Knowledge and attitude of the Greek educational community toward epilepsy and the epileptic student

Knowledge of and attitudes towards epilepsy among homeroom teachers of children with epilepsy in the Czech Republic

OBJECTIVE

Significant attention has been devoted to knowledge of and attitudes toward epilepsy among teachers, and the importance of their previous experience with epilepsy has been proved. However, no information about a specific group of homeroom teachers is available despite their importance in forming a positive climate in class and preventing related stigma. Thus, we aim to evaluate knowledge of and attitudes towards epilepsy in this group and compare the results with previously studied groups of 136 teachers in training and 123 primary school teachers not having, in most cases, experience with children with epilepsy.

METHODS

One hundred and four homeroom teachers of children with epilepsy attending mainstream schools were involved in the study. They fulfilled an 18-item knowledge test, a 5-item questionnaire focusing on epilepsy-related self-confidence, and a 21-item Czech version of the Attitudes Towards People with Epilepsy scale. All instruments were used and validated in our previous research focusing on the other groups of teachers, making possible the direct comparison of the results.

RESULTS

We found that homeroom teachers had significantly better knowledge of epilepsy (total score of 11.75 ± 2.29 points compared with 10.21 ± 2.08 points for primary school teachers and 9.60 ± 2.08 points for teachers in training) as well as more positive attitudes (30.81 ± 11.11 vs. 24.80 ± 11.01, and 25.81 ± 10.20, respectively). Regarding self-confidence, homeroom teachers were comparable with primary school teachers (total score of 18.31 ± 3.74 compared with 17.71 ± 3.86) but significantly better than teachers in training (16.37 ± 3.20).

CONCLUSIONS

The results suggest that despite having a higher level of epilepsy-related knowledge, self-confidence, and attitudes, homeroom teachers still have significant shortages in some specific issues, especially regarding the ability to recognize the adverse effects of antiepileptic drugs. Tailored education interventions focusing on these groups and topics are thus highly needed.

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

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.

Knowledge and attitudes toward epilepsy among teachers in Tunisia

BACKGROUND

The importance of school teachers' knowledge of and attitudes toward epilepsy and its contribution in improving the links between the Education and Health fields, is well recognized and appreciated. In order to clarify the amount of misconceptions about epilepsy among Tunisian teachers, we conducted a web-based survey. The main objectives of our study were, first, to determine the knowledge about and attitudes toward epilepsy, and second, to specify factors associated with a better understanding of this disease.

METHODS

Data were collected using a web-based survey "Google Forms".

RESULTS

The study showed a positive correlation between the level of teachers' knowledge of epilepsy and their attitudes toward a person with epilepsy. Despite the knowledge gaps revealed in Tunisian teachers, the overall attitude was at large positive. Familiarity with epilepsy, whether through family or work environment, made a tremendous contribution in redressing misconceptions about epilepsy in our study.

CONCLUSION

More educational interventions and programs are needed to increase teachers' familiarity with epilepsy and, consequently, increase their awareness and knowledge.

Knowledge and attitudes toward epilepsy among Libyan people with and without epilepsy in a tertiary medical center

BACKGROUND

Although patients with epilepsy (PWE) constitute a considerable sector of the population in Benghazi, there is no adequate knowledge about this disease.

OBJECTIVES

To assess knowledge and attitudes toward epilepsy among Libyan people who live in Benghazi city.

METHODS

A cross-sectional prospective hospital-based study was conducted in the year 2020, from June to August. The participants were adults, PWE were included as well as people without epilepsy (NEP). Participants were interviewed through a twelve-item questionnaire related to knowledge which included definition, causes, manifestations, first aids, treatment options, and curability. In addition, attitudes toward epilepsy were tested by questions that include immediate actions when seeing a patient seizing, and whether or not PWE can drive, work, marry, and conceive).

DATA ANALYSIS

Data were processed by the statistical software (SPSS) version 18.0. Differences between categorical variables were tested by Chi square and P value at 0.05, which has been considered statistically significant.

RESULTS

The total number of the interviewees was 156. The mean age was 43 ± 14 SD years (18-76 years), 105 (67%) were males. Twenty-eight (18%) of the participants were PWE, while the remaining 128 (82%) were NEP. Ninety-nine (64%) and 145 (92%) of the participants answered correctly regarding definition and manifestations of epilepsy, respectively. The participants with Bachelor degree and post graduate level have shown a better understanding of definitions and treatments of epilepsy (P = 0.000). They also had better attitudes toward PWE in terms of their ability to conceive (P = 0.002).PWE had better knowledge about manifestations and first aids of epilepsy compared to NEP, though they did not have differences in attitude compared to NEP. Participants' knowledge about epilepsy was mainly obtained from friends (41; 26%), patients (40; 26%), and media (37; 24%). A major portion of participants 94 (60%) did not feel satisfactory about their own information about epilepsy.

CONCLUSION

Knowledge and attitudes toward epilepsy were generally satisfactory. Participants with Bachelor degree or higher level of education had better knowledge and positive attitudes toward PWE. Patients and media are important tools to improve knowledge and attitudes about epilepsy.

Are the health needs of children with disabilities being met at primary schools?

The aim of this study was to provide current information about the health profile and needs of mainstreamed primary school children with disabilities and special educational needs during their school hours. The Study population is composed of students with special educational needs and disabilities attending mainstream primary schools located in three selected Turkish districts with low, moderate, and high socioeconomic status and literacy rates separately. Parents of 404 students from 72 primary schools constituted the research sample. The study showed that 13.4% of the students with disabilities had chronic illnesses and 8.9% had health problems requiring access to emergency medical care when the condition recurs (such as epileptic seizures, fainting, or falling). Of the students with disabilities, 39.9% usually or sometimes needed medical care during school hours in the previous week. Health needs of nearly half of the students with disabilities were met at school. Special health needs and risks of children with disabilities also continue at school along with other possible health concerns.

Impact of epilepsy training on school teachers and counselors: An intervention study in Lebanon

This study aimed to evaluate the immediate impact of an epilepsy training through the administration of a questionnaire (in Arabic) before and immediately after the intervention in Lebanese public and private schools. This project is part of an awareness campaign applied to 3 groups of teachers and counselors and consisted of a pretest, a unified conference and a posttest. The statistical analysis used the McNemar and Stuart Maxwell tests (statistical significance level of 0.05). 73 participants completed the questionnaires. The majority were female (68.5%), aged less than 39 years (57%) and familiar with epilepsy. A positive impact of the training was found regarding the effect of epilepsy on schooling, seizures manifestations, psychological effects, seizure first aid and the possibility of curing epilepsy with surgery. Most of our participants recognized that children with epilepsy have a comparable IQ to others. They did not exhibit a discriminatory attitude against people with epilepsy in terms of the direct attitude towards them, employment or marriage. This is one of few studies done worldwide demonstrating an immediate positive effect of epilepsy training among school teachers. Future research should be undertaken to develop robust training models to destigmatize epilepsy.

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An epilepsy training in Lebanese schools had an immediate positive impact.

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In total 73 teachers and counselors completed the pre and posttest questionnaires.

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Participants didn't exhibit a discriminatory attitude against people with epilepsy.

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Participants recognized that children with epilepsy have a comparable IQ to others.

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Training improved awareness on seizure first aid and epilepsy cure by surgery.

Awareness and attitudes toward persons with epilepsy among teachers: A Moroccan study

PURPOSE

Many studies performed in Morocco showed an important lack of knowledge about epilepsy among persons with epilepsy and their families. The misconceptions about the disease are a source of suffering for both patients and their families and increase the costs of epilepsy care. We conducted this investigation for assessing the origins of misinterpretation of the disease in the Moroccan society.

OBJECTIVES

The teachers' knowledge about epilepsy in the Fez-Meknes region in Morocco and their attitudes toward a person with epilepsy constitute the two major objectives of this study. We also assessed the impact of sociocultural parameters on Moroccan teachers' knowledge and attitudes toward a person with epilepsy.

MATERIAL AND METHODS

The data collection was based on the "Attitudes Toward Persons with Epilepsy" (ATPE) test.

RESULTS

The study showed a positive correlation between the level of teachers' knowledge of epilepsy and their attitudes toward a person with epilepsy. The results revealed the persistence of negative attitudes toward a person with epilepsy among teachers. The level of ATPE of teachers in Morocco was lower compared to high-middle income countries.

CONCLUSION

There is still poor knowledge about epilepsy among teachers in Morocco. This unawareness is negatively affecting teachers' attitudes toward a person with epilepsy. Hence, we recommend integrating epilepsy in teaching and training programs of teachers in the Moroccan educational system.

Knowledge of and attitudes towards epilepsy among teachers: A systematic review

The objective of this study was to systematically review research that has focused on knowledge of and attitudes towards epilepsy among teachers. Embase, PubMed, PsycINFO, Google Scholar, and Cochrane library databases from 2000 to 2017 were searched. Cross-sectional and interventional studies were included and analyzed for quality. Thematic analysis was used to identify common themes in the results. Fifty-four eligible studies (17,256 total participants in 27 different countries) were identified in the search period including seven studies that focused on assessing attitudes and knowledge before and after an educational intervention. It was not possible to systematically analyze levels of knowledge and nature of attitudes because of the wide variety of mostly bespoke study specific instruments used. Few studies employed valid and reliable instruments. Thematic analysis revealed three main themes in the results: 1.) deficits in knowledge and negative attitudes were pervasive across all studies; 2.) teachers often had a negative attitude towards participation of children with epilepsy in physical activities/sport; and 3.) teachers often expressed limited knowledge of seizure management/emergency procedures. There was a lower level of knowledge and more negative attitudes among teachers towards epilepsy compared with other conditions. All studies focusing on interventions showed that at least some aspects of knowledge and attitudes improved as a result of teacher participation in an educational intervention, but study quality was universally rated as low. A higher level of education and experience of teaching a child with epilepsy was significantly associated with greater knowledge in a number of studies. Additionally, having experience of teaching a child with epilepsy and greater assessed knowledge of epilepsy were associated with more positive attitudes. The wide range of methods used makes it difficult to generalize regarding level of attitudes and knowledge among teachers towards epilepsy. Nevertheless, all studies indicate that there are some deficits in knowledge of and negative attitudes towards epilepsy among teachers. It would appear that knowledge and attitudes can be improved by educational interventions. Future research should focus on developing psychometrically sound assessment instruments that can be used globally and on identifying the most effective ways of delivering efficacious educational initiatives employing robust study designs.

Primary school female teachers' knowledge, attitude, and practice toward students with epilepsy in Riyadh, Saudi Arabia

BACKGROUND

Epilepsy is the most neurological condition prevalent in humanity and it is associated with stigma and discrimination. Knowledge and practice of primary care teachers toward students with epilepsy, especially at young age, is imperative for their development.

OBJECTIVES

This study was designed to assess the level of knowledge, attitude, and practice of female primary school teachers toward students with epilepsy in Riyadh, Saudi Arabia.

SUBJECTS AND METHODS

In this cross-sectional study, 582 female primary school teachers had volunteered. They were assessed on their knowledge, attitude, and practice toward students with epilepsy using a self-administrated questionnaire. The questionnaire was cross-culturally validated before the distribution.

RESULTS

The results suggest above-average familiarity with epilepsy (79.2%). Younger teachers are less likely to associate epilepsy with retardation (P = 0.038). In general, the attitude was positive among the teachers, and 36.9% felt that the students should be treated normally and 63.1% with compassion toward them. Only 14.3% answered that epileptic students should be transferred to special need schools. Highly educated teachers were less likely to feel that epileptic students can cause problems (P = 0.038). The practice was poor with 31.8% expressed the ability to provide first aid to epileptic students. Only 27.5% accepted to give the students prescribed medications.

CONCLUSION

The knowledge about epilepsy needs improvement among primary school teachers in Riyadh. Public level interventions through proper courses can provide a leverage. The higher level of knowledge can be pivotal in increasing the positive attitude and practice of teachers toward epileptic students.

Ethiopian teachers: their knowledge, attitude and practice towards epilepsy

BACKGROUND

In Ethiopia where the burden of epilepsy is highest among school age children and teenagers, and where people with epilepsy (PWE) and their relatives suffers from high level of perceived stigma, there had not been any study that assessed the knowledge, attitude and practice of teachers towards PWE. This study aims to assess and understand the social and demographic determinants of knowledge, attitude and practice of teachers towards PLW in Addis Ababa, Ethiopia.

METHODS

Multistage cluster sampling procedure was used to identify twenty schools from three sub cities of Addis Ababa, Ethiopia. Standardized self administered questionnaire was used to collect data from 845 volunteer teachers in the pre identified schools. Frequencies were used to characterize the demographic variables while multiple response frequencies were used to characterize the multiple response variable sets. Non-parametric statistical methods were used to describe the association among the demographic variables of interest and the count sums of multiple response variables which were grouped into biologically and culturally plausible responses.

RESULTS

The most common biologically plausible responses were: brain diseases (26.5 %) from causes, allow my offspring to play with PWE (19.1 %) from attitude, protect the subject from injury (20.4 %) from first aid measures and seek help from medical doctors (52.2 %) from epilepsy treatment. On the contrary, the most common culturally plausible responses were: psychiatric illness (12.9 %) from causes, epilepsy be cured before attendance to school (21.6 %) from attitude, smelling the smoke of struck match (14.2 %) from first aid measures and Holy water treatment (20.3 %) from epilepsy treatment suggestions. The biologically and culturally plausible responses were negatively correlated. Level of education was positively associated with biologically plausible responses while teaching experience was negatively correlated with culturally plausible responses.

CONCLUSION

A high percentage of teachers in Addis Ababa considered epilepsy as a psychiatric illness closely linked to insanity. This explains their suggestions of Holy water treatment and Church healing sessions as epilepsy remedies. This is in agreement with Ethiopian culture, in which evil spirit and insanity are believed to be better treated by religious remedies than with modern medical treatments. Incorporating special needs educational training courses in the curriculum of teachers training may help them shift their knowledge, attitudes and practices from that of the culturally plausible to biologically plausible one.

Teachers' knowledge about epilepsy in Greece: Information sources and attitudes towards children with epilepsy during school time

AIM

The aim of this study was to explore the sources of information for the educators in Greek primary and secondary schools with regard to epilepsy, first aid to seizures, and pupils' health conditions.

METHOD

A semistructured anonymous 52-item questionnaire was sent to 100 public primary and secondary Greek schools from all districts. Two thousand thirty-seven teachers were approached; 446 questionnaires returned. The data were analyzed with SPSS20. Also, 70 head teachers were phone-interviewed with an open-ended unstructured questionnaire. The derived data were analyzed using mixed methodology.

RESULTS

Twenty-two percent of the addressed educational community responded to the questionnaire, mostly women (66.6%). More responses came from urban areas (71.5%). The main source for the teachers to obtain information about epilepsy was found to be personal experience (37.75%) and internet (34.93%). Only a small percentage was referred to courses (6.2%). Eighty point three percent of the educators knew what epilepsy is, and 88.1% had the right view about the nature of the illness. However, 92% of the educators replied that they have not had adequate first aid training. Although 80.3% of the teachers believed that the school personnel are aware of the pupils' medical history, 85.48% of the teachers considered that they are informed about the pupils' condition from the parents/carers, and only 5.53% believed that the information came from the family doctor. Ninety-five point seventy percent of the educators declared a wish for further information and training about epilepsy.

CONCLUSION

Knowledge and attitudes of the educators towards epilepsy are improved compared with those reported in previous studies conducted in Greece. However, there are still areas of uncertainty which need improvement. The necessity for more information about epilepsy and pupils' medical history along with appropriate training about seizure incidents seems crucial for the Greek educational community. Educational campaigns about epilepsy could improve teachers' knowledge of epilepsy to develop a well-informed and tolerant community. Further research in the field is necessary to provide teachers with accurate information about the illness and the ways to cope with it.

Knowledge about epilepsy and attitudes towards affected people among teachers in training in the Czech Republic

The aim of this study was to compare knowledge about, confidence with, and attitudes towards epilepsy and affected people between groups of freshmen and senior teachers in training (preservice teachers) at the Faculty of Education in Pilsen, Czech Republic. Two hundred thirty-six freshmen and 138 seniors completed the 21-item Scale of Attitudes Towards People with Epilepsy (ATPE), an 18-item multiple-choice test measuring their knowledge about epilepsy, and a 5-item questionnaire focused on confidence with epilepsy in a school environment. We found that despite a higher level of knowledge about epilepsy among seniors (mean score of 9.6 points compared with 8.48 points for freshmen, p<0.001), attitudes towards epilepsy, and also confidence in how to manage children affected with this disease did not differ significantly. The presented findings suggest that epilepsy-related training of preservice teachers should be more effective especially with respect to their ability to resolve problems that may happen to children with epilepsy in a class.

Teachers' perspectives of supporting pupils with long-term health conditions in mainstream schools: a narrative review of the literature

Teachers are supporting an increasing number of pupils with long-term health conditions in mainstream schools. The aim of this literature review was to critically appraise and synthesise research that has examined teachers' perceptions of the key barriers and facilitators to supporting pupils with long-term conditions, teachers' training needs and interventions that aim to improve teachers' knowledge of long-term conditions, and teachers' confidence in supporting children and young people. A narrative literature review was conducted using a systematic search of computerised databases and manual searches of key journals and reference lists to retrieve studies published between 2003 and 2013. Studies were critically appraised and key themes across studies identified. In total, 61 papers from 58 studies were included in the review. The findings suggest that teachers receive little formal training relevant to long-term condition management and are fearful of the risks involved in teaching children and young people with long-term conditions. Communication between families, school and health and social care services appears to be poor. Educational programmes developed in conjunction with and/or delivered by healthcare professionals seem to have the potential to increase teachers' knowledge and confidence. This review suggests that healthcare professionals have an important role to play in supporting teachers in identifying and meeting the needs of pupils with long-term conditions. It is vital that pupils with long-term conditions receive appropriate care and support in schools to ensure their safety and help them to integrate with their peers and achieve their academic potential. Limitations in the current evidence are highlighted and implications for future research are identified.

Comparative study of the health-related quality of life of children with epilepsy and their parents

PURPOSE

We aimed to evaluate the health-related quality of life (HRQoL) of schoolchildren with epilepsy and its determinants and the HRQoL of their parents in comparison with those of healthy children and their parents.

MATERIALS AND METHODS

The study sample comprised 100 children with epilepsy (58 males), 8-16 years of age, diagnosed at least 6 months earlier. The children with epilepsy were divided into two subgroups: A, with well controlled idiopathic epilepsy, and B, with drug-resistant or symptomatic epilepsy and with concomitant neurodevelopmental problems. A control group consisted of 100 healthy age- and gender-matched children. One parent in each family completed two questionnaires standardized for use in Greece: KIDSCREEN-27 (version for parents) to assess the HRQoL of the children and SF-12 to assess the parental HRQoL. For each of the five dimensions of KIDSCREEN-27 and for the physical and mental component scales of the SF-12 tool, the standardized mean difference (SMD) was used for comparison between the various groups and subgroups. Linear regression analysis was used to explore the effect of specific illness-related factors on the five dimensions of KIDSCREEN-27 in the children with epilepsy.

RESULTS

The parent-reported scores on KIDSCREEN-27 of the children with epilepsy were worse overall than those of healthy children, but the difference reached statistical significance only for the dimensions of "physical well-being" (p = 0.001) and "school environment" (p < 0.001). The differences were greater in adolescents (age group: 13.5-16years). The worst scores were recorded in subgroup B, the children with severe epilepsy, in the dimensions "physical well-being" (p < 0.001), "school environment" (p < 0.0001), and "peers and social support" (p = 0.044). The factors found to have a significant effect on all dimensions were mental retardation, physical disability, abnormal brain imaging findings, learning problems, and, to a lesser degree, administration of a large number of antiepileptic drugs and prolonged treatment. The parents of children with resistant epilepsy and accompanying neurodevelopmental problems scored significantly worse on the SF-12 mental health scale than those of healthy children (p < 0.001).

CONCLUSIONS

Epilepsy, particularly severe epilepsy with concomitant neurodevelopmental problems, adversely affects the HRQoL of both schoolchildren and their parents.

An educational campaign toward epilepsy among Italian primary school teachers: 1. Survey on knowledge and attitudes

A questionnaire survey was undertaken to assess the impact of a nationwide educational campaign about epilepsy on the knowledge and attitudes toward the disease among Italian primary school teachers. Five hundred and eighty-two teachers participated. All interviewees were aware of the existence of epilepsy, and most of them had direct experience with the disease. Answers about frequency, causes, outcome, and response to treatments were variable and not correlated with age, residency, and years of experience. Teachers had positive attitudes toward epilepsy, except for the idea that driving and sports can be safe for people with epilepsy. Epilepsy and its treatment were considered a source of learning disability and social disadvantages. Several teachers declared themselves being unable to help a child having seizures. Calling an ambulance was a frequent action. Knowledge and attitudes toward epilepsy are improved compared with those reported in our previous studies. Although this may be a positive reflection of the increasing knowledge and the greater availability of information on epilepsy, there are still areas of uncertainty and incorrect behaviors.

Association between knowledge and attitudes of school nurses towards epilepsy and the risk of accidents in Greek schools

School nurses have the ability to enhance the knowledge and tolerance of an entire community and to form more positive and sensitized attitudes to future adults. The aim of this study was to investigate the relationship between the knowledge and attitudes of nurses and the frequency of accidents caused by epilepsy in Greek schools. Our sample consisted of 306 school nurses from all over the country. It was observed that the knowledge of school nurses on epilepsy was quite high, although there were specific aspects that raise concerns on their preparedness to respond to seizure-related emergencies, while their attitudes, although positive, still need improvement. Accidents caused by epilepsy were reported by half of the nurses, and prevention was considered of major importance. Therefore, organized continuous education programs and clear guidelines by the responsible authorities would help school nurses provide better services to students with epilepsy.

Association between knowledge and attitudes of educators towards epilepsy and the risk of accidents in Greek schools

Accidents in children with epilepsy are an actual concern of teachers and parents in Greece and internationally. The aim of this study was to investigate the relationship between the knowledge and attitudes of teachers and the frequency of accidents caused by epilepsy in Greece. The study surveyed 1404 public elementary school teachers from all prefectures of the country by an anonymous questionnaire. Results showed that teachers cannot always recognize the manifestations of an epileptic seizure or an injury caused by it, making it difficult for them to report such incidents, and, sometimes, they use wrong or even dangerous manipulations during seizures. Furthermore, the knowledge and attitudes of teachers were associated with the occurrence of accidents. It is, therefore, of major importance that the responsible authorities provide teachers with appropriate guidelines to respond to such incidents, especially in schools where a school nurse is not present.

Knowledge and attitudes toward epilepsy among primary and secondary schoolteachers in Italy

A nationwide telephone interview was conducted on a random sample of Italian schoolteachers (300 from primary and 300 from secondary schools) to ascertain knowledge and attitudes about epilepsy. Included were 516 women and 84 men aged 22 to 70 years. Thirty-seven percent of the teachers believed epilepsy starts only in childhood, 55% considered it hereditary, 46.8% declared it incurable, and only 10.5% knew surgery is a therapeutic option. Thirty-three percent considered epilepsy a moderate-to-strong limitation for marriage, 24.6% for having children, 39.7% for regular employment, and 32.8% for sports and leisure activities. Among the teachers, 66.4% declared they were unable to manage a seizing child, 24.7% were convinced that epilepsy impairs learning, 26.0% believed that it carries mental/behavioral alterations, and 36.4% thought it requires support at school. Differences in knowledge and attitudes were predicted by teachers' age and area of residency. There were no major differences between teachers and the Italian population in their knowledge and attitudes.

Factors contributing to Korean teachers' attitudes toward students with epilepsy

We investigated factors contributing to teachers' attitudes toward students with epilepsy. Data were collected from 604 teachers in Korea. The questionnaire included the Scale of Attitudes Toward Persons with Epilepsy (ATPE) and a demographic and teaching experience survey. In stepwise linear regression analysis, ATPE Knowledge scores (P<0.001) and prior experience teaching a student with epilepsy (P=0.001) were identified as significant factors for ATPE Attitude scores. The ATPE Knowledge scores accounted for 50.1% of the variance in the Attitude scores, and experience teaching a student with epilepsy accounted only for 1.0%. Our finding that teachers' knowledge is the most important factor influencing teacher's attitudes toward epilepsy indicates that teachers should be provided with information about epilepsy universally, across geographic settings, educational levels, and experience levels.

Epilepsy impact on aspects of school life of children from different cultural populations in Thrace, Greece

Epilepsy influences the school life of children. The aims of this study were to (1) assess absenteeism and participation in sports activities, (2) investigate whether parents inform school and children inform their classmates, and (3) determine which factors influence these school aspects. Children from both Christian and Muslim families were enrolled and different cultural variables were prospectively documented. A total of 62 children with epilepsy (mean age: 10.2+/-3.3 years, range: 6-18) participated in the present study. Univariate analysis and multivariate logistic regression models were used to explore potential factors that could influence school life. Absenteeism was correlated with shorter disease duration, severity, lower parental educational level, and knowledge of epilepsy. Age>12 was associated with nonparticipation in activities. Schools were informed by 84% of families, and classmates, by 22.6% of children. In conclusion, better knowledge of epilepsy resulted in fewer missed school days. The majority of children did not discuss their disease, and children from the two populations with different religions did not differ significantly in the school aspects examined. These findings suggest a probable positive effect of educational programs on the issue of daily school life.

Questionnaire survey on the understanding of epilepsy among non-medical persons

BACKGROUND

A questionnaire survey was conducted on the understanding of epilepsy and febrile seizures in preschool teachers, public health nurses, and parents or caregivers of children with epilepsy.

METHODS

The survey was performed in three different sites at different dates. The participants were 16 preschool teachers, 25 public health nurses, and 34 parents or caregivers of children with epilepsy.

RESULTS

Seventy-seven percent of the participants thought that epilepsy was not always untreatable. Sixty-seven percent of the participants thought that epilepsy was not a hereditary disease. Sixty-one percent of the participants considered that repetitive seizures cause brain damage, and 93% of them thought that patients with epilepsy must be treated. Seventy-six percent of the participants thought that febrile seizures evolve into epilepsy if left untreated. Seventy-seven percent of the participants considered that vaccination can be performed in patients with epilepsy or febrile seizures, and 89% of them thought that swimming should not be forbidden in patients with epilepsy or febrile seizures. There was no significant difference in the answers with regard to the positions of the participants except in one question.

CONCLUSIONS

The present questionnaire survey provided some information on the understanding of epilepsy among non-medical persons. A nationwide public survey is needed to clarify the problems in the public understanding of epilepsy.

Seizure impact on the school attendance in children with epilepsy

RATIONALE

Epilepsy has a significant influence on the patient's quality of life. The objective of this study was to evaluate the impact of ongoing seizures on school attendance amongst children with epilepsy.

METHODS

This was a prospective study, conducted at the University of Campinas, in the pediatric epilepsy clinic, from January 2005 to August 2006. We enrolled 50 consecutive children who had a diagnosis of epilepsy. Parents were interviewed by one of the authors using a semi-structured questionnaire that included questions specifically addressing the impact of epilepsy on the child's academic life.

RESULTS

Fifty patients were evaluated, 34 boys and 16 girls; ages ranged from 6 to 18 years old (mean=11). Eighty-eight percent of patients in the study missed at least 1 day of school due to seizures. The reason given by parents for a school absence was seizure in 75%, medical appointment in 79.5%, epilepsy related tests (EEG, MRI, etc.) in 68.2%, and other in 0.03%. Almost half of the parents (46%) believed that if the child had a seizure at school he/she should leave school immediately. Sixty percent of families allowed the child to skip a school day even if there was no illness and the child had no seizures on that day. Among those patients with siblings, 12.5% had a brother or sister who was absent from school for at least 1 day due to his/her sibling's epilepsy.

CONCLUSION

Seizures have a significant impact on school attendance, and as a result may increase the academic difficulties faced by children with epilepsy. This effect may be especially pronounced in children with symptomatic epilepsy and medically intractable seizures.

A Survey of Public Awareness, Understanding, and Attitudes toward Epilepsy in Greece

PURPOSE

To assess familiarity, understanding, and attitude toward epilepsy in Greece and identification of negative predictive factors.

METHODS

A 19-item questionnaire was administered to 750 adults. The magnitude of social stigma toward epileptic people with epilepsy was measured with a quantitative scale of social rejection. Statistical analysis with chi-square and multiple regression analysis were used to identify factors associated with negative attitudes.

RESULTS

Of our respondents 38.8% knew someone with epilepsy and 50.8% had witnessed a seizure. Nineteen percent believed that epilepsy is a type of mental retardation, 15% believed it is a type of insanity, 91.8% considered epilepsy as a brain disorder while 5.2% considered it as a supernatural phenomenon. Seventy-seven percent considered epilepsy as a curable disease while 57.5% believed that the risk of inheriting it is very high. Regarding marriage to a patient with epilepsy 45.4% rejected it while regarding his employment 37.7% were positive, 47.8% were skeptical while 12.8% were against it. The Greek public's rejection tendency toward epileptic people was generally low. Negative predictive factors were older age, low educational level, unfamiliarity with epilepsy, and erroneous beliefs about epilepsy.

CONCLUSIONS

The Greek public is familiar with epilepsy but has a suboptimal level of appropriate understanding of essential aspects of the disease. The overall public's level of rejection toward people with epilepsy is low but certain groups of people are highly rejective. Information campaigns targeting specific population subgroups are necessary in Greece in order to improve the public's understanding of epilepsy and tolerance toward people with epilepsy.

High school students' knowledge, attitude, and practice with respect to epilepsy in Kerala, southern India

Very little information is available on knowledge, attitude, and practice (KAP) with respect to epilepsy among schoolchildren from developing countries. We quantified KAP with respect to epilepsy among 1213 tenth-grade students of Kerala, southern India. Ninety-eight percent of them had heard or read about epilepsy. However, nearly 60% of students thought that epilepsy was a form of insanity. Allopathic treatment was preferred by more than half of the respondents; however, many had faith in exorcism and visiting religious places as ways to cure epilepsy. Half of the students considered epilepsy a hindrance to education, employment, and marriage. Thirteen percent would be unwilling to sit adjacent to or play with a child with epilepsy. We conclude that although familiarity with epilepsy was high among high school students in Kerala, misconceptions and negative attitudes were alarmingly high. Persistent and effective information campaigns, therefore, are necessary to change their attitudes toward fellow students with epilepsy.

Zambian teachers: what do they know about epilepsy and how can we work with them to decrease stigma?

PURPOSE

Teachers play a central role in determining access to education and may mediate epilepsy-associated stigma. We developed and administered a teacher-specific survey to assess teachers' knowledge, attitudes, behaviors, and practices (KABPs) regarding epilepsy in Zambia and social and demographic determinants of KABPs.

METHODS

In 2004, we surveyed 171 teachers in urban and rural regions using a 46-item questionnaire. Knowledge and tolerance composite scores were developed and analyses completed to identify demographic and social determinants of KABPs and evaluate whether generic tolerance questions were associated with stigmatizing practices.

RESULTS

The response rate was 93% (n=159). Knowledge regarding epilepsy ranged broadly. Misattribution was evident for etiology (spirit possession 17.3%; contagion 28.2%; witchcraft 16.8%), and individuals with poorer knowledge were more likely to recommend traditional healers (p=0.0004) rather than physicians for epilepsy care. Higher knowledge was associated with higher tolerance (p=0.01). Tolerance was highest among urban residents (p=0.002) and individuals with personal familiarity/experience with epilepsy. More tolerant teachers were less likely to report stigmatizing practices, such as ejecting children with seizures from school.

CONCLUSIONS

Teacher-targeted interventions aimed at reducing epilepsy-associated stigma and its sequelae in Zambia should include both an educational component and a social component in which teachers are exposed to a person or persons with the condition. Education programs led by person(s) with epilepsy may be ideal.