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Cleft Care UK study. Part 5: child psychosocial outcomes and satisfaction with cleft services
A Waylen1, A R Ness1,2, A K Wills1
1School of Oral and Dental Sciences, University of Bristol, Bristol, UK.
Insights
Centralizing cleft services improved child self-confidence perceptions but did not significantly change parental satisfaction with care. Attending appointments remained similar for families.
Area of Science:
- Craniofacial medicine
- Pediatric surgery
- Healthcare services research
Background:
- Cleft lip and palate care requires multidisciplinary teams and coordinated services.
- Centralization of specialized healthcare services aims to improve outcomes and efficiency.
- Parental perceptions are crucial indicators of treatment success and satisfaction.
Purpose of the Study:
- To evaluate the impact of cleft service centralization on parental perceptions of child outcomes.
- To assess parental satisfaction with cleft care services post-centralization.
- To compare current parental perceptions with data from a previous study (CSAG) conducted 15 years prior.
Main Methods:
- A UK multicentre cross-sectional study (Cleft Care UK - CCUK) involving 5-year-olds with non-syndromic unilateral cleft lip and palate.
- Data collected via self-report questionnaires on child self-confidence and satisfaction with treatment and services.
- Comparison of CCUK data with findings from the 1998 Clinical Standards Advisory Group (CSAG) study.
Main Results:
- Fewer parents in the CCUK study perceived their children as having poor self-confidence (8%) compared to the CSAG study (19%).
- High parental satisfaction reported: 81% with facial features and 98% with overall care, similar to CSAG findings.
- Centralization did not adversely affect families' ability to attend appointments; attendance issues remained stable at around 30%.
Conclusions:
- Centralization of cleft services has positively impacted parental perceptions of certain child outcomes, notably self-confidence.
- Overall parental satisfaction with cleft care services remains high and was not significantly altered by centralization.
- Service centralization did not lead to increased difficulties for families in attending cleft clinic appointments.
Objectives:
To describe the impact of cleft service centralization on parental perceptions of child outcomes and satisfaction with care from the Cleft Care UK (CCUK) study and compare them to the Clinical Standards Advisory Group (CSAG) study that took place 15 years earlier.
Setting And Sample Population:
A subgroup of respondents from a UK multicentre cross-sectional study (CCUK) of 5-year-olds born with non-syndromic unilateral cleft lip and palate.
Materials And Methods:
Data on parents' perceptions of child self-confidence and their satisfaction with treatment outcomes and service provision were collected via self-report questionnaires. Data were compared with findings from the 1998 CSAG study.
Results:
Fewer parents in the CCUK study perceived their children as having poor self-confidence than in the 1998 CSAG study (8 and 19%, respectively). At least 81% of parents report satisfaction with the child's facial features after surgery and 98% report being satisfied with the care received. These results are similar to those reported in 1998. There is no evidence of an adverse impact on families' ability to attend appointments at the cleft clinic following centralization. Levels of reported problems (around 30%) with attendance were similar to those reported by CSAG.
Conclusion:
Centralization of cleft services appears to have improved parental perceptions of some child outcomes but has made little difference to already high levels of parental satisfaction with cleft care services. Centralization is not associated with an increase in the proportion of families who find it difficult to attend appointments.
