Orlagh Hunt

Self-reports of psychosocial functioning among children and young adults with cleft lip and palate.

Objective: A cross-sectional study was employed to determine the psychosocial effects of cleft lip and/or palate among children and young adults, compared with a control group of children and young adults without cleft lip and palate. Participants: The study comprised 160 children and young adults with cleft lip and/or palate and 113 children and young adults without cleft lip and/or palate. All participants were between 8 and 21 years of age. Outcome measures: Psychological functioning (anxiety, self-esteem, depression, and behavioral problems) was assessed using validated psychological questionnaires. Happiness with facial appearance was rated using a visual analog scale. Social functioning, including experience of teasing/bullying and satisfaction with speech, was assessed using a semistructured interview. Results: Participants with cleft lip and/or palate reported greater behavioral problems (p < .001) and more symptoms of depression (p < .01); they were teased more often (p < .001) and were less happy with their facial appearance (p < .01) and speech (p < .001), compared with controls. There were no significant difference between subjects with cleft lip and/or palate and subjects without cleft lip and/or palate in terms of anxiety (p > .05) or self-esteem (p > .05). Having been teased was a significant predictor of poor psychological functioning, more so than having a cleft lip and/or palate per se (p < .001). Conclusions: Teasing was greater among participants who had cleft lip and/ or palate and it was a significant predictor of poorer psychosocial functioning. Children and young adults with cleft lip and/or palate require psychological assessment, specifically focusing on their experience of teasing, as part of their routine cleft care.

Parent reports of the psychosocial functioning of children with cleft lip and/or palate.

Objectives: (1) to determine the opinion of parents regarding the psychosocial functioning of their child with cleft lip and/or palate (CLP); (2) to identify predictors of psychosocial functioning; and (3) to determine the level of agreement between children with CLP and their parents. Participants: One hundred twenty-nine parents of children with CLP and 96 parents of children without CLP participated in this cross-sectional study. Outcome measures: Parental opinion of the childs self-esteem, anxiety, happiness, and problems caused by facial appearance were assessed using visual analogue scales. Parents completed the Child Behavior Checklist and were interviewed. Results: Children with CLP were more anxious (p < 0.05), less happy with their appearance (p < 0.001), and in general (p < 0.05) had lower self-esteem (p < 0.05) and greater behavioral problems (p < 0.001) compared with non-CLP children. Parents reported that their child with CLP was teased more often (p < 0.001) and was less satisfied with his/her speech (p < 0.01) compared with reports of parents in the control group. A number of factors affected parents’ ratings of their childs psychosocial functioning (presence of CLP, appearance happiness, previous history of CLP, and visibility of scar). Children who had been teased were more anxious (p ≤ 0.01), less happy with their appearance (p < 0.001) and had greater behavioral problems (p < 0.001). Conclusions: Parents of children with CLP reported various psychosocial problems among their children. Parents considered children who had been teased to have greater psychosocial problems.

The communication experiences of education managers: identifying strengths, weaknesses and critical incidents

Education managers from various education settings were asked to record the three most typical work‐related incidents of communication within a specified time‐frame. They were also asked to identify the strengths and weaknesses of communication practices at work. The resultant data provide insight into the existing communication climate within education organisations, and the problems which need to be overcome. Specifically, the main findings were of persistent communication problems between managers and staff, the organisation of meetings, the transmission of information and the use of appropriate communication channels. The data suggest that there is a need for improved communication to facilitate the more effective management of education organisations, and to improve relationships between education managers and their staff. Greater communication skills training for managers is therefore recommended. This paper also considers areas where further research is indicated.

Psychological Status of Patients Referred for Orthognathic Correction of Skeletal II and III Discrepancies

OBJECTIVE To establish the extent of psychological problems among patients who require orthognathic treatment. MATERIALS AND METHODS Five aspects of psychological functioning were assessed for 162 patients who required orthognathic treatment and compared with 157 control subjects. RESULTS Analysis of variance did not detect any significant difference in the five psychological scores recorded for the skeletal II, skeletal III, and control groups. The proportion of subjects with one or more psychological measure beyond the normal range was 27% for skeletal II subjects, 25% for skeletal III subjects, and 26% for control subjects. One skeletal II subject (1.5%), three skeletal III subjects (3%), and five control subjects (3%) required referral for psychological counseling. CONCLUSIONS The orthognathic patients did not differ significantly from the control subjects in their psychological status.

Patient anxiety and IV sedation in Northern Ireland.

Background In recent years there has been an increase in the provision of conscious sedation, which is said to be a safe and effective means of managing the anxious patient. However, there are no guidelines to aid the dental practitioner in assessing the patients need for sedation based on their level of anxiety.Aims and methods The present study investigated the importance of patient anxiety as an indicator for IV sedation, using focus groups to inform the development of narrative vignettes. Ninety-nine practitioners responded to a series of scenarios to determine whether the level of patient anxiety and the patients demand for IV sedation influenced their decision making.Results Level of dental anxiety had a stronger influence on the clinicians decision making than patient demand, with increasing levels of dental anxiety being positively associated with the likelihood of clinicians indicating a need for IV patient sedation and also, the likelihood of clinicians providing IV sedation to these patients. Only 14% (n = 14) of respondents reported formally assessing dental anxiety.Conclusions While dental anxiety is considered to be a key factor in determining the need for IV sedation, there is a lack of guidance regarding the assessment of anxiety among patients.