Studying the Impact of Cleft of Lip and Palate among Adults Using the International Classification of Functioning, Disability and Health Framework

Abstract

Objectives: The study was conducted to document the impact of the cleft of lip and palate among adults using International Classification of Functioning, Disability and Health (ICF) framework. Design: This was a cross-sectional study. Participants: A total of 32 adults with cleft lip and palate (CLP) and a matched control group of 32 adults without CLP (non-CLP [NCLP]) were included in the study. Methods: To identify a set of items from ICF framework that is relevant to adults with CLP (ICF-CLP item set) from the components of activity participation and environmental factors. Two expert teams were involved in the selection of the final set of items from both the components. Then, the item set (ICF-CLP item set) was developed in Tamil. ICF-CLP item set in Tamil was piloted on 32 adults with repaired CLP and a matched control group of adults without CLP (NCLP) group by self-administering method. Results: There was a significant difference (P = 0.000) between CLP and NCLP group, in both the components –activity participation and environmental factors. In the item-wise comparison, individuals with CLP had a greater limitation in activity, restriction in participation in the domains of communication, maintaining interpersonal interactions and relationships, employment, and major life areas. In environmental factors, the domains of support, relationship, health services, education training systems and policies, attitudes of authorities, and strangers were projected as barriers by individuals with CLP. Conclusion: This study helps us in understanding the overall impact of the cleft of lip and palate among adults in the components of activity participation and environmental factors using the ICF framework. On the other hand, the ICF-CLP item set developed is clinically relevant in identifying conditions which limit activities/participation and serve as barriers/facilitators in their environments both in CLP population as well as in normal individuals.