Publication: Body image perception in non-syndromic cleft lip and palate
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Date
2020
Authors
Jeffrey, Mohamad Jeremi
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Abstract
Introduction: Cleft lip and palate (CL/P) poses a dynamic anatomical and functional
challenges that spans across multiple medical disciplines. While best effort is put in
restoring normal appearance and function, the psychosocial impact of CL/P, specifically
towards body image and self-esteem is not routinely addressed in the typical multidisciplinary
team approach. This study aims to assess the body image perception and its
correlation to self-esteem in patients with CLP who has completed treatment for their
primary deformities.
Methodology: Non-syndromic CL/P patients who have completed treatment for primary
deformities fulfilling the study criteria were invited to participate in the study. Malaylanguage
translated and validated version of the Body Image Disturbance Questionnaire
(BIDQ) and the Rosenberg Self-Esteem Scale (RSES) were used for this study. Based on
distribution pattern of data gathered, Pearson’s correlation or Spearman’s rank-order
analysis were utilised to correlate between mean scores of the tools, meanwhile
differences between subgroups were evaluated using the one-way analysis of variance or
Kruskal-Wallis H test with post-hoc Dunn-Bonferroni test.
Result: There were 109 participants in this study comprising of 78% (n=85) Malays,
13.5% (n=15) Chinese, 7.3% (n=8) Indian and 0.9% (n=1) indigenous. Females made up
63.3% (n=69) of the participants while the remainder 36.5% (n=40) were males. The
average age of participants were 22.8 years old (SD 5.8). The mean BIDQ score of the
participants was 2.0 (SD 0.79), while the mean RSES score of the participants was 16.8
(SD 3.18). There was no statistically significant difference in the mean BIDQ scores
between participants with different types of CL/P (P>0.01). There was a moderate,
negative correlation between body image dissatisfaction and self-esteem (P<0.01).
Participants who cited nose and lips deformities had higher body image dissatisfaction
scores (P<0.1) than other participants.
Conclusion: This study demonstrated the presence of body image dissatisfaction among
patients with CL/P, and the degree of dissatisfaction does not differ between types of
CL/P. There is a moderate, negative correlation between body image dissatisfaction and
self-esteem. Secondary nasal and lip deformity are the common cause of body image
dissatisfaction in patients with CL/P. While the degree of dissatisfaction does not warrant
a routine psychological assessment, patients with CL/P should be offered counselling or
considered for psychological assessment while under treatment for CL/P. The
psychosocial perspective of the impact of CL/P must be considered during decision
making for further corrective surgery during advanced stage of treatment protocol.
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Keywords
body image , cleft lip , cleft palate