Effect Of A Continuous Nursing Intervention For Speech Disorder Patients With Cleft Palate Postoperativel

Cleft lip and palate is the most common congenital malformations of oral and maxillofacial. The patients with cleft lip and palate is the largest group of patients who need oral and maxillofacial surgery, plastic surgery. It is the focus in the field of oral and maxillofacial surgery of congenital disorders world wide. According to statistics, it is estimated that there are about 25,000 newborn associated with cleft lip and palate each year in China. Speech disorder is one of the main symptoms in cleft palate patients. Although surgery can close the palate through the cracks and restore the normal anatomy of its local structure. However, patients'speech disorders may exist even if their cleft palate deformity are repaired. There is 30%-50%of patients with varying degrees of speech disorder. It may bring the physiological and psychological negative effects to child patients, and may affects their quality of life. The evidence has shown the positive effects of speech therapy on speech function recovery in cleft palate patients after operation. In present, the speech therapy is a short-term intensive training program with a period of 20 days and 2 times of training a day. But the time period of this type of speech therapy is short for patients. There is not report found the systematic study related to psychological intervention in patients with cleft lip and palate. The study on the quality of life for patients with cleft palate is not found.ObjectiveExplore the effects of a continuous nursing intervention on speech function recovery for patients with speech disorder postoperative cleft palate, the psychological conditions, the quality of life.MethodsThe research design is a randomized controlled study design,80 cases of cleft palate speech disorders who meet the inclusion criteria were involved in this study since September 2008 to December 2009, the patients were randomly allocated into the intervention group (41 cases) and the control group (39 cases). For intervention group patients, they received a systematic, planned, targeted a period of 3 months continuous nursing intervention in cleft palate repair, and the routine nursing intervention. Patients in the control group just received the routin nursing intervention. Data of voice clarity, mental status of the groups of patients were collected using the Chinese Speech Intelligibility Test Words Form and SCL-90 at the time before the intervention, the end of the 1st month,2nd month, and 3id month of the intervention.The quality of life of two groups of patients were assessed at the time before the intervention, and the end of the 3id month of intervention.ResultsVoice clarity:compared with patients in the control group, patients in the study group shew a significant higher voice clarity score assessed at the end of the 1st month,2nd month, and 3id month of the intervention.Mental Status:the score of SCL-90 was no significant difference between the two groups in the end of 1st month of intervention. But the scores of the control group in the end of 2nd month, and 3id month were higher significantly than the score of the study group.The quality of life:The score of quality of life of study group was higher than the score of control group measured at the end of 3id of the intervention.ConclusionA continuum of care intervention designed for patients with cleft palate in this study can improve voice clarity,mental state, and quality of life of postoperative cleft palate. Therefore, a continuous integrated intervention program may contribute to the comprehensive rehabilitation of cleft palate patient.