Health-related Quality of Life in Cleft Lip and Palate Patients Post-cleft Surgery in Kenya

Abstract

Background: Oro-facial cleft deformities usually exact a significant disease burden on patients and their families. A patient’s emotions and social lives and their sense of self-worth may be impacted by several procedures, protracted supplementary therapies, and reduced cosmetic and physiological outcomes, lowering their Quality of Life. Using patient-centered measures such as the health-related quality of life (HRQoL) is crucial for estimating the true burden of a condition to an individual and determining patient outcomes of healthcare programs and interventions. This study aims to evaluate the health-related Quality of Life following cleft lip and/or palate surgery. Methodology: Using an analytical cross-sectional research study design, patients who underwent cleft lip and palate repair were recruited using the consecutive sampling approach. Patients were sourced from the database of operations conducted over 20 years since 2000. Data were collected on demographic and clinical factors as independent variables. Quality of life measurement was derived from the CLEFT-Q tool comprising questions on speech, psychological and social parameters. Data analysis was done by SPSS. The significance level for all tests was 5% (p<0.05). Tables, charts, and graphs were used to present the data. To examine categorical data, frequencies and percentages were used. The students’ T-tests and analysis of variance (ANOVA) was employed to examine the validity of the hypothesis for continuous variables. Multiple regression models were used to investigate predictors of health-related characteristics in multivariate analysis. Results: out of a possible 100, the average score by the 114 participants was 86 in the test assessing psychological function, 83.1 in the test assessing social function, and 79.86 in the test assessing for speech distress. Female participants scored lower than male participants in all parameters, however this was not significant. Participants over 18 years old scored higher than participants under 18, with the difference in social function being statistically significant (p=0.05). The highest scores were seen in participants with unilateral cleft lip deformities in all scales, while the lowest CLEFT-Q scores were seen in participants with bilateral cleft lip and palate deformities in all scales, with that of speech and social function being statistically significant (p=0.027 and p=0.044 respectively). Conclusion: This study demonstrates that the quality of life of female and younger patients who have undergone corrective cleft surgery is mostly affected by the psychosocial burden of this genetic defect. The demonstrated findings on psychosocial function as well as speech distress amongst patients with cleft lip and palate deformities provide insight into the mental aspects of the health condition which are often overlooked, and provide information on additional measures to be taken in order to improve the quality of life amongst patients with this genetic defect.