title: Psychosocial acceptance of cleft patients: has something changed?
abstract: OBJECTIVE
  The main purpose of this study was to analyse the reactions of a panel (non-cleft adults) when observing cleft lip morphology. Although rehabilitation of cleft lip and palate is improving, there are still indications of social rejection of cleft patients by the people around them. Polarity profiles have been used since 1973 to measure social distance with regard to cleft patients. Because rehabilitation results and education of the society have improved in recent decades, we investigated whether social distance has been affected.
  
  
  METHODS
  The setting of this study is the Department of Oral, Craniomaxillofacial, and Facial Plastic Surgery, University Hospital of Leipzig, Germany
  
  
  METHODS
  Using a cross-sectional study design, we enrolled a sample of adult laypersons (n = 273). For the survey, we followed the concept of photograph presentation and questionnaire investigation reported by Sergl and Schmid (1973). We presented anonymised frontal and profile pictures of the faces of 50 cleft patients and asked the laypersons to specify social distance. Three predictor variables (layperson gender, profession and year of evaluation) were grouped.
  
  
  RESULTS
  Although social distance has reduced during the last 40 years, life situations which require emotional proximity still cause some concern. Professional background and gender affect laypersons' attitudes.
  
  
  CONCLUSIONS
  Although rehabilitation of cleft lip and palate is much better than 40 years ago, social distance remains a problem in society. It is necessary to improve both results of rehabilitation of cleft patients and social acceptance by the people around them.
authors.affiliation: Department of Oral, Craniomaxillofacial and Facial Plastic Surgery, Faculty of Medicine, University Hospital of Leipzig, Leipzig, Germany. niels.pausch@medizin.uni-leipzig.de.
authors.forename: Niels Christian
authors.initials: NC
authors.lastname: Pausch
authors.affiliation: Translational Centre for Regenerative Medicine (TRM), University of Leipzig, Leipzig, Germany.
authors.forename: Karsten
authors.initials: K
authors.lastname: Winter
authors.affiliation: Department of Oral, Craniomaxillofacial and Facial Plastic Surgery, Faculty of Medicine, University Hospital of Leipzig, Leipzig, Germany.
authors.forename: Dirk
authors.initials: D
authors.lastname: Halama
authors.affiliation: Karl-Olga-Hospital Stuttgart, Stuttgart, Germany.
authors.forename: Christian
authors.initials: C
authors.lastname: Wirtz
authors.affiliation: Department of Oral, Craniomaxillofacial and Facial Plastic Surgery, Faculty of Medicine, University Hospital of Leipzig, Leipzig, Germany.
authors.forename: Vedat
authors.initials: V
authors.lastname: Yildirim
authors.affiliation: Department of Oral, Craniomaxillofacial and Facial Plastic Surgery, Faculty of Medicine, University Hospital of Leipzig, Leipzig, Germany.
authors.forename: Nattapong
authors.initials: N
authors.lastname: Sirintawat
authors.affiliation: Department of Oral, Craniomaxillofacial and Facial Plastic Surgery, Faculty of Medicine, University Hospital of Leipzig, Leipzig, Germany.
authors.forename: Sirintawat
authors.initials: S
authors.lastname: Nattapong
mesh_terms: D000293:Adolescent; D002971:Cleft Lip / Q000523:psychology* / Q000534:rehabilitation; D002972:Cleft Palate / Q000523:psychology* / Q000534:rehabilitation; D003430:Cross-Sectional Studies; D005260:Female; D005858:Germany; D006266:Health Education; D006801:Humans; D008297:Male; D008875:Middle Aged; D012929:Psychological Distance; D012737:Sex Factors; D011795:Surveys and Questionnaires; D055815:Young Adult
keywords: Cleft lip patients; Laypersons; Social distance