{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,21]],"date-time":"2026-07-21T23:18:27Z","timestamp":1784675907916,"version":"3.55.0"},"reference-count":32,"publisher":"SAGE Publications","issue":"3","license":[{"start":{"date-parts":[[2021,12,3]],"date-time":"2021-12-03T00:00:00Z","timestamp":1638489600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["The Cleft Palate Craniofacial Journal"],"published-print":{"date-parts":[[2023,3]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>The aim of this study was to describe coping strategies used by parents of children with cleft palate with or without a cleft (CP\u2009\u00b1\u2009L) during the early development of their children in El Salvador.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Qualitative interviews were completed with 16 parents of children born with CP\u2009\u00b1\u2009L who were 6 months to 6 years old. Parents were questioned about their emotions and coping during eight time periods: prenatal, birth, social interaction before the first surgery, the beginning of surgeries, social interaction after the first surgery, early childhood education (ECE), speech\u2013language therapy, and formal education. Thematic analysis (TA) was used to identify coping strategies as conceptualized by Lazarus and Folkman (1984) .<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Four major themes emerged: (a) experienced emotions related to diagnosis, (b) interpretations related to the birth of a child with a cleft, (c) seeking and experiencing cleft treatment, and (d) social interaction of the children. During prenatal and birth stages, parents used emotion-focused strategies. A few hours to a week after birth, they used problem-focused strategies, which led them in search of treatment. Some parents used avoidance strategies during periods of social interaction before surgery, ECE, and formal education. Socioeconomic challenges impacted access to speech\u2013language therapy. Sociocultural factors, such as discrimination, religion, and folk beliefs, appeared to influence some of the coping strategies used by parents.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Problem-focused strategies appear to be helpful in seeking surgical treatments. The emotion-focused strategy of avoidance seemed to have adverse effects in minimizing opportunities for social interaction prior to surgery and early education.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/10556656211062839","type":"journal-article","created":{"date-parts":[[2021,12,3]],"date-time":"2021-12-03T07:14:39Z","timestamp":1638515679000},"page":"336-343","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":11,"title":["Thematic Analysis of Coping Strategies Used by Parents of Children with Cleft Lip and Palate in El Salvador"],"prefix":"10.1177","volume":"60","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0404-234X","authenticated-orcid":false,"given":"Ramon Manuel","family":"Aleman","sequence":"first","affiliation":[{"name":"Evangelical University of El Salvador, Dr Juan Jose Fernandez National Hospital of El Salvador, Chief of Clinica Aleman: Cleft Lip and Palate Center, San Salvador, El Salvador"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria Guadalupe","family":"Martinez","sequence":"additional","affiliation":[{"name":"Staff of Clinica Aleman: Cleft Lip and Palate Center, San Salvador, El Salvador"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2021,12,3]]},"reference":[{"key":"bibr1-10556656211062839","unstructured":"Achirica M. An\u00e1lisis de la problem\u00e1tica que presentan diez familias con un miembro con LPH, que asisten a terapia en el INCH. Dissertation. Ciudad de M\u00e9xico, Mexico: Instituto Nacional de Rehabilitaci\u00f3n; 1986."},{"key":"bibr2-10556656211062839","doi-asserted-by":"publisher","DOI":"10.1080\/13694670500040484"},{"key":"bibr3-10556656211062839","unstructured":"Almend\u00e1riz ML, Meza MX. Inclusi\u00f3n escolar y familiar en ni\u00f1os y adolescentes con labio leporino y paladar hendido, luego de su rehabilitaci\u00f3n oral postquir\u00fargica realizada por la fundaci\u00f3n internacional Interplast, la fundaci\u00f3n nacional Rostros Felices y el Club Rotario Portoviejo, durante el periodo 2001\u20132012. Dissertation. Ecuador: Universidad San Gregorio de Portoviejo; 2014."},{"key":"bibr4-10556656211062839","unstructured":"Aparicio Ju\u00e1rez LF, Guzm\u00e1n Molina SH, Romo AM. Percepci\u00f3n e impacto de padres de hijos con diagn\u00f3stico de labio o paladar hendido. Dissertation. San Salvador, El Salvador: Universidad Evang\u00e9lica de El Salvador; 2018."},{"key":"bibr5-10556656211062839","doi-asserted-by":"publisher","DOI":"10.5772\/intechopen.81779"},{"key":"bibr6-10556656211062839","doi-asserted-by":"publisher","DOI":"10.1597\/08-075.1"},{"key":"bibr7-10556656211062839","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-2648.2001.01814.x"},{"key":"bibr8-10556656211062839","doi-asserted-by":"publisher","DOI":"10.1597\/08-093.1"},{"key":"bibr9-10556656211062839","doi-asserted-by":"publisher","DOI":"10.1002\/9781118993811.ch21"},{"key":"bibr10-10556656211062839","doi-asserted-by":"publisher","DOI":"10.1597\/08-151.1"},{"key":"bibr11-10556656211062839","doi-asserted-by":"publisher","DOI":"10.1191\/1478088706qp063oa"},{"issue":"4","key":"bibr12-10556656211062839","first-page":"329","volume":"37","author":"Castro R","year":"1995","journal-title":"Salud P\u00fablica de M\u00e9xico"},{"key":"bibr13-10556656211062839","unstructured":"Cevallos Barzallo EM. Estilos de afrontamiento en padres de ni\u00f1os y ni\u00f1as con fisura palatina y paladar hendido. Dissertation. Ambato, Ecuador: Pontificia Universidad Cat\u00f3lica del Ecuador, 2021."},{"key":"bibr14-10556656211062839","doi-asserted-by":"publisher","DOI":"10.1177\/0091415017720890"},{"issue":"1","key":"bibr15-10556656211062839","first-page":"255","volume":"16","author":"Chenail RJ","year":"2011","journal-title":"Qualitative Report"},{"key":"bibr16-10556656211062839","doi-asserted-by":"publisher","DOI":"10.1080\/10615800701740457"},{"key":"bibr17-10556656211062839","volume-title":"Stress, appraisal, and coping (p. 460)","author":"Folkman S","year":"1984"},{"key":"bibr18-10556656211062839","doi-asserted-by":"publisher","DOI":"10.1177\/1609406920907254"},{"key":"bibr19-10556656211062839","unstructured":"Galindez Gonz\u00e1lez S. Estrategias de afrontamiento familiar ante el diagn\u00f3stico de malformaci\u00f3n cong\u00e9nita en la ciudad de Cali, 2013. Dissertation. Cali, Colombia: Universidas de San Buena Ventura, 2013."},{"key":"bibr20-10556656211062839","unstructured":"Gonzalez-Rodriguez E. Ansiedad, estr\u00e9s y estrategias de afrontamiento en padres de ni\u00f1os con labio y\/o paladar hendido (LPH). DissertationNuevo Le\u00f3n, Mexico: Universidad Aut\u00f3noma de Nuevo Le\u00f3n, 2013."},{"key":"bibr21-10556656211062839","doi-asserted-by":"publisher","DOI":"10.22439\/fs.v0i19.4827"},{"key":"bibr22-10556656211062839","doi-asserted-by":"publisher","DOI":"10.1597\/03-134.1"},{"key":"bibr23-10556656211062839","doi-asserted-by":"publisher","DOI":"10.1002\/9781119973249"},{"key":"bibr24-10556656211062839","unstructured":"Lazarus RS, Folkman S. Stress, appraisal, and coping. New York: Springer publishing company; 1984: 141-142."},{"key":"bibr25-10556656211062839","unstructured":"Najera MI. El temor a Los eclipses entre culturas mayas contemporaneas. In: Varela-Torrecilla C, Bonor-Villarejo JL, Fernandez-Marquinez Y, eds. Religi\u00f3n y Sociedad en el \u00c1rea Maya. 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