Reflections on the cleft experience by South african adults: use of qualitative methodology

This study explored the perceptions of a group of South African adults with repaired cleft lip, cleft palate, or both regarding their quality of life by considering the domains of communication, education, employment, family and marital life, social life, and emotional issues.

An exploratory-descriptive, qualitative research design was employed.

Individual, semistructured interviews were conducted in the homes of participants.

Twenty adults with repaired cleft lip, cleft palate, or both aged between 18 and 50 years participated in the study.

Participants were generally satisfied with their communicative abilities and perceived their speech to be intelligible. They also felt that speech therapy had improved the quality of their lives. Although they had experienced teasing during childhood, they did not feel that their cleft had affected their relationships with teachers and were generally satisfied with their educational attainments. Socially they reported being greatly affected by negative societal perceptions and prevailing cultural myths regarding etiology of clefts. Generally employment did not appear to be affected by the presence of a cleft. With regard to family life, participants reported being treated differently by parents in comparison with their siblings. For the majority of respondents, marital relationships and dating did not seem to be adversely affected. In terms of emotional factors, both positive and negative reactions were experienced in relation to the cleft. They also felt that the competent and compassionate care received from the multidisciplinary team had definitely enhanced the quality of their lives.

These findings have important clinical implications for a multidisciplinary approach to treatment; counseling of patients and their families; education of the community regarding cleft lip, cleft palate, or both; and further research.