Well-being and positive adjustment in adults with acquired facial palsy: a systematic review and empirical study

Sixteen studies were included from 1,752 identified records (PRISMA). Adjustment was operationalised across outcomes including quality of life, social functioning, and disability. Condition-related variables such as facial severity and impairment were associated with outcomes in some studies; however, findings were inconsistent. Psychological variables, including coping, illness perceptions, and self-evaluative processes, demonstrated more consistent associations with adjustment outcomes. Social and interpersonal factors, including emotional expression and concerns about social evaluation, were also associated with outcomes. Overall, psychological and social factors showed more consistent relationships with adjustment outcomes than condition-related variables. Within this review, condition-related variables refer to characteristics of the facial palsy itself (e.g., facial severity, facial function, duration, and synkinesis), psychological variables refer to individual cognitive and emotional processes (e.g., coping, illness perceptions, and self-esteem), and social-interpersonal variables refer to factors influencing social interaction and relationships (e.g., emotional expression, fear of negative evaluation, and social anxiety). Adjustment in adults with acquired facial palsy is influenced by a combination of condition-related, psychological and social-interpersonal factors. Psychological and social variables appear to play a particularly important role. These findings highlight the need to consider psychological and interpersonal processes alongside condition-related factors in understanding positive adjustment and informing more comprehensive approaches to care.