Abstract
Objective: The objective of this qualitative study is to examine how to treat cleft lip and palate in consideration of the feeling of patients, their mothers and families especially by understanding psychology and the therapeutic decision-making process of mothers at the end of Phase I orthodontic treatment.
Subjects and methods: We studied six mothers whose children with cleft lip and palate completed Phase I orthodontic treatment at the orthodontic department of A University. We measured their state anxiety and situation specific anxiety using the STAI psychological test and conducted semi-structured interviews, and obtained data by writing down the interview records word by word. The data was divided into contexts and categorized by analysis and understanding the meaning, and then integrated to obtain the central concepts as key themes and their structures.
Results: No subjects with strong anxiety tendencies were observed in judging the STAI for who should be excluded from this study. Seven key themes relating to psychology and the therapeutic decision-making of mothers were found in the data after the time of birth of children: embarrassment and shock, salvation through information, hopes and possibility of treatment, self-condemnation as a mother, hopes and anxiety of long-term treatment, parent-offspring conflict and persuasion for treatment, and trust in their doctor. In the therapeutic decision-making process, hopes and possibility of treatment, hopes and anxiety of long-term treatment, parent-offspring conflict and persuasion for treatment were running in circles. The structure of psychology showed the coexistence of self-condemnation as a mother and trust in their doctor.
Conclusion: We considered that self-condemnation as a mother is a wide-ranging issue including their child, treatment and pain, being deeply involved in their therapeutic decision-making, and being continuing indelibly with long-term treatment. We determined that trust in their doctor supports the decision-making of mothers in anxiety concerning long-term treatment and the mother-child relationship. We considered that these feelings consist of mutually correlated issues of the themes. As a new viewpoint for holistic medicine, it was suggested that the necessity of understanding these psychologies and the structure of decision-making of mothers and developing a continuous support system based on informed consent.
