Parental anxiety/incompliance and patients’ complications during COVID-19 pandemic regarding nasoalveolar molding treatment of infants with cleft lip/palate
Restricted accessResearch articleFirst published online June, 2024
Parental anxiety/incompliance and patients’ complications during COVID-19 pandemic regarding nasoalveolar molding treatment of infants with cleft lip/palate
The ideal time for nasoalveolar molding (NAM) of infants with cleft lip and/or palate (CLP) is the first weeks after birth. The burden and responsibility that this method of treatment imposes on parents may result in incompliance. The coronavirus (COVID-19) pandemic and the redirection of health resources can make the situation worse. Therefore, this study evaluated the anxiety, complications, and incompliance of parents undergoing NAM during the COVID-19 pandemic.
Materials and methods
Demographic data of 35 infants with CLP treated during the COVID-19 pandemic, compliance and level of anxiety of both parents in addition to their complications were reported. The association between different variables and incompliance was evaluated by simple and multiple logistic regressions. The level of significance was considered at P value less than 0.05.
Results
The highest level of parental anxiety related to the NAM process was the delay in ending the treatment. Meanwhile, the reason for the highest level of anxiety related to attending the treatment sessions was the probability of the infant's COVID-19 infection. Fathers expressed lower levels of anxiety than mothers, significantly. The most prevalent NAM complication was skin irritation. Parents of younger infants (≤28 days) and those with a history of COVID-19 infection were more compliant.
Conclusions
COVID-19 pandemic caused a significant increase in the level of anxiety in both parents, mainly due to the delay in treatment ending and the possibility of infant's infection. Moreover, considering the importance of treatment time, parents of younger infants were more compliant with the NAM process.
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References
1.
World Health Organization. WHO Director-General’s opening remarks at the media briefing on COVID-19-11 March 2020 Geneva, Switzerland: World Health Organization; 2020 [cited 2022 23 Aug]. Available from: https://www.who.int/director-general/speeches/detail/who-director-general-s-opening-remarks-at-the-media-briefing-on-covid-19---11-march-2020.
2.
AlFattaniAAlMeharishANasimMAlQahtaniKAlMudraaS. Ten public health strategies to control the COVID-19 pandemic: The Saudi experience. IJID Regions. 2021;1:12‐19. doi:https://doi.org/10.1016/j.ijregi.2021.09.003
3.
BrownNJWilsonBSzabadiS, et al.Ethical considerations and patient safety concerns for cancelling non-urgent surgeries during the COVID-19 pandemic: A review. Patient Saf Surg. 2021;15(1):19. doi:https://doi.org/10.1186/s13037-021-00293-7
4.
LignouSGreenwoodJSheehanMWolfeI. Changes in healthcare provision during COVID-19 and their impact on children with chronic illness: A scoping review. INQUIRY-J HEALTH CAR. 2022;59:00469580221081445. doi:https://doi.org/10.1177/00469580221081445
5.
MartelliDRColettaRDOliveiraEA, et al.Association between maternal smoking, gender, and cleft lip and palate. Braz J Otorhinolaryngol. 2015;81(5):514‐519. doi:https://doi.org/10.1016/j.bjorl.2015.07.011
6.
HuntOBurdenDHepperPJohnstonC. The psychosocial effects of cleft lip and palate: A systematic review. Eur J Orthod. 2005;27(3):274‐285. doi:https://doi.org/10.1093/ejo/cji004
7.
MillerCK. Feeding issues and interventions in infants and children with clefts and craniofacial syndromes. Semin Speech Lang. 2011;32(2):115‐126. doi:https://doi.org/10.1055/s-0031-1277714
8.
NagarajanRSavithaVHSubramaniyanB. Communication disorders in individuals with cleft lip and palate: An overview. Indian J Plast Surg. 2009;42(Suppl):137‐S143. doi:https://doi.org/10.4103/0970-0358.57199
9.
GraysonBHCuttingCWoodR. Preoperative columella lengthening in bilateral cleft lip and palate. Plast Reconstr Surg. Dec 1993;92(7):1422‐1423.
10.
GraysonBHShetyePR. Presurgical nasoalveolar moulding treatment in cleft lip and palate patients. Indian J Plast Surg. 2009;42(Suppl):56‐S61. doi:https://doi.org/10.4103/0970-0358.57188
11.
ShenCYaoCAMageeWChaiGZhangY. Presurgical nasoalveolar molding for cleft lip and palate: The application of digitally designed molds. Plast Reconstr Surg. 2015;135(6):1007e‐1015e. doi:https://doi.org/10.1097/prs.0000000000001286
12.
ChenYFLiaoYF. A modified nasoalveolar molding technique for correction of unilateral cleft nose deformity. J Craniomaxillofac Surg. 2015;43(10):2100‐2105. doi:https://doi.org/10.1016/j.jcms.2015.10.003
13.
SantiagoPEGraysonBHCuttingCBGianoutsosMPBrechtLEKwonSM. Reduced need for alveolar bone grafting by presurgical orthopedics and primary gingivoperiosteoplasty. Cleft Palate Craniofac J. 1998;35(1):77‐80. doi:https://doi.org/10.1597/1545-1569_1998_035_0077_rnfabg_2.3.co_2
14.
RubinMSCloustonSAhmedMM, et al.Assessment of presurgical clefts and predicted surgical outcome in patients treated with and without nasoalveolar molding. J Craniofac Surg. 2015;26(1):71‐75. doi:https://doi.org/10.1097/scs.0000000000001233
15.
BanariASDatanaSAgarwalSSBhandariSK. Does presurgical nasoalveolar molding have a long-term effect on nasal and upper airway dimensions?Cleft Palate Craniofac J. 2021;58(10):1257‐1264. doi:https://doi.org/10.1177/1055665620980234
AlfonsoARRamlyEPKantarRS, et al.What is the burden of care of nasoalveolar molding?Cleft Palate Craniofac J. 2020;57(9):1078‐1092. doi:https://doi.org/10.1177/1055665620929224
18.
AttiguppePRKarunaYMYavagalC, et al.Presurgical nasoalveolar molding: A boon to facilitate the surgical repair in infants with cleft lip and palate. Contemp Clin Dent. 2016;7(4):569‐573. doi:https://doi.org/10.4103/0976-237X.194104
19.
BruceMKPfaffMJAnstadtEELoseeJEGoldsteinJA. The impact of the COVID-19 pandemic on cleft care. Plast Reconstr Surg - Glob. 2021;9(4):e3587‐e3587. doi:https://doi.org/10.1097/GOX.0000000000003587
Rey-BelletCHohlfeldJ. Prenatal diagnosis of facial clefts: Evaluation of a specialised counselling. Swiss Med Wkly. 2004;134(43-44):640‐644.
22.
GrollemundBDissauxCGavelleP, et al.The impact of having a baby with cleft lip and palate on parents and on parent-baby relationship: The first French prospective multicentre study. BMC Pediatr. 2020;20(1):230‐230. doi:https://doi.org/10.1186/s12887-020-02118-5
23.
Levy-BercowskiDAbreuADeLeonE, et al.Complications and solutions in presurgical nasoalveolar molding therapy. Cleft Palate Craniofac J. 2009;46(5):521‐528. doi:https://doi.org/10.1597/07-236.1
24.
NelsonPAKirkSACaressALGlennyAM. Parents’ emotional and social experiences of caring for a child through cleft treatment. Qual Health Res. 2012;22(3):346‐359. doi:https://doi.org/10.1177/1049732311421178
25.
SischoLBroderHLPhillipsC. Coping with cleft: A conceptual framework of caregiver responses to nasoalveolar molding. Cleft Palate Craniofac J. 2015;52(6):640‐650. doi:https://doi.org/10.1597/14-113
26.
NamdarPPourasgharMLal AlizadehFShivaA. Anxiety, depression, and quality of life in caregivers of children with cleft lip and palate: A systematic review. Systematic review. Iran J Psychiatry Behav Sci. 2022;16(2):e113591. doi:https://doi.org/10.5812/ijpbs-113591
27.
ProkopowiczAStanczykiewiczBUchmanowiczI. Validation of the numerical anxiety rating scale in postpartum females: A prospective observational study. Ginekol Pol. 2022;93(9):686‐694. doi:https://doi.org/10.5603/GP.a2021.0197
28.
DaveyHMBarrattALButowPNDeeksJJ. A one-item question with a Likert or visual analog scale adequately measured current anxiety. J Clin Epidemiol. 2007;60(4):356‐360. doi:https://doi.org/10.1016/j.jclinepi.2006.07.015
29.
BinDhimNShamanAAlhawassiT. Confirming The One-Item Question Likert Scale To Measure Anxiety. Internet J Epidemiology. 2013;11:2.
30.
ShahroudiASodagarAShamshiriARahimpourSSamimiSM. Concerns and Problems of Orthodontic Patients During the COVID-19 Pandemic. Front Dent. 2022;19:18. doi:https://doi.org/10.18502/fid.v19i18.9964
31.
van den HeuvelMIVacaruSVBoekhorstMGBM, et al.Parents of young infants report poor mental health and more insensitive parenting during the first COVID-19 lockdown. BMC Pregnancy Childbirth. 2022;22(1):302. doi:https://doi.org/10.1186/s12884-022-04618-x
32.
JohnsonMSSkjerdingstadNEbrahimiOVHoffartAJohnsonSU. Parenting in a pandemic: Parental stress, anxiety and depression among parents during the government-initiated physical distancing measures following the first wave of COVID-19. Stress Health. 2021;38(4):637‐652. https://doi.org/10.1002/smi.3120
33.
OsawaIGotoTAsamiY, et al.Physician visits and medication prescriptions for major chronic diseases during the COVID-19 pandemic in Japan: Retrospective cohort study. BMJ open. 2021;11(7):e050938. doi:https://doi.org/10.1136/bmjopen-2021-050938
34.
MaedaTNishiTHaradaM, et al.Influence of the COVID-19 pandemic on regular clinic visits and medication prescriptions among people with diabetes: Retrospective cohort analysis of health care claims. Medicine (Baltimore).2022;101(29):e29458. doi:https://doi.org/10.1097/md.0000000000029458
35.
SalasJHinyardLCappellariA, et al.Infant, pediatric and adult well visit trends before and during the COVID-19 pandemic: A retrospective cohort study. BioMed Central. 2022;22(1):328. doi:https://doi.org/10.1186/s12913-022-07719-7
36.
SinghKKondalDMohanS, et al.Health, psychosocial, and economic impacts of the COVID-19 pandemic on people with chronic conditions in India: A mixed methods study. BMC Public Health. 2021;21(1):685. doi:https://doi.org/10.1186/s12889-021-10708-w
37.
WautersAVervoortTDhondtK, et al.Mental health outcomes among parents of children with a chronic disease during the COVID-19 pandemic: The role of parental burn-out. J Pediatr Psychol. 2022;47(4):420‐431. doi:https://doi.org/10.1093/jpepsy/jsab129
38.
YantziNRosenbergMWBurkeSOHarrisonMB. The impacts of distance to hospital on families with a child with a chronic condition. Soc Sci Med. 2001;52(12):1777‐1791. doi:https://doi.org/10.1016/s0277-9536(00)00297-5
39.
ShanbhagGPandeySMehtaNKiniYKiniA. A virtual noninvasive way of constructing a nasoalveolar molding plate for cleft babies, using intraoral scanners, CAD, and prosthetic milling. Cleft Palate Craniofac J. Feb 2020;57(2):263‐266. doi:https://doi.org/10.1177/1055665619886476
40.
Mohammadian KhonsariNShafieeGZandifarA, et al.Comparison of psychological symptoms between infected and non-infected COVID-19 health care workers. BMC Psychiatry. 2021;21(1):170. doi:https://doi.org/10.1186/s12888-021-03173-7
41.
RothMLonicDGrillFD, et al.NAM-help or burden? Intercultural evaluation of parental stress caused by nasoalveolar molding: A retrospective multi-center study. Clin Oral Investig. 2021;25(9):5421‐5430. doi:https://doi.org/10.1007/s00784-021-03850-7
42.
Abd El-GhafourMElkordySAFayedMMSEl-BeialyAREidFHK. Parents’ acceptance to alveolar and nasoalveolar molding appliances during early cleft lip and palate care: A call for high-quality research. Open Access Maced J Med Sci. 2020;8(F):58‐64. doi:https://doi.org/10.3889/oamjms.2020.3856
