title: Causal attributions of cleft lip and palate across cultures.
abstract: Objective : To describe and compare the causal beliefs associated with cleft lips and/or palates across several different countries. Design : Cross-sectional survey. Setting : Operation Smile surgery screenings in six developing countries. Participants : Two hundred seventy-nine adult patients and parents of children with cleft lips and/or palates in Kenya, Russia, Cambodia, India, Egypt, and Peru. Interventions : In person interviews were conducted with interpreters. Main Outcome Measure : As part of a larger study, a semistructured questionnaire was created to explore cleft perceptions, belief systems that affect these perceptions, and social reactions to individuals with clefts. Results : Causal attributions were grouped by category (environment, self-blame, supernatural, chance, unknown, or other) and type of locus of control (external, internal, or unknown). Results indicate significant difference by country for both causal attribution category (P < .001) and type (P < .001). This difference was maintained in multivariate analyses, which controlled for differences by demographic variables between countries. Conclusions : This study provides evidence that causal attributions for clefts are influenced by culture. As harmful beliefs about cause may continue to impact affected individuals and their families even after a repair, it is insufficient to provide surgical care alone. Care of the entire person must include attempts to change misinformed cultural beliefs through educating the broader community.
authors.forename: Lauren
authors.initials: L
authors.lastname: Mednick
authors.forename: Julie
authors.initials: J
authors.lastname: Snyder
authors.forename: Carolyn
authors.initials: C
authors.lastname: Schook
authors.forename: Emily A
authors.initials: EA
authors.lastname: Blood
authors.forename: Shan-Estelle
authors.initials: SE
authors.lastname: Brown
authors.forename: R C A
authors.initials: RC
authors.lastname: Weatherley-White
mesh_terms: D002971:Cleft Lip / Q000601:surgery; D002972:Cleft Palate / Q000601:surgery; D003430:Cross-Sectional Studies; D006801:Humans; D010290:Parents