [Indexed: 10/27/2022]
Abstract
BACKGROUND Physical violence against children and adolescents comprises a serious public health problem and often results in oral and maxillofacial traumas. Social determinants may favour the occurrence of these events, but few studies have critically evaluated the interaction between social and geographical risk factors. AIMS To investigate the spatiotemporal distribution of oral and maxillofacial traumas resulting from violence against children and adolescents through geostatistical techniques. METHODS This study was an ecological analysis of cases of trauma caused by violence against Brazilian children and adolescents using aggregated data from victims attended at a Center of Forensic Medicine and Forensic Dentistry between January 2012 and December 2015. Data were analysed through modelling based on geographic information system (GIS). RESULTS Two distinct patterns of longitudinal trajectory of oral and maxillofacial trauma related to violence against children and adolescents were identified (TP1 and TP2, P < 0.05). The spatial regression analysis revealed a statistically significant association between higher incidence of cases and areas with worse socioeconomic conditions (β = 0.047, SE = 0.020, P < 0.05). CONCLUSION Neighbourhoods with considerable socio-spatial vulnerability for violence against children and adolescents and maxillofacial traumas were identified.
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Affiliation(s)
| | | | | | | | | | - Sérgio d'Ávila
- Department of Dentistry, Universidade Estadual da Paraíba, Campina Grande, Paraíba, Brazil
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31
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Patnaik U, Nilakantan A, Bajpai R, Addya K. Comprehensive assessment in cosmetic rhinoplasty: The use of the Derriford Appearance Scale for evaluation of patients. Med J Armed Forces India 2019; 75:184-189. [PMID: 31065188 PMCID: PMC6495105 DOI: 10.1016/j.mjafi.2018.07.011] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2015] [Accepted: 07/23/2018] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Rhinoplasty has a tremendous psychosocial impact. A good surgical correction may not guarantee an expected response from the patient. This is due to the fact that there may be associated psychological distress, the assessment of which may have to be incorporated while evaluating the surgical result. We aimed to identify if the questionnaire may help in identifying patients who might be less satisfied psychologically to the surgical result. This aspect of psychological assessment is not standardized, although it is reported in Western literature and recently in Asian Koreans. Similar studies in an Indian scenario merit deliberation. METHODS Fifty-one patients who underwent cosmetic rhinoplasty from August 2011 to July 2013 were administered the Derriford Questionnaire preoperatively and postoperatively at 3 months at a mid-zonal hospital. The responses were scored on a five-point Likert scale and analyzed. RESULTS The overall postoperative score improved from 1.32 ± 0.24 to 1.27 ± 0.24. There was statistically significant improvement in subscales of general, sociosexual, and bodily self-consciousness of appearance. However, the improvement in facial self-consciousness of appearance and negative self-concept was not statistically significant. CONCLUSION We recommend the use of the Derriford Assessment Scale (DAS) for objective assessment of psychological distress associated with living with a problem of appearance, in addition to assessment of anatomical deformity in patients undergoing cosmetic rhinoplasty. Better preoperative counseling may benefit those with a high score for negative self-concept and facial self-consciousness of appearance.
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Affiliation(s)
- Uma Patnaik
- Senior Adviser (ENT), Command Hospital (Southern Command), Pune 411040, India
| | | | - Ram Bajpai
- Assistant Professor, Army College of Medical Sciences, New Delhi, India
| | - Kalyani Addya
- Medical Officer, Military Hospital Leh, C/O 56 APO, India
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32
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The effects of society on the psychosocial functioning of those with a facial difference. HEALTH PSYCHOLOGY REPORT 2019. [DOI: 10.5114/hpr.2019.85657] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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Assessment of quality-of-life in patients with face-and-neck burns: The Burn-Specific Health Scale for Face and Neck (BSHS-FN). Burns 2018; 44:1602-1609. [PMID: 29958746 DOI: 10.1016/j.burns.2018.03.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2017] [Revised: 02/10/2018] [Accepted: 03/03/2018] [Indexed: 01/19/2023]
Abstract
INTRODUCTION Burns to the cephalic extremities are particularly implicated in problems of self-image and alterations to personal social relations. The aim of this study was to objectively assess the quality-of-life (QoL) of patients suffering from face-and-neck burns through our newly created scale: The Burn-Specific Health Scale for Face and Neck (BSHS-FN). METHODS After constructing the BSHS-FN, we compared QoL of patients with or without face-and-neck burns. SF-36, the French version of the BSHS-B (Burn Specific Health Scale-Brief), and the BSHS-FN were administrated to 53 patients divided into two groups: GB group (general burns, 26 patients) and FN group (face-neck burns, 27 patients). RESULTS QoL evaluated using the SF-36 had a higher average total score in GB patients compared to FN patients, but there were no significant difference between the two groups (54.3±18.5 vs. 47.0±17.3, respectively, p=0.11). In contrast, in BSHS-B the total score was significantly different between the two groups with a higher score recorded for the GB group (71.9±13.4 [median: 72.8] in the GB group vs. 62.2±14.4 [median: 64.4] in the FN group). In percentage terms, total score of BSHS-FN for GB group was 79.1±10.1, while total score for FN group was 53.6±13.1 (p<0.001), with the highest score for the Face and Neck domain in GB group (99.7±1.1, p<0.001) CONCLUSION: The BSHS-FN seemed to be more appropriate to assess QoL for FN burn patients. This study supports its application in routine clinical practice and in international studies.
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34
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Bennis I, De Brouwere V, Belrhiti Z, Sahibi H, Boelaert M. Psychosocial burden of localised cutaneous Leishmaniasis: a scoping review. BMC Public Health 2018; 18:358. [PMID: 29544463 PMCID: PMC5855994 DOI: 10.1186/s12889-018-5260-9] [Citation(s) in RCA: 61] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2017] [Accepted: 03/06/2018] [Indexed: 01/02/2023] Open
Abstract
Background Cutaneous Leishmaniasis (CL) is a parasitic skin disease, linked to poverty, and belonging to the group of Neglected Tropical Diseases. Depending on the severity, the type of lesions or scars, and the context, CL can lead to self- and social stigma influencing the quality of life and psychological well-being of the patient. This dimension is, however, little documented for the most common, localized form of cutaneous leishmaniasis (LCL). We aimed to describe the current knowledge on the psychological burden and the stigma related to LCL. Methods The population of interest for this scoping review are patients or their relatives with localized LCL or related scars. We searched the electronic databases PubMed, Web of Knowledge, PsycINFO, POPLINE, Cochrane Library, Science Direct, Global Health, and LILACS, for articles written in Arabic, English, French, Dutch, Portuguese, or Spanish, and published until the end of August 2017. Results From 2485 initial records, 15 papers met our inclusion criteria. Dermatology life quality index was the most frequent used scale to assess LCL psychological impact in quantitative studies. Six qualitative studies used individual interviews and/or focus groups discussions to explore the psychological and/or the social burden of this disease. Quantitative assessments using standard scales as well as qualitative research asserts that LCL is a source of psychological suffering, stigmatization, and decreased quality of life (QoL). Conclusion Most studies showed that LCL has a significant negative effect on the QoL and mental health. However, the fact that the psychosocial burden generated by LCL is time-dependent makes it hard to measure. We recommend to develop a more specific and validated assessment scale to appreciate the full burden of this disease and enhance comparability of findings. Electronic supplementary material The online version of this article (10.1186/s12889-018-5260-9) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Issam Bennis
- National School of Public Health, Ministry of Health, Lemfedel Cherkaoui Street, Madinat Al Irfane, 10000, Rabat, Morocco. .,Department of Public Health, Institute of Tropical Medicine, Antwerp, Belgium. .,Department of Biomedical Sciences, Faculty of Pharmaceutical, Biomedical and Veterinary Sciences, University of Antwerp, Antwerp, Belgium.
| | - Vincent De Brouwere
- Department of Public Health, Institute of Tropical Medicine, Antwerp, Belgium
| | - Zakaria Belrhiti
- National School of Public Health, Ministry of Health, Lemfedel Cherkaoui Street, Madinat Al Irfane, 10000, Rabat, Morocco.,Department of Public Health, Institute of Tropical Medicine, Antwerp, Belgium.,Vrije Universiteit Brussel, Rabat, Morocco
| | - Hamid Sahibi
- Department of Pathology and Veterinary Public Health, Hassan II Agronomy and Veterinary Institute, Rabat, Morocco
| | - Marleen Boelaert
- Department of Public Health, Institute of Tropical Medicine, Antwerp, Belgium
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35
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Espinel AG, Bauman NM. Psychosocial Impact of Vascular Anomalies on Children and Their Families. Otolaryngol Clin North Am 2018; 51:99-110. [DOI: 10.1016/j.otc.2017.09.018] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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36
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Rahtz E, Bhui K, Hutchison I, Korszun A. Are facial injuries really different? An observational cohort study comparing appearance concern and psychological distress in facial trauma and non-facial trauma patients. J Plast Reconstr Aesthet Surg 2018; 71:62-71. [DOI: 10.1016/j.bjps.2017.08.006] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2017] [Revised: 07/27/2017] [Accepted: 08/06/2017] [Indexed: 11/25/2022]
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37
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Nakarada-Kordic I, Patterson N, Wrapson J, Reay SD. A Systematic Review of Patient and Caregiver Experiences with a Tracheostomy. PATIENT-PATIENT CENTERED OUTCOMES RESEARCH 2017; 11:175-191. [DOI: 10.1007/s40271-017-0277-1] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
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38
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Fernandes Y, Buckley DM, Eberhart JK. Diving into the world of alcohol teratogenesis: a review of zebrafish models of fetal alcohol spectrum disorder. Biochem Cell Biol 2017; 96:88-97. [PMID: 28817785 DOI: 10.1139/bcb-2017-0122] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
The term fetal alcohol spectrum disorder (FASD) refers to the entire suite of deleterious outcomes resulting from embryonic exposure to alcohol. Along with other reviews in this special issue, we provide insight into how animal models, specifically the zebrafish, have informed our understanding of FASD. We first provide a brief introduction to FASD. We discuss the zebrafish as a model organism and its strengths for alcohol research. We detail how zebrafish has been used to model some of the major defects present in FASD. These include behavioral defects, such as social behavior as well as learning and memory, and structural defects, disrupting organs such as the brain, sensory organs, heart, and craniofacial skeleton. We provide insights into how zebrafish research has aided in our understanding of the mechanisms of ethanol teratogenesis. We end by providing some relatively recent advances that zebrafish has provided in characterizing gene-ethanol interactions that may underlie FASD.
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Affiliation(s)
- Yohaan Fernandes
- Molecular Biosciences, University of Texas at Austin, Austin, TX 78713, USA.,Molecular Biosciences, University of Texas at Austin, Austin, TX 78713, USA
| | - Desire M Buckley
- Molecular Biosciences, University of Texas at Austin, Austin, TX 78713, USA.,Molecular Biosciences, University of Texas at Austin, Austin, TX 78713, USA
| | - Johann K Eberhart
- Molecular Biosciences, University of Texas at Austin, Austin, TX 78713, USA.,Molecular Biosciences, University of Texas at Austin, Austin, TX 78713, USA
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39
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Nellis JC, Ishii M, Byrne PJ, Boahene KDO, Dey JK, Ishii LE. Association Among Facial Paralysis, Depression, and Quality of Life in Facial Plastic Surgery Patients. JAMA FACIAL PLAST SU 2017; 19:190-196. [PMID: 27930763 DOI: 10.1001/jamafacial.2016.1462] [Citation(s) in RCA: 123] [Impact Index Per Article: 17.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Importance Though anecdotally linked, few studies have investigated the impact of facial paralysis on depression and quality of life (QOL). Objective To measure the association between depression, QOL, and facial paralysis in patients seeking treatment at a facial plastic surgery clinic. Design, Setting, Participants Data were prospectively collected for patients with all-cause facial paralysis and control patients initially presenting to a facial plastic surgery clinic from 2013 to 2015. The control group included a heterogeneous patient population presenting to facial plastic surgery clinic for evaluation. Patients who had prior facial reanimation surgery or missing demographic and psychometric data were excluded from analysis. Main Outcomes and Measures Demographics, facial paralysis etiology, facial paralysis severity (graded on the House-Brackmann scale), Beck depression inventory, and QOL scores in both groups were examined. Potential confounders, including self-reported attractiveness and mood, were collected and analyzed. Self-reported scores were measured using a 0 to 100 visual analog scale. Results There was a total of 263 patients (mean age, 48.8 years; 66.9% were female) were analyzed. There were 175 control patients and 88 patients with facial paralysis. Sex distributions were not significantly different between the facial paralysis and control groups. Patients with facial paralysis had significantly higher depression, lower self-reported attractiveness, lower mood, and lower QOL scores. Overall, 37 patients with facial paralysis (42.1%) screened positive for depression, with the greatest likelihood in patients with House-Brackmann grade 3 or greater (odds ratio, 10.8; 95% CI, 5.13-22.75) compared with 13 control patients (8.1%) (P < .001). In multivariate regression, facial paralysis and female sex were significantly associated with higher depression scores (constant, 2.08 [95% CI, 0.77-3.39]; facial paralysis effect, 5.98 [95% CI, 4.38-7.58]; female effect, 1.95 [95% CI, 0.65-3.25]). Facial paralysis was associated with lower QOL scores (constant, 81.62 [95% CI, 78.98-84.25]; facial paralysis effect, -16.06 [95% CI, -20.50 to -11.62]). Conclusions and Relevance For treatment-seeking patients, facial paralysis was significantly associated with increased depression and worse QOL scores. In addition, female sex was significantly associated with increased depression scores. Moreover, patients with a greater severity of facial paralysis were more likely to screen positive for depression. Clinicians initially evaluating patients should consider the psychological impact of facial paralysis to optimize care. Level of Evidence 2.
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Affiliation(s)
- Jason C Nellis
- Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University, Baltimore, Maryland
| | - Masaru Ishii
- Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University, Baltimore, Maryland
| | - Patrick J Byrne
- Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University, Baltimore, Maryland
| | - Kofi D O Boahene
- Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University, Baltimore, Maryland
| | - Jacob K Dey
- Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University, Baltimore, Maryland
| | - Lisa E Ishii
- Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University, Baltimore, Maryland
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40
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Affiliation(s)
- Siang Yong Tan
- Emeritus Professor of Medicine, University of Hawaii, USA
| | - Patricia Sims Poole
- Research carried out during Transitional Residency, Hawaii Residency Programs Inc, Honolulu, Hawaii, USA
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Chen SC, Huang CY, Huang BS, Lin CY, Fan KH, Chang JTC, Wu SC, Lai YH. Factors associated with healthcare professional's rating of disfigurement and self-perceived body image in female patients with head and neck cancer. Eur J Cancer Care (Engl) 2017; 27:e12710. [PMID: 28488375 DOI: 10.1111/ecc.12710] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/06/2017] [Indexed: 11/26/2022]
Abstract
The purpose of this study was to determine factors associated with self-perceived body image in female patients with head and neck cancer (HNC), and factors associated with healthcare professional's rating of disfigurement, as well as the correlation between patient and observer ratings. This cross-sectional study recruited 105 women with HNC at a large medical centre. Measures of facial disfigurement and body image, as well as demographic and clinical characteristics, were collected. Multivariate multiple linear regression modelling was used to identify factors associated with healthcare professional's rating of disfigurement and patient self-perceived body image. Disfigurement ratings by healthcare professionals were positively associated with patient self-perceived body image. Medical treatment, cancer stage, radiation dose and cancer site were significantly associated with disfigurement. Medical treatment was an important predictor of perceived body image. These findings indicate a moderate prevalence of disfigurement among women with HNCs. Patients with more disfigurement were more likely to have dissatisfaction with their body image. Nursing professionals need to carefully assess the appearance of women with HNC. Camouflage interventions can be used to help appropriately cope with the disfigurement, and to achieve improved satisfaction with their body image.
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Affiliation(s)
- S-C Chen
- Department of Nursing, College of Nursing, Chang Gung University of Science and Technology, Taoyuan, Taiwan.,Department of Radiation Oncology, Chang Gung Medical Foundation, Linkou Chang Gung Memorial Hospital, Proton and Radiation Therapy Center, Taoyuan, Taiwan
| | - C-Y Huang
- Department of Plastic and Reconstruction Surgery, Taipei Municipal Wangfang Hospital, Taipei, Taiwan.,Department of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - B-S Huang
- Department of Radiation Oncology, Chang Gung Medical Foundation, Linkou Chang Gung Memorial Hospital, Proton and Radiation Therapy Center, Taoyuan, Taiwan.,Department of Medicine, College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - C-Y Lin
- Department of Radiation Oncology, Chang Gung Medical Foundation, Linkou Chang Gung Memorial Hospital, Proton and Radiation Therapy Center, Taoyuan, Taiwan.,Department of Medicine, College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - K-H Fan
- Department of Radiation Oncology, Chang Gung Medical Foundation, Linkou Chang Gung Memorial Hospital, Proton and Radiation Therapy Center, Taoyuan, Taiwan.,Department of Medicine, College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - J T-C Chang
- Department of Radiation Oncology, Chang Gung Medical Foundation, Linkou Chang Gung Memorial Hospital, Proton and Radiation Therapy Center, Taoyuan, Taiwan.,Department of Medicine, College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - S-C Wu
- Department of Radiation Oncology, Chang Gung Medical Foundation, Linkou Chang Gung Memorial Hospital, Proton and Radiation Therapy Center, Taoyuan, Taiwan
| | - Y-H Lai
- School of Nursing, College of Medicine, National Taiwan University, Taipei, Taiwan.,Department of Nursing, National Taiwan University Hospital, Taipei, Taiwan
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De Maria B, de Jager T, Sarubbi C, Bartsch O, Bianchi A, Brancati F, Chung HYB, David A, Kariminejad A, Foresti M, Gallottini M, Isidor B, Marchegiani S, Martins F, Mazzanti L, Roche N, Singh A, Stevens C, Suga K, Zenker M, Hennekam RC. Barber-Say Syndrome and Ablepharon-Macrostomia Syndrome: A Patient's View. Mol Syndromol 2017; 8:172-178. [PMID: 28690482 DOI: 10.1159/000472408] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/17/2017] [Indexed: 11/19/2022] Open
Abstract
Barber-Say syndrome (BSS) and ablepharon-macrostomia syndrome (AMS) are infrequently reported congenital malformation disorders caused by mutations in the TWIST2 gene. Both are characterized by abnormalities in ectoderm-derived structures and cause a very unusual morphology of mainly the face in individuals with otherwise normal cognition and normal physical functioning. We studied the impact that the presence of BSS and AMS has on psychosocial functioning of affected individuals and their families, using their point of view to start with. We tabulated frequently asked questions from affected individuals and families, and a parent of an affected child and an affected adult woman offered personal testimonies. We focused on perception of illness, body satisfaction, and the consequences for an otherwise normal individual who has a disorder that interferes with body image. The importance of paying particular attention to the management of both the physical appearance and the consequences of these entities on the quality of life is stressed by the affected individuals themselves.
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Affiliation(s)
- Beatrice De Maria
- Department of Pediatrics and Translational Genetics, Academic Medical Center (AMC), University of Amsterdam, Amsterdam, The Netherlands.,Department of Pediatrics, S. Orsola-Malpighi Hospital, University of Bologna, Bologna
| | | | - Caitlin Sarubbi
- Department of Social Sciences, Harvard University, Boston, MA
| | - Oliver Bartsch
- Institute of Human Genetics, Medical Centre of the Johannes Gutenberg University, Mainz
| | - Alberto Bianchi
- Department of Oral and Maxillofacial Surgery, S. Orsola-Malpighi Hospital, University of Bologna, Bologna
| | - Francesco Brancati
- Department of Medical, Oral, and Biotechnological Sciences, University of G. d'Annunzio Chieti and Pescara, Chieti, Italy
| | - Hon-Yin B Chung
- Department of Pediatrics and Adolescent Medicine, Centre for Genomic Sciences, LKS Faculty of Medicine, University of Hong Kong, Hong Kong, China
| | - Albert David
- Unité de Génétique Clinique, Hôpital Mère-Enfant, CHU de Nantes, Nantes, France
| | | | - Maura Foresti
- Department of Pediatrics, S. Orsola-Malpighi Hospital, University of Bologna, Bologna
| | - Marina Gallottini
- Department of Stomatology, Special Care Dentistry Center, School of Dentistry, University of São Paulo, São Paulo, Brazil
| | - Bertrand Isidor
- Unité de Génétique Clinique, Hôpital Mère-Enfant, CHU de Nantes, Nantes, France
| | - Shannon Marchegiani
- Department of Pediatrics, NIH and National Human Genome Research Institute, NIH, Bethesda, MD
| | - Fabiana Martins
- Department of Plastic and Reconstructive Surgery, University Hospital, Ghent, Belgium
| | - Laura Mazzanti
- Department of Pediatrics, S. Orsola-Malpighi Hospital, University of Bologna, Bologna
| | - Nathalie Roche
- Department of Plastic and Reconstructive Surgery, University Hospital, Ghent, Belgium
| | - Ankur Singh
- Department of Pediatrics, Institute of Medical Sciences, Genetic and Metabolic Clinic, Banaras Hindu University, Varanasi, India
| | - Cathy Stevens
- Department of Medical Genetics, T.C. Thompson Children's Hospital, Chattanooga, TN, USA
| | - Kenichi Suga
- Department of Pediatrics, Perinatal Center, Tokushima University Hospital, Tokushima, Japan
| | - Martin Zenker
- Institute of Human Genetics, Medical Faculty, University Clinic, Magdeburg, Germany
| | - Raoul C Hennekam
- Department of Pediatrics and Translational Genetics, Academic Medical Center (AMC), University of Amsterdam, Amsterdam, The Netherlands
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Richards HS, Jenkinson E, Rumsey N, Harrad RA. Pre-operative experiences and post-operative benefits of ptosis surgery: A qualitative study. Orbit 2017; 36:147-153. [PMID: 28594300 DOI: 10.1080/01676830.2017.1279669] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
This qualitative study sought to explore the experiences of patients who had undergone successful ptosis correction surgery. Participants were recruited from Bristol Eye Hospital. Nine participants were interviewed using a semi-structured interview schedule and open ended questions. Data were analysed using inductive thematic analysis. Four major themes were identified from patient accounts. Patients described the psychosocial and functional difficulties they experienced living with ptosis, and the subsequent benefits of surgery. Patients reported experiencing appearance related anxiety pre-operatively due to their condition and engaging in behaviours to avoid social encounters. Gender differences were noted in the internalization of perceived negative reactions from others, with men describing fewer adverse impacts. Patients described perceived barriers to seeking surgery including a lack of awareness of ptosis as a treatable condition, the perception that being concerned with their appearance could be seen as vain and the view that ptosis surgery is synonymous with cosmetic surgery. Following successful surgery patients outlined positive impacts on their vision, appearance and psychosocial well-being after successful surgery. This qualitative study highlights the complexities of the factors and processes contributing to the psychosocial impacts of ptosis and the potential benefits of surgery and/or psychosocial support. An increased awareness amongst people with ptosis of the potential positive impacts of surgery and an enhanced understanding of the reasons why patients may not seek treatment amongst health care professionals are likely to benefit this often overlooked patient group.
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Affiliation(s)
- Hollie S Richards
- a Centre for Appearance Research , University of the West of England , Bristol , United Kingdom
| | - Elizabeth Jenkinson
- a Centre for Appearance Research , University of the West of England , Bristol , United Kingdom
| | - Nicola Rumsey
- a Centre for Appearance Research , University of the West of England , Bristol , United Kingdom
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Yadav SK, Shrestha S. A study on posttraumatic experience of road traffic accident afflicted maxillofacial trauma patient at tertiary hospital. J Nat Sci Biol Med 2017; 8:40-45. [PMID: 28250673 PMCID: PMC5320822 DOI: 10.4103/0976-9668.198358] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Objectives: Patients are usually left in a vulnerable state after an accident. Because of this, they long for a good encounter when they are brought to the hospital. Physical impairment and psychological morbidities are some of the complications that can occur to them. Traditionally, surgeons tend to pay little attention to a patient's emotional and psychological perspective. The aim of this study was to understand the experience of oral and maxillofacial trauma patients due to road traffic accident right from immediate after the accident till the end of definitive treatment. Materials and Methods: Phenomenological approach of qualitative study was used to explore these patients’ experience. Twenty subjects involved in road traffic accidents without any cognitive impairment aged 18 and above were recruited. Purposive sampling was used to include maximal variation sample regarding age, gender, types of injury, and types of treatment received. Semi-structured and open-ended interview approach was used to obtain in-depth information. Results: Seven themes were identified to describe the patients’ response to and experience after meeting with a road traffic accident; they are unreal experiences, emotional responses, need to inform and need for information, need for assistance, their perception toward the maxillofacial injury, their experience on treatment and staff-patient interaction. Conclusion: This qualitative study has provided an in-depth understanding of patients experience during maxillofacial trauma and treatment, which otherwise cannot be obtained by the use of surveys and test questions.
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Affiliation(s)
- Santosh Kumar Yadav
- Department of Oral and Maxillofacial Surgery, College of Medical Sciences, Bharatpur, Chitwan, Nepal
| | - Suraksha Shrestha
- Department of Prosthodontics, College of Medical Sciences, Bharatpur, Chitwan, Nepal
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Social and Support Services Offered by Cleft and Craniofacial Teams: A National Survey and Institutional Experience. J Craniofac Surg 2016; 27:356-60. [PMID: 26825746 DOI: 10.1097/scs.0000000000002385] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND A multidisciplinary approach to patients with craniofacial abnormalities is the standard of care by the American Cleft Palate-Craniofacial Association (ACPA). The standards of team care, however, do not require provision of social support services beyond access to a social worker. The purpose of this investigation is to study social support services provided by ACPA teams, funding sources for services, and family interest in services. METHODS A survey was submitted to ACPA cleft and craniofacial team leaders (N = 161), which evaluated the provision of potentially beneficial social support services, and their funding sources. A second survey administered to patient families at our institution gauged their level of interest in these services. Statistical analysis evaluated the level of interest among services. RESULTS Seventy-five of 161 (47%) teams and 39 of 54 (72%) families responded to the surveys. Services provided included scholarships (4%), summer camp (25%), social media (32%), patient support groups (36%), parties (42%), parent support groups (46%), other opportunities (56%), and social workers (90%). The majority of funding for social workers was by the institution (61%) whereas funding for ancillary services varied (institution, team, fundraisers, grants, and other sources). Families indicated an average interest of 2.4 ± 1.41 for support groups, 2.5 ± 1.63 for summer camps, 2.92 ± 1.66 for parties, 3.16 ± 1.65 for social media, and 3.95 ± 1.60 for scholarships (P value <0.05). CONCLUSIONS The ACPA standards of team care do not require teams to provide social support services beyond access to a social worker. Among our survey respondents, the authors found that in addition to a social worker, teams offered social support services, which were not required. The social worker position is usually institutionally funded, whereas funding sources for additional services varied. Respondents at our center desired additional social support services. The authors recommend a hybrid model of hospital and nonhospital funding to provide social and support services to patients with craniofacial deformities.
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Lovely CB, Fernandes Y, Eberhart JK. Fishing for Fetal Alcohol Spectrum Disorders: Zebrafish as a Model for Ethanol Teratogenesis. Zebrafish 2016; 13:391-8. [PMID: 27186793 PMCID: PMC5035362 DOI: 10.1089/zeb.2016.1270] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Fetal Alcohol Spectrum Disorders (FASD) describes a wide array of ethanol-induced developmental defects, including craniofacial dysmorphology and cognitive impairments. It affects ∼1 in 100 children born in the United States each year. Due to the pleiotropic effects of ethanol, animal models have proven critical in characterizing the mechanisms of ethanol teratogenesis. In this review, we focus on the utility of zebrafish in characterizing ethanol-induced developmental defects. A growing number of laboratories have focused on using zebrafish to examine ethanol-induced defects in craniofacial, cardiac, ocular, and neural development, as well as cognitive and behavioral impairments. Growing evidence supports that genetic predisposition plays a role in these ethanol-induced defects, yet little is understood about these gene-ethanol interactions. With a high degree of genetic amenability, zebrafish is at the forefront of identifying and characterizing the gene-ethanol interactions that underlie FASD. Because of the conservation of gene function between zebrafish and humans, these studies will directly translate to studies of candidate genes in human populations and allow for better diagnosis and treatment of FASD.
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Affiliation(s)
| | - Yohaan Fernandes
- Molecular Biosciences, University of Texas at Austin , Austin, Texas
| | - Johann K Eberhart
- Molecular Biosciences, University of Texas at Austin , Austin, Texas
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Kenny SA, Majeed N, Zhand N, Glikstein R, Agid R, Dos Santos MP. Psychological comorbidities and compliance to interventional treatment of patients with cutaneous vascular malformations. Interv Neuroradiol 2016; 22:489-94. [PMID: 27177874 PMCID: PMC4984393 DOI: 10.1177/1591019916647194] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2016] [Accepted: 04/03/2016] [Indexed: 11/16/2022] Open
Abstract
PURPOSE The aim of this study was to assess qualitatively the psychological stressors affecting patients with cutaneous vascular malformations and hemangiomas (CVM-H) and their impact on compliance to interventional treatment. METHODS A retrospective chart review was conducted of all patients with CVM-H treated by interventional neuroradiology at a single academic institution during a five-year period (2009-2014). Psychological complaints were documented during each clinic visit by a neuroradiologist. Compliance to interventional treatment was defined by adherence to the scheduled treatment sessions. Fisher's exact test was used to assess for associations between psychological complaints and compliance. RESULTS Seventy-five patients were assessed, of whom 49 (65.3%) were female, with an age range of 2-78 years (mean age 30.2 years). All except one patient older than seven years of age (n = 71; 94.6%) had a psychological complaint, including fear of negative appearance (n = 53; 70.6%), dissatisfaction with appearance (n = 46; 61.3%), low self-esteem (n = 35; 46.6%), anxiety (n = 16; 21.3%), stress (n = 13; 17.3%), bullying (n = 5; 6.6%), and low mood (n = 4; 5.3%). Twenty-three (31%) patients were non-compliant. Low self-esteem was significantly associated with non-compliance (p = 0.0381). CONCLUSION There is a high prevalence of psychological comorbidities among patients treated for CVM-H. This has potential implications for interventional treatment, as it was found that low self-esteem is significantly associated with non-compliance. These results suggest the need for early psychological support in these patients in order to maximize compliance to interventional treatment.
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Affiliation(s)
| | - Nevin Majeed
- Department of Medical Imaging, University of Ottawa, Canada
| | - Naista Zhand
- Department of Psychiatry, University of Ottawa, Canada
| | - Rafael Glikstein
- Department of Medical Imaging, University of Ottawa, Canada Department of Medical Imaging, The Ottawa Hospital, Canada Ottawa Hospital Research Institute, and Brain and Mind Research Institute, Canada
| | - Ronit Agid
- Department of Medical Imaging, UHN - Toronto Western Hospital, University of Toronto, Canada
| | - Marlise P Dos Santos
- Department of Medical Imaging, University of Ottawa, Canada Department of Medical Imaging, The Ottawa Hospital, Canada Ottawa Hospital Research Institute, and Brain and Mind Research Institute, Canada
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Kopacheva-Barsova G, Nikolovski N. Justification for Rhinoseptoplasty in Children - Our 10 Years Overview. Open Access Maced J Med Sci 2016; 4:397-403. [PMID: 27703562 PMCID: PMC5042622 DOI: 10.3889/oamjms.2016.080] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2016] [Revised: 07/17/2016] [Accepted: 07/19/2016] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND: Nasal septal surgery and rhinoplasty are controversial in children. Traditionally, an attitude of restraint has been employed by most surgeons till an empirical age of 16 to 18 years. This is to avoid the possible adverse effects that the growth spurts may have on the nose and midface region. AIM: The aim of this paper was to present the results of rhinoplasty in children in order to restore the anatomy and function or to promote normal development and outgrowth of the nose. MATERIAL AND METHODS: Ninety seven children aged 6-14, with severe nose deformities and breathing problems through the nose, were admitted for septo/rhinoplasty at the University Clinic for Ear, Nose and Throat, Faculty of Medicine, Ss Cyril and Methodius University of Skopje, Republic of Macedonia. At our Clinic, they have been observed and photographed (with parent permission) in the period of 10 years (2006-2016). The most frequent cause of these deformities was the nasal trauma in early childhood which was ignored or untreated. All of them rhino/septoplasty were indicated in accordance with the above-mentioned recommendations for rhino/septoplasty in early childhood and in adolescents. RESULTS: In 51 children and adolescents septoplasty were prepared. Mostly there was a group of younger children age from 6-10 (68%) and adolescents (32%). In the other 31 children and adolescents, septorhinoplasty was prepared. Mostly there were children older than 12 years old and adolescents (70%). Only 30% were younger than 12 years, of course with severe nasal breathing problems, nasal septal deformities and deformities of the nasal pyramid. CONCLUSION: The growth centres of the nose have to be avoided if possible; long-term nasal issues will theoretically be minimised. If the surgeon replaces it, the cartilage of the nose becomes straighter but still intact.
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Affiliation(s)
- Gabriela Kopacheva-Barsova
- University Clinic for Ear, Nose and Throat, Faculty of Medicine, Ss Cyril and Methodius University of Skopje, Vodnjanska 17, Skopje, MK 1109, Republic of Macedonia
| | - Nikola Nikolovski
- University Clinic for Ear, Nose and Throat, Faculty of Medicine, Ss Cyril and Methodius University of Skopje, Vodnjanska 17, Skopje, MK 1109, Republic of Macedonia
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Landes C, Hoefer SH, Richards T, Walcher F, Sader R. Perspectives of patients about bioabsorbable internal fixation for maxillofacial fractures. Ann Maxillofac Surg 2016; 5:185-90. [PMID: 26981468 PMCID: PMC4772558 DOI: 10.4103/2231-0746.175769] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
PURPOSE Resorbable/bioabsorbable internal fixation provides effective treatment for maxillofacial fractures and avoids the need for metal hardware removal. We evaluated the initial knowledge, attitudes, subjective demand, and treatment satisfaction of patients concerning bioabsorbable osteofixation for maxillofacial trauma. MATERIALS AND METHODS From May 2007 to October 2009, there were 71 patients (63 males and 8 females; mean age: 35 ± 15 years) included in this prospective study. The patients completed preoperative and postoperative (4-6 weeks and 1 year) questionnaires. RESULTS After receiving information, 70 patients (99%) preferred resorbable/bioabsorbable bone fixation, usually because they preferred to avoid a second operation to remove metal hardware (67 patients [94%]). The higher cost of resorbable/bioabsorbable bone fixation was believed and justified by 41 patients (58%) and not justified by 30 patients (42%). No adverse events were reported by 27 of 34 patients (79%) at 4-6 weeks and by 14 of 21 patients (67%) at 1 year after surgery. Most patients were very satisfied with the outcome of surgery. CONCLUSION Patients who have maxillofacial trauma have a high frequency of preference and high satisfaction with resorbable/bioabsorbable than metal osteofixation. Literature review showed increased activity in research and publication worldwide about resorbable bone fixation, suggesting that there may be increased patient demand for resorbable bone fixation in the future.
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Affiliation(s)
- Constantin Landes
- Department of Cranio-Maxillofacial Surgery, Sana Hospital, Offenbach, Germany
| | - Sebastian H Hoefer
- Department of Oral, Cranio-Maxillofacial and Facial Plastic Surgery, Goethe University Medical Centre, Frankfurt, Germany
| | | | - Felix Walcher
- Department of Trauma Surgery, Medical Faculty University Hospital, Magdeburg, Germany
| | - Robert Sader
- Department of Oral, Cranio-Maxillofacial and Facial Plastic Surgery, Goethe University Medical Centre, Frankfurt, Germany
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