PDF(Pubmed)
Abstract：
Challenges providing cleft/craniofacial care in rural communities are often reported, leading to disparities in resources available to clinicians. The purpose of this study was to identify the impact of rurality on caseloads and practice patterns of speech-language pathologists (SLPs) regarding speech and velopharyngeal function for children with cleft lip and/or palate (CL/P).
A national, survey of US-based SLPs (N = 359 respondents) investigated resources, comfort level, caseloads, and practice patterns for children with CL/P. Sub-county classifications that delineated levels of rurality were utilized. Descriptive statistics and chi-square analyses were conducted to determine the impact of population density on assessment and referral decisions.
Nearly 83% of SLPs reported providing care for a child with CL/P and 41.4% of these SLPs reported five or more children with CL/P on caseload throughout their career. There were no significant differences in rurality of practice setting and the likelihood of treating a child with CL/P. Significant differences were present between rural, town, suburban, and metropolitan-based SLPs regarding available resources (p = 0.035). SLPs in rural settings reported feeling uncomfortable treating children with CL/P compared to those in metropolitan settings (p = 0.02). Distance to the cleft/craniofacial team and comfort levels impacted referral decisions.
Most SLPs report having children with CL/P on caseload regardless of practice location. Rurality impacted assessment and referral decisions, especially surrounding access to resources and comfort levels engaging in team care. Findings have implications for developing support systems and reducing barriers for rural SLPs working with children born with CL/P.
A national, survey of US-based SLPs (N = 359 respondents) investigated resources, comfort level, caseloads, and practice patterns for children with CL/P. Sub-county classifications that delineated levels of rurality were utilized. Descriptive statistics and chi-square analyses were conducted to determine the impact of population density on assessment and referral decisions.
Nearly 83% of SLPs reported providing care for a child with CL/P and 41.4% of these SLPs reported five or more children with CL/P on caseload throughout their career. There were no significant differences in rurality of practice setting and the likelihood of treating a child with CL/P. Significant differences were present between rural, town, suburban, and metropolitan-based SLPs regarding available resources (p = 0.035). SLPs in rural settings reported feeling uncomfortable treating children with CL/P compared to those in metropolitan settings (p = 0.02). Distance to the cleft/craniofacial team and comfort levels impacted referral decisions.
Most SLPs report having children with CL/P on caseload regardless of practice location. Rurality impacted assessment and referral decisions, especially surrounding access to resources and comfort levels engaging in team care. Findings have implications for developing support systems and reducing barriers for rural SLPs working with children born with CL/P.
摘要：
经常报告在农村社区提供left裂/颅面护理的挑战，导致临床医生可用资源的差异。这项研究的目的是确定乡村对唇裂和/或腭裂（CL/P）儿童的语言和咽喉功能的语言病理学家（SLP）的病例量和实践模式的影响。
一个国家,对美国SLP的调查(N=359名受访者)调查了资源，舒适度,案件量,和CL/P儿童的实践模式利用了划定乡村水平的县以下分类。进行描述性统计和卡方分析以确定人口密度对评估和转诊决定的影响。
近83％的SLP报告为患有CL/P的儿童提供护理，其中41.4％的SLP报告说，在整个职业生涯中，有5名或更多的患有CL/P的儿童。实践设置的普遍性和治疗儿童CL/P的可能性没有显着差异。农村之间存在显著差异，镇,郊区,郊区以及关于可用资源的基于都市的SLP(p=0.035)。与大城市环境相比，农村环境中的SLP报告对CL/P儿童的治疗感觉不舒服（p=0.02）。与裂口/颅面团队的距离和舒适度会影响转诊决定。
大多数SLP报告说，无论执业地点如何，都有患有CL/P的儿童。农村影响评估和转诊决定，尤其是周围的资源访问和参与团队护理的舒适度。研究结果对发展支持系统和减少与CL/P出生的儿童一起工作的农村SLP的障碍具有影响。
一个国家,对美国SLP的调查(N=359名受访者)调查了资源，舒适度,案件量,和CL/P儿童的实践模式利用了划定乡村水平的县以下分类。进行描述性统计和卡方分析以确定人口密度对评估和转诊决定的影响。
近83％的SLP报告为患有CL/P的儿童提供护理，其中41.4％的SLP报告说，在整个职业生涯中，有5名或更多的患有CL/P的儿童。实践设置的普遍性和治疗儿童CL/P的可能性没有显着差异。农村之间存在显著差异，镇,郊区,郊区以及关于可用资源的基于都市的SLP(p=0.035)。与大城市环境相比，农村环境中的SLP报告对CL/P儿童的治疗感觉不舒服（p=0.02）。与裂口/颅面团队的距离和舒适度会影响转诊决定。
大多数SLP报告说，无论执业地点如何，都有患有CL/P的儿童。农村影响评估和转诊决定，尤其是周围的资源访问和参与团队护理的舒适度。研究结果对发展支持系统和减少与CL/P出生的儿童一起工作的农村SLP的障碍具有影响。
