Exploring assessment measures including psychological aspects in adults with acquired Peripheral Facial Palsy (PFP): a scoping review

Given the lack of specific assessment measures and consensus on how to evaluate the psychological aspects of acquired peripheral facial palsy, this study aimed to identify the existing instruments in current use, as well as the key psychological domains considered. A secondary objective was to identify mental health-related areas not addressed or under-represented by those instruments. A scoping review was conducted to identify assessment measures, their underlying dimensions, and frequency of use. Findings were thematically synthesized across specific areas and grouped by consensus among the three authors to identify key domains for evaluating facial palsy. 46 instruments were identified, also capturing social and quality-of-life aspects often closely linked to psychological factors. Their dimensions were classified into five generic areas: health-related quality of life perception, symptomatology (emotional and physical), appearance-related matters, intrapersonal and social skills, and care experience. Analysis of the items led to the identification of specific areas, which were classified by relevance into six broader psychosocial domains: (1) social functioning, (2) emotional symptomatology, (3) facial palsy- related QoL, (4) general health-related QoL, (5) psychological functioning, and (6) care experience-satisfaction. The FDI, FaCE, followed by the SF-36, and HADS emerged as the most used instruments. The results showed a lack of consensus due to the heterogeneity of the instruments retrieved for the evaluation of psychological outcomes. This review identified under-represented psychological areas, such as social and appearance-related anxiety, body self-perception, and experience of the care process which may warrant further evaluation. Several of the instruments retrieved were general rather than facial palsy-specific, which could not fully address the specific psychological needs of adults suffering with acquired peripheral facial palsy.