{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,30]],"date-time":"2026-04-30T04:40:49Z","timestamp":1777524049410,"version":"3.51.4"},"reference-count":78,"publisher":"SAGE Publications","issue":"5","license":[{"start":{"date-parts":[[2025,3,18]],"date-time":"2025-03-18T00:00:00Z","timestamp":1742256000000},"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":[[2026,5]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Spiritual distress describes an \u201cimpaired ability to experience and integrate meaning and purpose,\u201d frequently occurring after receipt of a major diagnosis. We measured spiritual distress in caregivers of children presenting to a multidisciplinary cleft and craniofacial clinic, hypothesizing that a significant percentage of caregivers would demonstrate spiritual distress.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Caregivers were surveyed utilizing the Functional Assessment of Chronic Illness Therapy\u2014Spiritual Well-Being scale, non-illness version (FACIT-Sp 12), the eight-item Patient Health Questionnaire depression scale (PHQ-8) and the seven-item General Anxiety Disorder scale (GAD-7), as well as questions evaluating caregiver health, financial strain, and religiosity measured by the Duke Religion Index (DUREL). Logistic regression with cluster adjustment was used to control for demographic and clinical variables.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>A multidisciplinary cleft and craniofacial clinic.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Patients, Participants<\/jats:title>\n                    <jats:p>All caregivers able to read English were surveyed. 149 of 191 completed the survey (response rate\u2009=\u200978.0%).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Main Outcome Measure(s)<\/jats:title>\n                    <jats:p>Caregiver spiritual distress, as measured by the FACIT-Sp 12, non-illness version.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The median age of caregivers was 33 (interquartile range 25-39). Most were female (76.7%), white (86.7%), non-Latino (91.1%), and Christian (76.7%). Most patients were seen for a cleft diagnosis (90.8%). Thirty percent of caregivers demonstrated spiritual distress. Depression was present in 16.1% and moderate to severe anxiety in 18.1%. On adjusted analysis, Christianity was associated with lower odds of spiritual distress (OR 0.32,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u2009.039). Additionally, both depression (OR 14.36,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u2009.001) and anxiety (OR 3.81,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u2009.006) were associated with higher odds of spiritual distress.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Nearly one-third of caregivers demonstrated spiritual distress, which was associated with mood disorders. Addressing spiritual stress and providing necessary resources is critical for effective team-based care.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/10556656251326479","type":"journal-article","created":{"date-parts":[[2025,3,18]],"date-time":"2025-03-18T17:58:43Z","timestamp":1742320723000},"page":"1099-1108","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Spiritual Distress in Caregivers of Patients with Cleft and Craniofacial Anomalies\u2014A Single-Center Cross-Sectional Study"],"prefix":"10.1177","volume":"63","author":[{"ORCID":"https:\/\/orcid.org\/0009-0002-5401-9850","authenticated-orcid":false,"given":"Patrick F.","family":"Mercho","sequence":"first","affiliation":[{"name":"Department of Surgery, Indiana University School of Medicine"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Khoa D.","family":"Tran","sequence":"additional","affiliation":[{"name":"Riley Hospital for Children"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rodica I.","family":"Muraru","sequence":"additional","affiliation":[{"name":"Indiana University School of Medicine"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Emma J.","family":"Cordes","sequence":"additional","affiliation":[{"name":"Indiana University School of Medicine"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sunil","family":"Tholpady","sequence":"additional","affiliation":[{"name":"Indiana University School of Medicine"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Katelyn G.","family":"Makar","sequence":"additional","affiliation":[{"name":"Indiana University School of Medicine"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2025,3,18]]},"reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.3171\/2022.4.PEDS21596"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1177\/2374373520948650"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.2307\/1131022"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1177\/1055665619862457"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.1080\/13548506.2018.1529328"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2214.2011.01244.x"},{"key":"e_1_3_3_8_2","unstructured":"Religious Landscape Study. 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