| 1. |
- Malmqvist, Carina, et al.
(författare)
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Simplified Postoperative Care After Spring-assisted Strip Craniotomy for Sagittal Synostosis: A Prospective Before-and-After Study.
- 2021
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Ingår i: The Journal of craniofacial surgery. - 1536-3732. ; 32:4, s. 1507-1510
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Tidskriftsartikel (refereegranskat)abstract
- Since the development of spring-assisted techniques for corrective craniofacial surgery, routine postoperative admission to intensive care units (ICUs) has been questioned. However, close monitoring is necessary if the continuous infusion of morphine is used as recommended for better pain relief. In this study, the authors evaluated a simplified postoperative protocol without continuous morphine infusion and no indwelling urinary catheter following spring-assisted surgery (SAS) for sagittal synostosis. Ten children were cared for according to a standard protocol with postoperative intravenous (i.v.) infusion of morphine and an indwelling urinary catheter, and 11 consecutive children were treated according to a simplified protocol with pain relief based on intermittent injections of morphine and clonidine [according to Face, Legs, Activity, Cry, Consolability (FLACC) scores >4] without the indwelling catheter. A Mann-Whitney U test was used for comparison of distributions between the two groups. The results revealed no differences between groups regarding the proportion of FLACC scores >4, total amount of administered i.v. morphine and clonidine, total volume of buffered glucose infused, time to first feeding on breast milk or substitute, or the length of stay. Despite the inherent limitations of our small observational study, the authors concluded that at our institution, it was possible to exclude a standard continuous i.v. infusion of morphine and an indwelling urinary catheter from our postoperative care protocol without decreasing the quality of pain relief in children submitted to SAS for sagittal synostosis. This finding supports downgrading the level of care from the ICU to a regular ward after limited immediate postoperative observation.
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| 2. |
- Paganini, Anna, 1979, et al.
(författare)
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A gender perspective on appearance-related concerns and its manifestations among persons born with unilateral cleft lip and palate
- 2021
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Ingår i: Psychology Health & Medicine. - : Informa UK Limited. - 1354-8506 .- 1465-3966. ; 26:6, s. 771-778
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Tidskriftsartikel (refereegranskat)abstract
- Cleft lip and palate (CLP) affects a person's facial appearance and can cause appearance-related distress. Appearance-related distress and its manifestations are not fully understood. Women with CLP tend to experience a higher degree of distress as well as undergo more aesthetic revisions than men. The aim of this study was to investigate if self-reported appearance-related gender differences occur among adults born with unilateral CLP using the Derriford Appearance Scale 24 (DAS24). One hundred sixty two consecutive patients, 107 men and 55 women, with unilateral CLP and no associated syndromes treated at the same hospital were asked to answer the DAS24. A mixed methods approach was used to analyse the questionnaires both quantitively and qualitatively. Fifty men and 30 women participated, the results showed that the aspects of appearance considered most disturbing was cleft-related among both genders, most common in regards to the nose. Three themes were found: acceptance, cleft features, and general appearance issues. The quantitative part showed that women reported higher appearance-related social anxiety and avoidance than men. This study demonstrated that appearance-related distress is present in both genders; however, women expressed more distress than men. Moreover, non-cleft as well as cleft features are of importance for self-reported dissatisfaction.
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| 3. |
- Paganini, Anna, 1979
(författare)
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Experiences of living with cleft lip and palate - a gender perspective
- 2021
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The primary aim of this thesis was to investigate the influence of gender on the CL/P population with regard to treatment, self-reported appearance, psychosocial adjustment, and subjective experiences. Study I, a retrospective chart review that investigated whether there were any gender differences in the number of esthetic surgical treatment received, found that women received more treatment than men. Studies II–III used the questionnaires DAS24, LOT-Rs, and Brief-COPE to investigate appearance-related distress as well as dispositional optimism and coping. Study II found that women reported higher appearance-related social anxiety and avoidance than men, and analysis showed that not only cleft features but general appearance issues caused distress. Study III showed that appearance-related distress among women was significantly correlated with several coping strategies as well as low levels of optimism, whereas in men it was found to be correlated with low levels of pessimism. Study IV was a qualitative interview study of young adults, and a content analysis of the interviews was conducted. The interviews revealed a group of generally well- adjusted young adults, but participants also described a duality where they felt both normal and at the same time different, and this feeling varied over time and in different situations. They all described the influence of gender norms. This thesis illuminates the need for gender awareness in the treatment and outcomes of CL/P .
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