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1.
Int. j. pediatr. otorhinolaryngol ; 131: 1-29, Apr., 2020. ilus.
Artículo en Inglés | Sec. Est. Saúde SP, SESSP-IDPCPROD, Sec. Est. Saúde SP | ID: biblio-1052848

RESUMEN

OBJECTIVE: To characterize the eating behavior, orofacial, speech myofunctional conditions, and facial temperature of children with congenital heart disease. METHOD: This is a cross-sectional and analytical study. The sample consisted of 30 children with heart disease (cyanotic or acyanotic; mean of 5.48 ± 0.84 years old) and 28 healthy children (4.98 ± 0.64 years old). Parents were given a questionnaire to assess eating behaviors (Montreal Children's Hospital Feeding Scale). The orofacial myofunctional assessment protocol (OMES-E), the Child Language Test (ABFW), and thermography infrared of facial temperature were used. Data analysis was conducted by student's t-tests, Chi-square, logistic regression, and correlation analysis. RESULTS: Eating behavior in Parents did not perceive eating behavior differences between the heart disease and control groups. However, the percentage of children with some feeding difficulty was higher in the heart disease group. There was a difference between groups regarding the appearance and posture of structures, the mobility of the mandibular and cheek, swallowing function, and the total function score. Thermographic variables did not differ between the groups, but better performance in orofacial functions correlated with the temperature of the labial commissure and lower lip points. CONCLUSIONS: The frequency of children with eating difficulties was higher among those with congenital heart disease, as was the increased facial temperature at the medial eyelid commission point when submitted to interventional procedures. The orofacial myofunctional aspects showed changes in posture and position, mobility, and orofacial functions among children with heart disease as compared to the control group. There was a correlation between the temperature of the thermo-anatomical points of the labial commissure and the lower lip as well as the OMES-E function score. (AU)


Asunto(s)
Logoterapia , Sistema Estomatognático , Termografía , Conducta Alimentaria
3.
Dev Med Child Neurol ; 62(1): 140-146, 2020 01.
Artículo en Inglés | MEDLINE | ID: mdl-31353456

RESUMEN

AIM: To explore the relationship between rehabilitation therapies and development in children with cerebral palsy (CP). METHOD: We conducted a prospective, longitudinal study involving 656 children with CP (mean age [SD] 6y [2y 8mo] at study entry; 1y 6mo-11y 11mo; 287 females, 369 males), and their parents. Children were assessed two to five times over 2 years by therapists using standardized measures of balance and walking endurance. Parents completed questionnaires on demographics, rehabilitation therapies, and their children's performance in self-care and participation in recreation. Therapists and parents collaboratively classified children's Gross Motor Function Classification System (GMFCS) levels. We created longitudinal graphs for each GMFCS level, depicting change across time using centiles. Using multinomial models, we analyzed the relationship between therapies (amount, focus, family-centeredness, and the extent therapies met children's needs) and whether change in balance, walking endurance, and participation was 'more than' and 'less than' the reference of 'as expected'. RESULTS: Children were more likely to progress 'more than expected' when participating in recreation when therapies were family-centered, met children's needs, and focused on structured play/recreation. A focus on health and well-being was positively associated with participation and self-care. The amount of therapy did not predict outcomes. INTERPRETATION: Therapy services that are family-centered, consider the needs of the child, and focus on structured play/recreational activities and health/well-being may enhance the development of children with CP. WHAT THIS PAPER ADDS: Family-centered rehabilitation therapies were positively associated with greater participation in family/recreation activities and walking endurance. Parental perception that rehabilitation therapies met children's needs was associated with greater participation in family/recreation activities. Structured play, recreational activities, and health/well-being are important for self-care and participation when planning rehabilitation therapy. The amount of rehabilitation therapy was not related to developmental outcomes.


Asunto(s)
Parálisis Cerebral/rehabilitación , Familia , Terapia Ocupacional , Satisfacción del Paciente , Modalidades de Fisioterapia , Terapia Recreativa , Logoterapia , Niño , Preescolar , Femenino , Humanos , Lactante , Estudios Longitudinales , Masculino , Índice de Severidad de la Enfermedad
4.
Zh Nevrol Psikhiatr Im S S Korsakova ; 119(8. Vyp. 2): 90-94, 2019.
Artículo en Ruso | MEDLINE | ID: mdl-31825368

RESUMEN

AIM: To determine the dependence of speech recovery on the type of aphasia in patients with acute ischemic stroke in the carotid territory. MATERIAL AND METHODS: Three hundred and fifty-one patients, aged 61 [55; 72] years, with ischemic stroke were examined. The degree of speech recovery was characterized by an increase in the score on the Speech Questionnaire (SQ) on the 21st day from the beginning of the disease compared to baseline. Patients were divided into 2 groups: low (ΔSQ ≤6) and high (ΔSQ >6) recovery. Speech disorders were represented by motor, sensorimotor and subcortical aphasia. RESULTS: The group ΔSQ ≤6 was dominated by patients with sensorimotor aphasia (n=141, (76,6%)). In the ΔSQ >6 group, motor aphasia was more frequent (119 people (71.3%)), sensorimotor aphasia was observed in 48 patients (28.7%) (p=0.0001). Patients of the group with the worst speech restoration more often had cortical aphasia (n=108; 73.0%), and patients with subcortical aphasia slightly prevailed in the group with the best recovery: 40 (27.0%) in group I and 57 (47.5%) in group II (p=0.001). CONCLUSION: Motor aphasia and subcortical aphasia are associated with good recovery of speech function in the acute period of ischemic stroke.


Asunto(s)
Afasia , Isquemia Encefálica , Logoterapia , Rehabilitación de Accidente Cerebrovascular , Accidente Cerebrovascular , Anciano , Humanos , Habla , Accidente Cerebrovascular/complicaciones
5.
Zh Nevrol Psikhiatr Im S S Korsakova ; 119(9. Vyp. 2): 32-36, 2019.
Artículo en Ruso | MEDLINE | ID: mdl-31825387

RESUMEN

Speech disorders are widely spread in patients with Parkinson's disease, and these symptoms are only getting worse as the disease progresses. Nevertheless, only a few percent of the population have an access to an adequate and qualified care. This review describes the pathophysiology of parkinsonian speech disorders, methods of diagnostics and monitoring and treatment modalities, which include pharmacotherapy, speech therapy and surgical approaches. The authors believe that treatment of parkinsonism-related speech disorder is an integral part of a multidisciplinary patient care.


Asunto(s)
Enfermedad de Parkinson , Trastornos del Habla , Disartria , Humanos , Enfermedad de Parkinson/complicaciones , Trastornos del Habla/etiología , Trastornos del Habla/terapia , Logoterapia
7.
BMJ ; 367: l4962, 2019 11 04.
Artículo en Inglés | MEDLINE | ID: mdl-31685480

RESUMEN

The studyEveritt H, Landau G, Little P. Therapist telephone-delivered CBT and web-based CBT compared with treatment as usual in refractory irritable bowel syndrome: the ACTIB three-arm RCT. Health Technol Assess 2019;23:1-154.This project was funded by the NIHR Health Technology Assessment Programme (project number 11/69/02).To read the full NIHR Signal, go to https://discover.dc.nihr.ac.uk/content/signal-000784/irritable-bowel-syndrome-helped-by-telephone-or-internet-cbt.


Asunto(s)
Síndrome del Colon Irritable , Humanos , Internet , Logoterapia , Evaluación de la Tecnología Biomédica , Teléfono
8.
Codas ; 31(5): e20180274, 2019.
Artículo en Portugués, Inglés | MEDLINE | ID: mdl-31721913

RESUMEN

PURPOSE: To verify the effect of dog intervention on the regular session of speech therapy for developmental stuttering in adults. METHODS: The study involved young adults and adults with developmental stuttering. The study sample was composed of eight participants, six males and two females, ranging in age from 16 to 45 years. Participants were divided into two groups: G1 - those who underwent treatment for stuttering with the presence of a dog-therapist in the therapy room and G2 - those who underwent treatment for stuttering without the presence of the dog therapist. We included a control group, G3, composed of fluent participants, matched in age and sex to G1 and G2 to control the natural variability of speech fluency. RESULTS: Comparative results between the groups indicated that the group that performed the treatment without the presence of the dog achieved better performance, evolution and efficacy rates. CONCLUSION: for the population in this study, the dog intervention on speech therapy did not improve treatment.


Asunto(s)
Terapia Asistida por Animales/métodos , Logoterapia/métodos , Tartamudeo/terapia , Adolescente , Adulto , Animales , Perros , Femenino , Humanos , Masculino , Persona de Mediana Edad , Proyectos Piloto , Adulto Joven
9.
Nervenarzt ; 90(12): 1279-1291, 2019 Dec.
Artículo en Alemán | MEDLINE | ID: mdl-31776592

RESUMEN

Due to their high prevalence, Parkinson's syndromes are exemplary geriatric syndromes. In addition to idiopathic Parkinson's disease, drug-induced and vascular Parkinson's syndromes are especially relevant in older age. A comprehensive anamnesis, thorough clinical neurological examination and rational additional diagnostics ensure the correct differential diagnostic classification. The multidimensional geriatric assessment is used to quantify the syndrome-specific ability impairments. The primary therapeutic objective in old age is the preservation of everyday competences. Drug treatment is centered around L­dopa because of its favorable effect-side effect ratio. In cases of motor fluctuations, entacapone, opicapone or safinamide can be added, whereas dopamine agonists are generally unsuitable. Rivastigmine is indicated in mild to moderate Parkinson's dementia and furthermore can possibly improve gait stability. Speech therapy, as well as physical and occupational therapy, including the Parkinson's disease-specific Lee Silverman voice treatment are indispensable components of the multiprofessional treatment concept.


Asunto(s)
Enfermedad de Parkinson , Anciano , Alemania/epidemiología , Humanos , Levodopa , Enfermedad de Parkinson/diagnóstico , Enfermedad de Parkinson/epidemiología , Enfermedad de Parkinson/terapia , Logoterapia , Síndrome
10.
Codas ; 32(1): e20180306, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-31664312

RESUMEN

PURPOSE: Search for reliability and validity evidence for the Montreal Communication Evaluation Brief Battery (MEC B) for adults with right brain damage. METHODS: Three hundred twenty-four healthy adults and 26 adults with right brain damage, aged 19-75 years, with two or more years of education were evaluated with MEC B. The MEC B Battery contains nine tasks that aim to evaluate communicative abilities as discourse, prosody, lexical-semantic and pragmatic process. Two sources of reliability evidence were used: internal consistency (Cronbach's alpha) and interrater reliability. Construct validity was evaluated comparing the Montreal Communication Evaluation Battery (MEC), expanded version and MEC B tasks. RESULTS: Internal consistence was satisfactory and the interrater reliability was considered excellent, as were correlations between MEC Battery and MEC B Battery tasks. CONCLUSION: The MEC B Battery showed satisfactory reliability and validity evidences. It can be used as outcome measure of intervention programs and assist speech therapists to plan rehabilitation programs.


Asunto(s)
Lesiones Encefálicas/fisiopatología , Trastornos de la Comunicación/diagnóstico , Pruebas Neuropsicológicas/estadística & datos numéricos , Adulto , Anciano , Brasil , Estudios de Casos y Controles , Femenino , Humanos , Masculino , Persona de Mediana Edad , Reproducibilidad de los Resultados , Logoterapia/métodos
11.
Codas ; 31(5): e20190004, 2019.
Artículo en Portugués, Inglés | MEDLINE | ID: mdl-31664371

RESUMEN

PURPOSE: To review the Speech-Language Pathology literature studies from the epidemiology and causality perspective. RESEARCH STRATEGIES: A national and international literature survey was carried out with searches from PubMed, SciELO and gray literature bases, conducted according to the instructions of the Cochrane Collaboration and published until January 9th, 2019. The review guiding question asks if Speech-Language Pathology uses methods in their evidence to infer causality. SELECTION CRITERIA: All studies that presented a causal epidemiological approach in speech therapy were included, as well as excluded those that did not present an appropriate methodological approach for cause and effect analysis. DATA ANALYSIS: Two authors of this study independently reviewed all citations. A priori determined form was used to extract the following data: author, year of publication, country of origin, theoretical conception, application or not of the study and central discussion addressed in the article. RESULTS: From the search performed 3842 articles were found. However, none of them investigated their outcomes from the causality point of view, not allowing cause and effect inference. CONCLUSION: There is a shortage of studies that evidence causality in Speech-Language Pathology, which may alter the effectiveness and reliable handling of diagnosis and speech-language therapy, since it is still based on association and not on cause and effect based on studies designed to that.


Asunto(s)
Trastornos del Habla/epidemiología , Trastornos del Habla/etiología , Patología del Habla y Lenguaje , Causalidad , Métodos Epidemiológicos , Humanos , Logoterapia
12.
Curr Med Sci ; 39(5): 810-815, 2019 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-31612400

RESUMEN

Total laryngectomy affects the speaking functions of many patients. Speech deprivation has great impacts on the quality of life of patients, especially on self-efficacy. Learning esophageal speech represents a way to help laryngectomees speak again. The purpose of this study was to determine the influence of collective esophageal speech training on self-efficacy of laryngectomees. In this study, 28 patients and 30 family members were included. The participants received information about training via telephone or a WeChat group. Collective esophageal speech training was used to educate laryngectomees on esophageal speech. Before and after collective esophageal speech training, all participants completed the General Self-Efficacy Scale (GSES) to assess their perceptions on self-efficacy. Through the training, laryngectomees recovered their speech. After the training, the self-efficacy scores of laryngectomees were higher than those before the training, with significant differences noted (T<0.05). However, family members' scores did not change significantly. In conclusion, collective esophageal speech training is not only convenient and economical, but also improves self-efficacy and confidence of laryngectomees. Greater self-efficacy is helpful for laryngectomees to master esophageal speech and improve their quality of life. In addition, more attention should be focused on improving the self-efficacy of family members and making them give full play to their talent and potential on laryngectomees' voice rehabilitation.


Asunto(s)
Laringectomía/rehabilitación , Psicoterapia de Grupo/métodos , Autoeficacia , Logoterapia/métodos , Voz Esofágica/métodos , Familia/psicología , Femenino , Humanos , Lenguaje , Neoplasias Laríngeas/patología , Neoplasias Laríngeas/cirugía , Laringe/patología , Laringe/cirugía , Masculino , Persona de Mediana Edad , Calidad de Vida/psicología , Voz Esofágica/psicología , Encuestas y Cuestionarios , Resultado del Tratamiento
13.
Prensa méd. argent ; 105(9 especial): 628-633, oct 2019.
Artículo en Inglés | LILACS, BINACIS | ID: biblio-1046836

RESUMEN

The article reveals the features of the study and development of the tempo-rhythmic speech components of children with disabilities as exemplified by preschool children with a stutter. The article describes the course and methods of an ascertaining experiment to identify the initial state of the tempo-rhythmic speech components of children with stuttering. Games and tasks, with the help which it is possible to determine the state of the tempo and rhythm of children's speech, are offered and the obtained results are described. The stages of correctional work with children on the development of the tempo-rhythmic speech components of children with stuttering are given.


Asunto(s)
Humanos , Preescolar , Niño , Habla , Logoterapia/métodos , Tartamudeo/etiología , Tiempo , Métodos Epidemiológicos , Niños con Discapacidad/rehabilitación , Juegos Experimentales
14.
Int J Pediatr Otorhinolaryngol ; 126: 109631, 2019 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-31445481

RESUMEN

OBJECTIVE: Although various studies have depicted the importance of language intervention programs in facilitating language acquisition in cochlear implanted children, to this date rarely has a specific language intervention approach been recommended as better than the other and no best practice has been introduced in terms of language acquisition outcomes. Thus, the therapists remain uncertain as to which approach to follow and how to apply evidence to practice. Hence, the main goal of this study was to take a step in this regard by comparing the communication development of pediatric cochlear implant users who enrolled in two different language intervention approaches: the routine auditory-verbal approach, and the routine auditory-verbal approach plus a new intervention protocol specifically designed to enhance receptive vocabulary development in cochlear implanted children. METHOD AND MATERIALS: This prospective experimental study compared the receptive and expressive communication developmental scores of 26 cochlear implanted 20-24 months old children who received both a routine auditory-verbal intervention and a new cognitive based intervention protocol specifically designed to enhance receptive vocabulary development, with that of a group of 25 participants whose intervention program was only auditory-verbal. The children were recruited from Fars cochlear implant center situated in the city of Shiraz in Iran, and were assigned randomly to the two groups. The communication development of both groups was evaluated by the Bayley scales of Infant and Toddler Development- Third Edition, and statistical analysis was performed using the Statistical Package for Social Sciences-version 21(SPSS-21). RESULTS: The two groups were not significantly different in terms of age, sex and parents' educational level. Both the receptive and expressive communication outcomes of the children who received auditory-verbal as well as the new specifically-designed cognitive-based intervention protocol focusing on receptive vocabulary enhancement, were significantly higher than the control group (p < 0.001). CONCLUSION: The new specifically-designed cognitive-based language intervention protocol focusing on receptive vocabulary enhancement was significantly more effective in promoting and enhancing the communication development of cochlear implanted children than the routine auditory-verbal intervention.


Asunto(s)
Implantes Cocleares , Sordera/rehabilitación , Terapia del Lenguaje , Logoterapia , Vocabulario , Preescolar , Corrección de Deficiencia Auditiva/métodos , Sordera/cirugía , Femenino , Humanos , Lactante , Desarrollo del Lenguaje , Masculino , Estudios Prospectivos
15.
Int J Pediatr Otorhinolaryngol ; 126: 109635, 2019 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-31421357

RESUMEN

OBJECTIVE: To determine and describe parent-perceived challenges related to the pediatric cochlear implantation process and support services received. METHOD: A multicenter survey study across six cochlear implant (CI) programs in South Africa (SA) was conducted. The study sample included 82 parents of pediatric (≤18 years) CI recipients with at least 12 months CI experience. A self-administered questionnaire was developed for the purpose of this study, exploring parental challenges regarding the CI process, education of their implanted children and the support services received. RESULTS: The financial implications of cochlear implantation, including CI device maintenance, were identified by parents as the most prominent challenge. Financing issues were the highest scoring reason that attributed to the delay between diagnosis of hearing loss and cochlear implantation, as well as the greatest barrier to bilateral implantation. Parent-perceived educational challenges included finding adequate educational settings specific to the individual needs of their child and a shortage of trained teachers equipped to support children with CIs. The presence of one/more additional developmental conditions and grade repetition were associated with more pronounced parent-perceived educational challenges. Parents considered speech-language therapy as the most critical support service for their implanted children to achieve optimal outcomes, while parent guidance was indicated to be the most critical support service required for parents of pediatric CI recipients. CONCLUSION: A greater understanding of parent-perceived challenges will guide CI professionals to promote optimal outcomes, evidence-based service delivery and on-going support to pediatric CI recipients and their families. Study results imply a call for action regarding financial and educational support for pediatric CI recipients in SA.


Asunto(s)
Implantación Coclear , Evaluación de Necesidades , Padres , Niño , Preescolar , Implantación Coclear/economía , Educación de Personas con Discapacidad Auditiva , Femenino , Humanos , Lactante , Terapia del Lenguaje , Masculino , Sudáfrica , Logoterapia , Encuestas y Cuestionarios
16.
Behav Modif ; 43(6): 898-932, 2019 11.
Artículo en Inglés | MEDLINE | ID: mdl-31422681

RESUMEN

This study used a multiple baseline, single-subject research design to investigate the efficacy of an iPad®-based speech-generating device (SGD). The iPad was equipped with the SPEAKall!® application to function as a SGD. SGDs are a form of aided augmentative and alternative communication (AAC) allowing a user to communicate using digitized and/or synthesized speech. Instruction followed a modified version of the intervention phases from the Picture Exchange Communication System (PECS). This modified PECS protocol was implemented with two adolescents and one young adult between the ages of 14 and 23. All three participants were diagnosed with severe autism spectrum disorder and little to no functional speech. Dependent measures included the ability to request for edible and tangible items as the primary measure, and the ability to engage in natural speech production as an ancillary measure to determine simultaneous, additive effects on speech acquisition. Results indicated increases in requesting behaviors for all three participants across intervention and maintenance phases. Once participants mastered requesting of edible items, they were able to generalize the skill to tangible items. However, mixed results were found when targeting natural speech production. Based on the current findings, the infusion of an iPad-based SGD into PECS instruction may be effective in increasing initial requesting skills; however, a facilitative effect on increasing speech acquisition cannot necessarily be expected for every participant.


Asunto(s)
Trastorno del Espectro Autista/terapia , Equipos de Comunicación para Personas con Discapacidad , Trastornos de la Comunicación/terapia , Computadores de Bolsillo , Logoterapia/instrumentación , Logoterapia/métodos , Adolescente , Trastorno del Espectro Autista/complicaciones , Trastornos de la Comunicación/complicaciones , Humanos , Masculino , Adulto Joven
17.
Biomed Res Int ; 2019: 4589056, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-31467892

RESUMEN

Objective: To evaluate and compare the effects of repetitive transcranial magnetic stimulation (rTMS) over the right pars triangularis of the posterior inferior frontal gyrus (pIFG) and the right posterior superior temporal gyrus (pSMG) in global aphasia following subacute stroke. Methods: Fifty-four patients with subacute poststroke global aphasia were randomized to 15-day protocols of 20-minute inhibitory 1 Hz rTMS over either the right triangular part of the pIFG (the rTMS-b group) or the right pSTG (the rTMS-w group) or to sham stimulation, followed by 30 minutes of speech and language therapy. Language outcomes were assessed by aphasia quotient (AQ) scores obtained from the Chinese version of the Western Aphasia Battery (WAB) at baseline and immediately after 3 weeks (15 days) of experimental treatment. Results: Forty-five patients completed the entire study. The primary outcome measures include the changes in WAB-AQ score, spontaneous speech, auditory comprehension, and repetition. These measures indicated significant main effect between the baseline of the rTMS-w, rTMS-b, and sham groups and immediately after stimulation (P<0.05). Compared with the sham group, the increases were significant for auditory comprehension, repetition, and AQ in the rTMS-w group (P<0.05), whereas the changes in repetition, spontaneous speech, and AQ tended to be higher in the rTMS-b group (P<0.05). Conclusions: Inhibitory rTMS targeting the right pIFG and pSTG can be an effective treatment for subacute stroke patients with global aphasia. The effect of rTMS may depend on the stimulation site. Low-frequency rTMS inhibited the right pSTG and significantly improved language recovery in terms of auditory comprehension and repetition, whereas LF-rTMS inhibited the right pIFG, leading to apparent changes in spontaneous speech and repetition.


Asunto(s)
Afasia/terapia , Accidente Cerebrovascular/terapia , Lóbulo Temporal/fisiopatología , Estimulación Magnética Transcraneal , Anciano , Afasia/complicaciones , Afasia/fisiopatología , Femenino , Humanos , Lenguaje , Masculino , Persona de Mediana Edad , Habla/efectos de la radiación , Logoterapia/métodos , Accidente Cerebrovascular/complicaciones , Accidente Cerebrovascular/fisiopatología , Rehabilitación de Accidente Cerebrovascular , Lóbulo Temporal/efectos de la radiación , Resultado del Tratamiento
18.
Behav Modif ; 43(6): 767-773, 2019 11.
Artículo en Inglés | MEDLINE | ID: mdl-31469004

RESUMEN

Individuals with complex communication needs are likely to experience considerable difficulties and challenges with everyday communication interactions due to limited use and understanding of natural speech. In this editorial, we review the nature of complex communication needs, describe the wide range of individuals who may experience such needs, and provide a brief history of behavioral approaches to addressing these needs. We also highlight the six papers in this special issue that contribute to the further understanding of the use of behavioral intervention approaches for addressing complex communication needs. These papers include one conceptual overview of aided augmentative and alternative communication (AAC) interventions for individuals with complex communication needs, four intervention studies addressing a range of communicative topographies (i.e., vocal speech, AAC, and a social messaging app), and one systematic review examining interventions that promote communicative response variability. These six papers highlight the diversity of complex communication needs and emphasize the importance of examining the efficacy of a wide range of individualized behavioral approaches that are matched to specific needs and goals.


Asunto(s)
Trastornos de la Comunicación/terapia , Logoterapia/métodos , Humanos
20.
S Afr Med J ; 109(6): 426-430, 2019 May 31.
Artículo en Inglés | MEDLINE | ID: mdl-31266562

RESUMEN

BACKGROUND: Cleft lip and/or palate (CLP) is the most common congenital anomaly of the craniofacial complex, with an estimated worldwide prevalence of 1/500 - 700 live births. Affected children require immediate medical treatment and prolonged management by a multidisciplinary team of health professionals. OBJECTIVES: To describe and compare healthcare provision to individuals with CLP at specialised care centres in South Africa (SA). METHODS: The study was conducted at all CLP care centres in 6 of SA's 9 provinces that provide specialised treatment and care to individuals with CLP. At each centre, the team leader was interviewed using a semi-structured questionnaire that focused on the point-of-care entry for CLP patients; type of services provided; whether treatment protocols were used, which treatment protocols were used and internal referral systems; and members of the healthcare team. Stata 13 (StataCorp., USA) was used to analyse the data. RESULTS: Eleven CLP team leaders participated in the study, of whom 5 were from Gauteng Province. The point-of-care for CLP patients in the majority of centres was plastic surgery (n=9/11; 81.8%). The majority of centres (n=10/11; 90.9%) followed similar treatment protocols and only 1 centre performed lip surgery at 12 - 18 months. Although all centres reported a multidisciplinary team approach for CLP care provision, there were gaps in the health professions categories, which influenced the type of treatment provided. Hence, surgical repair of the lip and palate (n=10/11; 90.9%) and speech therapy (n=7/11; 63.6%) dominated the type of treatment provided, and patients were referred to other provinces or to the private health sector for other types of treatment. CONCLUSIONS: The gaps in services at the CLP care centres in SA need to be addressed to ensure integrated, holistic care provision.


Asunto(s)
Labio Leporino/terapia , Fisura del Paladar/terapia , Procedimientos Quirúrgicos Reconstructivos , Logoterapia , Centros Médicos Académicos , Injerto de Hueso Alveolar , Asesoramiento Genético , Humanos , Ortodoncia , Grupo de Atención al Paciente , Pautas de la Práctica en Medicina , Derivación y Consulta , Sudáfrica , Cirugía Bucal , Cirugía Plástica
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