Browsing by Author "Brand, Bea-Mari"
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- ItemCleft lip and palate feeding intervention : a scoping review(Stellenbosch : Stellenbosch University, 2020-03) Brand, Bea-Mari; De Beer, Alida; Stellenbosch University. Faculty of Medicine and Health Sciences. Dept. of Health & Rehabilitation Sciences. Speech Language and Hearing Therapy.ENGLISH ABSTRACT : Background: Infants with cleft lip and palate (CLP) often suffer from feeding difficulties before surgical intervention. Speech therapists can provide different types of feeding intervention for this population. A scoping review was suggested to determine the evidence-based practice for feeding intervention in the CLP population. The research question for this scoping review was: What management strategies and associated outcomes are described in the research literature for feeding difficulties in the CLP population? Objectives: To summarize available literature on CLP feeding management strategies and their associated outcomes, as well as to identify gaps in the evidence base of feeding intervention in the CLP population. Methods: Arksey and O’Malley’s (2005) scoping review methodological framework was utilized and included all six stages of the framework. Inclusion criteria: Only articles published between 1990 and 2018 were included. The studies needed to be either published or translated into English or Afrikaans. The age range of the research participants was from newborn to six years of age. The primary diagnosis had to be cleft lip, cleft palate or CLP, which was not related to other syndromes. The articles had to include feeding intervention as well as an outcome for that intervention. Only primary research was included in this scoping review. Search strategy: The following Boolean search string was used to search through 5 databases: (“cleft lip and palate” OR “cleft lip” OR “cleft palate” OR craniofacial) AND (feeding OR swallowing OR breastfeeding OR dysphagia OR eating OR deglutition) AND (manage* OR rehabilitation OR treatment OR intervention OR therapy). Extraction of data: Screening measures first included the titles of the articles, then the abstracts, and finally, full-text reviews. The charting of the final selection of articles was grouped according to the following categories: title, authors, year of publication, location of the study, design, participants, timing of intervention, feeding intervention and associated outcomes. After the data was extracted from the articles, interviews were held with experienced speech therapists to determine their perceptions on the studied subject. Analysis of results: Thirty-one articles were included in this scoping review. The main feeding intervention themes included: caregiver training (43%), use of feeding utensils (40%), use of prostheses (14%) and alternative feeding (3%). The use of various modified bottles and teaching caregivers feeding strategies were some of the commonly reported strategies in the articles. Generally, positive outcomes were reported in the articles, such as weight gain. The interviewed speech therapists, however, prefer to use other interventions in their clinical practice compared to the feeding interventions reported in the research. Their clinical contexts had an influence on the type of feeding intervention prescribed for their patients. Conclusions: The results from the research and the perceptions of the therapists indicated a need for more evidence-based research within the South African and other low- and middle-income countries’ contexts, as most of the available research is from high-income countries. A recommendation for speech therapists in low- and middle-income countries is that they need to rely more on their clinical experience than the available research to provide evidence-based practice.