Facilitators and Barriers to Speech Intervention of Patients with Orofacial Cleft in the Philippines: A Qualitative Study

Kerwyn Jim C. Chan; Larissa Christia F. Adique; Kathy B. Reyes-Brander; Steven Angelo J. Maristela; Ken Kristoffer A. Tort

doi:10.1055/s-0043-1764432

Seminars in Speech and Language, Table of Contents

Semin Speech Lang 2023; 44(03): 155-169
DOI: 10.1055/s-0043-1764432

Research Article

Facilitators and Barriers to Speech Intervention of Patients with Orofacial Cleft in the Philippines: A Qualitative Study

Authors

Kerwyn Jim C. Chan

¹Department of Speech and Language Pathology, College of Rehabilitation Sciences, De La Salle Medical and Health Sciences Institute, Dasmariñas, Cavite, Philippines
Larissa Christia F. Adique

¹Department of Speech and Language Pathology, College of Rehabilitation Sciences, De La Salle Medical and Health Sciences Institute, Dasmariñas, Cavite, Philippines
Kathy B. Reyes-Brander

¹Department of Speech and Language Pathology, College of Rehabilitation Sciences, De La Salle Medical and Health Sciences Institute, Dasmariñas, Cavite, Philippines
Steven Angelo J. Maristela

¹Department of Speech and Language Pathology, College of Rehabilitation Sciences, De La Salle Medical and Health Sciences Institute, Dasmariñas, Cavite, Philippines

²Department of Communication Sciences and Disorders, School of Allied Health Professions, Loma Linda University, Loma Linda, California
Ken Kristoffer A. Tort

¹Department of Speech and Language Pathology, College of Rehabilitation Sciences, De La Salle Medical and Health Sciences Institute, Dasmariñas, Cavite, Philippines

Abstract

Most individuals with orofacial cleft require various healthcare services, including speech therapy. However, Filipino patients constantly face challenges in availing these services due to limitations in the healthcare system of the Philippines. This study aimed to explore the perceptions of patients with orofacial cleft on the factors that may serve as facilitators and barriers to speech intervention. A descriptive phenomenological approach to qualitative research was used to obtain an in-depth understanding of the perceptions of these patients. Semistructured interviews were conducted through online video conferences or mobile phone calls. Twenty-one participants were interviewed, most of who were mothers (90%) of children with orofacial cleft. Ten themes were derived from the transcripts. Five were categorized as facilitators, while the rest were considered as barriers. Generally, the respondents showed positive attitudes toward orofacial cleft, were aware of the communication and swallowing issues of the patients, and actively sought services to address these issues. Most barriers to speech intervention resulted from limited access to quality healthcare services and information. These findings highlight the importance of considering patient perspectives in clinical care. Maximizing facilitators and addressing barriers may improve access to universal healthcare among Filipinos with orofacial cleft.

Keywords

orofacial cleft - perceptions - speech therapy - phenomenology - health-seeking behavior

Full Text

References

References
Adrian, M. (2022, May 19). Who are the middle class in the Philippines? IMoney.Ph. Accessed February 23, 2023 at: https://www.imoney.ph/articles/middle-class-sector-philippines/
Alighieri, C., Peersman, W., Bettens, K., Van Herreweghe, V., & Van Lierde, K. (2020). Parental perceptions and expectations concerning speech therapy-related cleft care - a qualitative study. Journal of Communication Disorders, 87, 106028
Bennett, K. G., Ranganathan, K., Patterson, A. K., Baker, M. K., Vercler, C. J., Kasten, S. J., Buchman, S. R., & Waljee, J. F. (2018). Caregiver-reported outcomes and barriers to care among patients with cleft lip and palate. Plastic and Reconstructive Surgery, 142(6), 884e–891e
Bondoc, I. P. M., & Ligot, F. A. C. (2015). Awareness and causal beliefs on cleft lip and/or palate: perspectives from Filipino parents and caregivers. Philippine Journal of Health Research and Development, 19(2), 10
Capuno, J. J., Kraft, A. D., Poco, L. C., Quimbo, S. A., & Tan, C. A. R., Jr. (2019). Health conditions, payments, proximity, and opportunity costs: examining delays in seeking inpatient and outpatient care in the Philippines. Social Science & Medicine, 238, 112479
Cassell, C. H., Krohmer, A., Mendez, D. D., Lee, K. A., Strauss, R. P., & Meyer, R. E. (2013). Factors associated with distance and time traveled to cleft and craniofacial care. Birth Defects Research. Part A, Clinical and Molecular Teratology, 97(10), 685–695
Cura, J. D. (2015). Respecting autonomous decision making among Filipinos: a re-emphasis in genetic counseling. Journal of Genetic Counseling, 24(2), 213–224
Daack-Hirsch, S., & Gamboa, H. (2010). Filipino explanatory models of cleft lip with or without cleft palate. The Cleft Palate-Craniofacial Journal, 47(2), 122–133
David-Padilla, C., Cutiongco-de la Paz, E. M. C., Lucero, F., Villafuerte, C., Cardenas, J., & Villanueva, E. (2008). Profile of oral cleft cases reported in the Philippine Oral Cleft Registry from May 2003 to December 2006. Acta Medica Philippina, 42(2), 2. doi: 10.47895/amp.v42i2.2416
Hopf, S. C., McLeod, S., McDonagh, S. H., Wang, C., & Rakanace, E. N. (2018). Communication disability in Fiji: community self-help and help-seeking support. International Journal of Speech-Language Pathology, 20(5), 554–568
Kanmounye, U. S., Dutton, J. L., Naidu, P., Msokera, C., Collier, Z. J., Fernanda Tapia, M., Mikhail, S., Xepoleas, M., Auslander, A., Yao, C. A., & Magee, W., III. (2022). Cleft lip and palate research in low- and middle-income countries: a scientometric analysis. Plastic and Reconstructive Surgery. Global Open, 10(2), e4122
Lamberton, H., & Sorajjakool, S. (2004). Spirituality, Health, and Wholeness: An Introductory Guide for Health Care Professionals. Routledge. Accessed February 23, 2023 at: https://doi.org/10.4324/9780203048771
Lauver, D. (1992). A theory of care-seeking behavior. Image–The Journal of Nursing Scholarship, 24(4), 281–287
Maneze, D., DiGiacomo, M., Salamonson, Y., Descallar, J., & Davidson, P. M. (2015). Facilitators and barriers to health-seeking behaviours among Filipino migrants: inductive analysis to inform health promotion. BioMed Research International, 2015, 506269
Massenburg, B. B., Hopper, R. A., Crowe, C. S., Morrison, S. D., Alonso, N., Calis, M., Donkor, P., Kreshanti, P., Yuan, J., & The Global Burden of Disease 2017 Orofacial Clefting Collaborators. (2021). Global burden of orofacial clefts and the world surgical workforce. Plastic and Reconstructive Surgery, 148(4), 568e–580e
Massenburg, B. B., Jenny, H. E., Saluja, S., Meara, J. G., Shrime, M. G., & Alonso, N. (2016). Barriers to cleft lip and palate repair around the world. The Journal of Craniofacial Surgery, 27(7), 1741–1745
Morrow, R., Rodriguez, A., & King, N. (2015). Colaizzi's descriptive phenomenological method. The Psychologist, 28(8), 643–644
Mossey, P. A., & Modell, B. (2012). Epidemiology of oral clefts 2012: an international perspective. Frontiers of Oral Biology, 16, 1–18
Opdenakker, R. (2006). Advantages and disadvantages of four interview techniques in qualitative research. Forum Qualitative Social Research, 7(4), 4. doi: 10.17169/fqs-7.4.175
Perez, J. (2018). Total health expenditures grew by 8.0 percent in 2017. Accessed February 23, 2023 at: https://psa.gov.ph/content/total-health-expenditures-grew-80-percent-2017
Philippine Health Insurance Corporation. (2017). PhilHealth Circular No. 2017–0029: Z benefits for children with developmental disabilities. Accessed February 23, 2023 at: https://www.philhealth.gov.ph/circulars/2017/TS_circ2017-0029.pdf
Philippine Health Insurance Corporation. (2021). PhilHealth Circular No. 2021–0022: The guiding principles of the Z Benefits (Revision 1). Accessed February 23, 2023 at: https://www.philhealth.gov.ph/circulars/2021/circ2021-0022.pdf
Philippine Health Research Ethics Board. (2017). National ethical guidelines for health and health related research. Accessed February 23, 2023 at: https://ethics.healthresearch.ph/index.php/phoca-downloads/category/4-neg#
Rees, J., Muskett, T., Enderby, P., & Stackhouse, J. (2016). Implications of untreated cleft palate in the developing world: adaptation of an outcome measure. Folia Phoniatrica et Logopaedica, 68(1), 1–9
Salari, N., Darvishi, N., Heydari, M., Bokaee, S., Darvishi, F., & Mohammadi, M. (2022). Global prevalence of cleft palate, cleft lip and cleft palate and lip: a comprehensive systematic review and meta-analysis. Journal of Stomatology, Oral and Maxillofacial Surgery, 123(2), 110–120
Sundararajan, R., Mwanga-Amumpaire, J., King, R., & Ware, N. C. (2019). A conceptual model for pluralistic healthcare behavior: results from a qualitative study in southwestern Uganda (p. 19008508). medRxiv. Accessed February 23, 2023 at: https://doi.org/10.1101/19008508
Swanson, J. W., Yao, C. A., Auslander, A., Wipfli, H., Nguyen, T.-H.-D., Hatcher, K., Vanderburg, R., & Magee, W. P., III. (2017). Patient barriers to accessing surgical cleft care in Vietnam: a multi-site, cross-sectional outcomes study. World Journal of Surgery, 41(6), 1435–1446
Tolentino, P. (2022, August 25). Transforming health professions education for Universal Health Care [Conference presentation]. National Conference on the Roll-out of Universal Health Care in Higher Education, Iloilo City, Philippines. Available at: https://www.facebook.com/chedro6.gov/videos/ched-ro6-events-national-conference-on-the-roll-out-of-universal-healthcare-in-h/775586650222848/. Accessed March 24, 2023
Vasileiou, K., Barnett, J., Thorpe, S., & Young, T. (2018). Characterising and justifying sample size sufficiency in interview-based studies: systematic analysis of qualitative health research over a 15-year period. BMC Medical Research Methodology, 18(1), 148
Widayanti, A. W., Green, J. A., Heydon, S., & Norris, P. (2020). Health-seeking behavior of people in Indonesia: a narrative review. Journal of Epidemiology and Global Health, 10(1), 6–15
Wylie, K., McAllister, L., Davidson, B., Marshall, J., Amponsah, C., & Bampoe, J. O. (2017). Self-help and help-seeking for communication disability in Ghana: implications for the development of communication disability rehabilitation services. Globalization and Health, 13(1), 92

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