Psychosocial functioning in patients with altered facial expression: A scoping review in five neurological diseases
Purpose
To perform a scoping review to investigate the psychosocial impact of having an altered facial expression in five neurological diseases.
Methods
A systematic literature search was performed. Studies were on Bell’s palsy, facioscapulohumeral muscular dystrophy (FSHD), Moebius syndrome, myotonic dystrophy type 1, or Parkinson’s disease patients; had a focus on altered facial expression; and had any form of psychosocial outcome measure. Data extraction focused on psychosocial outcomes.
Results
Bell’s palsy, myotonic dystrophy type 1, and Parkinson’s disease patients more often experienced some degree of psychosocial distress than healthy controls. In FSHD, facial weakness negatively influenced communication and was experienced as a burden. The psychosocial distress applied especially to women (Bell’s palsy and Parkinson’s disease), and patients with more severely altered facial expression (Bell’s palsy), but not for Moebius syndrome patients. Furthermore, Parkinson’s disease patients with more pronounced hypomimia were perceived more negatively by observers. Various strategies were reported to compensate for altered facial expression.
Conclusions
This review showed that patients with altered facial expression in four of five included neurological diseases had reduced psychosocial functioning. Future research recommendations include studies on observers’ judgements of patients during social interactions and on the effectiveness of compensation strategies in enhancing psychosocial functioning.
Implications for rehabilitation
Negative effects of altered facial expression on psychosocial functioning are common and more abundant in women and in more severely affected patients with various neurological disorders.
Health care professionals should be alert to psychosocial distress in patients with altered facial expression.
Learning of compensatory strategies could be a beneficial therapy for patients with psychosocial distress due to an altered facial expression.
To perform a scoping review to investigate the psychosocial impact of having an altered facial expression in five neurological diseases.
Methods
A systematic literature search was performed. Studies were on Bell’s palsy, facioscapulohumeral muscular dystrophy (FSHD), Moebius syndrome, myotonic dystrophy type 1, or Parkinson’s disease patients; had a focus on altered facial expression; and had any form of psychosocial outcome measure. Data extraction focused on psychosocial outcomes.
Results
Bell’s palsy, myotonic dystrophy type 1, and Parkinson’s disease patients more often experienced some degree of psychosocial distress than healthy controls. In FSHD, facial weakness negatively influenced communication and was experienced as a burden. The psychosocial distress applied especially to women (Bell’s palsy and Parkinson’s disease), and patients with more severely altered facial expression (Bell’s palsy), but not for Moebius syndrome patients. Furthermore, Parkinson’s disease patients with more pronounced hypomimia were perceived more negatively by observers. Various strategies were reported to compensate for altered facial expression.
Conclusions
This review showed that patients with altered facial expression in four of five included neurological diseases had reduced psychosocial functioning. Future research recommendations include studies on observers’ judgements of patients during social interactions and on the effectiveness of compensation strategies in enhancing psychosocial functioning.
Implications for rehabilitation
Negative effects of altered facial expression on psychosocial functioning are common and more abundant in women and in more severely affected patients with various neurological disorders.
Health care professionals should be alert to psychosocial distress in patients with altered facial expression.
Learning of compensatory strategies could be a beneficial therapy for patients with psychosocial distress due to an altered facial expression.
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