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Erkal E, Kiyak E, Uren Y, Milanlioglu A. Determination of stigma and attitude in relatives of patients with epilepsy. Seizure 2024; 121:64-69. [PMID: 39089140 DOI: 10.1016/j.seizure.2024.07.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2024] [Revised: 07/26/2024] [Accepted: 07/27/2024] [Indexed: 08/03/2024] Open
Abstract
PURPOSE This study was conducted to determine stigma and attitudes in the relatives of patients with epilepsy and the factors affecting them. METHODS This descriptive and cross-sectional study was conducted with 173 relatives of patients with epilepsy who were admitted to the neurology outpatient clinic of a university hospital in Van Province, eastern Turkey, between April and December 2021. Individual information forms, the Epilepsy Stigma Scale Patient's Relative, and the Epilepsy Attitude Scale were used to collect the data. RESULTS The mean stigma score was 54.58 (standard deviation [SD] = 10.96), and the mean attitude score was 53.05 (SD = 8.14). A negative and significant correlation was found between stigma score and attitude score (r = -0.457, p < 0.001). It was found that stigma and attitude scores differed significantly in terms of education, hiding epilepsy, and the idea that epilepsy is related to spiritual thoughts (p < 0.05). CONCLUSION As a result of this study, it was found that the relatives of patients with epilepsy were generally moderately stigmatized (64.8 %) and had moderate attitudes toward epilepsy. As the stigma increased in the participants, it was determined that they showed more negative attitudes toward epilepsy. The results indicated that relatives of patients with epilepsy who had one or more seizures per month experienced more stigma, and relatives of patients with epilepsy who did not take their medication regularly exhibited a more negative attitude toward epilepsy.
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Affiliation(s)
- Emre Erkal
- Health Services Vocational School, Artvin Coruh University, Artvin, Turkey..
| | - Emine Kiyak
- Faculty of Nursing, Ataturk University, Erzurum, Turkey
| | - Yavuz Uren
- Faculty of Health Sciences, Van Yüzüncü Yıl University, Van, Turkey
| | - Aysel Milanlioglu
- Department of Neurology, Faculty of Medicine, Van Yüzüncü Yıl University, Van, Turkey
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Kerkez M, Vural Ö. The association of perceived stigma, religiosity, and paranormal beliefs in parents of children with epilepsy. Epilepsy Behav 2024; 155:109789. [PMID: 38640723 DOI: 10.1016/j.yebeh.2024.109789] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2024] [Revised: 04/09/2024] [Accepted: 04/10/2024] [Indexed: 04/21/2024]
Abstract
OBJECTIVE The aim of this study is to investigate the relationship between stigma perception, religiosity, and paranormal beliefs in parents of children with epilepsy. METHODS The sample of this cross-sectional study consisted of 103 parents of children with epilepsy registered at a state hospital in a city with middle socio-economic status located in southeastern Türkiye. The data were collected using descriptive information forms for parents and children with epilepsy, the Parent Stigma Scale, the Religious Attitude Scale, and the Paranormal Belief Scale. The Mann-Whitney U test, Kruskal-Wallis analysis of variance, and Spearman's correlation analysis were used to assess the data. RESULTS The results of the study revealed that while 78.6 % of the parents were female, 59.2 % of the children with epilepsy were boys. Total mean scores of the participants were 18.48 ± 4.84 in the Parent Stigma Scale, 51.73 ± 14.15 in the Classical (Non-Religious) Paranormal Beliefs Dimension, and 33.89 ± 6.55 in the Religious Attitude Scale. A weak positive correlation was found between total mean scores of the Parent Stigma Scale, the Paranormal Belief Scale and the Religious Attitude Scale (p < 0.05). However, there was no statistically significant correlation between the mean scores of the Paranormal Belief Scale and the Religiosity Attitude Scale (p > 0.05). All of the three scales were positively correlated with the age of the parents and the duration of the illness (p < 0.05). CONCLUSION In this study, it was observed that while the parents had high levels of stigma perception and religious attitudes, they had moderate attitudes toward paranormal beliefs. While no direct correlation was found between religious attitudes and paranormal beliefs, cognitive inclinations toward religion were negatively correlated with paranormal beliefs. Additionally, the parents who perceived a higher level of stigma were more likely to hold stronger religious attitudes and beliefs related to various aspects of paranormal events. In the light of these findings, it is recommended to design educational programs and information campaigns aimed at reducing social stigma and raising awareness about epilepsy in such a way as to take individual belief systems into considerations.
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Affiliation(s)
- Müjde Kerkez
- Şırnak University/ Faculty of Health Sciences/ Department of Health Nursing, Türkiye; Gaziantep Cengiz Gökçek Gynecology and Pediatrics Hospital, Türkiye.
| | - Özlem Vural
- Şırnak University/ Faculty of Health Sciences/ Department of Health Nursing, Türkiye; Gaziantep Cengiz Gökçek Gynecology and Pediatrics Hospital, Türkiye
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Biresaw MS, Vitrai J, Halász P, Correa V, Szűcs A. Changes in public attitude toward epilepsy in Hungary since 1994. A multicriteria weighting analysis. Epilepsia Open 2024; 9:1042-1050. [PMID: 38546973 PMCID: PMC11145619 DOI: 10.1002/epi4.12935] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2024] [Revised: 03/13/2024] [Accepted: 03/19/2024] [Indexed: 06/04/2024] Open
Abstract
OBJECTIVE To assess the adult Hungarian population's knowledge about and attitude toward epilepsy and compare the present findings with previous ones in 1994 and 2000. METHODS We performed a cross-sectional survey of the Hungarian adult population from 28th February to 8th March 2023. A non-probability quota sampling with a random walk method was used. We applied the computer-assisted personal interviewing (CAPI) method and used a multicriteria weighting procedure to correct for bias along the main sociodemographic variables. To detect changes over time, we used chi-squared tests, and to analyze the effect of sociodemographic characteristics, we applied multivariate logistic regression. RESULTS One thousand participants (53.1% women, mean age 48.1 ± 16.75 years) representing Hungary's population were interviewed yielding a response rate of 80.3%. 26.3% knew someone with epilepsy (55.9% in 1994 and 51.9% in 2000), and 30.8% saw an epileptic seizure (58% in 1994 and 55.3% in 2000). Compared to the young, fewer adults and elderly people knew someone with epilepsy or had seen a seizure. Like in 1994 and 2000, 16.6% reported objection to their children's interaction with people with epilepsy; however, in the present study, significantly fewer people opposed their children marrying or working together with epileptic people, indicating a change in attitude (p < 0.0001). Rural residents had less objection to their children's interaction with people with epilepsy (p < 0.05). People with secondary education objected significantly more often than those with primary education to their children's interaction (p = 0.037), marriage to people with epilepsy (p = 0.043), or their having equal employment (p = 0.008). Higher education people were as "permissive" as those with primary education. SIGNIFICANCE Certain parameters of familiarity and attitude markers of the Hungarian population toward epilepsy have improved. These tendencies are promising, but work is still needed; our results will hopefully evoke educational programs and campaigns against negative attitudes. PLAIN LANGUAGE SUMMARY The knowledge of the Hungarian population about epilepsy and their attitude toward people with epilepsy has been improved since 1994. People from rural areas have shown more acceptance for people with epilepsy. Those people who completed secondary education were significantly more prone to stigmatization than those with primary education.
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Affiliation(s)
- Mengesha Srahbzu Biresaw
- Department of Behavioral SciencesDoctoral School of Mental Health SciencesSemmelweis UniversityBudapestHungary
| | - József Vitrai
- Department of Preventive Health Sciences, Faculty of Health and Sport SciencesSzéchenyi István UniversityGyőrHungary
| | - Péter Halász
- Department of Preventive Health SciencesSzentágothai Doctoral SchoolSemmelweis UniversityBudapestHungary
| | - Vivian Correa
- Department of Behavioral SciencesDoctoral School of Mental Health SciencesSemmelweis UniversityBudapestHungary
| | - Anna Szűcs
- Department of Behavioral SciencesSemmelweis UniversityBudapestHungary
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Aydemir N, Sakman ÖK, Delil Ş, Özkara Ç. Determinants of felt-stigma in adolescents with epilepsy: Is it the same story? Seizure 2023; 113:34-40. [PMID: 37952261 DOI: 10.1016/j.seizure.2023.11.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Revised: 10/30/2023] [Accepted: 11/01/2023] [Indexed: 11/14/2023] Open
Abstract
PURPOSE The present study aimed to investigate previously researched variables in adult people with epilepsy (PWE), which include felt stigma, perceived overprotection, concealment of epilepsy, and epilepsy-related concerns for adolescents with epilepsy (AWE). Another goal was to determine the reported levels of these variables and explore the relationships among them, as well as their associations with demographic and clinical factors. Additionally, we also investigated whether clinical and demographic variables create significant changes in these variables. Lastly, we aimed to determine the variables that predict felt-stigma in AWE. METHODS On hundred and nineteen AWE aged between 10 and 18 were included in the study by using convenience sampling. Participants received the scales and demographic information form either in face to face meeting or via a Zoom session. RESULTS Nearly half of the participants stated high level of felt stigma, perceived overprotection and concealment of epilepsy, while more than half reported concerns about their future/occupational prospects. Also, felt stigma had significant relations with concealment of epilepsy and concerns related to epilepsy. Early adolescents were under more risk for perceived overprotection, while late adolescents had higher concerns related to future/occupation. Females reported more felt stigma. Finally, felt stigma was predicted by concealment, concerns related to future/occupation, and concerns related to social life. CONCLUSION The variables that explain the felt-stigma in AWE appear to be quite similar to those in adult PWE.
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Affiliation(s)
- Nuran Aydemir
- Faculty of Letters, Department of Psychology, Istanbul University, Istanbul, Turkiye.
| | | | - Şakir Delil
- Faculty of Medicine, Department of Neurology, Istanbul Cerrahpaşa University, Istanbul, Turkiye
| | - Çiğdem Özkara
- Faculty of Medicine, Department of Neurology, Istanbul Cerrahpaşa University, Istanbul, Turkiye
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Clifford LM, Brothers SL, Lang A. Self-Disclosure Patterns Among Children and Youth with Epilepsy: Impact of Perceived-Stigma. Adolesc Health Med Ther 2023; 14:27-43. [PMID: 36776152 PMCID: PMC9910097 DOI: 10.2147/ahmt.s336124] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Accepted: 01/19/2023] [Indexed: 02/05/2023] Open
Abstract
This review aimed to synthesize the minimal existing literature on the impact of perceived stigma on self-disclosure patterns among children and youth with epilepsy (YWE). Initial literature searches were conducted in PsycInfo, Scopus, Web of Science, and PubMed using search terms focused on epilepsy, pediatrics, disclosure, and/or stigma. Articles were included if they were original human research articles published in peer-reviewed journals that were accessible in English through Cincinnati Children's Hospital Medical Center Pratt Library and fit study aims. Thirteen articles, which primarily used qualitative self-report methodologies, fit the study's inclusion criteria. YWE report greater perceived stigma and lower illness disclosure compared to youth with other chronic health conditions. Across studies, perceived stigma was consistently identified as a barrier to YWE disclosing their epilepsy diagnosis. Consequences of perceived stigma included lower self-esteem, poorer perceived competency, lack of self-confidence, social withdrawal, and lower quality of life. YWE's reluctance to disclose epilepsy was associated with worry about differential treatment, negative impact on close relationships, negative impact on others' perceptions, and negative self-perceptions. While WHO and ILAE have identified stigma as contributing to higher disease burden in people with epilepsy and have highlighted the importance of prioritizing social policy focused on decreasing epilepsy-related stigma, progress has been incremental and much work remains. Future research is needed to understand socio-cultural factors perpetuating stigma among YWE in order to further develop, evaluate, and disseminate evidence-based clinical and education programming to combat epilepsy-related stigma.
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Affiliation(s)
- Lisa M Clifford
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA,Correspondence: Lisa M Clifford, Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children’s Hospital Medical Center, 3333 Burnet Ave, MLC 3015, Cincinnati, OH, 45229, USA, Tel +1 513 803 3409, Fax +1 513 636 7756, Email
| | - Shannon L Brothers
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA
| | - Amy Lang
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA
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Tarhini Z, Jost J, Ratsimbazafy V, Preux PM, Salameh P, Al-Hajje A, Boumediene F, Mroueh L. Knowledge of epilepsy, quality of life, and psychiatric comorbidities in Lebanese adults with epilepsy. Epilepsy Behav 2022; 136:108924. [PMID: 36195023 DOI: 10.1016/j.yebeh.2022.108924] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Revised: 09/14/2022] [Accepted: 09/15/2022] [Indexed: 12/14/2022]
Abstract
INTRODUCTION People with epilepsy (PWE) face a variety of psychosocial challenges. A lack of knowledge of epilepsy, a high level of depression and anxiety and a low quality of life (QoL) are among the major problems that affect most PWE. The objective of this study was to examine the association of sociodemographic characteristics, clinical factors and knowledge of epilepsy with the level of QoL, and the presence of psychiatric comorbidities. METHOD A cross-sectional study was conducted in Lebanon. The PWE were recruited from neurologists' clinics in Beirut and its suburbs. A questionnaire translated into Arabic was used and composed of four parts: sociodemographic factors, clinical characteristics, psychosocial characteristics (QoL, psychiatric disorders), and knowledge epilepsy scale. Backward logistic regression models were developed, the associations were estimated by odds ratio (OR), and the level of significance was set at p ≤ 0.05. RESULTS Four hundred and four PWE were recruited in this study. About a half of PWE had controlled epilepsy (46.3 %) and 40.3 % had epilepsy for less than 5 years. The QoL was low for 38.6 % of PWE and 30.2 % had psychiatric comorbidities. More than half of PWE had a good level of knowledge (71.5 %). Controlled epilepsy (OR = 1.8; 95 %CI: 1.2-2.9), and good knowledge about epilepsy (OR = 5.5; 95 %CI: 3.4-9.1) were associated with better QoL. Patients on polytherapy with anti-seizure drugs (OR = 0.6; 95 %CI: 0.4-0.9), experienced side effects of anti-seizure drugs (OR = 0.6; 95 %CI: 0.4-0.9) and with psychiatric comorbidities (OR = 0.6; 95 %CI: 0.3-0.9) had a lower QoL. A high number of nonpsychiatric comorbidities (OR = 2.5; 95 %CI: 2.0-3.1) and a polytherapy increased the risk of having psychiatric comorbidities (OR = 1.8; 95 %CI: 1.1-2.8). CONCLUSIONS Good knowledge of epilepsy and the absence of psychiatric comorbidities are important predictors of good QoL in Lebanese PWE. Educational programs are needed to reduce misconceptions about epilepsy and improve mental health of PWE.
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Affiliation(s)
- Zeinab Tarhini
- Univ. Limoges, EpiMaCT - Epidemiology of Chronic Diseases in Tropical Zone, Institute of Epidemiology and Tropical Neurology, OmegaHealth, Limoges, France; Inserm, U1094, EpiMaCT - Epidemiology of Chronic Diseases in Tropical Zone, Limoges, France; IRD, U270, EpiMaCT - Epidemiology of Chronic Diseases in Tropical Zone, Limoges, France
| | - Jeremy Jost
- Univ. Limoges, EpiMaCT - Epidemiology of Chronic Diseases in Tropical Zone, Institute of Epidemiology and Tropical Neurology, OmegaHealth, Limoges, France; Inserm, U1094, EpiMaCT - Epidemiology of Chronic Diseases in Tropical Zone, Limoges, France; IRD, U270, EpiMaCT - Epidemiology of Chronic Diseases in Tropical Zone, Limoges, France; CHU Limoges, Department of Pharmacy, Limoges, France
| | - Voa Ratsimbazafy
- Univ. Limoges, EpiMaCT - Epidemiology of Chronic Diseases in Tropical Zone, Institute of Epidemiology and Tropical Neurology, OmegaHealth, Limoges, France; Inserm, U1094, EpiMaCT - Epidemiology of Chronic Diseases in Tropical Zone, Limoges, France; IRD, U270, EpiMaCT - Epidemiology of Chronic Diseases in Tropical Zone, Limoges, France; CHU Limoges, Department of Pharmacy, Limoges, France
| | - Pierre-Marie Preux
- Univ. Limoges, EpiMaCT - Epidemiology of Chronic Diseases in Tropical Zone, Institute of Epidemiology and Tropical Neurology, OmegaHealth, Limoges, France; Inserm, U1094, EpiMaCT - Epidemiology of Chronic Diseases in Tropical Zone, Limoges, France; IRD, U270, EpiMaCT - Epidemiology of Chronic Diseases in Tropical Zone, Limoges, France
| | - Pascale Salameh
- Clinical and Epidemiological Research Laboratory, Faculty of Pharmacy, Lebanese University, Hadath, Beirut, Lebanon; Institut National de Santé Publique, Epidémiologie Clinique et Toxicologie - Liban (INSPECT-LB), Beirut, Lebanon; University of Nicosia Medical School, Nicosia, Cyprus; Lebanese American University, School of Medicine, Lebanon
| | - Amal Al-Hajje
- Clinical and Epidemiological Research Laboratory, Faculty of Pharmacy, Lebanese University, Hadath, Beirut, Lebanon
| | - Farid Boumediene
- Univ. Limoges, EpiMaCT - Epidemiology of Chronic Diseases in Tropical Zone, Institute of Epidemiology and Tropical Neurology, OmegaHealth, Limoges, France; Inserm, U1094, EpiMaCT - Epidemiology of Chronic Diseases in Tropical Zone, Limoges, France; IRD, U270, EpiMaCT - Epidemiology of Chronic Diseases in Tropical Zone, Limoges, France
| | - Lara Mroueh
- Univ. Limoges, EpiMaCT - Epidemiology of Chronic Diseases in Tropical Zone, Institute of Epidemiology and Tropical Neurology, OmegaHealth, Limoges, France; Inserm, U1094, EpiMaCT - Epidemiology of Chronic Diseases in Tropical Zone, Limoges, France; IRD, U270, EpiMaCT - Epidemiology of Chronic Diseases in Tropical Zone, Limoges, France; Clinical and Epidemiological Research Laboratory, Faculty of Pharmacy, Lebanese University, Hadath, Beirut, Lebanon.
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Perceived stigma and self-esteem for children with epilepsy. Epilepsy Res 2022; 186:107017. [PMID: 36113252 DOI: 10.1016/j.eplepsyres.2022.107017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2022] [Revised: 08/24/2022] [Accepted: 09/07/2022] [Indexed: 11/23/2022]
Abstract
OBJECTIVE The study was conducted to determine the sense of stigma and self-esteem in children with epilepsy. METHODS The study has a descriptive-correlational design.The research group included 150 children aged 9 to 15 who presented to a hospital in eastern Turkey, the Pediatric Neurology Clinic and Polyclinic, between January and June 2021, and were admitted to a pediatric clinic associated with the epilepsy polyclinic. A personal information form, a child perceptions scale (CPS), and the Coopersmith Self-Esteem Inventory (CSEI) were used to collect the data. RESULTS Children scored an average of 3.31 ± 1.10 on the CPS and an average of 37.33 ± 27.78 on the CSEI. A statistically significant, high-level, and negative relationship was found between CSEI and CPS scores (p < 0.05). As the CSEI score increases, the CPS score drops. A statistically significant model was obtained from the regression analysis (F = 246.816; p = 0.000; R2 = 0.791; SH = 17.07). The CSEI score significantly predicts the CPS score. CONCLUSION The research study revealed that children with epilepsy have a high perception of stigma and low self-esteem levels, and that children's perceptions of being stigmatized are influenced by their educational status, their parents' educational status, their income level, their family type variables, and their self-esteem. The study determined that children's self-esteem decreased as their perception of stigma increased.
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Yu Z, Shao Q, Hou K, Wang Y, Sun X. The experiences of caregivers of children with epilepsy: A meta-synthesis of qualitative research studies. Front Psychiatry 2022; 13:987892. [PMID: 36177220 PMCID: PMC9513543 DOI: 10.3389/fpsyt.2022.987892] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Accepted: 08/18/2022] [Indexed: 11/13/2022] Open
Abstract
Objective Epilepsy is one of the most common chronic neurological disorders in children. The caregivers of these children bear heavy burden of care in the process of taking care of them. The objective of this metasynthesis was to explore the experiences and needs of caregivers of children with epilepsy. Methods and data sources Eight databases (PubMed, CINAHL, EMBASE, Web of Science, CNKI, Wanfang Data, VIP database, and CBM) were searched for qualitative studies from each database's inception to 31 June 2021. Studies were critically appraised using the Joanna Briggs Institute (JBI) Critical Appraisal Checklist for Qualitative Research. Qualitative data were extracted, summarized, and meta-synthesized. Results 13 studies were included, covering the data of 316 participants. 36 research results were extracted from these studies, which were combined into 11 categories, and finally formed 4 themes: (a) heavy burden of care; (b) emotional experience; (c) coping strategies; (d) care needs. Conclusion Caregivers beared a heavy burden of care and psychological burden. Despite the adoption of different coping strategies, their emotional distress was still very serious. Caregivers had unmet care needs. In order to improve caregivers' care capacity, the society and healthcare workers need to provide them with information support, psychological support, and take measures to create a friendly medical and living environment for them. Impact Understanding the experiences of caregivers of children with epilepsy will inform future research and practice. Healthcare workers could develop interventions to reduce caregiver burden and improve the level of caregivers' mental health. On the other hand, effective programs should be designed to improve caregivers' knowledge of the disease and enhance their ability to care. Society needs to take steps to improve the medical environment and the social stigma that is not friendly to epilepsy.
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Affiliation(s)
- Zhichao Yu
- Shengjing Hospital of China Medical University, Shenyang, China
| | - Qinwen Shao
- Wuhan University of Bioengineering, Wuhan, China
| | - Kunhua Hou
- Henan Provincial People's Hospital, Zhengzhou, China
| | | | - Xianghong Sun
- Shengjing Hospital of China Medical University, Shenyang, China
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Parents’/caregivers’ fears and concerns about their child’s epilepsy: A scoping review. PLoS One 2022; 17:e0274001. [PMID: 36067199 PMCID: PMC9447888 DOI: 10.1371/journal.pone.0274001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Accepted: 08/20/2022] [Indexed: 11/19/2022] Open
Abstract
Background Childhood epilepsy is a serious and common neurological condition and can have life-long consequences and its impact can pervade all aspects of family life. Whilst the medical management of seizures is important, much of the day-to-day home management of epilepsy is invisible to people external to the family, including health care professionals, and parents’/caregivers’ fears and concerns can go unacknowledged and unaddressed by health care professionals. Objective This objective of this review was to examine parents’/caregivers’ fears and concerns regarding their child’s epilepsy, the impact of these fears and concerns on family life, the social and emotional well-being of parents/caregivers and any factors which mitigate these fears and concerns. Design Scoping review using a modified version of Arksey and O’Malley’s framework. Data sources Relevant studies were identified using key search terms in Scopus, Medline, CINAHL and PsychInfo databases in March 2021 with hand checking of reference lists. Search terms were developed using population (parents/caregivers of children aged ≤ 18 years with epilepsy, families); concept (parents’/caregivers’ fears, concerns, anxiety about their child’s epilepsy); and context (any setting). A further search was run in April 2022. Other inclusion criteria: English language empirical studies, 2010–2021. Study appraisal methods A minimum of two reviewers independently screened articles and undertook data extraction and decisions were consensually made. Methodological quality appraisal was undertaken using the Mixed Methods Appraisal Tool v2018. A data extraction table was created to chart all studies. The conduct and reporting of this study followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidance for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) (S1 Table). There is no published copy of the review protocol. Main findings The search identified a total of 4077 papers (after duplicates were removed) of which 110 were assessed for eligibility. Twenty-four papers published between 2010–2021 were included in the review and each paper was treated as a separate study. The review findings indicate that parents’/caregivers’ fears and concerns stem from more than their child’s seizures and relate to many wider aspects of family life. These fears and concerns had far-reaching influences on their parenting/caregiving, and on the lifestyle and activities of their child and their family. What was less evident was what parents/caregivers wanted in terms of support or how they thought health professionals could acknowledge and/or allay their fears and concerns. The discussion is framed within the compassion-focused therapy model as a basis for generating new thinking about the impact of these fears and concerns and the need for a new agenda for clinical consultations in childhood epilepsy. Conclusions The review concludes with a proposal that a more compassionate agenda underpins the dialogue between parents/caregivers and clinicians to encompass and mitigate the wider emotional, psychosocial, and societal threats that impact on the parent/caregivers of children with epilepsy.
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Kwon CS, Jacoby A, Ali A, Austin J, Birbeck GL, Braga P, Cross JH, de Boer H, Dua T, Fernandes PT, Fiest KM, Goldstein J, Haut S, Lorenzetti D, Mifsud J, Moshe S, Parko KL, Tripathi M, Wiebe S, Jette N. Systematic review of frequency of felt and enacted stigma in epilepsy and determining factors and attitudes toward persons living with epilepsy-Report from the International League Against Epilepsy Task Force on Stigma in Epilepsy. Epilepsia 2022; 63:573-597. [PMID: 34985782 DOI: 10.1111/epi.17135] [Citation(s) in RCA: 36] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Revised: 11/09/2021] [Accepted: 11/10/2021] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To review the evidence of felt and enacted stigma and attitudes toward persons living with epilepsy, and their determining factors. METHODS Thirteen databases were searched (1985-2019). Abstracts were reviewed in duplicate and data were independently extracted using a standardized form. Studies were characterized using descriptive analysis by whether they addressed "felt" or "enacted" stigma and "attitudes" toward persons living with epilepsy. RESULTS Of 4234 abstracts, 132 met eligibility criteria and addressed either felt or enacted stigma and 210 attitudes toward epilepsy. Stigma frequency ranged broadly between regions. Factors associated with enacted stigma included low level of knowledge about epilepsy, lower educational level, lower socioeconomic status, rural areas living, and religious grouping. Negative stereotypes were often internalized by persons with epilepsy, who saw themselves as having an "undesirable difference" and so anticipated being treated differently. Felt stigma was associated with increased risk of psychological difficulties and impaired quality of life. Felt stigma was linked to higher seizure frequency, recency of seizures, younger age at epilepsy onset or longer duration, lower educational level, poorer knowledge about epilepsy, and younger age. An important finding was the potential contribution of epilepsy terminology to the production of stigma. Negative attitudes toward those with epilepsy were described in 100% of included studies, and originated in any population group (students, teachers, healthcare professionals, general public, and those living with epilepsy). Better attitudes were generally noted in those of younger age or higher educational status. SIGNIFICANCE Whatever the specific beliefs about epilepsy, implications for felt and enacted stigma show considerable commonality worldwide. Although some studies show improvement in attitudes toward those living with epilepsy over time, much work remains to be done to improve attitudes and understand the true occurrence of discrimination against persons with epilepsy.
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Affiliation(s)
- Churl-Su Kwon
- Departments of Neurosurgery, Neurology and Population Health Sciences & Policy, Icahn School of Medicine, New York, New York, USA
| | - Ann Jacoby
- Department of Public Health and Policy, University of Liverpool, Liverpool, UK
| | - Amza Ali
- Kingston Public Hospital and University of the West Indies, Kingston, Jamaica
| | - Joan Austin
- Indiana University School of Nursing, Indianapolis, Indiana, USA
| | - Gretchen L Birbeck
- Epilepsy Division, University of Rochester, Rochester, New York, USA
- Epilepsy Care Team, Chikankata Hospital, Mazabuka, Zambia
| | - Patricia Braga
- Facultad de Medicina, Institute of Neurology, Universidad de la República, Montevideo, Uruguay
| | - J Helen Cross
- Developmental Neurosciences Programme, UCL-NIHR BRC Great Ormond Street Institute of Child Health, London, UK
| | - Hanneke de Boer
- SEIN - Epilepsy Institute in the Netherlands Foundation, Heemstede, The Netherlands
| | - Tarun Dua
- Department of Mental Health and Substance Abuse, World Health Organization, Geneva, Switzerland
| | - Paula T Fernandes
- Department of Sport Science, Faculty of Physical Education, UNICAMP, Campinas, Brazil
| | - Kirsten M Fiest
- Department of Critical Care Medicine and Department of Community Health Sciences, Hotchkiss Brain Institute, O'Brien Institute for Public Health, University of Calgary, Calgary, Alberta, Canada
| | - Jonathan Goldstein
- Departments of Neurology and Population Health Sciences & Policy, Icahn School of Medicine, New York, New York, USA
| | - Sheryl Haut
- Saul R. Korey Department of Neurology, Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, New York, USA
| | - Diane Lorenzetti
- Department of Community Health Sciences, University of Calgary and Health Sciences Library, University of Calgary, Calgary, Alberta, Canada
| | - Janet Mifsud
- Department of Clinical Pharmacology and Therapeutics, Faculty of Medicine and Surgery, University of Malta, Msida, Malta
| | - Solomon Moshe
- Saul R. Korey Department of Neurology, Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, New York, USA
- Department of Pediatrics and Dominick P. Purpura Department of Neuroscience, Albert Einstein College of Medicine, Bronx, New York, USA
| | - Karen L Parko
- Department of Neurology, University of California at San Francisco, San Francisco, California, USA
- Epilepsy Center, San Francisco VA Medical Center, San Francisco, California, USA
| | - Manjari Tripathi
- Department of Neurology, All India Institute of Medical Sciences, New Delhi, India
| | - Samuel Wiebe
- Department of Clinical Neurosciences and Department of Community Health Sciences, Hotchkiss Brain Institute, O'Brien Institute for Public Health, University of Calgary, Calgary, Alberta, Canada
| | - Nathalie Jette
- Departments of Neurology and Population Health Sciences & Policy, Icahn School of Medicine, New York, New York, USA
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11
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Lang J, Jeschke S, Herziger B, Müller RM, Bertsche T, Neininger MP, Bertsche A. Prejudices against people with epilepsy as perceived by affected people and their families. Epilepsy Behav 2022; 127:108535. [PMID: 35026561 DOI: 10.1016/j.yebeh.2021.108535] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2021] [Revised: 12/27/2021] [Accepted: 12/27/2021] [Indexed: 11/03/2022]
Abstract
PROBLEM Prejudices can impair social participation of people with epilepsy. METHODS From 2019 to 2020, we invited people with epilepsy and their relatives across Germany to fill in a questionnaire. RESULTS Two hundred and thirty people with epilepsy (PWE, median age: 40 years; min./max.: 19/83; 66% female) and 103 relatives (REL, median age: 42 years; min./max. 23/70; 83% female) took part in the survey. 44% PWE and 40% REL said prejudices against PWE had not declined in recent years. Of PWE, 64% reported they had experienced prejudices themselves. In an open question with multiple answers possible, 71% of the PWE described concrete prejudices against PWE, 62% of the REL did so. The reported prejudices concerned symptoms of epilepsy (37% PWE; 23% REL), academic or occupational performance (47% PWE; 38% REL), social or family life (27% PWE, 29% REL), and other topics (7% PWE, 4% REL). Of PWE, 88% said all or almost all relatives knew about their condition, 74% stated this applied to all or almost all friends, and 48% told all or almost all colleagues about their epilepsy. Of PWE, 94% would want to know if a relative had epilepsy, 87% would like to know about a friend's epilepsy, 70% about a colleague's epilepsy. Fear of stigmatization was a reason for not always communicating the condition according to 20% PWE and 63% REL. None of PWE and 16% of REL named shame as a reason. CONCLUSION People with epilepsy still experience prejudices and fear of stigmatization hinders an open communication about the condition.
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Affiliation(s)
- Jana Lang
- Neuropaediatrics, University Hospital for Children and Adolescents, Ernst-Heydemann-Straße 8, 18057 Rostock, Germany.
| | - Sarah Jeschke
- Neuropaediatrics, University Hospital for Children and Adolescents, Ernst-Heydemann-Straße 8, 18057 Rostock, Germany.
| | - Birthe Herziger
- Neuropaediatrics, University Hospital for Children and Adolescents, Ernst-Heydemann-Straße 8, 18057 Rostock, Germany.
| | - Ruth Melinda Müller
- Neuropaediatrics, University Hospital for Children and Adolescents, Ernst-Heydemann-Straße 8, 18057 Rostock, Germany.
| | - Thilo Bertsche
- Clinical Pharmacy, Institute of Pharmacy, Medical Faculty, Leipzig University and Drug Safety Center, Leipzig University and University Hospital, Bruederstraße 32, 04103 Leipzig, Germany.
| | - Martina Patrizia Neininger
- Clinical Pharmacy, Institute of Pharmacy, Medical Faculty, Leipzig University and Drug Safety Center, Leipzig University and University Hospital, Bruederstraße 32, 04103 Leipzig, Germany.
| | - Astrid Bertsche
- Neuropaediatrics, University Hospital for Children and Adolescents, Ernst-Heydemann-Straße 8, 18057 Rostock, Germany.
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12
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Malik NI, Fatima R, Ullah I, Atta M, Awan A, Nashwan AJ, Ahmed S. Perceived stigma, discrimination and psychological problems among patients with epilepsy. Front Psychiatry 2022; 13:1000870. [PMID: 36440406 PMCID: PMC9681901 DOI: 10.3389/fpsyt.2022.1000870] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Accepted: 10/12/2022] [Indexed: 11/11/2022] Open
Abstract
OBJECTIVE The current study sought to investigate the effects of perceived stigma and discrimination on epilepsy patients' psychological problems, such as depression, anxiety, and quality of life. STUDY DESIGN A purposive sampling technique was used in this cross-sectional study. MATERIALS AND METHODS The sample consisted of 186 patients with epilepsy. The Stigma Scale, Depression Anxiety Stress Scale, and Quality of life in Epilepsy-10 were used to measure the study variables. RESULTS Findings showed that both the perception of stigma and discrimination have a significant positive correlation with depression as well as anxiety. Stigma is a significant positive predictor of depression and anxiety at [F (1, 184) = 27.8, 15.92, p < 0.001, 0.001, respectively] and explains 12.7 and 7.5% variance that could be attributed to Stigma. Stigma is also a significant predictor of quality of life at [F (1, 184) = 16.10, p < 0.001] and explains the 7.5% variance that could be attributed to Stigma. Results also indicate that discrimination is a significant positive predictor of depression and anxiety at [F (1, 184) = 32.39, 19.91, p < 0.001] and explains 15 and 9.8 % variance, respectively, that could be attributed to Stigma. However, stigma negatively predicts quality of life at [F (1, 184) = 20.34, p < 0.001] and explains 10 % variance. Non-significant differences were found in all the demographic variables (i.e., gender, socio-economic status, and disease duration), except the quality of life was significantly high among individuals with high Socio-economic status. CONCLUSIONS Stigma is significantly higher in epileptic patients and has a detrimental effect on the patient's quality of life, recovery, and prognosis. Thus, there is undoubtedly a need to address psychological issues, most notably the stigma associated with illnesses. Psychologists, psychiatrists, other physicians, and care givers of epileptic patients must pay close attention to the stigma in this patient population.
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Affiliation(s)
- Najma Iqbal Malik
- Department of Psychology, University of Sargodha, Sargodha, Pakistan
| | - Rabia Fatima
- Department of Psychology, University of Sargodha, Sargodha, Pakistan
| | - Irfan Ullah
- Kabir Medical College, Gandhara University, Peshawar, Pakistan
| | - Mohsin Atta
- Department of Psychology, University of Sargodha, Sargodha, Pakistan
| | | | | | - Saeed Ahmed
- Rutland Regional Medical Center, Rutland, VT, United States
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13
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Rice DR, Cisse FA, Djibo Hamani AB, Tassiou NR, Sakadi F, Bah AK, Othon GC, Conde ML, Diawara K, Traoré M, Doumbouya I, Koudaye C, Mateen FJ. Epilepsy stigma in the Republic of Guinea and its socioeconomic and clinical associations: A cross-sectional analysis. Epilepsy Res 2021; 177:106770. [PMID: 34619642 DOI: 10.1016/j.eplepsyres.2021.106770] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Revised: 09/13/2021] [Accepted: 09/19/2021] [Indexed: 11/28/2022]
Abstract
OBJECTIVE We aim to quantify the degree of epilepsy stigma perceived by people living with epilepsy (PLWE) in the Republic of Guinea (2019 gross national income per capita, 930 USD) and analyze the demographic, social, and clinical factors associated with epilepsy stigma in this setting. METHODS A prospective convenience cohort of PLWE was recruited at the Ignace Deen Hospital in Conakry and evaluated by U.S. and Guinean neurology-trained physicians. A survey instrument exploring demographic, social, and clinical variables was designed and administered. The primary outcome measure was the Stigma Scale of Epilepsy (SSE), a 24-item scale with scores ranging from 0 (least stigma)-100 (most). Regression models were fit to assess associations between SSE score and pre-selected demographic, social, and clinical variables of interest. RESULTS 249 PLWE (112 female; mean age 20.0 years; 22 % from rural locales; 14 % of participants >16 years old with no formal schooling; 11 % seizure-free for >=6 months) had an average SSE score of 46.1 (standard deviation = 14.5) points. Children had an average SSE score of 45.2, and adults had an average score of 47.0. There were no significant differences between self- and guardian-reported SSE scores (means = 45.8 and 46.5, respectively), p = .86. In univariate analyses, higher stigma scores were associated with more seizures (p = .005), more depressive symptoms (p = .01), and lower household wealth (p = .03). In a multivariable model including sex, educational level, household wealth, generalized tonic-clonic seizures, seizure frequency, and seizure-related burns, only higher seizure frequency (β = -2.34, p = .03) and lower household wealth (β = 4.05, p = .03) were significantly associated with higher SSE scores. CONCLUSION In this Guinean cohort of people living with poorly-controlled epilepsy, there was a moderate degree of perceived stigma on average. Stigma was associated with higher seizure frequency and lower household wealth-both potentially modifiable factors.
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Affiliation(s)
- Dylan R Rice
- Department of Neurology, Massachusetts General Hospital, Boston, MA, USA
| | | | | | | | - Foksouna Sakadi
- Department of Neurology, Ignace Deen Hospital, Conakry, Guinea
| | | | | | - Mohamed L Conde
- Department of Neurology, Ignace Deen Hospital, Conakry, Guinea
| | - Karinka Diawara
- Department of Neurology, Ignace Deen Hospital, Conakry, Guinea
| | - Mohamed Traoré
- Department of Neurology, Ignace Deen Hospital, Conakry, Guinea
| | | | - Camara Koudaye
- Department of Neurology, Ignace Deen Hospital, Conakry, Guinea
| | - Farrah J Mateen
- Department of Neurology, Massachusetts General Hospital, Boston, MA, USA.
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14
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Johnson EC, Atkinson P, Muggeridge A, Cross JH, Reilly C. Epilepsy in schools: Views on educational and therapeutic provision, understanding of epilepsy and seizure management. Epilepsy Behav 2021; 122:108179. [PMID: 34256338 DOI: 10.1016/j.yebeh.2021.108179] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Revised: 06/07/2021] [Accepted: 06/11/2021] [Indexed: 11/08/2022]
Abstract
OBJECTIVE To gain an understanding of the views of young people with epilepsy, their parents and school staff regarding educational and therapeutic provision, understanding of epilepsy and seizure management in schools. METHODS School-aged children (n = 20) with 'active epilepsy' (taking Anti-Seizure Medications (ASMs) for epilepsy), their parents (n = 68), and school staff (n = 56) were interviewed or completed bespoke questionnaires. In addition, all participating children underwent psychological assessment including measures of behavior and cognition. RESULTS Only 15% of participating children had received psychological support despite 60% scoring within the at-risk range on a measure of behavioral and emotional difficulties. More than half of the responding children reported that some of their teachers and friends did not know that they had epilepsy. A significant minority of parents (32%) did not feel that the child's transition from preschool to primary, or primary to secondary school was managed well. Knowledge of the child's epilepsy was felt to be significantly better in special schools than mainstream schools according to both parents and school staff. Staff in special schools perceived they were more knowledgeable about the child's ASMs and changes to ASMs than staff in mainstream schools. Staff in special schools were significantly more likely to have received training on general aspects of epilepsy, seizure management, and impacts on learning and/or behavior. Parental interviews indicated difficulties accessing educational and therapeutic supports. Parents often felt that they had to drive the process to gain supports themselves. They also reported limited professional support, and inadequate communication between themselves and the school and school staff and medical/therapeutic professionals regarding their child's needs. Parents would like more school staff to recognize the impacts of epilepsy on learning and behavior and to support their child more holistically. Many parents wanted more resources for assessment and therapeutic provision in relation to their child's learning, behavior, and emotions. CONCLUSION Knowledge of epilepsy is felt by parents and staff to be significantly better in special schools compared with mainstream schools. Parents highlighted the need for increased knowledge of the impacts of epilepsy on learning and behavior and perceived a need for more resources for assessment of these difficulties.
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Affiliation(s)
- Emma C Johnson
- Research Department, Young Epilepsy, Lingfield, Surrey RH7 6PW, UK
| | - Patricia Atkinson
- Child Development Centre, Crawley Hospital, West Green Drive, Crawley RH11 7DH, West Sussex, UK
| | - Amy Muggeridge
- Research Department, Young Epilepsy, Lingfield, Surrey RH7 6PW, UK
| | - J Helen Cross
- Research Department, Young Epilepsy, Lingfield, Surrey RH7 6PW, UK; Great Ormond Street Hospital for Children NHS Trust, Great Ormond Street, London WC1N 3JH, UK; UCL, NIHR BRC Great Ormond Street Institute of Child Health (ICH), 30 Guilford Street London WC1N 1EH, UK
| | - Colin Reilly
- Research Department, Young Epilepsy, Lingfield, Surrey RH7 6PW, UK; UCL, NIHR BRC Great Ormond Street Institute of Child Health (ICH), 30 Guilford Street London WC1N 1EH, UK.
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15
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Monnapula-Mazabane P, Petersen I. Mental health stigma experiences among caregivers and service users in South Africa: a qualitative investigation. CURRENT PSYCHOLOGY 2021; 42:9427-9439. [PMID: 34465971 PMCID: PMC8396139 DOI: 10.1007/s12144-021-02236-y] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/13/2021] [Indexed: 11/06/2022]
Abstract
The study aimed to understand the nature and context of mental health stigma among people living with a mental health condition and the subsequent effect on their caregivers. Semi-structured qualitative face to face interviews were conducted by trained mental healthcare professionals with mental health service users (n = 26) and caregivers (n = 24) in private rooms at a tertiary health facility, where service users were admitted. Following transcription and translation, data was analysed using framework analysis. There was limited knowledge about their mental health diagnosis by service users and generally low mental health literacy among service users and caregivers. Mental health service users reported experiences of stigma from their own families and communities. Caregivers reported withholding the patient’s diagnosis from the community for fear of being stigmatised, and this fear of stigma carries the risk of negatively affecting care treatment-seeking. Limited mental health knowledge, coupled with a high prevalence of perceived family and community stigma among caregivers and service users, impedes the capacity of caregivers to effectively cope in supporting their family members living with mental illness. There is a need for interventions to provide psychoeducation, reduce community stigma, and support coping strategies for caregivers and people with mental health conditions.
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Affiliation(s)
- Portia Monnapula-Mazabane
- School of Applied Human Sciences, Discipline of Psychology, University of KwaZulu-Natal, Durban, 4001 South Africa
| | - Inge Petersen
- Centre for Rural Health, School of Nursing and Public Health, University of KwaZulu-Natal, Durban, 4001 South Africa
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16
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Roberts CM, Addante SM, Baudino MN, Edwards CS, Gamwell KL, Jacobs NJ, Tung J, Grunow JE, Mullins LL, Chaney JM. Stigma Moderates the Relation Between Peer Victimization, Thwarted Belongingness, and Depressive Symptoms in Youth with Inflammatory Bowel Disease. J Pediatr Nurs 2021; 59:137-142. [PMID: 33878539 DOI: 10.1016/j.pedn.2021.04.011] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Accepted: 04/10/2021] [Indexed: 10/21/2022]
Abstract
PURPOSE The stigmatizing nature of IBD symptoms may place youth at risk for being targets of peer victimization, potentially resulting in a decreased sense of social belongingness and poorer emotional adjustment. The present study tested a series of mediation and moderated mediation models examining the associations among peer victimization, thwarted social belongingness, and depressive symptoms, as well as the moderating role of IBD stigma in these associations. We hypothesized peer victimization would have an indirect effect on youth depressive symptoms through thwarted belongingness, and this effect would be amplified for youth endorsing greater IBD stigma. DESIGN AND METHODS Seventy-five youth (10-18 yrs.) diagnosed with IBD were recruited from a pediatric gastroenterology clinic. Participants completed self-report measures of IBD stigma, peer victimization, thwarted belongingness, and depressive symptoms. RESULTS As anticipated, mediation analyses revealed a significant peer victimization → thwarted belongingness → depressive symptoms indirect path. Moderated mediation analyses indicated that this indirect effect was moderated by IBD stigma and was significantly greater among youth reporting higher IBD stigma. CONCLUSIONS Youth who experience higher levels of IBD-related stigma are at increased risk for depressive symptoms as a function of the socially isolating effects of peer victimization. PRACTICE IMPLICATIONS Our findings highlight the need for routine screening and identification of the socioemotional challenges faced by youth with IBD. Clinical interventions that incorporate coping strategies aimed at minimizing youths' stigmatizing self-perceptions and improving overall social skills and social engagement may lessen the negative impact of peer victimization on youths' social and emotional adjustment.
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Affiliation(s)
- Caroline M Roberts
- Center for Pediatric Psychology, Psychology Department, Oklahoma State University, USA.
| | - Samantha M Addante
- Center for Pediatric Psychology, Psychology Department, Oklahoma State University, USA
| | - Marissa N Baudino
- Center for Pediatric Psychology, Psychology Department, Oklahoma State University, USA
| | - Clayton S Edwards
- Center for Pediatric Psychology, Psychology Department, Oklahoma State University, USA
| | | | - Noel J Jacobs
- University of Oklahoma Children's Physicians, General and Community Pediatrics, USA
| | - Jeanne Tung
- University of Oklahoma Children's Physicians, Pediatric Gastroenterology, USA
| | - John E Grunow
- University of Oklahoma Children's Physicians, Pediatric Gastroenterology, USA
| | - Larry L Mullins
- Center for Pediatric Psychology, Psychology Department, Oklahoma State University, USA
| | - John M Chaney
- Center for Pediatric Psychology, Psychology Department, Oklahoma State University, USA
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17
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Reciprocal burden: Adults with drug-resistant epilepsy reflect upon informal caregiver support. Seizure 2021; 89:85-92. [PMID: 34034062 DOI: 10.1016/j.seizure.2021.04.022] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Revised: 04/19/2021] [Accepted: 04/27/2021] [Indexed: 11/23/2022] Open
Abstract
PURPOSE To explore how a sample of people with uncontrolled seizures describe their experiences of receiving informal supportive care. METHODS Using constructivist grounded theory, in-person, semi-structured interviews were conducted in 35 adults with drug-resistant epilepsy. These 20 (57%) women and 15 (43%) men were aged 18-68 years (mean= 35.6 years), with a range of verbal comprehension scores. The majority, 28 (80%) lived in nuclear family settings. RESULTS Unpredictable seizures disrupted personal autonomy and generated unique challenges for everyday life. While supportive care was deemed necessary to survival, subjective reflections around the implications of care-receiving and caregiving, were ultimately experienced as mutually burdensome. Four dynamic and interactive dimensions revealed a mirrored, interactive perspective of what it meant to be a care-recipient: assuming responsibility; protecting and supervising; acknowledging reliance and setting boundaries. Care-recipience was not one-sided, but included actively hiding personal struggles as a way to shield the caregiver from the emotional and physical demands of caregiving. Relationship dynamics between caregivers and care-recipients played a major role in treatment decision-making. A clinically useful Theory of Reciprocal Burden resulted from our study. CONCLUSIONS This study adds an explanatory dimension to the concept of illness burden from the perspective of care-recipients. Relationship dynamics play a key role in patient-centered epilepsy care, with clinical implications for guiding supportive caregiving, fostering independence and promoting self-management strategies.
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18
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Shi Y, Liu S, Wang J, Li C, Zhang J. Stigma experienced by patients with epilepsy: A systematic review and meta-synthesis of qualitative studies. Epilepsy Behav 2021; 118:107926. [PMID: 33862535 DOI: 10.1016/j.yebeh.2021.107926] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2020] [Revised: 03/03/2021] [Accepted: 03/03/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND Epilepsy, one of the most common and serious chronic neurological diseases, is accompanied by a series of complex psychosocial problems. A number of qualitative studies have investigated the stigma experiences among patients with epilepsy (PWE). However, the findings are different and complementary to a certain degree. We conducted a systematic review to investigate and synthesize existing qualitative research findings to fully identify stigma experienced by PWE. The aim was to develop anti-stigma interventions and reduce any adverse sequelae. OBJECTIVE To synthesize qualitative evidence on the stigma experiences of PWE. METHODS This was a systematic review and qualitative evidence synthesis guided by the Joanna Briggs Methodology. Systematic literature search for primary studies was conducted in PubMed, PsychINFO, EMBASE, and Web of Science databases until December 2019. Findings from the included qualitative studies were extracted, assessed for quality, and aggregated using meta-synthesis. RESULTS Twenty-six studies were included in the review. Four distinct synthesized findings were identified from the original researches: 'stigma experienced in daily life'; 'stigma perceived from others'; 'psychological reactions to stigma'; and 'strategies to address stigma'. CONCLUSION The present meta-synthesis thoroughly investigated the stigma experienced by PWE. The findings suggest that appropriate multi-level interventions targeting the general public, health professionals, caregivers, and patients themselves are warranted to reduce the harmful impacts of stigma.
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Affiliation(s)
- Ying Shi
- School of Nursing, Sun Yat-sen University, Guangzhou, China
| | - Sha Liu
- Department of Hematology, Union Hospital Affiliated to Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Jingjing Wang
- Department of Nursing, Internal Hospital of Tianjin Medical University General Hospital, Tianjin, China
| | - Chen Li
- Department of Neurology, The First Affiliated Hospital of Jinan University, Guangzhou, China
| | - June Zhang
- School of Nursing, Sun Yat-sen University, Guangzhou, China.
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19
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Assessing knowledge and attitudes toward epilepsy among schoolteachers and students: Implications for inclusion and safety in the educational system. PLoS One 2021; 16:e0249681. [PMID: 33798252 PMCID: PMC8018618 DOI: 10.1371/journal.pone.0249681] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2020] [Accepted: 03/22/2021] [Indexed: 11/20/2022] Open
Abstract
Several studies have evidenced inadequate knowledge about epilepsy and inappropriate seizure management, influencing quality of life and social inclusion of patients with epilepsy. Aim of the study was to estimate the knowledge and the attitudes toward epilepsy in schoolteachers and students in Italy. Custom-designed and validated questionnaires in Italian on general and specific knowledge, and social impact of epilepsy have been administered in a random sample of schoolteachers and students. Overall, 667 schoolteachers and 672 students have been included. Among teachers and students, consider epilepsy a psychiatric disorder (16.8% and 26.5%) or an incurable disease (43.9% and 33%). The 47.5% of teachers declared to be unable to manage a seizing student, 55.8% thought it requires specific support and 21.6% reported issues in administer antiseizure medications in school. Healthcare professionals should have an active role in the educational system, dispelling myths, preparing educators and students with appropriate attitudes in the event of a seizure and prevent over limitations in patients with epilepsy. These findings highlight still poor knowledge and attitudes about epilepsy among teachers and students although the 99.4% claimed to have heard/read something about epilepsy. Therefore, improving existing dedicated educational/training interventions could be necessary.
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20
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Roberts CM, Gamwell KL, Baudino MN, Grunow JE, Jacobs NJ, Tung J, Gillaspy SR, Hommel KA, Mullins LL, Chaney JM. The Contributions of Illness Stigma, Health Communication Difficulties, and Thwarted Belongingness to Depressive Symptoms in Youth with Inflammatory Bowel Disease. J Pediatr Psychol 2020; 45:81-90. [PMID: 31633787 DOI: 10.1093/jpepsy/jsz084] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2019] [Revised: 09/21/2019] [Accepted: 09/22/2019] [Indexed: 01/16/2023] Open
Abstract
OBJECTIVE Youth with inflammatory bowel disease (IBD) often experience difficulties communicating about their disease. It is suspected that the stigmatizing nature of IBD symptoms contributes to youths' health communication difficulties, leaving youth feeling disconnected from their social environment and potentially resulting in decreased social belongingness and poorer emotional functioning. In this study, we tested an illness stigma → health communication difficulties → thwarted belongingness → depressive symptoms serial mediation model. It was anticipated that youth illness stigma would confer a serial indirect effect on youth depressive symptoms through the sequential effects of stigma on health communication difficulties and thwarted social belongingness. METHODS Seventy-five youth with IBD between the ages of 10 and 18 completed measures of perceived illness stigma, health communication difficulties, thwarted belongingness, and depressive symptoms. RESULTS Results indicated a significant illness stigma → thwarted belongingness → depressive symptoms simple mediation path. Importantly, findings also revealed a significant serial mediation path for illness stigma → health communication difficulties → thwarted belongingness → depressive symptoms. CONCLUSIONS Youth who perceive greater IBD stigma appear to experience increased difficulty communicating about their IBD with others, which in turn is associated with feelings of thwarted social belongingness and ultimately elevated depressive symptoms. These findings suggest that difficulty communicating about IBD is one potential route by which illness stigma has a negative impact on youth adjustment outcomes. Results could also inform clinical interventions to address IBD stigma and health communication difficulties associated with the social and emotional challenges in youth with IBD.
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Affiliation(s)
- Caroline M Roberts
- Center for Pediatric Psychology, Psychology Department, Oklahoma State University
| | - Kaitlyn L Gamwell
- Center for Pediatric Psychology, Psychology Department, Oklahoma State University
| | - Marissa N Baudino
- Center for Pediatric Psychology, Psychology Department, Oklahoma State University
| | | | | | - Jeanne Tung
- University of Oklahoma Health Sciences Center
| | | | | | - Larry L Mullins
- Center for Pediatric Psychology, Psychology Department, Oklahoma State University
| | - John M Chaney
- Center for Pediatric Psychology, Psychology Department, Oklahoma State University
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Mroueh L, Boumediene F, Jost J, Ratsimbazafy V, Preux PM, Salameh P, Al-Hajje A. Quality of life and stigma in Lebanese people with epilepsy taking medication. Epilepsy Res 2020; 167:106437. [DOI: 10.1016/j.eplepsyres.2020.106437] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2020] [Revised: 07/07/2020] [Accepted: 08/01/2020] [Indexed: 11/24/2022]
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22
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Rank WP. Standing up to stigma in epilepsy. Nursing 2020; 50:48-52. [PMID: 32558791 DOI: 10.1097/01.nurse.0000659324.50792.71] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
This article explores the nature of stigma and discusses how stigma negatively affects both adults and children with epilepsy.
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Affiliation(s)
- Wendi Pope Rank
- Wendi Pope Rank is a certified neuroscience RN currently working as a substitute nurse in the Centennial School District in Pennsylvania
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23
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Jeschke S, Woltermann S, Neininger MP, Pauschek J, Kiess W, Bertsche T, Bertsche A. Why do children and adolescents with epilepsy disclose or not disclose their condition to their friends? Eur J Pediatr 2020; 179:1627-1633. [PMID: 32372187 PMCID: PMC7479002 DOI: 10.1007/s00431-020-03661-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2020] [Revised: 04/15/2020] [Accepted: 04/22/2020] [Indexed: 02/07/2023]
Abstract
A diagnosis of epilepsy substantially influences the lives of affected children and adolescents, and concealing the diagnosis can generate additional stress. However, little is known about whether children and adolescents communicate their diagnosis to their friends. We performed a survey at two German university hospitals. Epilepsy patients aged 6-18 years were asked why they did or did not disclose their condition to their friends. A total of 101 patients (44 female, 57 male) were interviewed. Twenty-one (21%) informed all their friends about their epilepsy, 63 (62%) informed only certain friends, and 3 (3%) did not specify. Fourteen (14%) did not inform any friends. Their reasons for informing their friends were trust in friends (47/87; 54%); questions from friends, e.g., about missed school days (29/87; 33%); a wish for friends to be informed in case of an emergency (15/87; 17%); and a desire to live openly with the condition (8/87; 9%). The reasons for not informing friends were fear of stigmatization/shame (4/14; 29%), discouragement from parents (3/14; 21%), and a wish for confidentiality (3/14; 21%).Conclusion: Most children and adolescents inform their friends about their epilepsy. Fear of stigmatization is the main reason for not informing friends about this condition. What is Known • An epilepsy diagnosis is a life-changing event for affected children and adolescents. • Having to conceal the diagnosis can be very stressful. What is New • Most pediatric epilepsy patients informed at least some close friends about their diagnosis motivated by trust in friends; questions from friends, e.g., about missed school days; and a wish for friends to be informed in case of an emergency. • Fear of stigmatization/shame, discouragement from parents, and a wish for confidentiality were the motivations for concealing the disease.
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Affiliation(s)
- Sarah Jeschke
- Neuropaediatrics, University Hospital for Children and Adolescents, Ernst-Heydemann-Str. 8, 18057 Rostock, Germany
| | - Sarah Woltermann
- Center for Pediatric Research, University Hospital for Children and Adolescents, Liebigstraße 20a, 04103 Leipzig, Germany
- Drug Safety Center and Clinical Pharmacy, Institute of Pharmacy, Medical Faculty, Leipzig University, Bruederstraße 32, 04103 Leipzig, Germany
| | - Martina Patrizia Neininger
- Drug Safety Center and Clinical Pharmacy, Institute of Pharmacy, Medical Faculty, Leipzig University, Bruederstraße 32, 04103 Leipzig, Germany
| | - Josefine Pauschek
- Neuropaediatrics, University Hospital for Children and Adolescents, Ernst-Heydemann-Str. 8, 18057 Rostock, Germany
| | - Wieland Kiess
- Center for Pediatric Research, University Hospital for Children and Adolescents, Liebigstraße 20a, 04103 Leipzig, Germany
| | - Thilo Bertsche
- Drug Safety Center and Clinical Pharmacy, Institute of Pharmacy, Medical Faculty, Leipzig University, Bruederstraße 32, 04103 Leipzig, Germany
| | - Astrid Bertsche
- Neuropaediatrics, University Hospital for Children and Adolescents, Ernst-Heydemann-Str. 8, 18057 Rostock, Germany
- Center for Pediatric Research, University Hospital for Children and Adolescents, Liebigstraße 20a, 04103 Leipzig, Germany
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O'Toole S, Gallagher P, Benson A, Shahwan A, Austin JK, Lambert V. Exploring the relationship between parent-child communication about epilepsy and psychosocial well-being. J Health Psychol 2019; 26:1207-1221. [PMID: 31448626 DOI: 10.1177/1359105319871642] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
Abstract
This study examined the relationship between parent-child communication and psychosocial well-being of 47 children living with epilepsy and 72 parents of children living with epilepsy. Open communication was associated with positive illness attitude, positive self-perception and greater health-related quality of life for children living with epilepsy; positive response to illness for parents; and more perceived social support and less need for epilepsy-related support for children living with epilepsy and parents. By contrast, closed communication was associated with poorer psychosocial well-being in children living with epilepsy and parents. Healthcare professionals should provide guidance for families living with childhood epilepsy on the importance of open communication in promoting greater psychosocial well-being.
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Affiliation(s)
| | | | | | - Amre Shahwan
- Children's Health Ireland at Temple Street, Ireland
| | - Joan K Austin
- Indiana University-Purdue University Indianapolis, USA
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Yildirim Z, Ertem DH, Ceyhan Dirican A, Baybas S. Who is the bigger stigmatizor?: The loved one or the society. Epilepsy Behav 2019; 96:13-22. [PMID: 31077937 DOI: 10.1016/j.yebeh.2019.04.013] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2019] [Revised: 04/09/2019] [Accepted: 04/10/2019] [Indexed: 11/18/2022]
Abstract
OBJECTIVE Epilepsy has long been considered by the society as a dangerous and frightening spiritual possession or even a contagious disease. This results in an unavoidable embarrassment for both the patient and the family leading to social isolation, seclusion, and secretiveness about the diagnosis. The aim of this study was to determine the stigmatizing level of the general Turkish population and to compare these results with the stigmatizing level of the patients' relatives group (PRG). METHODS This is a substudy of our main study which aimed to develop two scales for the quantification of the stigma level in patients with epilepsy (PWE) and their relatives [Stigma Scale for Epilepsy (SSE) -Self Report (SR) and -Informant Report (IR)]. First-degree relatives of the patients had been included in the main study. For the present study, 202 healthy people who were caregivers and relatives of neurologic patients other than epilepsy were recruited for the control group (CG). A sociodemographic and clinical data form and SSE-IR scale were administered to the CG as well. The relationship between sociodemographic characteristics and SSE-IR scores was evaluated, and a regression analysis was performed in order to analyze sociodemographic factors contributing to SSE-IR scores. Stigmatizing levels were compared between PRG and CG. Statistical analysis was performed using Statistical Package for the Social Sciences version 22.0 software. RESULTS Comparison of stigma scores among different sociodemographic strata of the CG showed that there was a statistically significant difference in terms of educational status and occupation (p < 0.01). Multivariate linear regression analysis revealed that education accounted for 10.8% and 8.9% of the variance in the SSE-IR scale respectively in the PRG and the CG. Prejudgment scores and total scores of the PRG were significantly higher than those of the CG. There was no statistically significant difference between two groups in terms of discrimination and false beliefs subscales scores. The proportion of highly stigmatizor participants in the PRG was statistically significantly higher than that of the CG. DISCUSSION/CONCLUSIONS This study showed us that the stigmatization levels in a group of subjects drawn from general population without acquaintance of epilepsy were lower than the relatives of the patients. This result may be partially explained by the ambivalent attitudes of the relatives, as those high scores may stem from not only enacted but also the felt stigma that they were experiencing themselves. It must be a warning sign for both of all the clinicians treating epilepsy and national association against epilepsy, as well as public health officials to increase efforts for awareness raising.
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Affiliation(s)
- Zerrin Yildirim
- Istanbul University, Aziz Sancar Institute of Experimental Medicine, Department of Neuroscience, Istanbul, Turkey; Bagcilar Education and Research Hospital, Department of Neurology, Istanbul, Turkey.
| | - Devrimsel Harika Ertem
- Sisli Hamidiye Etfal Education and Research Hospital, Department of Algology, Istanbul, Turkey
| | - Ayten Ceyhan Dirican
- Bakirkoy Prof. Dr. Mazhar Osman Mental Health and Neurological Diseases Education and Research Hospital, Department of Neurology, Istanbul, Turkey
| | - Sevim Baybas
- Bakirkoy Prof. Dr. Mazhar Osman Mental Health and Neurological Diseases Education and Research Hospital, Department of Neurology, Istanbul, Turkey
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Blomberg K, Brorson LO, Stenninger E, Eriksson M. Fifty-year follow-up of childhood epilepsy - Social, psychometric, and occupational outcome. Epilepsy Behav 2019; 96:224-228. [PMID: 31176891 DOI: 10.1016/j.yebeh.2019.01.034] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2019] [Revised: 01/26/2019] [Accepted: 01/27/2019] [Indexed: 11/15/2022]
Abstract
OBJECTIVE The objective of this study was to explore and describe the experience of a childhood diagnosis of epilepsy and its consequences for the experiences of daily life over a span of 50 years. METHODS A descriptive mixed method design was chosen. Data were collected through a survey returned by 86 persons (59% response rate) who had received diagnoses of epilepsy as children. The survey contained questions about education, vocation, family status, and included the 14-item Hospital Anxiety and Depression Scale (HAD). Additionally, interviews (n = 11) were conducted and analyzed by interpretative description. RESULTS Few persons reported that the childhood diagnosis of epilepsy had affected their choice of education, work, or leisure activities. However, 20% reported that the diagnosis had caused problems in school or at work and had restricted their activities of daily living. Sixty-six percent of the participants were married, and 68% had children; of those, 12 (20%) reported that one or more of the children had also had seizures. Almost all reported no anxiety (82%) and no depression (90%). The results of the interviews revealed a balancing act between 'Controlling and managing the situation' and 'Not being restricted by the condition'. SIGNIFICANCE This long-term follow-up over a 50-year life-span of persons who received childhood diagnoses of epilepsy suggests that the consequences for education, work, and leisure activities were few. Most of the participants had developed strategies to manage their situation.
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Affiliation(s)
- Karin Blomberg
- Faculty of Medicine and Health, School of Health Sciences, Örebro University, Örebro, Sweden.
| | - Lars-Olov Brorson
- Department of Paediatrics, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
| | - Erik Stenninger
- Department of Paediatrics, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
| | - Mats Eriksson
- Faculty of Medicine and Health, School of Health Sciences, Örebro University, Örebro, Sweden; Department of Paediatrics, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
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Kirk S, Hinton D. "I'm not what I used to be": A qualitative study exploring how young people experience being diagnosed with a chronic illness. Child Care Health Dev 2019; 45:216-226. [PMID: 30652354 DOI: 10.1111/cch.12638] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/09/2018] [Revised: 12/06/2018] [Accepted: 12/12/2018] [Indexed: 11/30/2022]
Abstract
BACKGROUND Childhood long-term conditions are usually diagnosed in infancy or early childhood. Little is known about the particular experiences and needs of young people who receive a chronic illness diagnosis during adolescence or late childhood. This paper will examine this experience in relation to multiple sclerosis (MS), which is increasingly being diagnosed before adulthood. AIMS To explore how young people experience an MS diagnosis. METHODS Qualitative study using a grounded theory approach. In-depth interviews were conducted with 21 young people diagnosed with MS. Participants were recruited through health service and voluntary sector organizations in the United Kingdom. RESULTS Young people's pre-illness normality was disrupted by the diagnosis of a chronic illness (MS). Participants experienced their body as changed physically, cognitively, and emotionally and as changeable due to symptom unpredictability. This influenced how participants perceived and presented their identity, disrupted their relationships, and altered their future biography. Young people developed strategies to manage their condition and identities in order to incorporate MS into their current and future lives, which required continual illness and identity work in response to changing symptoms, social contexts, and relationships. CONCLUSIONS Although young peoples' experience of living with chronic illness has been widely explored, the aftermath of diagnosis has been underresearched from their perspective. This study contributes to this knowledge gap by illuminating how young people experience a chronic illness diagnosis and negotiate the resulting changes to their identity, relationships, and future. The findings suggest that young people need preparation and support in disclosing their diagnosis to others. Professionals supporting young people with long-term conditions need to work closely with specialist mental health services to ensure that they receive appropriate emotional support. Schools have an important role in ensuring young people with long-term conditions achieve their academic potential and receive appropriate careers advice.
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Affiliation(s)
- Susan Kirk
- School of Health Sciences, University of Manchester, Manchester, UK
| | - Denise Hinton
- School of Health Sciences, University of Manchester, Manchester, UK
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Im Y, Cho Y, Kim D. Family Management Style as a Mediator between Parenting Stress and Quality of Life of Children with Epilepsy. J Pediatr Nurs 2019; 45:e73-e78. [PMID: 30581065 DOI: 10.1016/j.pedn.2018.12.007] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2018] [Revised: 12/10/2018] [Accepted: 12/10/2018] [Indexed: 10/27/2022]
Abstract
PURPOSE To examine the possible relationship between parenting stress and quality of life of children with epilepsy together with the mediating effects of family management styles on this relationship. DESIGN AND METHODS We conducted a descriptive and exploratory study using data of participants were 93 parents with an epileptic child. Instruments were self-reported questionnaires including the Korean version of the Quality of Life (QOL) in Childhood Epilepsy Questionnaire (K-QOLCE), the Korean version of the Parenting Stress Index (PSI), and the Korean version of the Family Management Measure (FaMM). Six domains of FaMM were clustered into two domains: easy or difficult family management styles. Descriptive and Pearson correlation path analyses were used to analyze the data. RESULTS The direct effects of PSI on QOL were not significant (b = -0.21, t = -0.94, p = .349). Indirect effects of PSI through easy family management styles on QOL were significant (b = -0.33, 95% CI = [-0.77, -0.05]). Additionally, two other effects (i.e., indirect effects through difficult family management styles and direct effects) were non-significant. All effects of PSI on QOL were fully mediated through easy family management styles. CONCLUSION Easy family management styles are the most important factor in predicting QOL in childhood epilepsy patients. PRACTICE IMPLICATIONS Comprehensive intervention programs are recommended for parents and families of epileptic children to promote positive perceptions of the child's life and to increase parental management ability of the child's condition and parental mutuality.
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Affiliation(s)
- YeoJin Im
- Kyung Hee University, Department of Nursing, Seoul Republic of Korea.
| | - YoungIl Cho
- Sungshin University, Department of Psychology, Seoul, Republic of Korea.
| | - DongHee Kim
- Sungshin University, Department of Nursing, Seoul, Republic of Korea.
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Stigmatization of Children and Adolescents with Autism Spectrum Disorders and their Families: a Scoping Study. REVIEW JOURNAL OF AUTISM AND DEVELOPMENTAL DISORDERS 2019. [DOI: 10.1007/s40489-018-00156-5] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
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Exploring the needs and challenges of parents and their children in childhood epilepsy care: A qualitative study. Epilepsy Behav 2018; 88:268-276. [PMID: 30321756 DOI: 10.1016/j.yebeh.2018.09.018] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2018] [Revised: 09/15/2018] [Accepted: 09/16/2018] [Indexed: 11/23/2022]
Abstract
Because of the nature of epilepsy, and the unpredictability of seizure recurrence, epilepsy requires long-term treatment with medications. As a consequence, epilepsy has a negative pervasive impact in children with epilepsy (CWE), and their parents. Hence, our aim was to explore the needs and challenges of parents and their CWE. In-depth interviews (IDIs) were conducted with 15 families (12 mothers and 3 fathers) and 15 CWE (aged 8-18 years). Data were transcribed verbatim and thematically analyzed using the descriptive phenomenology approach. The experiences of parents and their CWE could be divided into two time frames: "experiences during a child's first seizure" and "experiences whilst growing up with epilepsy". Parents' main concerns and worries were regarding their child's physical health, psychological and emotional wellbeing, academic achievement, and future. The children's main concerns were restrictions imposed, their interpersonal relationship with peers, and being independent in the future. Parents reported that they needed epilepsy-related information, continuity of care, and a parental support group, while CWE reported that their main needs were independence and autonomy. The views of parents and their child with epilepsy were similar in physical functioning and academic achievement. However, parents and children had different views on how epilepsy impacted on the child emotionally, as well as behavioral and interpersonal relationship with peers.
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Benson A, Lambert V, Gallagher P, O'Toole S, Shahwan A, Austin JK. Development and psychometric evaluation of the youth and parent versions of the Epilepsy Disclosure Scale (EDS). Epilepsy Behav 2018; 82:111-118. [PMID: 29604483 DOI: 10.1016/j.yebeh.2018.02.015] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2018] [Revised: 02/16/2018] [Accepted: 02/16/2018] [Indexed: 11/29/2022]
Abstract
OBJECTIVES The aim of this paper was to describe the development and psychometric evaluation of new Epilepsy Disclosure Scales (EDSs) for youths with epilepsy (YWE) and their parents. METHODS Developing the EDSs for youths and parents comprised a number of stages, including questionnaire construction and item development for the new EDSs (consisting of a pilot and review of the newly developed EDSs) and psychometric evaluation of the measures to assess their appropriateness, factor structure, reliability, and validity. Psychometric properties were determined using a cross-sectional survey of 47 YWE and 72 parents. RESULTS Two scales were developed to assess the epilepsy disclosure behaviors of YWE and their parents; that is, the extent to which they tell and talk to others about the child's epilepsy. The youth version of the EDS comprised six items and had a unidimensional factor structure that explained 55% of the variance. The parent version of the EDS also consisted of six items, with a single factor explaining 47% of the variance. The suitability, validity, and reliability of the youth and parent versions of EDSs were supported by positive indicators, such as a high Cronbach's alpha (representative of good internal consistency) and the confirmation of a number of hypothesized relationships between epilepsy disclosure and psychosocial and illness attitude variables (demonstrative of their convergent validity). CONCLUSION Prior to the development of these instruments, no valid and reliable measures existed that could suitably capture disclosure amongst populations living with epilepsy. The youth and parent versions of the EDS are valid, reliable, brief, and easily administered and thus could prove useful in research as well as in the clinical setting. These scales will enable researchers and clinicians to profile the epilepsy disclosure behaviors of YWE and their parents, which play an important role and have implications both for the psychosocial wellbeing of families living with epilepsy and for epilepsy-related stigma.
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Affiliation(s)
- Ailbhe Benson
- Centre for Disability Studies, School of Psychology, University College Dublin, Dublin 4, Ireland
| | - Veronica Lambert
- School of Nursing and Human Sciences, Faculty of Science and Health, Dublin City University, Dublin 9, Ireland.
| | - Pamela Gallagher
- School of Nursing and Human Sciences, Faculty of Science and Health, Dublin City University, Dublin 9, Ireland
| | - Stephanie O'Toole
- School of Psychology, David Keir Building, Queen's University Belfast, Belfast, Northern Ireland, United Kingdom
| | - Amre Shahwan
- Neurology Department, Temple Street Children's University Hospital, Temple Street, Dublin 1, Ireland
| | - Joan K Austin
- Indiana University School of Nursing, Indiana University-Purdue University Indianapolis, Indianapolis, IN, USA
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Boling W, Means M, Fletcher A. Quality of Life and Stigma in Epilepsy, Perspectives from Selected Regions of Asia and Sub-Saharan Africa. Brain Sci 2018; 8:brainsci8040059. [PMID: 29614761 PMCID: PMC5924395 DOI: 10.3390/brainsci8040059] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2017] [Revised: 02/26/2018] [Accepted: 03/29/2018] [Indexed: 11/16/2022] Open
Abstract
Epilepsy is an important and common worldwide public health problem that affects people of all ages. A significant number of individuals with epilepsy will be intractable to medication. These individuals experience an elevated mortality rate and negative psychosocial consequences of recurrent seizures. Surgery of epilepsy is highly effective to stop seizures in well-selected individuals, and seizure freedom is the most desirable result of epilepsy treatment due to the positive improvements in psychosocial function and the elimination of excess mortality associated with intractable epilepsy. Globally, there is inadequate data to fully assess epilepsy-related quality of life and stigma, although the preponderance of information we have points to a significant negative impact on people with epilepsy (PWE) and families of PWE. This review of the psychosocial impact of epilepsy focuses on regions of Asia and Sub-Saharan Africa that have been analyzed with population study approaches to determine the prevalence of epilepsy, treatment gaps, as well as factors impacting psychosocial function of PWE and their families. This review additionally identifies models of care for medically intractable epilepsy that have potential to significantly improve psychosocial function.
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Affiliation(s)
- Warren Boling
- Department of Neurosurgery, Loma Linda University, Loma Linda, CA 92354, USA.
| | - Margaret Means
- School of Medicine, University of Louisville, Louisville, KY 40202, USA.
| | - Anita Fletcher
- Department of Neurology, University of Louisville, Louisville, KY 40202, USA.
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Mendes TP, Crespo CA, Austin JK. The psychological costs of comparisons: Parents' social comparison moderates the links between family management of epilepsy and children's outcomes. Epilepsy Behav 2017; 75:42-49. [PMID: 28826008 DOI: 10.1016/j.yebeh.2017.07.017] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2017] [Revised: 07/12/2017] [Accepted: 07/14/2017] [Indexed: 10/19/2022]
Abstract
Parents play a key role in how children deal with epilepsy. When diagnosed with health conditions, people seek comparison information from fellow patients and families, and this information has consequences for how they evaluate their situation. This study examined the moderating role of parents' social comparison orientation in the associations between family management (parental perceptions of family life difficulties and child's daily life) and adaptation outcomes of children with epilepsy (HRQoL and perceived stigma). Participants included 201 dyads of children with epilepsy and either their mother or father. The results showed that when parents perceived higher difficulties managing their child's epilepsy and/or reported that their child was more affected by this condition, children reported higher perceived stigma and worse HRQoL only when parents had a higher social comparison orientation. Our results are innovative in showing that when parents have a higher social comparison orientation, their children may be at increased risk of poorer outcomes.
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Affiliation(s)
- Teresa P Mendes
- Faculdade de Psicologia e de Ciências da Educação, Universidade de Coimbra, Portugal.
| | - Carla A Crespo
- Faculdade de Psicologia, Universidade de Lisboa, Portugal
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Kampra M, Tzerakis N, Lund Holm Thomsen L, Katsarou E, Voudris K, D Mastroyianni S, Mouskou S, Drossou KS, Siatouni A, Gatzonis S. The challenges that parents of children with epilepsy face: A qualitative study. Epilepsy Behav 2017; 71:94-103. [PMID: 28564623 DOI: 10.1016/j.yebeh.2017.04.034] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2016] [Revised: 04/20/2017] [Accepted: 04/22/2017] [Indexed: 11/18/2022]
Abstract
OBJECTIVE This qualitative study explored the challenges that Greek parents/caregivers of children with controlled epilepsy (CwE) face regarding the disorder. METHODS Interviews were conducted based on open-ended questions guided by a review of the literature. A total of 91 parents/caregivers were recruited by neurologists at the neurology clinics of two Athens public hospitals. A hermeneutic phenomenological approach was used to explore parent/caregiver experiences. The data were grouped and analyzed through a textual interpretation. RESULTS Two key challenges were identified for parents of CwE: the disclosure of epilepsy and the absence of adequate information about coping with epilepsy. Parents in Greece were hesitant to reveal their child's epilepsy to school staff and their wider social milieu. Also, although satisfied with the patient-centered approach they experienced with their hospital doctor, parents/caregivers found that they needed more education about the existing sources of psychosocial and emotional support to cope with their child's epilepsy personally and as a family. Finally, the parents/caregivers who let their child know about the epilepsy and discussed the implications with the child found that parent-child communication improved. CONCLUSION This study provides valuable insight into the impact of epilepsy on parents of CwE, which might help hospital and school staff support families with greater understanding, sensitivity, and skill. The findings suggest that Greek authorities should staff hospitals and schools with experts and more systematically advertise sources of information about epilepsy and ways to cope with it.
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Affiliation(s)
- Matina Kampra
- Ministry of Health, 40-42C Amarisias Artemidos st., PC 151 24 Marousi, Greece.
| | - Nikolaos Tzerakis
- Department of Neurosurgery, University Hospital of North Midlands NHS Trust, United Kingdom.
| | - Louise Lund Holm Thomsen
- Public Health and Epidemiology Group, Department of Health Science and Technology, Aalborg University, Niels Jernes Vej 14, 1., room 3-208|, 9220 Aalborg Øst, Denmark.
| | - Efstathia Katsarou
- Neurology Department, "P&A Kyriakou" Children's Hospital, Athens, Greece.
| | | | - Sotiria D Mastroyianni
- Department of Neurology, Children's Hospital of Athens "P. and A. Kyriakou", Thivon and Levadias str, Athens P.C. 115 27, Greece.
| | - Stella Mouskou
- Children's Hospital "P&A Kyriakou", Athens 115 27, Greece.
| | - Kyriaki S Drossou
- Human Resource Management, Newcastle College, Department of Health & Enterprise, United Kingdom.
| | - Anna Siatouni
- A' Department of Neurosurgery, "Evangelismos" Hospital, National and Kapodistrian University, Greece.
| | - Stylianos Gatzonis
- A' Department of Neurosurgery, "Evangelismos" Hospital, National and Kapodistrian University, Greece.
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Shi Y, Wang S, Ying J, Zhang M, Liu P, Zhang H, Sun J. Correlates of perceived stigma for people living with epilepsy: A meta-analysis. Epilepsy Behav 2017; 70:198-203. [PMID: 28431368 DOI: 10.1016/j.yebeh.2017.02.022] [Citation(s) in RCA: 57] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2017] [Revised: 02/12/2017] [Accepted: 02/12/2017] [Indexed: 01/25/2023]
Abstract
OBJECTIVE Epilepsy, one of the most common, serious chronic neurological diseases, is accompanied by different levels of perceived stigma that affects people in almost all age groups. This stigma can negatively impact the physical and mental health of people living with epilepsy (PLWE). Good knowledge of perceived stigma for PLWE is important. In this study, we conducted a meta-analysis to identify the correlates of perceived stigma for PLWE. METHODS Studies on factors associated with perceived stigma for PLWE, including sociodemographic, psychosocial, and disease-related variables, were searched in PubMed, PsychINFO, EMBASE, and Web of Science. RESULTS Nineteen variables (k>1) were included in the meta-analysis. For sociodemographic characteristics, findings revealed that the significant weighted mean correlation (R) for "residence" and "poor financial status" were 0.177 and 0.286, respectively. For disease-related characteristics, all variables of significance, including "seizure severity," "seizure frequency," "number of medicines," and "adverse event" (R ranging from 0.190 to 0.362), were positively correlated with perceived stigma. For psychosocial characteristics, "depression" and "anxiety" with R values of 0.414 and 0.369 were significantly associated with perceived stigma. In addition, "social support," "quality of life (QOLIE-31,89)," "knowledge," and "attitude," with R values ranging from -0.444 to -0.200 indicating negative correlation with perceived stigma. CONCLUSION The current meta-analysis evaluated the correlates of perceived stigma for PLWE. Results can serve as a basis for policymakers and healthcare professionals for formulating health promotion and prevention strategies.
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Affiliation(s)
- Ying Shi
- School of Nursing, Jilin University, Changchun, China
| | - Shouqi Wang
- School of Nursing, Jilin University, Changchun, China
| | - Jie Ying
- School of Nursing, Jilin University, Changchun, China
| | - Meiling Zhang
- School of Nursing, Jilin University, Changchun, China
| | - Pengcheng Liu
- School of Nursing, Jilin University, Changchun, China
| | | | - Jiao Sun
- School of Nursing, Jilin University, Changchun, China.
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Smets EMA, Deveugele M, Kripalani S, Cameron KA. New insights on information provision, decision making and patient autonomy. PATIENT EDUCATION AND COUNSELING 2016; 99:1439-1440. [PMID: 27578368 DOI: 10.1016/j.pec.2016.08.008] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Affiliation(s)
- Ellen M A Smets
- Department of Medical Psychology, Academic Medical Centre, University of Amsterdam, The Netherlands.
| | - Myriam Deveugele
- Faculty of Medicine and Health Sciences, Department of Family Medicine and Primary Health Care, Ghent University, Ghent, Belgium
| | - Sunil Kripalani
- Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA; Institute for Medicine and Public Health, Vanderbilt University, Nashville, TN, USA
| | - Kenzie A Cameron
- Division of General Internal Medicine and Geriatrics, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
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