1
|
Abuawad M, Rjoub A, Abu Zahra W. Assessment of epilepsy awareness, knowledge, and attitudes among preclinical and clinical medical students in the West Bank of Palestine. Epilepsy Behav 2023; 145:109317. [PMID: 37348411 DOI: 10.1016/j.yebeh.2023.109317] [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: 04/07/2023] [Revised: 06/04/2023] [Accepted: 06/08/2023] [Indexed: 06/24/2023]
Abstract
OBJECTIVE The purpose of this research was to evaluate the level of epilepsy-related awareness, knowledge, and attitude exhibited by medical students at a specific medical school in Palestine, as well as the students' reactions to the treatment and social activities provided to patients with epilepsy. METHODS A cross-sectional, observational research of 306 medical students at An-Najah National University in the West Bank, Palestine, was conducted. We used a validated survey taken from previous publications. We split the medical students into preclinical (2nd and 3rd year) and clinical (4th, 5th, and 6th year) groups to see if there were significant differences in their awareness, knowledge, attitude, and their practices toward patients with epilepsy. Several elements, such as sociodemographics, awareness, knowledge, attitude, and practices regarding epilepsy, were included in the survey. The data were analyzed using the Statistical Package for the Social Sciences (SPSS) 29.0. Quantitative data were expressed as mean and standard deviation, whereas qualitative data as frequencies and percentages. The chi-square test was used to compare groups.Any P-value below 0.05 was considered statistically significant. RESULTS In general, clinical medical students exhibited better epilepsy awareness, knowledge, and attitude than preclinical students. Of note, 73.6% of clinical students believe epilepsy is a treatable disorder, compared to 44.6% of preclinical students (P-value < 0.001). Some students believe that depression/anxiety (39.6%), psychosis (35.7%), jinns (evil spirit) (7.8%), evil eye (5.8%), and punishment from God (4.5%) cause epilepsy. Clinical students were more likely than preclinical students to have rotated in a neurology clinic or department (40% vs. 4.6%, P-value < 0.001). In total, 95.5% of clinical students and 86.9% of preclinical students (P-value = 0.006) thought patients with epilepsy should marry. Clinical stage students were more likely than preclinical stage students to think that patients with epilepsy can have children (92.7% vs. 83.1%, P-value = 0.009). Preclinical stage students were more likely than clinical stage students to believe that students with epilepsy should not play sports (22.3% versus 13%, P-value = 0.030). Generally, there were no significant gender differences in awareness, knowledge, and attitudes. CONCLUSION The study found that medical students knew little about epilepsy types, causes, triggers, and first aid. Negative attitudes toward people with epilepsy living alone and discrimination against people with epilepsy were also observed. Students' perceptions of this prevalent disease must be improved through educational programs that provide increased opportunities for clinical exposure to this condition as well as proper inclusion of epilepsy in the regular curriculum.
Collapse
Affiliation(s)
- Mohammad Abuawad
- Department of Biomedical Sciences, Faculty of Medicine and Health Sciences, An-Najah National University, Nablus, Palestine.
| | - Ahmad Rjoub
- Department of Medicine, Faculty of Medicine and Health Sciences, An-Najah National University, Nablus, Palestine
| | - Wafaa Abu Zahra
- Department of Medicine, Faculty of Medicine and Health Sciences, An-Najah National University, Nablus, Palestine
| |
Collapse
|
2
|
Singh G, Singh MB, Ding D, Maulik P, Sander JW. Implementing WHO's Intersectoral Global Action Plan for epilepsy and other neurological disorders in Southeast Asia: a proposal. THE LANCET REGIONAL HEALTH. SOUTHEAST ASIA 2023; 10:100135. [PMID: 37197018 PMCID: PMC7614540 DOI: 10.1016/j.lansea.2022.100135] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Revised: 11/25/2022] [Accepted: 12/16/2022] [Indexed: 05/19/2023]
Abstract
The World Health Assembly approved the Intersectoral Global Action Plan for epilepsy and neurological disorders. Member states, including those in Southeast Asia, must now prepare to achieve IGAP's strategic targets by embracing novel approaches and strengthening existing policies and practices. We propose and present evidence to support four such processes. The opening course should engage all stakeholders to develop people-centric instead of outcome-centric approaches. Rather than caring for convulsive epilepsy alone, as currently done, primary care providers should also be skilled in diagnosing and treating focal and non-motor seizures. This could reduce the diagnostic gap as over half of epilepsies present with focal seizures. Currently, primary care providers lack knowledge and skills to manage focal seizures. Technology-enabled aids can help overcome this limitation. Lastly, there is need to add newer "easy to use" epilepsy medicines to Essential Medicines lists in light of emerging evidence for better tolerability, safety and user-friendliness.
Collapse
Affiliation(s)
- Gagandeep Singh
- Department of Neurology, Dayanand Medical College & Hospital, Ludhiana, India
- Department of Clinical & Experimental Epilepsy, UCL Queen Square Institute of Neurology, Queen Square, London, UK
| | - Mamta B. Singh
- Department of Neurology, All India Institute of Medical Sciences, New Delhi, India
| | - Ding Ding
- Institute of Neurology, Fudan University Hospital, Shanghai, China
| | - Pallab Maulik
- George Institute for Global Health, New Delhi, India
| | - Josemir W. Sander
- Department of Clinical & Experimental Epilepsy, UCL Queen Square Institute of Neurology, Queen Square, London, UK
- Stichting Epilepsie Instellingen Nederland (SEIN), Heemstede 2103 SW, the Netherlands
- Neurology Department, West of China Hospital, Sichuan University, Chengdu 61004, China
| |
Collapse
|
3
|
Arinda A, Ouma S, Kalani K, Ramasubramanian P, Johnson T, Charles A, Newson C, Ratliff O, Kakooza-Mwesige A, Njeru P, Kaddumukasa M, Kaddumukasa M, Kolls B, Husain A, Tchapyjnikov D, Haglund M, Fuller A, Prose N, Koltai D. Evaluation of a tailored epilepsy training program for healthcare providers in Uganda. Epilepsy Behav 2023; 138:108977. [PMID: 36446268 DOI: 10.1016/j.yebeh.2022.108977] [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: 06/30/2022] [Revised: 09/29/2022] [Accepted: 10/27/2022] [Indexed: 11/27/2022]
Abstract
OBJECTIVE This study evaluated an epilepsy training program for healthcare workers that was designed to improve their knowledge of epilepsy, its treatment, and its psychosocial effects. METHODS This single group, before and after survey was conducted in three regional referral hospitals in Uganda. Healthcare workers participated in a 3-day epilepsy training program and were assessed immediately prior to and following the program using a 39-item epilepsy knowledge questionnaire. Pretest to posttest changes and acceptability ratings were analyzed. RESULTS Twenty healthcare workers from each of our three study hospitals (N = 60) participated in the study. The average age of the participants was 39.9 years (SD = 9.6). Female participants constituted 45% of the study population. There was a significant improvement in the knowledge of healthcare workers about epilepsy following the training (t = 7.15, p < 0.001). Improvement was seen across the three sub-scores of general knowledge about epilepsy, assessment and diagnosis of epilepsy, and management of epilepsy. Subgroup analysis showed that both high and low baseline scorers showed significant training gains. CONCLUSIONS The study suggested that our training program was effective in improving the knowledge of health workers about epilepsy and that participants had favorable impressions of the program. Further work is needed to determine if the knowledge is retained over time and if the change in knowledge translates into a change in clinical practice.
Collapse
Affiliation(s)
- Anita Arinda
- Midmay Uganda, P.O. Box 24985, Kampala, Uganda; School of Medicine, College of Health Sciences, Makerere University, P.O. Box 7072, Kampala, Uganda
| | - Simple Ouma
- The AIDS support Organization (TASO) Uganda, P.O. Box 10443, Kampala, Uganda
| | | | | | - Tyler Johnson
- Duke University Trinity College of Arts & Sciences, Durham, NC 27708, USA
| | | | - Colby Newson
- University of Virginia School of Medicine, Charlottesville, VA 22903, USA
| | - Olivia Ratliff
- Duke University Trinity College of Arts & Sciences, Durham, NC 27708, USA
| | - Angelina Kakooza-Mwesige
- Department of Pediatrics and Child Health, Makerere University College of Health Sciences, Mulago Hill Road, P.O. Box 7072, Kampala, Uganda; Department of Pediatrics and Child Health, Mulago National Referral Hospital, Pediatric Neurology Unit, Kampala, Uganda
| | - Paula Njeru
- Duke Division of Global Neurosurgery and Neurology, Department of Neurosurgery, Box 3807, Duke University Medical Center, Durham, NC 27705, USA; Duke Global Health Institute, 310 Trent Dr, Durham, NC 27710, USA
| | - Martin Kaddumukasa
- School of Medicine, College of Health Sciences, Makerere University, P.O. Box 7072, Kampala, Uganda
| | - Mark Kaddumukasa
- School of Medicine, College of Health Sciences, Makerere University, P.O. Box 7072, Kampala, Uganda; Department of Medicine, Mulago National Referral Hospital, Neurology Unit, Kampala, Uganda
| | - Bradley Kolls
- Duke Division of Global Neurosurgery and Neurology, Department of Neurosurgery, Box 3807, Duke University Medical Center, Durham, NC 27705, USA; Duke Clinical Research Institute, Neuroscience Medicine, 300 W Morgan St, Durham, NC 27701, USA; Duke University School of Medicine, Department of Neurology, Durham, NC 27704, USA
| | - Aatif Husain
- Duke University School of Medicine, Department of Neurology, Durham, NC 27704, USA; Veterans Affairs Medical Center, 299B Hanes House, 315 Trent Drive, P.O. Box 102350, Durham, NC 27710, USA
| | - Dmitry Tchapyjnikov
- Duke University School of Medicine, Department of Neurology, Durham, NC 27704, USA; Duke University School of Medicine, Department of Pediatrics, Durham, NC 27710, USA
| | - Michael Haglund
- Duke University School of Medicine, Durham, NC 27710, USA; Duke Division of Global Neurosurgery and Neurology, Department of Neurosurgery, Box 3807, Duke University Medical Center, Durham, NC 27705, USA; Duke Global Health Institute, 310 Trent Dr, Durham, NC 27710, USA
| | - Anthony Fuller
- Duke University School of Medicine, Durham, NC 27710, USA; Duke Division of Global Neurosurgery and Neurology, Department of Neurosurgery, Box 3807, Duke University Medical Center, Durham, NC 27705, USA; Duke Global Health Institute, 310 Trent Dr, Durham, NC 27710, USA
| | - Neil Prose
- Duke Global Health Institute, 310 Trent Dr, Durham, NC 27710, USA; Department of Dermatology and Pediatrics, Duke University Medical Center, Durham, NC 27710, USA
| | - Deborah Koltai
- Duke Division of Global Neurosurgery and Neurology, Department of Neurosurgery, Box 3807, Duke University Medical Center, Durham, NC 27705, USA; Duke University School of Medicine, Department of Neurology, Durham, NC 27704, USA; Duke University School of Medicine, Department of Psychiatry and Behavioral Sciences, DUMC, Box 3119, Trent Drive, Durham, NC 27710, USA.
| |
Collapse
|
4
|
Cumbe VFJ, Greene C, Fumo AMT, Fumo H, Mabunda D, Gouveia LC, Oquendo MA, Duarte CS, Sidat M, Mari JDJ. Community Health Workers' Knowledge, Attitudes, and Practices towards Epilepsy in Sofala, Central Mozambique. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:15420. [PMID: 36430139 PMCID: PMC9693375 DOI: 10.3390/ijerph192215420] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Revised: 07/22/2022] [Accepted: 07/26/2022] [Indexed: 05/14/2023]
Abstract
BACKGROUND Epilepsy is the most common neurological disease in the world, affecting 50 million people, with the majority living in low- and middle-income countries (LMICs). A major focus of epilepsy treatment in LMICs has been task-sharing the identification and care for epilepsy by community health workers (CHWs). The present study aimed to assess the knowledge, attitudes, and practices (KAPs) of CHWs towards epilepsy in Mozambique. METHODS One hundred and thirty-five CHWs completed a questionnaire that included socio-demographic characteristics and 44-items divided into six subscales pertaining to KAPs towards epilepsy (QKAP-EPI) across nine districts of Sofala, Mozambique. The internal consistency was examined to evaluate the reliability of the instrument (QKAP-EPI). The association between sociodemographic variables and QKAP-EPI subscales was examined using linear regression models. RESULTS The internal consistency was moderate for two subscales (causes of epilepsy, α = 0.65; medical treatment, α = 0.694), acceptable for cultural treatment (α = 0.797) and excellent for 2 subscales (safety and risks, α = 0.926; negative attitudes, α = 0.904). Overall, CHWs demonstrated accurate epilepsy knowledge (medical treatment: mean = 1.63, SD = 0.28; safety/risks: mean = 1.62, SD = 0.59). However, CHWs reported inaccurate epilepsy knowledge of the causes, negative attitudes, as well as culturally specific treatments for epilepsy, such as: "if a person with epilepsy burns when set on fire they cannot be treated". Knowledge about how to manage epileptic seizures varied across the different emergency care practices, from the accurate belief that it is not advisable to place objects in the individual's mouth during an epileptic seizure, to the wrong perception of the need to hold the person in seizures to control seizures. Heterogeneity in the level of epilepsy knowledge was observed among CHWs, when considering epilepsy according to the local names as treatable ("Dzumba") and other forms as untreatable ("Nzwiti"). CONCLUSION CHWs knowledge of medical treatment and epilepsy safety/risks were adequate. However, information on the causes of epilepsy, stigmatizing attitudes, cultural treatment, and some knowledge of epileptic seizure management were low. These areas of poor knowledge should be the focus of educating CHWs in increasing their ability to provide quality care for patients with epilepsy in Mozambique.
Collapse
Affiliation(s)
- Vasco Francisco Japissane Cumbe
- Mental Health Department, Ministry of Health, Provincial Health Directorate of Sofala, Beira 543, Mozambique
- Mental Health and Psychiatry Department, Faculty of Medicine, Eduardo Mondlane University (UEM), Maputo 257, Mozambique
- Medicine Department, Psychiatry and Mental Health Service, Beira Central Hospital, Sofala 1613, Mozambique
- Departamento de Psiquiatria, Escola Paulista de Medicina, Universidade Federal de São Paulo, UNIFESP, São Paulo 04017-030, Brazil
| | - Claire Greene
- Program on Forced Migration and Health, Heilbrunn Department of Population and Family Health, Columbia University Mailman School of Public Health, New York, NY 10032, USA
| | - Afonso Mazine Tiago Fumo
- Medicine Department, Psychiatry and Mental Health Service, Beira Central Hospital, Sofala 1613, Mozambique
- Department and Institute of Psychiatry, Faculty of Medicine, University of São Paulo (USP), São Paulo 05403-903, Brazil
| | - Hélder Fumo
- Mental Health Department, Ministry of Health, Provincial Health Directorate of Sofala, Beira 543, Mozambique
| | - Dirceu Mabunda
- Mental Health and Psychiatry Department, Faculty of Medicine, Eduardo Mondlane University (UEM), Maputo 257, Mozambique
- Departamento de Psiquiatria, Escola Paulista de Medicina, Universidade Federal de São Paulo, UNIFESP, São Paulo 04017-030, Brazil
- Service of Psychiatry and Mental Health, Mavalane General Hospital, Maputo 7981000, Mozambique
| | - Lídia Chaúque Gouveia
- Mental Health and Psychiatry Department, Faculty of Medicine, Eduardo Mondlane University (UEM), Maputo 257, Mozambique
- Departamento de Psiquiatria, Escola Paulista de Medicina, Universidade Federal de São Paulo, UNIFESP, São Paulo 04017-030, Brazil
- Department of Mental Health, Directorate of Public Health, Ministry of Health, Maputo 264, Mozambique
| | - Maria A. Oquendo
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Cristiane S. Duarte
- Department of Psychiatry, College of Physicians and Surgeons, Columbia University, New York, NY 10032, USA
| | - Mohsin Sidat
- Department of Community Health, Faculty of Medicine, Eduardo Mondlane University (UEM), Maputo 257, Mozambique
| | - Jair de Jesus Mari
- Departamento de Psiquiatria, Escola Paulista de Medicina, Universidade Federal de São Paulo, UNIFESP, São Paulo 04017-030, Brazil
| |
Collapse
|
5
|
Yu Q, Ying YQ, Lu PP, Sun MT, Zhu ZL, Xu ZYR, Guo Y. Evaluation of the knowledge, awareness, and attitudes toward epilepsy among nurses. Epilepsy Behav 2022; 136:108920. [PMID: 36166878 DOI: 10.1016/j.yebeh.2022.108920] [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: 08/03/2022] [Revised: 09/11/2022] [Accepted: 09/12/2022] [Indexed: 12/14/2022]
Abstract
BACKGROUND The standard of care provided to patients with chronic epilepsy might be affected by clinical nurses' understanding, awareness, and attitudes toward the condition. The objective of this study was to assess the knowledge, awareness, and attitudes toward chronic epilepsy among clinical nurses in the Second Affiliated Hospital of Zhejiang University School of Medicine, China. METHODS Two hundred and thirty-eight nurses from the neurosurgery, neurology, epilepsy center, other internal medicine and other surgery department working at our hospital participated in this descriptive and cross-sectional study in 2022. The data were collected through an electronic questionnaire, which comprised four domains including demographic and clinical epilepsy-related questions, awareness of epilepsy section, 18 items for knowledge and a 15-item scale for attitudes. Mann-Whitney U tests, Kruskal-Wallis H tests, post hoc analysis, Pearson correlation analysis, and descriptive statistics were used to analyze the non-normal distribution of the dataset. RESULTS The clinical nurses' average score on the awareness of epilepsy section was 14.93 ± 2.69 (maximum score: 20), the knowledge of epilepsy section scored 15.41 ± 2.30 (maximum score: 18), and the epilepsy attitude section scored 30.65 ± 7.40. The knowledge and awareness accuracy of the responses to the epilepsy-related questions were positively and significantly correlated (r = 0.251, p < 0.001). The multiple linear regression model found that the department (p < 0.001) and rank (p = 0.015) of nurses were independently associated with awareness toward epilepsy. Meanwhile, there was a statistically significant difference between the departments of nurses and accuracy on the Epilepsy Knowledge Scale (H = 18.340, p < 0.001). In addition, 92.77% of nurses agreed that people with chronic epilepsy have the same rights as all people. Unfortunately, over 30% of nurses maintained an uncertain attitude toward the employment, marriage, and emotion related to epilepsy. CONCLUSION Our findings revealed that nurses had a general awareness and understanding of epilepsy, attitudes toward epilepsy. Specifically, nurses working in the Neurology Department and the Epilepsy Center were predisposed to have a considerably better level of awareness and knowledge of epilepsy. Additionally, as their understanding of epilepsy grew, so did their sensitivity to those who suffer from the condition. The study also recommends that epilepsy experts deliver additional lectures and training sessions to enhance nurses' knowledge of first-aid for seizures.
Collapse
Affiliation(s)
- Qun Yu
- Nursing Department, the Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China
| | - Yu-Qi Ying
- Department of Neurosurgery, the Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China
| | - Pan-Pan Lu
- Department of General Practice and International Medicine, the Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China
| | - Meng-Tian Sun
- Department of General Practice and International Medicine, the Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China
| | - Zhou-le Zhu
- Department of Neurosurgery, the Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China
| | - Zheng-Yan-Ran Xu
- Department of Neurology, Epilepsy Center, the Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China
| | - Yi Guo
- Department of General Practice and International Medicine, the Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China; Department of Neurology, Epilepsy Center, the Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China.
| |
Collapse
|
6
|
Austin JK, Birbeck G, Parko K, Kwon CS, Fernandes PT, Braga P, Fiest KM, Ali A, Cross JH, de Boer H, Dua T, Haut SR, Jacoby A, Lorenzetti DL, Mifsud J, Moshé SL, Tripathi M, Wiebe S, Jette N. Epilepsy-related stigma and attitudes: Systematic review of screening instruments and interventions - Report by the International League Against Epilepsy Task Force on Stigma in Epilepsy. Epilepsia 2022; 63:598-628. [PMID: 34985766 DOI: 10.1111/epi.17133] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Revised: 11/09/2021] [Accepted: 11/10/2021] [Indexed: 11/29/2022]
Abstract
OBJECTIVE This is a systematic review aimed at summarizing the evidence related to instruments that have been developed to measure stigma or attitudes toward epilepsy and on stigma-reducing interventions. METHODS This review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) standards. A broad literature search (1985-2019) was performed in 13 databases. Articles were included if they described the development and testing of psychometric properties of an epilepsy-related stigma or attitude scale or stigma-reducing interventions. Two reviewers independently screened abstracts, reviewed full-text articles, and extracted data. Basic descriptive statistics are reported. RESULTS We identified 4234 abstracts, of which 893 were reviewed as full-text articles. Of these, 38 met inclusion criteria for an instrument development study and 30 as a stigma-reduction intervention study. Most instruments were initially developed using well-established methods and were tested in relatively large samples. Most intervention studies involved educational programs for adults with pre- and post-evaluations of attitudes toward people with epilepsy. Intervention studies often failed to use standardized instruments to quantify stigmatizing attitudes, were generally underpowered, and often found no evidence of benefit or the benefit was not sustained. Six intervention studies with stigma as the primary outcome had fewer design flaws and showed benefit. Very few or no instruments were validated for regional languages or culture, and there were very few interventions tested in some regions. SIGNIFICANCE Investigators in regions without instruments should consider translating and further developing existing instruments rather than initiating the development of new instruments. Very few stigma-reduction intervention studies for epilepsy have been conducted, study methodology in general was poor, and standardized instruments were rarely used to measure outcomes. To accelerate the development of effective epilepsy stigma-reduction interventions, a paradigm shift from disease-specific, siloed trials to collaborative, cross-disciplinary platforms based upon unified theories of stigma transcending individual conditions will be needed.
Collapse
Affiliation(s)
- Joan K Austin
- Indiana University School of Nursing, Indianapolis, Indiana, USA
| | - Gretchen Birbeck
- Epilepsy Division, University of Rochester, Rochester, New York, USA.,Epilepsy Care Team, Chikankata Hospital, Mazabuka, Zambia
| | - Karen 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
| | - Churl-Su Kwon
- Departments of Neurosurgery and Neurology, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Paula T Fernandes
- Department of Sport Science, Faculty of Physical Education, UNICAMP, Campinas, Brazil
| | - Patricia Braga
- Institute of Neurology, Facultad de Medicina, Universidad de la República, Montevideo, Uruguay
| | - 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
| | - Amza Ali
- Kingston Public Hospital and University of the West Indies, Kingston, Jamaica
| | - J Helen Cross
- Developmental Neurosciences Programme, UCL-Great Ormond Street Institute of Child Health, London, UK
| | | | - Tarun Dua
- Department of Mental Health and Substance Abuse, World Health Organization, Geneva, Switzerland
| | - Sheryl R Haut
- Saul R. Korey Department of Neurology, Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, New York, USA
| | - Ann Jacoby
- Department of Public Health and Policy, University of Liverpool, Liverpool, UK
| | - Diane L Lorenzetti
- Department of Community Health Sciences, University of Calgary and Heath 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 L Moshé
- Department of Pediatrics and Dominick P. Purpura Department of Neuroscience, Albert Einstein College of Medicine, Bronx, New York, 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 at Mount Sinai, New York, New York, USA
| |
Collapse
|
7
|
Ibrahim ME, Hasabo EA, Hsabo EA, Alhadi AS. Awareness and attitude of first-year medical students toward epilepsy in University of Khartoum, Sudan. Brain Behav 2022; 12:e2461. [PMID: 34904401 PMCID: PMC8785617 DOI: 10.1002/brb3.2461] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2021] [Revised: 10/05/2021] [Accepted: 11/06/2021] [Indexed: 11/09/2022] Open
Abstract
PURPOSE Very little is known about the knowledge and attitude of students about epilepsy at Sudanese universities. Therefore, we aimed to assess knowledge and attitude of undergraduate medical students toward epilepsy. METHODS A 35-items standardized questionnaire was self-administered to 320 students between December 2020 and February 2021 with a recorded response rate of 61.8%. Google form was used to collect the data. The data was analyzed using R software. RESULTS Overall, our findings showed a negative trend in the awareness and attitude towards epilepsy. While the majority of students (84.8%) had read or heard about epilepsy, only 43.9% of them had seen someone with epilepsy. Epilepsy was considered contagious and psychological by 1.7% and 56%, respectively. About 62.2% of students believed head / birth trauma is a cause of epilepsy. On the other hand, 15.7 % and 5.1 % of students thought evil eye and divine retribution are also causes of epilepsy, respectively. The latter beliefs were more uniform among participants from rural background (p < .05). Regarding attitude, 19.7% of students considered it inappropriate for a patient with epilepsy to have a child. This attitude correlates with the mother's education as the percentage was higher for students whose mothers had a lower education (pre-college education) (p < .05). The majority of students were aware that certain people with epilepsy need long-term drug treatment; this belief was more uniform among females than in males (p < .05). The vast majority of students (93.9%) thought that a child with epilepsy could succeed in a normal class. Compared to the corresponding group, this belief was found more common in students whose mothers had a higher education (university level and above) (p < .05). CONCLUSION This study concludes that Sudanese undergraduate students' understanding of epilepsy was minimal, necessitating a well-directed educational campaign to develop a well-informed and tolerant society.
Collapse
Affiliation(s)
| | | | - Elmuiz A. Hsabo
- Department of UrologyWythenshawe hospitalManchester University NHS Foundation TrustManchesterUK
| | | |
Collapse
|
8
|
Shehata N, Saleh SM, Kamal AM, Awad OK. Assessment of the Frequency of Depressive Symptoms in Epileptic Children (Single Center Study). Risk Manag Healthc Policy 2021; 14:2089-2097. [PMID: 34295198 PMCID: PMC8290486 DOI: 10.2147/rmhp.s301058] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Accepted: 03/29/2021] [Indexed: 11/23/2022] Open
Abstract
Background Epilepsy, the most common neurological disorder in children, may present with many psychiatric comorbidities, the most common of which is depression. Aim of the Work We evaluated the frequency of depressive symptoms in epileptic children, with regard to the possible association between depression and their demographic data or seizure-related variables. Patients and Methods This cohort study was conducted on 80 children (6-13 years old) diagnosed as idiopathic epilepsy and were regularly recruiting the pediatric neurology clinic at Minya University Children Hospital. The Structured Birleson Depression Scale Questionnaire was used for assessment of presence of depressive symptoms, and Quality Of Life in Epilepsy (QOLIE-31) score was used to assess quality of life in those patients. Results Depressive symptoms were found in 37.5% of enrolled patients. There were statistically significant differences between the patients with depressive symptoms and the other group regarding age (p=0.001), residence (p=0.006) and past history of mood disorders (p=0.03). Sleep disturbance was the highest predictor of depression in cases with depressive symptoms, detected in 90% of cases, followed by appetite disturbance in 86.6% of cases, while delusions and hallucinations were the lowest, detected in only 10% of cases. Both duration of epilepsy and frequency of seizures were significantly higher in cases with depressive symptoms than the other group (p=0.001) for both. QOLIE score was significantly lower in cases with depressive symptoms than the other group (p= 0.01 for all). Conclusion Depressive symptoms are common in epileptic children, and it is often challenging and underestimated. It should be screened during the management of such children. Early diagnosis and more comprehensive package of care for depression in epileptic children will enable them to have a better quality of life.
Collapse
Affiliation(s)
- Nageh Shehata
- Department of Pediatrics, Faculty of Medicine, Minya University, El Minya, 61111, Egypt
| | - Salah Mahmoud Saleh
- Department of Pediatrics, Faculty of Medicine, Minya University, El Minya, 61111, Egypt
| | - Ahmed M Kamal
- Department of Neurology, Faculty of Medicine, Minya University, El Minya, Egypt
| | - Omnia Kamal Awad
- Department of Pediatrics, Faculty of Medicine, Minya University, El Minya, 61111, Egypt
| |
Collapse
|
9
|
The effect of a seminar on medical students' information acquisition of and attitudes toward epilepsy. Epilepsy Behav 2021; 116:107720. [PMID: 33485166 DOI: 10.1016/j.yebeh.2020.107720] [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: 10/07/2020] [Revised: 12/15/2020] [Accepted: 12/15/2020] [Indexed: 11/22/2022]
Abstract
AIM The aim of the present study was to investigate the effect of a brief seminar focusing on medical and social aspects of epilepsy on information acquisition of and attitudes toward epilepsy among medical school students. METHOD The sample of this pretest-posttest study consisted of 57 fifth-grade medical students. The students participated in a one-hour seminar including medical and social aspects of epilepsy. An epilepsy-related awareness form developed by researchers and also the Epilepsy Attitude Scale were applied to the participants before and after the seminar. RESULTS It was determined that half of the students (50.9%) encountered an epileptic seizure and 12.3% of them applied first aid. The students had difficulty in describing the seizure type before education. Before education, the rate of describing the seizure was 47.4% for myoclonic seizure, 50.9% for simple partial seizure, and 64.9% for absence seizure, and after education, these rates increased to 82.5% (p < 0.001), 91.2% (p < 0.001), and 98.2% (p < 0.001), respectively. Students generally well described the seizure triggering factors; however, the rate of students reporting the menstrual period as triggering factors were lower (66.7%), and the rates increased after the education (93.0%) (p = 0.001). The percentages of correct answers increased also for the questions regarding seizure first aid. The percentage of students who felt competent for seizure first-aid management increased from 12.3% to 91.2% (p < 0.001) after the education. The correct response rates of students for social aspects of epilepsy was generally high. In our study, attitude toward epilepsy was also evaluated. After the education, a mild increase in the attitude score of students was found (p = 0.009). Although it is minimal, the number of students who marked more positive attitude increased for each item of the Attitude scale. CONCLUSION Although a lack of acquaintance was found in some areas, awareness of epilepsy in our sample was at a moderate level. This study showed a positive effect of the education given to students on information acquisition and attitude.
Collapse
|
10
|
Recognizing and refuting the myth of tongue swallowing during a seizure. Seizure 2020; 83:32-37. [DOI: 10.1016/j.seizure.2020.09.023] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2020] [Revised: 09/28/2020] [Accepted: 09/29/2020] [Indexed: 11/23/2022] Open
|
11
|
Patel AA, Ciccone O, Nkole KL, Kalyelye P, Sham L, Kielian A, Berger T, Huff HV, Johnson HF, Sulu M, Mathews M, Mazumdar M. Development and Evaluation of a Pediatric Epilepsy Training Program for First Level Providers in Zambia. Glob Pediatr Health 2020; 7:2333794X20968718. [PMID: 33225022 PMCID: PMC7649896 DOI: 10.1177/2333794x20968718] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2020] [Revised: 09/08/2020] [Accepted: 09/30/2020] [Indexed: 11/16/2022] Open
Abstract
Introduction. The developing world continues to face challenges in closing the large treatment gap for epilepsy, due to a high burden of disease and few experienced providers to manage the condition. Children with epilepsy are susceptible to higher rates of developmental impairments and refractory disease due to delays or absence of appropriate management as a result. We demonstrated that a structured education intervention on pediatric epilepsy can improve knowledge, confidence, and impact clinical practice of first level providers in Zambia. Methods. Three first-level facilities across Zambia were included. After initial pilot versions and revisions, the final course was implemented at each site. Pre- and post-intervention knowledge and confidence assessments were performed. Additionally, chart reviews were conducted prior to intervention and 4 months after completion of training at each site to assess change on management. Results. Twenty-three of the original 24 participants from all 3 sites completed the training; 48% clinical officers, 43% nurses, 9% other expertise. Of the 15 concepts tested by knowledge assessment, 12 showed trends in improvement, 7 of which were significant (P < .05). Chart reviews demonstrated significant improvement in documentation of seizure description (P = .008), seizure frequency (P = .00), and possible causes of seizures/epilepsy (P = .034). Discussion. Key elements of success to this program included hands on clinical skills building and case-based teaching, development of a program with direct and ongoing input from the target audience, and inclusion of assessments to monitor impact on clinical practice. Future studies looking at health outcomes are necessary to determine sustained impact.
Collapse
Affiliation(s)
- Archana A Patel
- Boston Children's Hospital, Department of Neurology, Harvard Medical School, Boston, MA, USA.,University of Zambia, School of Medicine, Department of Paediatrics and Child Health, Lusaka, Zambia
| | - Ornella Ciccone
- University Teaching Hospital- Children's Hospital, Lusaka, Zambia
| | | | - Prisca Kalyelye
- University Teaching Hospital- Children's Hospital, Lusaka, Zambia
| | - Lauren Sham
- Boston Children's Hospital, Department of Neurology, Harvard Medical School, Boston, MA, USA
| | - Agnieszka Kielian
- Boston Children's Hospital, Department of Neurology, Harvard Medical School, Boston, MA, USA
| | - Tamar Berger
- Beth Israel Deaconess Medical Center, Department of Neurology, Boston, MA, USA
| | - Hanalise V Huff
- Boston Children's Hospital, Department of Neurology, Harvard Medical School, Boston, MA, USA
| | - Hannah F Johnson
- Boston Children's Hospital, Department of Neurology, Harvard Medical School, Boston, MA, USA
| | - Mercy Sulu
- Arthur Davison Children's Hospital, Ndola, Zambia
| | - Manoj Mathews
- University of Zambia, School of Medicine, Department of Paediatrics and Child Health, Lusaka, Zambia.,Ministry of Health, Lusaka, Zambia
| | - Maitreyi Mazumdar
- Boston Children's Hospital, Department of Neurology, Harvard Medical School, Boston, MA, USA
| |
Collapse
|
12
|
Unsar S, Özdemir Ö, Erol Ö, Bıkmaz Z, Yenici Bulut E. Evaluation of nursing students' epilepsy-related knowledge and attitudes. Epilepsy Behav 2020; 111:107167. [PMID: 32603806 DOI: 10.1016/j.yebeh.2020.107167] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2019] [Revised: 05/07/2020] [Accepted: 05/11/2020] [Indexed: 12/16/2022]
Abstract
AIM This study evaluated the knowledge and attitudes of nursing students toward epilepsy. METHOD The descriptive and cross-sectional study was conducted with the voluntary participation of 161 nursing students in their 2nd, 3rd, and 4th years of study who were registered at the summer school of Trakya University, Faculty of Health Sciences in the 2017-2018 academic year. The data were collected through a research questionnaire form and the Epilepsy Knowledge and Attitude Scales. The normal distribution of the data was tested using the one-sample Kolmogorov-Smirnov test. Nonparametric tests were used since the data were not normally distributed. Descriptive statistics (mean, standard deviation, range, numbers, and percentages), the Mann-Whitney U test, the Kruskal-Wallis test, and Spearman's correlation test were used in the data analysis. FINDINGS Half of the nursing students (55.9%) were females with a mean age of 22.14 ± 1.81 years, and 43.5% of the students were third-year students. Of the students, 90.7% were informed about epilepsy from sources including their school/course/instructor (64%), the television/internet (10.6%), and healthcare professionals (6.8%). The mean scores obtained on the Epilepsy Knowledge Scale (EKS) and the mean score on the Epilepsy Attitude Scale (EAS) were 10.23 ± 4.24 and 57.66 ± 8.83, respectively. A significant positive correlation was found between the knowledge and attitude scores of the students regarding epilepsy (p < .001). As the students' knowledge increased, their attitudes also increased positively toward epilepsy. The female students had a more positive attitude toward epilepsy than did the male students. Further, the students who had knowledge about epilepsy and who provided care for patients with epilepsy had higher scores and displayed more positive attitudes toward epilepsy (p < .05). CONCLUSION This study determined that the participating nursing students had a moderate level of knowledge regarding epilepsy. In addition to theoretical knowledge of epilepsy, the experience of caring for a patient with epilepsy had a positive effect on the students' attitudes. The nursing education curriculum should place greater focus on epilepsy and interventions for epilepsy seizures.
Collapse
Affiliation(s)
- Serap Unsar
- Trakya University, Balkan Campus, Faculty of Health Sciences, Department of Internal Medicine Nursing, Edirne, Turkey.
| | - Özlem Özdemir
- Kırklareli University, School of Health, Department of Health Management, Kırklareli, Turkey.
| | - Özgül Erol
- Trakya University, Balkan Campus, Faculty of Health Sciences, Department of Internal Medicine Nursing, Edirne, Turkey.
| | - Zülfiye Bıkmaz
- Kırklareli University, School of Health, Department of Health Management, Kırklareli, Turkey
| | | |
Collapse
|
13
|
Assadeck H, Toudou-Daouda M, Mamadou Z, Moussa-Konate M, Douma-Maiga D, Sanoussi S. Knowledge, Attitudes, and Practices with Respect to Epilepsy among Nurses in the City of Niamey, Niger. J Neurosci Rural Pract 2020; 11:454-458. [PMID: 32753812 PMCID: PMC7394661 DOI: 10.1055/s-0040-1713292] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Objective
The aim of this study is to evaluate knowledge, attitudes, and practices about epilepsy among nurses in the city of Niamey, Niger, to identify existing gaps in their knowledge concerning epilepsy to formulate recommendations to improve the quality of care for people with epilepsy.
Materials and Methods
We conducted a descriptive cross-sectional survey on epilepsy knowledge among nurses in the city of Niamey, using a self-administered questionnaire including questions related to knowledge about epilepsy.
Results
A total of 98 nurses (29 men and 69 women) were included in the survey. The mean age of the participants was of 32.88 ± 10.87 years (range: 17–58 years). The sample consisted of 10.2% of student nurses, 64.3% of college patent, and 25.5% of bachelor nurses. Only 22.4% of participants reported having heard about epilepsy during their training programs. Among the respondents, 43.9% of them had already attended at least one epileptic seizure. Epilepsy is considered as a psychiatric illness and contagious disease by 11.2 and 19.4% of respondents, respectively. The main transmission routes reported were physical contact with an epileptic person (14.3%) and contact with saliva (4.1%). Epilepsy was considered as an incurable disease by 5.1% of respondents. When someone has an epileptic seizure, 10.2% of respondents think that physical contact with this person should be avoided to prevent from contamination. Only 6.1% of respondents had appropriate attitudes when someone has an epileptic seizure such as lying the patient on his side, clearing the airway if necessary, and diazepam injection.
Conclusion
Considering that people with epilepsy are largely cared out by nurses in Niger, the results of the study justify the need to train nurses with respect to epilepsy to improve their knowledge about epilepsy and the care of people with epilepsy.
Collapse
Affiliation(s)
- Hamid Assadeck
- Department of Neurology, National Hospital of Niamey, Niamey, Niger.,Department of Medicine and Medical Specialties, Faculty of Medicine and Pharmacy, Niamey, Niger
| | | | - Zakaria Mamadou
- Department of Neurology, National Hospital of Niamey, Niamey, Niger
| | | | - Dijbo Douma-Maiga
- Department of Medicine and Medical Specialties, Faculty of Medicine and Pharmacy, Niamey, Niger.,Department of Psychiatry, National Hospital of Niamey, Niamey, Niger
| | - Samuila Sanoussi
- Department of Neurosurgery, National Hospital of Niamey, Niamey, Niger.,Department of Surgery and Surgical Specialties, Faculty of Medicine and Pharmacy, Abdou, Niger
| |
Collapse
|
14
|
Buddhiraja R, Sharma S, Sharma S, Bansal RK, Setia RK, Bansal N, Chowdhury A, Goraya JS, Kaur S, Kaur M, Kalra S, Sander JW, Singh G. Epilepsy knowledge, attitudes, and practices among primary healthcare providers in an Indian district. Epilepsy Behav 2020; 104:106899. [PMID: 32058300 DOI: 10.1016/j.yebeh.2019.106899] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2019] [Revised: 12/28/2019] [Accepted: 12/29/2019] [Indexed: 11/27/2022]
Abstract
INTRODUCTION Scaling up the involvement of primary care providers in epilepsy management in low- and middle-income countries (LMICs) requires an understanding of their epilepsy knowledge, attitudes, and practices (KAP). AIM The aim of the study was to document levels of knowledge about, attitudes towards, and practices regarding epilepsy among different ranks of primary healthcare providers in a North-Western Indian district. METHODS The survey included government medical officers (MOs), auxiliary nurse midwives (ANMs), and accredited social health activists (ASHAs). They were administered a specially designed KAP questionnaire. Responses were analyzed according to rank. RESULTS The survey showed that nearly 10% of ANMs and almost a fifth of ASHAs had never heard about epilepsy. A quarter of MOs and over two-thirds of ANMs and ASHAs had never provided care to someone with epilepsy. There were significant differences in the levels of knowledge between the three groups of workers. CONCLUSIONS Closing the huge gaps in KAP by educating primary care and community health workers about epilepsy should be a priority before engaging them in the epilepsy care delivery.
Collapse
Affiliation(s)
- Richa Buddhiraja
- Research & Development Unit, Dayanand Medical College, Ludhiana, India
| | - Sarit Sharma
- Department of Social & Preventive Medicine, Dayanand Medical College, Ludhiana, India
| | - Suman Sharma
- Research & Development Unit, Dayanand Medical College, Ludhiana, India
| | - Rajnder K Bansal
- Department of Neurology, Dayanand Medical College, Ludhiana, India
| | - Raj K Setia
- Punjab Remote Sensing Centre, Ludhiana, India
| | - Namita Bansal
- Research & Development Unit, Dayanand Medical College, Ludhiana, India
| | - Anuraag Chowdhury
- Department of Social & Preventive Medicine, Dayanand Medical College, Ludhiana, India
| | - Jatinder S Goraya
- Department of Paediatrics, Dayanand Medical College, Ludhiana, India
| | - Sukhpreet Kaur
- Research & Development Unit, Dayanand Medical College, Ludhiana, India
| | - Manpreet Kaur
- Research & Development Unit, Dayanand Medical College, Ludhiana, India
| | - Shivani Kalra
- College of Nursing, Dayanand Medical College, Ludhiana, India
| | - Josemir W Sander
- NIHR University College London Hospitals, UCL Queen Square Institute of Neurology, London WC1N 3BG, United Kingdom; Department of Clinical & Experimental Epilepsy, UCL Queen Square Institute of Neurology, London WC1N 3BG, United Kingdom; Chalfont Centre for Epilepsy, Chalfont St Peter SL9 0RJ, United Kingdom; Stichting Epilepsie Instellingen Nederland (SEIN), Heemstede 2103 SW, Netherlands
| | - Gagandeep Singh
- Research & Development Unit, Dayanand Medical College, Ludhiana, India; Department of Social & Preventive Medicine, Dayanand Medical College, Ludhiana, India; Department of Clinical & Experimental Epilepsy, UCL Queen Square Institute of Neurology, London WC1N 3BG, United Kingdom.
| |
Collapse
|
15
|
Differences in knowledge about epilepsy and antiepileptic drugs among pharmacy-dispensing workers in Cambodia and in Lao PDR. Epilepsy Behav 2020; 103:106834. [PMID: 31884119 DOI: 10.1016/j.yebeh.2019.106834] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2019] [Revised: 11/26/2019] [Accepted: 11/26/2019] [Indexed: 11/22/2022]
Abstract
UNLABELLED Epilepsy is the most common neurological disorder encountered in primary care in Southeast Asia. People with epilepsy require long-term therapy management. Nonadherence to antiepileptic drugs (AEDs) has been identified as a major factor in suboptimal control of epilepsy. Pharmacies offer patients a first-line point of contact with the healthcare system. Many pharmacies operate with limited or nonqualified human resources that can lead to insufficient knowledge, inappropriate supply of medicines, and insufficient counseling. OBJECTIVE The aim of this study was to evaluate the qualification and knowledge concerning epilepsy and AEDs among pharmacy-dispensing workers who sell drugs to people with epilepsy. METHOD A cross-sectional qualitative study was conducted in public and private pharmacies, in both urban and rural areas of Cambodia and Lao People's Democratic Republic (Lao PDR). The knowledge was collected through a questionnaire. RESULTS A total of 180 respondents from 123 outlets in the two countries were included in this study. A proportion of 40.8% (31) of respondents in Cambodia and 38.5% (40) in Lao PDR were pharmacists, followed by sellers who did not received any healthcare training with a proportion of 18.4% (14) in Cambodia compared to 20.2% (21) in Lao PDR. Head trauma was cited as the main cause of epilepsy by 72.4% (55) in Cambodia and 27.2% (28) in Lao PDR (p < 0.001). Epilepsy was considered as a contagious disease by 6.6% (5) of respondents in Cambodia compared to 18.4% (19) in Lao PDR (p = 0.03). Eighty-seven percent (66) of respondents in Cambodia knew at least one long-term AED versus 67.3% (70) in Lao PDR (p = 0.003). Phenobarbital was mentioned in more than 90.0% of cases in both countries. In overall, 15.4% (21) thought that if seizures are controlled for some months, people with epilepsy could stop taking their AEDs. Only one respondent from Lao PDR was aware of drug-drug interaction between AEDs and oral contraception. CONCLUSION An educational intervention should be implemented to improve the knowledge of epilepsy and AEDs for pharmacy-dispensing workers. This could include advice for all pharmacy-dispensing workers in order to improve AED management and follow-up of therapeutic adherence.
Collapse
|
16
|
Awareness and attitudes toward epilepsy among medical and allied healthcare students - A survey study in a teaching hospital in Jeddah. Epilepsy Behav 2020; 102:106815. [PMID: 31837506 DOI: 10.1016/j.yebeh.2019.106815] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2019] [Revised: 11/18/2019] [Accepted: 11/19/2019] [Indexed: 12/31/2022]
Abstract
PURPOSE Epilepsy affects individuals of all ages and genders and places high physical, mental, financial, and social burdens on these individuals. In Saudi Arabia, its prevalence is 6.5 cases per 1000 individuals. Physicians and healthcare professionals have a key role in increasing the knowledge and awareness of the general population about epilepsy. The purpose of this study was to assess the level of awareness of different aspects of epilepsy, such as, presentation; causes; social aspects of epilepsy in school, work, and social life; treatment options; and attitudes toward epilepsy of students at King Abdulaziz University (KAU) in medical and allied healthcare specialties. We also aimed to assess if the level of knowledge and attitude improves throughout the study years by comparing preclinical-year students to clinical-year students. METHOD This cross-sectional study included 255 participants from multiple health specialties studying at KAU. Surveys from prior validated publications were used. We divided the respondents into two categories (preclinical [2nd, 3rd, 4th-year students] and clinical [5th, 6th, and internship year]) to evaluate if knowledge and attitude are different among these two groups. RESULTS In general, medical students had more awareness than did students from other specialties about what to do if someone was having a seizure. A total of 17.3% of medical students answered that they would put a spoon or cloth in the mouth of someone having a seizure, whereas 21% of nursing students thought this answer was appropriate (p = .04). The proportion of clinical-year students who were knowledgable of the symptoms and causes of epilepsy was significantly higher than that of students in preclinical years (p < .0001). Only 12.3% of the clinical-year students thought epilepsy was an untreatable disease versus 35.5% of preclinical-year students (p = .02). Interestingly, nursing students had the highest percentage of respondents who answered yes to surgical options (p = .009) (57.9%, n = 11), followed by dental students (50%, n = 6), medical students (46.4%, n = 78), and finally clinical pharmacy students (45.5%, n = 20). CONCLUSION The level of awareness among medical students was higher than that among students of other specialties, with progressive improvement over the study years. However, knowledge about surgical options was minimal. Thus, further emphasis is needed in teaching and educational campaigns, particularly for allied healthcare students.
Collapse
|
17
|
Impact of knowledge, attitudes, and sociocultural factors on school enrollment of children with epilepsy in Gabon. Seizure 2019; 71:145-150. [DOI: 10.1016/j.seizure.2019.07.014] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2019] [Revised: 06/24/2019] [Accepted: 07/15/2019] [Indexed: 11/23/2022] Open
|
18
|
Patel AA, Wibecan L, Tembo O, Kalyelye P, Mathews M, Ciccone O. Improving paediatric epilepsy management at the first level of care: a pilot education intervention for clinical officers in Zambia. BMJ Open 2019; 9:e029322. [PMID: 31345977 PMCID: PMC6661618 DOI: 10.1136/bmjopen-2019-029322] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/12/2019] [Revised: 06/24/2019] [Accepted: 07/01/2019] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVE Epilepsy affects approximately 50 million people globally, with approximately 80% living in low/middle-income countries (LMIC), where access to specialist care is limited. In LMIC, primary health workers provide the majority of epilepsy care, despite limited training in this field. Recognising this knowledge gap among these providers is an essential component for closing the epilepsy treatment gap in these regions. SETTING In Zambia, the vast majority of healthcare is provided by clinical officers (COs), primary health providers with 3 years post-secondary general medical education, who predominantly work in first-level health centres around the country. PARTICIPANTS With cooperation from the Ministry of Health, a total of 10 COs from 4 surrounding first-level health centres around the capital city of Lusaka participated, with 9 completing the entire course. INTERVENTION COs were trained in a 3-week structured course on paediatric seizures and epilepsy, based on adapted evidence-based guidelines. RESULTS Preassessment and postassessment were conducted to assess the intervention. Following the course, there was improved overall knowledge about epilepsy (69% vs 81%, p<0.05), specifically knowledge regarding medication management and recognition of focal seizures (p<0.05), improved seizure history taking and appropriate medication titration (p<0.05). However, knowledge regarding provoked seizures, use of diagnostic studies and general aetiologies of epilepsy remained limited. CONCLUSIONS This pilot project demonstrated that a focused paediatric epilepsy training programme for COs can improve knowledge and confidence in management, and as such is a promising step for improving the large epilepsy treatment gap in children in Zambia. With feasibility demonstrated, future projects are needed to expand to more rural regions for more diverse and larger sample of primary health provider participants and encompass more case-based training and repetition of key concepts as well as methods to improve and assess long-term knowledge retention.
Collapse
Affiliation(s)
- Archana A Patel
- Neurology, Division of Epilepsy & Clinical Neurophysiology, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts, USA
- Paediatrics, University of Zambia School of Medicine, Lusaka, Zambia
| | - Leah Wibecan
- Department of Pediatrics, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Owen Tembo
- Paediatric Centre of Excellence, University Teaching Hospitals Children's Hospital, Lusaka, Zambia
| | - Prisca Kalyelye
- Paediatric Centre of Excellence, University Teaching Hospitals Children's Hospital, Lusaka, Zambia
| | - Manoj Mathews
- Paediatrics, University of Zambia School of Medicine, Lusaka, Zambia
- Ministry of Health, Lusaka, Zambia
| | - Ornella Ciccone
- Paediatrics, University of Zambia School of Medicine, Lusaka, Zambia
- Paediatric Centre of Excellence, University Teaching Hospitals Children's Hospital, Lusaka, Zambia
| |
Collapse
|
19
|
Shah QN, Dave PA, Loh DA, Appasani RK, Katz CL. Knowledge of and Attitudes Towards Mental Illness Among ASHA and Anganwadi Workers in Vadodara District, Gujarat State, India. Psychiatr Q 2019; 90:303-309. [PMID: 30690671 DOI: 10.1007/s11126-019-9625-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Unmet needs in mental health care are high in low and middle-income countries like India. We propose recruiting community health workers (CHWs) to provide mental health services and address the treatment gap, but there is limited data available on the training needs for this potential role. The aim of this study is to help determine what type of formal mental health training and programming could most benefit CHWs in India. This was a cross sectional study design. Self-administered surveys were conducted amongst CHWs in the villages of Vadodara District, Gujarat, India. Statistical analyses included two tailed t-tests using Microsoft Excel 2011. The most common causes for mental illness were attributed to anxiety (61%) and brain disease (61%) followed by stress (45%) and alcohol use disorder (38%). CHWs were dismissive of faith healers ability to treat mental illness (72.9%) showing a strong approval for recommending psychiatric care for the mentally ill (84.4%). Over 50% of participants believed that mentally ill have a lower IQ and that they were unpredictable, but at the same time asserted that people with mental illness can live in the community (80.8%), and recover if given treatment and support (91.8%). Results are promising with CHWs displaying basic knowledge of the etiology and treatment of disease harboring positive attitudes towards psychiatrist's ability to treat mental illness. Future direction should focus on training CHWs towards minimizing stigmatizing views and increasing their knowledge of mental illness in order to scale up mental health services in these low resource communities.
Collapse
Affiliation(s)
- Qainat N Shah
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, 1420 Madison Avenue, New York, NY, 10029, USA.
| | - Pooja A Dave
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, 1420 Madison Avenue, New York, NY, 10029, USA
| | - Daniella A Loh
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, 1420 Madison Avenue, New York, NY, 10029, USA
| | | | - Craig L Katz
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, 1420 Madison Avenue, New York, NY, 10029, USA
| |
Collapse
|
20
|
Knowledge, attitudes, and practices of health sciences students regarding epilepsy at the end of their curriculum in Benin. Epilepsy Behav 2019; 92:165-170. [PMID: 30660967 DOI: 10.1016/j.yebeh.2018.12.020] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2018] [Revised: 12/17/2018] [Accepted: 12/22/2018] [Indexed: 12/28/2022]
Abstract
OBJECTIVE The main objective of this study was to evaluate the knowledge, attitudes, and practices (KAP) of health sciences students regarding epilepsy at the end of their curriculum in Benin. METHODS We conducted a cross-sectional survey among medical, pharmacy, nursing, and midwife students in their last year of health sciences training in the University of Abomey-Calavi in Benin. Students completed a self-administered questionnaire, containing items addressing demographics, epilepsy treatment, diagnosis, clinical practice, and social tolerance regarding a person with epilepsy (PWE). RESULTS The response rate to our survey was 87.7% (n = 164). The sample consisted of 64 medical students, 22 pharmacy students, 43 nursing students, and 35 midwife students. They were divided into 95 female subjects and 69 males; sex ratio was 0.7. The mean age of participants was 23.6 ± 1.8 years. The mean scores for epilepsy knowledge, practices, and attitudes were respectively 7.6 ± 1.7 out of a maximum score of 11, 3.9 ± 1.8 out of 8, and 9.6 ± 0.8 out of 10. The KAP overall score was 21.1 ± 3.4 out of a maximum score of 29.0. The variables associated with the overall KAP score were training school, gender, having heard about epilepsy before health sciences studies (p = 0.017), and having a relative with epilepsy (p = 0.001). Male students and medical school students had significantly better overall KAP score than female students or the other training schools respectively (p < 0.001). SIGNIFICANCE These findings support the need to improve the health sciences students' knowledge of epilepsy, in particular, during their training.
Collapse
|
21
|
Anand P, Othon GC, Sakadi F, Tassiou NR, Hamani ABD, Bah AK, Allaramadji BT, Barry DN, Vogel A, Cisse FA, Mateen FJ. Epilepsy and traditional healers in the Republic of Guinea: A mixed methods study. Epilepsy Behav 2019; 92:276-282. [PMID: 30731293 PMCID: PMC6433505 DOI: 10.1016/j.yebeh.2019.01.017] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2018] [Revised: 01/11/2019] [Accepted: 01/11/2019] [Indexed: 12/17/2022]
Abstract
PURPOSE The purpose of this study was to characterize the reasons, extent, and impact of traditional medicine use among people with epilepsy (PWE) in the Republic of Guinea. METHODS Guinea is a low-income country in sub-Saharan Africa (SSA) with limited healthcare resources. People with epilepsy and their caregivers were seen at a public referral hospital in Conakry, the capital city, where they completed semi-structured interviews with physicians regarding their beliefs about epilepsy, medical care, and engagement with traditional healers. RESULTS Of 132 participants (49% children, 44% female, 55% with a university-educated head of household), 79% had seen a traditional healer, and 71% saw a traditional healer before seeing a medical provider for their epilepsy. Participants were treated by a traditional healer for a mean of 39 months before seeing a medical provider. By contrast, 58% of participants reported taking antiepileptic drugs (AEDs) regularly; 46% reported having undergone a head computed tomography (CT) scan; 58% reported having had an electroencephalogram, and 4% reported having had a brain magnetic resonance imaging (MRI) scan. CONCLUSIONS Traditional healers in Guinea provide frontline care for PWE in Guinea with considerable delays in AED initiation, even among a cohort of PWE actively seeking medical care. Engaging with these healers is critical for both influencing community perceptions and appropriately managing epilepsy throughout the country.
Collapse
Affiliation(s)
- Pria Anand
- Department of Neurology, Massachusetts General Hospital, Boston, MA, USA.
| | | | - Foksouna Sakadi
- Department of Neurology, Ignace Deen Teaching Hospital, Conakry, Republic of Guinea,Department of Clinical Neurophysiology, Ibn Sina Hospital Center, Rabat, Morocco
| | | | | | - Aissatou Kenda Bah
- Department of Neurology, Ignace Deen Teaching Hospital, Conakry, Republic of Guinea
| | | | - Djenabou Negue Barry
- Department of Neurology, Ignace Deen Teaching Hospital, Conakry, Republic of Guinea
| | - Andre Vogel
- Department of Neurology, Massachusetts General Hospital, Boston, Massachusetts, U.S.A
| | - Fodé Abass Cisse
- Department of Neurology, Ignace Deen Teaching Hospital, Conakry, Republic of Guinea
| | - Farrah Jasmine Mateen
- Department of Neurology, Massachusetts General Hospital, Boston, Massachusetts, U.S.A
| | | |
Collapse
|
22
|
du Toit A, Pretorius C. Seizures in Namibia: A study of traditional health practitioners. Epilepsia Open 2018; 3:374-382. [PMID: 30187008 PMCID: PMC6119750 DOI: 10.1002/epi4.12240] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/26/2018] [Indexed: 01/03/2023] Open
Abstract
OBJECTIVE Countries in sub-Saharan Africa are plagued by poor healthcare facilities, lack of specialist care, and limited financial resources. People with seizures often rely on the help of traditional health practitioners (THPs). Traditional health practices are not acknowledged in Namibia and remain unregulated and open to exploitation. We conducted a qualitative study to gain an understanding of THPs' perceptions and experiences in delivering seizure care in Namibia. METHODS This study formed part of a larger mixed-method study that explored seizure care among healthcare providers (HCPs) in Namibia. Semi-structured interviews were conducted with 11 THPs in Namibia. Thematic analysis was used to identify themes and subthemes in the data. Themes were interpreted using the different levels of Bronfenbrenner's Ecological Systems Theory to illustrate the perceptions and experiences of THPs in the management of seizures. RESULTS THPs distinguish between seizures with physical causes and those caused by witchcraft, evil spirits, and supernatural forces. THPs acknowledge the role of Western medicine in the treatment of medically explained seizures (physical causes). Seizures as a result of medically unexplained symptoms (spiritual) are deemed best treated by traditional medicine (TM). Diagnostic and treatment practices are person-specific and are guided by divination and the use of plant and animal material. Treatment success is measured by the complete absence of seizures. Biomedical treatment is seen as lacking due to its focus on seizure control and failure to provide a permanent cure. SIGNIFICANCE In countries with limited healthcare resources, the untapped potential of THPs may play a valuable role in bridging the treatment gap for seizures. Incorporating THPs into the healthcare system depends on proper regulation and clear demarcation of roles between service providers. Improved referral practices and collaboration between service providers will be of benefit for people with seizures who are often exposed to stigma and discrimination.
Collapse
Affiliation(s)
- Anina du Toit
- Department of PsychologyStellenbosch UniversityStellenboschSouth Africa
| | - Chrisma Pretorius
- Department of PsychologyStellenbosch UniversityStellenboschSouth Africa
| |
Collapse
|
23
|
Singh G, Selai C, Islam S, Chaudhary P, Sander JW. Marriage in epilepsy: The impact of the question in knowledge, attitude, and practice surveys. Epilepsy Behav 2018; 85:164-172. [PMID: 29957343 DOI: 10.1016/j.yebeh.2018.06.005] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2018] [Revised: 05/30/2018] [Accepted: 06/01/2018] [Indexed: 12/21/2022]
Abstract
BACKGROUND Knowledge, attitudes, and practice (KAP) questionnaire-based surveys have captured negative attitudes towards marriage involving people with epilepsy (PWE). The attitudes may vary according to the nature of the question posed, whether personal or generic, in addition to many other covariates. METHODS We carried out meta-proportion and -regression analyses of epilepsy-related KAP surveys published between 1970 and 2016 in the medical literature analysis retrieval system online (MEDLINE) database. RESULTS The pooled estimate of the proportion of those responding positively to the marriage question was 0.45 (95% confidence interval (95%CI): 0.35 to 0.54; I2res = 99.89%). The pooled proportion of positive responders to a personal question (0.40; 95%CI: 0.35 to 0.46) was significantly lower than those responding positively to a generic question (0.64; 95%CI: 0.57 to 0.70) (P = 0.001). When modeled individually in regression analyses, only the continent of origin of the survey (P = 0.001; tau2: 0.06; I2res: 99.8%; adjusted R2: 11.4%) and subject population type (P = 0.02; tau2: 0.07; I2res: 99.9%; adjusted R2: 4.2%) were associated with the pooled estimate of positive responders to the question on marriage. CONCLUSIONS Personal questions probing the possibility of marriage of self or family members to someone with epilepsy bring about negative attitudes more often than generic questions inquiring the marriage-worthiness of PWE.
Collapse
Affiliation(s)
- Gagandeep Singh
- Department of Neurology, Dayanand Medical College, Ludhiana, India; NIHR University College London Hospitals Biomedical Research Centre, UCL Institute of Neurology, Queen Square, London WC1N 3BG, UK
| | - Caroline Selai
- Education Unit, NIHR University College London Hospitals Biomedical Research Centre, UCL Institute of Neurology, Queen Square, London WC1N 3BG, UK
| | - Saiful Islam
- Education Unit, NIHR University College London Hospitals Biomedical Research Centre, UCL Institute of Neurology, Queen Square, London WC1N 3BG, UK
| | | | - Josemir W Sander
- NIHR University College London Hospitals Biomedical Research Centre, UCL Institute of Neurology, Queen Square, London WC1N 3BG, UK; Chalfont Centre for Epilepsy, Chalfont St Peter, Bucks SL9 0RJ, UK; Stichting Epilepsie Instellingen Nederland (SEIN), Achterweg 5, Heemstede 2103SW, Netherlands.
| |
Collapse
|
24
|
Kaddumukasa M, Kaddumukasa MN, Buwembo W, Munabi IG, Blixen C, Lhatoo S, Sewankambo N, Katabira E, Sajatovic M. Epilepsy misconceptions and stigma reduction interventions in sub-Saharan Africa, a systematic review. Epilepsy Behav 2018; 85:21-27. [PMID: 29906697 PMCID: PMC6355646 DOI: 10.1016/j.yebeh.2018.04.014] [Citation(s) in RCA: 55] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2018] [Revised: 03/14/2018] [Accepted: 04/20/2018] [Indexed: 01/21/2023]
Abstract
OBJECTIVE This systematic review identified papers that described epilepsy misconceptions or stigma in sub-Saharan Africa (SSA) and research interventions focused on reducing these misconceptions. MATERIALS AND METHODS Publications in the English language from January 2000 to October 2017 that described original research conducted in SSA on misconceptions about epilepsy were utilized. RESULTS Twenty-three publications were identified. Studies were from Nigeria (N = 4), Cameroon (N = 4), Uganda (N = 3), Zambia (N = 2), Ethiopia (N = 2), Tanzania (N = 2), Kenya (N = 2), Ghana, Zimbabwe, Benin, and Mali (N = 1 each). The studies included assessments of misconceptions among healthcare providers and medical students (N = 3), high school students (N = 2), teachers (N = 2), the general public (N = 10), people with epilepsy (N = 7), and traditional healers (N = 1). Only two studies had stigma-focused interventions. Majority of the studies reported limitations to socialization with people with epilepsy and various beliefs associated with epilepsy. CONCLUSIONS Epilepsy misconceptions, stigmatizing cultural beliefs, and perceptions were widely prevalent in SSA, and there are a few studies targeting epilepsy stigma. Existing stigma-reduction educational approaches may be impractical for general population implementation. Scalable approaches to reduce stigma are urgently needed within SSA.
Collapse
Affiliation(s)
- Mark Kaddumukasa
- Department of Medicine, School of Medicine, College of Health Sciences, Makerere University, P.O. Box 7072, Kampala, Uganda.
| | - Martin N Kaddumukasa
- Department of Medicine, School of Medicine, College of Health Sciences, Makerere University. P.O. Box 7072, Kampala, Uganda
| | - William Buwembo
- School of Biomedical Sciences, Makerere University, P.O. Box 7072, Kampala, Uganda
| | - Ian. G. Munabi
- School of Biomedical Sciences, Makerere University, P.O. Box 7072, Kampala, Uganda
| | - Carol Blixen
- Neurological and Behavioral Outcomes Center, University Hospitals Cleveland Medical Center & Case Western Reserve University School of Medicine, 11100 Euclid Avenue, Cleveland, OH 44106, USA..
| | - Samden Lhatoo
- Epilepsy Center, UH Case Medical Center, 11100 Euclid Avenue, Cleveland, OH, 44106, USA.
| | - Nelson Sewankambo
- Department of Medicine, School of Medicine, College of Health Sciences, Makerere University. P.O. Box 7072, Kampala, Uganda
| | - Elly Katabira
- Department of Medicine, School of Medicine, College of Health Sciences, Makerere University. P.O. Box 7072, Kampala, Uganda
| | - Martha Sajatovic
- Neurological and Behavioral Outcomes Center, University Hospitals Cleveland Medical Center & Case Western Reserve University School of Medicine, 11100 Euclid Avenue, Cleveland, OH 44106, USA..
| |
Collapse
|
25
|
Knowledge, attitudes, and practices towards epilepsy among general practitioners in rural Bolivia: Results before and after a training program on epilepsy. Epilepsy Behav 2018; 83:113-118. [PMID: 29694941 DOI: 10.1016/j.yebeh.2018.02.030] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/02/2018] [Revised: 02/06/2018] [Accepted: 02/06/2018] [Indexed: 11/22/2022]
Abstract
INTRODUCTION Epilepsy represents a major health problem in low- and middle-income countries where treatment gap (TG) levels are high. The reduction of epilepsy TG in the rural area of the Chaco region, Plurinational State of Bolivia, has been the aim of many projects based on the reinforcement of the primary care setting. To plan educational campaigns directed to the healthcare professionals, it is necessary to establish their baseline knowledge level. The objective of our study was to assess the baseline level of knowledge, attitudes, and practices (KAP) towards epilepsy among general practitioners (GPs) of the rural communities of the Chaco region. METHODS The study was conducted in three departments of Bolivia. All the GPs living in these areas were invited to participate in the study consisting of two training modules six months apart from each other, each with two-day duration. They answered a validated questionnaire to evaluate the KAP towards epilepsy before and after the courses. RESULTS Fifty GPs [30 men (60%); mean age: 32.1±5.8years] participated in the first training course. After six months, 31 GPs (62%) [19 men (61.3%); mean age: 33±5.0years] participated in the second module. Before the training, the majority of GPs declared a low level of satisfaction about their epilepsy knowledge, which improved after the courses. A change in practices was recorded after the training, with an increased confidence to manage antiepileptic treatment. CONCLUSION Our study showed the significant impact of specific training programs on epilepsy among GPs.
Collapse
|
26
|
Martino T, Lalla A, Carapelle E, Di Claudio MT, Avolio C, d'Orsi G. First-aid management of tonic-clonic seizures among healthcare personnel: A survey by the Apulian section of the Italian League Against Epilepsy. Epilepsy Behav 2018; 80:321-325. [PMID: 29402633 DOI: 10.1016/j.yebeh.2017.11.017] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/15/2017] [Revised: 11/15/2017] [Accepted: 11/19/2017] [Indexed: 02/07/2023]
Abstract
INTRODUCTION To evaluate the knowledge of healthcare workers about first-aid measures to be performed during and after a tonic-clonic seizure. METHODS One hundred and fifty-four healthcare workers (86 physicians) working at 8 tertiary hospitals in the Apulia region, Italy, responded to a questionnaire comprising of 28 questions based on available Italian and international recommendations about what to do during a tonic-clonic seizure. RESULTS One hundred and fifty-four healthcare workers completed and returned surveys with a response rate of 96.25%. There were 55 nurses (35.7%), 86 physicians (55.8%), and 13 healthcare workers with different roles (Electroencephalograph technicians, psychologists, social workers). Among physicians, there were 7 cardiologists, 3 surgeons, 12 infectious-disease specialists, 11 internal medicine specialists, 2 psychiatrists, 2 gynecologists, 27 specialists working in the emergency department, and 22 physicians with different specializations. Nearly 90% of the respondents identified head protection as important first aid, while 100% responded to not keep the legs elevated. To avoid tongue bite, both physicians and other healthcare workers would put something in the mouth (54.0%), like a Guedel cannula (71.0%) fingers (29.5%). Grabbing arms and legs, trying to stop the seizure, would be potentially performed by 11.6% of our sample. Physicians would administer a benzodiazepine during the seizure (65.7%) and during the postictal phase (29.2%), even if the patient is known to have epilepsy (23.7%), and in this case, 11.3% of respondents would administer the usual antiepileptic medications. More than half of respondents would call the emergency telephone number, because of necessary hospitalization in case of tonic-clonic seizure, even if it is experienced by a patient known to have epilepsy. CONCLUSION Our survey suggests the need for epilepsy educational programs on first-aid management of seizures among healthcare workers.
Collapse
Affiliation(s)
- Tommaso Martino
- Epilepsy Centre - Clinic of Nervous System Diseases, Riuniti Hospital, Foggia, Italy
| | - Alessandra Lalla
- Epilepsy Centre - Clinic of Nervous System Diseases, Riuniti Hospital, Foggia, Italy
| | - Elena Carapelle
- Epilepsy Centre - Clinic of Nervous System Diseases, Riuniti Hospital, Foggia, Italy
| | | | - Carlo Avolio
- Epilepsy Centre - Clinic of Nervous System Diseases, Riuniti Hospital, Foggia, Italy
| | - Giuseppe d'Orsi
- Epilepsy Centre - Clinic of Nervous System Diseases, Riuniti Hospital, Foggia, Italy.
| | -
- Epilepsy Centre - Clinic of Nervous System Diseases, Riuniti Hospital, Foggia, Italy
| |
Collapse
|
27
|
|
28
|
Kiyak E, Dayapoglu N. An evaluation of knowledge and attitudes toward epilepsy in Eastern Turkey. Epilepsy Behav 2017; 75:241-245. [PMID: 28843950 DOI: 10.1016/j.yebeh.2017.06.036] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2017] [Accepted: 06/24/2017] [Indexed: 11/28/2022]
Abstract
PURPOSE This study was designed to determine the knowledge and attitudes regarding epilepsy among individuals in eastern Turkey. METHOD This descriptive study involved 530 healthy individuals who came to the Research and Application Hospital of Ataturk University in Erzurum, Turkey. A questionnaire and the epilepsy knowledge and attitude scale were administered to collect data. Mann-Whitney U, Kruskal-Wallis, and Spearman's correlation tests were used to analyze the data. RESULTS The participants' epilepsy knowledge mean score was 6.34 (SD=3.71), and their attitude mean score was 50.22 (SD=11.17). There was a positive (r=0.404) correlation between the knowledge and the attitude scores (p<0.001), and negative correlations between age and the knowledge (p=0.036) and the attitude scores (p<0.001). The mean knowledge and attitude scores were higher for the participants who were high school and university graduates, had expenses equal to income, and lived in nuclear families and in the city center (p<0.001). Civil servants and housewives had significantly higher mean knowledge scores, and students had significantly higher mean attitude scores (p<0.001). Significantly higher knowledge and attitude mean scores were also found for those who knew patients with epilepsy, had witnessed epileptic seizures, obtained information from healthcare personnel, and did not believe that epilepsy was associated with religion (p<0.001). CONCLUSIONS The study participants had low knowledge about epilepsy but displayed positive attitudes toward it. Higher knowledge positively affected attitude, and younger individuals had greater knowledge and, thus, more positive attitudes. Women, civil servants, and housewives had higher knowledge, whereas singles and students had better attitudes. The participants who had high educational levels and expenses equal to income and lived in nuclear families and the city center had more knowledge and displayed more positive attitudes. Greater knowledge and more positive attitudes were also found among the participants who knew patients with epilepsy, had witnessed epileptic seizures, obtained the information from healthcare personnel, and did not believe that epilepsy was associated with religion.
Collapse
Affiliation(s)
- Emine Kiyak
- Facility of Nursing, Ataturk University, Erzurum, Turkey.
| | | |
Collapse
|
29
|
Zhao T, Gao Y, Zhu X, Wang N, Chen Y, Zhang J, He G, Feng Y, Xu J, Han X, Zhang J. Awareness, attitudes toward epilepsy, and first aid knowledge of seizures of hospital staff in Henan, China. Epilepsy Behav 2017; 74:144-148. [PMID: 28738284 DOI: 10.1016/j.yebeh.2017.06.026] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2017] [Revised: 06/19/2017] [Accepted: 06/20/2017] [Indexed: 12/15/2022]
Abstract
AIM The aim of this study was to evaluate awareness of, attitudes toward, and first aid knowledge of seizures of hospital staff in Henan, China. METHOD Two hundred nineteen hospital staff, including doctors, nurses, medical technicians, logisticians, and executives working at tertiary hospitals in Henan, China, completed the survey from March to September in 2016. The data comprised the demographic data section, awareness of epilepsy section, attitude toward epilepsy section, and first aid knowledge of seizure attack section. RESULTS The participants obtained a mean score of 7.48±1.705 on the awareness of epilepsy section, and a mean score of 5.32±1.165 on the first aid knowledge of seizure attacks section. There were significant correlations between educational level (r=0.187, P=0.006), occupation (r=-0.244, P=0.000), and attitudes toward patients with epilepsy (r=0.351, P=0.000) with the awareness of epilepsy. There were significant correlations between age (r=0.170, P=0.014), educational status (r=0.139, P=0.040), and professional titles (r=0.197, P=0.004) with the first aid knowledge of seizures. CONCLUSION The study showed that hospital staff had a moderate level of knowledge regarding epilepsy, and they generally displayed a positive attitude. It was also determined that as the awareness of epilepsy increased, they displayed more positive attitudes toward patients with epilepsy. The study also suggests that specialists working on epilepsy should provide more lectures and educational sessions to improve the knowledge of and attitude toward epilepsy and first aid knowledge of seizures among hospital staff.
Collapse
Affiliation(s)
- Ting Zhao
- Department of Neurology, Henan Provincial People's Hospital, People's Hospital, Henan University, Zhengzhou 450003, China
| | - Yajuan Gao
- Department of Clinical Medicine, Zhengzhou University, Zhengzhou 450000, China
| | - Xuerui Zhu
- Department of Neurology, Henan Provincial People's Hospital, People's Hospital, Henan University, Zhengzhou 450003, China
| | - Na Wang
- Department of Neurology, Henan Provincial People's Hospital, People's Hospital, Henan University, Zhengzhou 450003, China
| | - Yanan Chen
- Department of Neurology, Henan Provincial People's Hospital, People's Hospital, Henan University, Zhengzhou 450003, China
| | - Jiahui Zhang
- Department of Neurology, Henan Provincial People's Hospital, People's Hospital, Henan University, Zhengzhou 450003, China
| | - Guinv He
- Department of Neurology, Henan Provincial People's Hospital, People's Hospital, Henan University, Zhengzhou 450003, China
| | - Yan Feng
- Department of Neurology, Henan Provincial People's Hospital, People's Hospital, Henan University, Zhengzhou 450003, China
| | - Jun Xu
- Department of Neurology, Henan Provincial People's Hospital, People's Hospital, Henan University, Zhengzhou 450003, China
| | - Xiong Han
- Department of Neurology, Henan Provincial People's Hospital, People's Hospital, Henan University, Zhengzhou 450003, China.
| | - Jiewen Zhang
- Department of Neurology, Henan Provincial People's Hospital, People's Hospital, Henan University, Zhengzhou 450003, China
| |
Collapse
|
30
|
Keikelame MJ, Suliaman T, Hendriksz M, Swartz L. Psychosocial challenges affecting the quality of life in adults with epilepsy and their carers in Africa: A review of published evidence between 1994 and 2014. Afr J Prim Health Care Fam Med 2017; 9:e1-e5. [PMID: 28397523 PMCID: PMC5387367 DOI: 10.4102/phcfm.v9i1.1275] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2016] [Revised: 02/10/2017] [Accepted: 12/08/2016] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Little attention has been paid to the psychosocial challenges of adult patients with epilepsy and their carers in Africa in published studies conducted between 1994 and 2014 - yet these psychosocial challenges have been reported to have a major impact on the quality of life (QOL) of people living with the illness and those who care for them. AIM This review aimed to examine the literature on published studies conducted in Africa between 1994 and 2014 that examined psychosocial challenges of adult people with epilepsy and their carers. The aim was to examine the kind of psychosocial challenges from published evidence and to identify gaps in current knowledge. METHODS MEDLINE, PubMed, ERIC, Web of Science, Scopus, Cochrane Library, Africa Wide, PsycINFO, EMBASE, PASCAL, SABINET and Google Scholar databases and hand searches of Epilepsy & Behavior, Epilepsia, South African Medical Journal, African Journal of Disability, African Journal of Primary Health Care and Family Medicine were reviewed. RESULTS Very few studies in Africa have examined psychosocial challenges affecting the adult patients with epilepsy and their carers. This review reported the existence of evidence of such challenges and the insights into the psychosocial and economic factors that underpin them. There is evidence that where these have been addressed, there were valuable insights on the types of psychosocial, socio-cultural and socio-economic challenges. Collaborative empowering interventions are needed to enable the attainment of good QOL for those affected. CONCLUSION Research on psychosocial challenges of adult patients with epilepsy and their carers from different sectors of healthcare to inform the design of appropriate models is needed.
Collapse
Affiliation(s)
- Mpoe J Keikelame
- Primary Health Care Directorate, Groote Schuur Hospital; Department of Psychology, Stellenbosch University.
| | | | | | | |
Collapse
|
31
|
Clinical nurses' knowledge and attitudes toward patients with epilepsy. Epilepsy Behav 2016; 61:206-209. [PMID: 27372960 DOI: 10.1016/j.yebeh.2016.05.009] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2016] [Revised: 04/09/2016] [Accepted: 05/06/2016] [Indexed: 11/21/2022]
Abstract
BACKGROUND Insufficient knowledge and negative attitudes of clinical nurses regarding epilepsy may affect the quality of health care for patients with epilepsy. AIM The aim of this study was to evaluate knowledge and attitudes of nurses working at a university hospital located in eastern Turkey regarding epilepsy. METHOD The descriptive study was conducted with 85 nurses working at the internal medicine clinics at Yakutiye Research Hospital in Erzurum, Turkey in March 2014. The data comprised the personal information form, epilepsy knowledge scale, and epilepsy attitude scale. RESULTS Clinical nurses obtained a mean score of 12.62±2.77 on the epilepsy knowledge scale and 55.43±6.59 on the epilepsy attitude scale. There was a significant difference between the educational status of nurses and mean scores on the epilepsy knowledge scale and epilepsy attitude scale (P<0.05). There was a positive, significant correlation between knowledge scores and attitude scores of clinical nurses regarding epilepsy (r=0.227, P<0.05). In addition, more than half of nurses (57.6%) knew that epileptic seizures would not pose a danger to other people. Unfortunately, approximately one-third of clinical nurses (36.5%) believed that epilepsy was incurable. CONCLUSION As a result of the study, it was determined that nurses had a moderate level of knowledge regarding epilepsy, and they generally displayed a positive attitude, but it was not sufficient. In addition, more knowledge was associated with a more positive attitude.
Collapse
|
32
|
Patel AA, Ciccone O, Njau A, Shanungu S, Grollnek AK, Fredrick F, Hodgeman R, Sideridis GD, Kapur K, Harini C, Kija E, Peters JM. A pediatric epilepsy diagnostic tool for use in resource-limited settings: A pilot study. Epilepsy Behav 2016; 59:57-61. [PMID: 27088519 DOI: 10.1016/j.yebeh.2016.03.019] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2016] [Revised: 03/08/2016] [Accepted: 03/12/2016] [Indexed: 11/25/2022]
Abstract
OBJECTIVE It is estimated that nearly 80% of the 50 million people affected with epilepsy globally live in regions where specialist care and diagnostic tests are scarce and care is often delivered through a primary health provider with limited training. To improve diagnostic accuracy of the history and physical examination, we developed and piloted a questionnaire to discriminate between focal versus generalized epilepsy, with the future goal to guide medication choices. METHODS Through literature review and retrospective chart review of 75 children with epilepsy at Boston Children's Hospital, a 15-item questionnaire was developed. Simple motor seizures were excluded for the purposes of this questionnaire. The questionnaire was then translated in local dialects and prospectively validated at Muhimbili National Hospital in Dar Es Salaam, Tanzania, and University Teaching Hospital in Lusaka, Zambia. Children 6months-18years of age with suspected or active epilepsy were identified, and a nonphysician administered the questionnaire to the patient's caregiver. Next, each patient was evaluated by a pediatric neurologist blinded to the questionnaire results, and together with locally obtained but remotely interpreted EEG, an electroclinical diagnosis was made. The questionnaire data were compared with this clinical gold standard. RESULTS A total of 59 children participated: 28 from Tanzania and 31 from Zambia. Sixteen patients were excluded: 5 were excluded because of incomplete data, and 11 did not meet criteria for epilepsy based on initial screening questions. Of the remaining 43 patients, 28 had focal or multifocal epilepsy (65%), and 15 (35%) had generalized epilepsy. The questionnaire had a sensitivity of 78% and positive predictive value of 81.5%. Data were analyzed using a Rasch model, testing the questionnaire's internal consistency, reliability, and its discriminative validity in classifying focal versus generalized epilepsy against an electroclinical diagnosis. The mean epilepsy score for focal epilepsy was 0.084 logits compared with -1.147 logits for generalized epilepsy, demonstrating a large effect size [F (1, 41)=13.490, p<0.001]. CONCLUSIONS Our questionnaire provides a straightforward method to improve diagnostic accuracy, and could assist in bridging the diagnostic gap in pediatric epilepsy in resource-limited settings. This tool was specifically designed to be easily implemented by any healthcare provider. This pilot study prompts broader prospective validation in additional settings for further refinement, and for performance assessment of impact on provider's practice, ability to guide medication choices, and ultimately improve treatment outcomes in resource-limited regions.
Collapse
Affiliation(s)
- Archana A Patel
- Boston Children's Hospital, Department of Neurology, Division of Epilepsy and Clinical Neurophysiology, Harvard Medical School, Boston, MA, United States.
| | - Ornella Ciccone
- Paediatric Centre of Excellence, University Teaching Hospital, Lusaka, Zambia
| | - Adrian Njau
- Muhimbili University of Health and Allied Sciences, Dar Es Salaam, Tanzania
| | - Sandra Shanungu
- Paediatric Centre of Excellence, University Teaching Hospital, Lusaka, Zambia
| | | | - Francis Fredrick
- Muhimbili University of Health and Allied Sciences, Dar Es Salaam, Tanzania; Muhimbili National Hospital, Department of Pediatrics, Dar Es Salaam, Tanzania
| | - Ryan Hodgeman
- Boston Children's Hospital, Department of Neurology, Division of Epilepsy and Clinical Neurophysiology, Harvard Medical School, Boston, MA, United States
| | - Georgios D Sideridis
- Boston Children's Hospital, Department of Pediatrics, Harvard Medical School, Boston, MA, United States
| | - Kush Kapur
- Boston Children's Hospital, Department of Neurology, Division of Epilepsy and Clinical Neurophysiology, Harvard Medical School, Boston, MA, United States
| | - Chellamani Harini
- Boston Children's Hospital, Department of Neurology, Division of Epilepsy and Clinical Neurophysiology, Harvard Medical School, Boston, MA, United States
| | - Edward Kija
- Muhimbili National Hospital, Department of Pediatrics, Dar Es Salaam, Tanzania
| | - Jurriaan M Peters
- Boston Children's Hospital, Department of Neurology, Division of Epilepsy and Clinical Neurophysiology, Harvard Medical School, Boston, MA, United States
| |
Collapse
|
33
|
Brizzi K, Deki S, Tshering L, Clark SJ, Nirola DK, Patenaude BN, McKenzie ED, McLane HC, Cash SS, Dorji C, Mateen FJ. Knowledge, attitudes and practices regarding epilepsy in the Kingdom of Bhutan. Int Health 2016; 8:286-91. [PMID: 27160683 DOI: 10.1093/inthealth/ihw017] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2015] [Accepted: 12/11/2015] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE To assess the knowledge, attitudes and practices of epilepsy among healthcare workers (HCWs) and people with epilepsy (PWE) living in Bhutan. METHODS A survey with similar questions was distributed to HCWs and PWE (2014-2015). Responses were compared between the two groups. A Stigma Scale in Epilepsy Score was tested for an independent association with patient age, sex, years of education and presence of seizure freedom using regression models. RESULTS PWE (n=177), when compared to HCWs (n=75), were more likely to believe that epilepsy is contagious; epilepsy results from karma or past actions; PWE need help in school; and people with epilepsy have spiritual powers (p<0.05 for each comparison). Among people with epilepsy, a higher stigma score was independently associated with lower educational attainment (p=0.006) and presence of a seizure in the prior year (p=0.013), but not age, sex or anti-epileptic drug side effects. CONCLUSIONS While knowledge of epilepsy was overall fairly high, PWE more often held certain stigmatizing beliefs, including theories of contagion and a relationship between seizures and spiritual powers. Higher educational level and seizure freedom were associated with lower stigma, underscoring their importance in stigma reduction.
Collapse
Affiliation(s)
- Kate Brizzi
- Massachusetts General Hospital, Boston, MA, USA
| | - Sonam Deki
- Department of Psychiatry, Jigme Dorji Wangchuck National Referral Hospital, Bhutan
| | - Lhab Tshering
- Department of Psychiatry, Jigme Dorji Wangchuck National Referral Hospital, Bhutan
| | | | - Damber K Nirola
- Department of Psychiatry, Jigme Dorji Wangchuck National Referral Hospital, Bhutan
| | | | | | | | - Sydney S Cash
- Massachusetts General Hospital, Boston, MA, USA Harvard Medical School, Boston, MA, USA
| | - Chencho Dorji
- Department of Psychiatry, Jigme Dorji Wangchuck National Referral Hospital, Bhutan
| | - Farrah J Mateen
- Massachusetts General Hospital, Boston, MA, USA Harvard Medical School, Boston, MA, USA
| |
Collapse
|
34
|
Atakli D, Dogan Ak P, Guveli BT, Yuksel B. Knowledge of epilepsy among persons with epilepsy in Turkey. Epilepsy Behav 2016; 57:41-45. [PMID: 26921597 DOI: 10.1016/j.yebeh.2016.01.030] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2015] [Revised: 01/24/2016] [Accepted: 01/25/2016] [Indexed: 01/28/2023]
Abstract
PURPOSE It has been shown in studies that there are knowledge gaps about epilepsy in both developing and developed countries all around the world. Lack of knowledge exists even among people with epilepsy (PWE), and this may affect their lives negatively. This study aimed to evaluate what PWE in Turkey know about their disease. METHOD A self-completed questionnaire consisting of demographic details, an item about perceived stigmatization, and 24 items about general knowledge of medical and social aspects of epilepsy was developed. Applicants were asked to answer 'true', 'false', or 'do not know' to each statement. The scores of the questionnaire were defined as low (< 15 point), medium (≥ 15-20), and high (≥ 20). RESULTS The mean score on the questionnaire was 15.17 ± 3.74 (range, 4-24). One hundred twenty-five PWE (37.9%) scored low, 170 PWE (51.5%) scored medium, and 35 PWE (10.6%) scored high. The education level and household income were highly correlated with the knowledge level. Higher education level (r: 0.31) and high income (r: 0.25) were correlated with higher mean scores (p < 0.01). Lack of information was present particularly in terms of etiology, management of seizures, and medication during pregnancy. CONCLUSION We documented the knowledge deficit of PWE about their disease, a situation that may lead to suboptimal management and negative attitudes. We concluded that study programs should be organized and more education should be provided to PWE in order to overcome these issues.
Collapse
Affiliation(s)
- Dilek Atakli
- Bakirkoy Education and Research Hospital for Psychiatry, Neurology and Neurosurgery, Neurology Department, Istanbul, Turkey; Fatih Sultan Mehmet Education and Research Hospital, Neurology Department, Istanbul, Turkey; Antalya Education and Research Hospital, Neurology Department, Antalya, Turkey
| | - Pelin Dogan Ak
- Bakirkoy Education and Research Hospital for Psychiatry, Neurology and Neurosurgery, Neurology Department, Istanbul, Turkey; Fatih Sultan Mehmet Education and Research Hospital, Neurology Department, Istanbul, Turkey; Antalya Education and Research Hospital, Neurology Department, Antalya, Turkey.
| | - Betul Tekin Guveli
- Bakirkoy Education and Research Hospital for Psychiatry, Neurology and Neurosurgery, Neurology Department, Istanbul, Turkey; Fatih Sultan Mehmet Education and Research Hospital, Neurology Department, Istanbul, Turkey; Antalya Education and Research Hospital, Neurology Department, Antalya, Turkey
| | - Burcu Yuksel
- Bakirkoy Education and Research Hospital for Psychiatry, Neurology and Neurosurgery, Neurology Department, Istanbul, Turkey; Fatih Sultan Mehmet Education and Research Hospital, Neurology Department, Istanbul, Turkey; Antalya Education and Research Hospital, Neurology Department, Antalya, Turkey
| |
Collapse
|
35
|
|
36
|
Al-Eryani B, Saied KG, Sharaf Alddin R, Al-Sobaihi S, Lutf W, Al-Taiar A. Knowledge of, attitudes toward, and perceptions of epilepsy among university students in Yemen. Epilepsy Behav 2015; 52:102-7. [PMID: 26409137 DOI: 10.1016/j.yebeh.2015.08.011] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2015] [Revised: 08/08/2015] [Accepted: 08/08/2015] [Indexed: 10/23/2022]
Abstract
This cross-sectional study aimed to describe the knowledge and perceptions about epilepsy and the attitudes toward people with epilepsy (PWEs) among university students in Yemen. A self-administered questionnaire was completed by 1155 students. Approximately 23% thought that epilepsy is a form of insanity, and 18% thought that it is a form of mental retardation. About 22% and 10% believed that evil spirits and an evil eye cause epilepsy, respectively. Similarly, 12% believed that children with epilepsy (CWEs) should be isolated from other children, while 12% and 14% thought that PWEs should not get married and should not have children, respectively. Approximately 23% of the students would not allow their child to play with CWEs, and 37% would not employ PWEs in a clerical job. Furthermore, 64% of the students would not agree to marry PWEs. Some misconceptions were strongly linked to attitudes toward PWEs. In conclusion, the negative attitudes toward PWEs among university students in Yemen were slightly more common compared with other settings in the Middle East and showed significant differences between genders which may warrant consideration when designing educational campaigns.
Collapse
Affiliation(s)
- Bilguis Al-Eryani
- Department of Paediatrics, Faculty of Medicine and Health Sciences, Sana'a University, Yemen
| | - Khaled Ghilan Saied
- Department of Community Medicine, Faculty of Medicine and Health Sciences, Sana'a University, Yemen
| | - Reem Sharaf Alddin
- Department of Community Medicine, Faculty of Medicine and Health Sciences, Sana'a University, Yemen
| | - Saber Al-Sobaihi
- Department of Global Health Promotion, Division of Public Health, Tokyo Medical and Dental University, Tokyo, Japan
| | | | - Abdullah Al-Taiar
- Department of Community Medicine and Behavioural Sciences, Faculty of Medicine, Kuwait University, Kuwait.
| |
Collapse
|
37
|
Ak PD, Atakli D, Yuksel B, Guveli BT, Sari H. Stigmatization and social impacts of epilepsy in Turkey. Epilepsy Behav 2015; 50:50-4. [PMID: 26117273 DOI: 10.1016/j.yebeh.2015.05.014] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2015] [Revised: 05/06/2015] [Accepted: 05/07/2015] [Indexed: 10/23/2022]
Abstract
OBJECTIVE Stigma associated with epilepsy has negative effects on psychosocial outcomes, affecting the lives of people with epilepsy (PWE). Obtaining basic social rights can be difficult compared to the general population. The aim of our study was to evaluate the perceived stigma among PWE and social attitude towards the disease and to compare the social measures with the general population in Turkey. METHOD A self-completed questionnaire consisting of demographic details and items about attitudes and perceived stigmatization was developed. Participants consisted of patients with various types of seizures who were randomly chosen from the epilepsy outpatient clinic. They were requested to complete the questionnaire. RESULTS Questionnaires were obtained from 330 PWE. One hundred forty individuals (43.3%) out of 323 reported feeling stigmatized. The marriage and total fertility rates were below the national rates of Turkey. Keeping their epilepsy as a secret from society was prevalent. Although the education rate was not below the national rate, unemployment rate was high, and the average monthly wage was significantly lower than that of the general population. The majority thought that their families were protective towards them. Only 2 of the 330 participants were living alone. CONCLUSION The present study supports the perception of stigma associated with epilepsy and its negative impact on the lives of PWE in Turkey. Clearly, more research is needed to understand the reasons for stigma and how to decrease its impact.
Collapse
Affiliation(s)
- Pelin Dogan Ak
- Fatih Sultan Mehmet Education and Research Hospital, Neurology Department, Istanbul, Turkey.
| | - Dilek Atakli
- Bakirkoy Education and Research Hospital for Psychiatry, Neurology and Neurosurgery, Neurology Department, Istanbul, Turkey.
| | - Burcu Yuksel
- Antalya Education and Research Hospital, Neurology Department, Antalya, Turkey.
| | - Betul Tekin Guveli
- Bakirkoy Education and Research Hospital for Psychiatry, Neurology and Neurosurgery, Neurology Department, Istanbul, Turkey.
| | - Huseyin Sari
- Bakirkoy Education and Research Hospital for Psychiatry, Neurology and Neurosurgery, Neurology Department, Istanbul, Turkey.
| |
Collapse
|
38
|
Gilani ZA, Naidoo K, Ross A. A review of 'medical' knowledge of epilepsy amongst isiZulu-speaking patients at a regional hospital in KwaZulu-Natal. Afr J Prim Health Care Fam Med 2015; 7:789. [PMID: 26245616 PMCID: PMC4564855 DOI: 10.4102/phcfm.v7i1.789] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2014] [Revised: 04/25/2015] [Accepted: 03/26/2015] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND Epilepsy is a common disorder in South Africa and the literature indicates that many patients do not access treatment. The reasons are complex and include a poor knowledge about causes, symptoms, diagnosis and treatment (medical knowledge). This study aimed to assess the medical knowledge of isiZulu-speaking people with epilepsy (PWE) who attend a combination regional and district hospital in the eThekwini district in KwaZulu-Natal Province. METHOD This was a prospective, cross-sectional, descriptive study. Data were collected using a validated data collection tool for assessing the medical knowledge of PWE and analysed descriptively. RESULTS The questionnaires were completed by 199 PWE, with the general level of schooling being low and half being unemployed. Knowledge around causes, symptoms, diagnosis and treatments was good, but there were significant gaps in knowledge that may affect morbidity and mortality. DISCUSSION The findings will serve as a useful guide to develop both preventive and educational interventions to enhance knowledge around the causes and treatment of epilepsy in this population. It is important that such interventions also consider family and healthcare providers. CONCLUSION There were considerable gaps in the medical knowledge of isiZulu-speaking PWE's, indicating the need for an educational intervention to improve their understanding of epilepsy. Further research is needed-using a range of tools to ensure that the data is reliable and valid-if the results are to be generalisable to the rest of the province and South Africa.
Collapse
|
39
|
Watila MM, Beida O, Kwari S, Nyandaiti NW, Nyandaiti YW. Seizure occurrence, pregnancy outcome among women with active convulsive epilepsy: one year prospective study. Seizure 2015; 26:7-11. [PMID: 25799895 PMCID: PMC4386020 DOI: 10.1016/j.seizure.2015.01.007] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2014] [Revised: 12/21/2014] [Accepted: 01/07/2015] [Indexed: 11/28/2022] Open
Abstract
PURPOSE To determine the prevalence of active convulsive epilepsy, seizure frequency and the outcome of pregnancy amongst a cohort of pregnant women attending antenatal clinic (ANC) at two tertiary hospitals. METHODS An observational cohort study conducted at the University of Maiduguri Teaching Hospital and State Specialist Hospital, Northeast Nigeria. Pregnant women attending antenatal care were screened for previous history of active convulsive epilepsy, and recruited consecutively according to a specified protocol. A standardized questionnaire was administered to record pregnancy history, nature of epilepsy and treatments received. They were followed-up during the course of the pregnancy based on the ANC schedule up to delivery. The outcome of pregnancies was recorded. RESULTS A total of 7063 pregnant women were screened, of whom 103 (1.46%) subjects had at least a past history of seizure. Seventy-eight (1.10%) had a past history of seizure(s) from eclampsia and 23 (0.33%) pregnant subjects recruited were identified to have active convulsive epilepsy. The unadjusted prevalence of active convulsive epilepsy in pregnant women was found to be 3.33 per 1000 (95% CI: 2.1-4.8). Subjects who had a history of head injury and encephalitis were more likely to have seizures during pregnancy. (P=0.013 and P=0.041). Those who had recurrent seizures within the last six months before recruitment were more likely to have a negative pregnancy outcome (P=0.043). CONCLUSION Our study found a prevalence of active epilepsy of 3.33 per 1000 among pregnant women, with about one percent having a past history of seizure from eclampsia.
Collapse
Affiliation(s)
- Musa Mamman Watila
- Department of Medicine, University of Maiduguri Teaching Hospital, PMB 1414 Maiduguri, Borno state, Nigeria.
| | - Omeiza Beida
- Federal Neuropsychiatric Hospital, Maiduguri PMB 1322, Borno State, Nigeria
| | - Shiktra Kwari
- Department of Gynaecology and Obstetrics, University of Maiduguri Teaching Hospital, PMB 1414 Maiduguri, Borno state, Nigeria
| | - Na'awurti Williams Nyandaiti
- Department of Statistics, School of Nursing, University of Maiduguri Teaching Hospital, PMB 1414 Maiduguri, Borno state, Nigeria
| | | |
Collapse
|
40
|
Knowledge, attitudes, and behavior among key people involved in the employment of people with epilepsy in southern Benin. Epilepsy Behav 2015; 42:153-8. [PMID: 25467743 DOI: 10.1016/j.yebeh.2014.10.022] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2014] [Revised: 09/22/2014] [Accepted: 10/17/2014] [Indexed: 02/04/2023]
Abstract
PURPOSE This study aimed to investigate knowledge, attitudes, and behavior among individuals working to achieve, or promote, the employment and retention in employment of people with epilepsy (PWE) in Benin. METHODS We interviewed 300 subjects using a self-administered questionnaire. RESULTS Knowledge: 93% had heard of epilepsy; 8.8% had at least one person with epilepsy (PWE) in their family; and 67.3% had witnessed a person having epileptic seizures. Attitudes and behavior: 95.3% and 95%, respectively, expressed their views that PWE should be able to enter mainstream education and that PWE should marry; 76.4% considered PWE equal to themselves; and 28.6% reported they would not hire a PWE. We found some associations between demographic characteristics and knowledge, attitudes, and behavior among respondents. A few unhelpful aspects of knowledge, attitudes, and behavior were identified. CONCLUSIONS Our study showed a fairly high level of accurate knowledge of epilepsy, but some misperceptions and unhelpful attitudes and practices toward PWE in Benin were noted. This study's findings can be used to help plan appropriate strategies based on correcting misperceptions concerning inclusion and retention in employment of PWE in Benin.
Collapse
|
41
|
Pupillo E, Vitelli E, Messina P, Beghi E. Knowledge and attitudes towards epilepsy in Zambia: a questionnaire survey. Epilepsy Behav 2014; 34:42-6. [PMID: 24681384 DOI: 10.1016/j.yebeh.2014.02.025] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2013] [Revised: 02/19/2014] [Accepted: 02/22/2014] [Indexed: 11/19/2022]
Abstract
Misconception and stigma towards epilepsy have a profound impact on this disease in Africa. An unselected sample of Zambian people was interviewed to investigate their knowledge and attitudes towards epilepsy. Proper/improper answers were scored, and a composite score was developed with negative values for unsatisfactory awareness and high stigma levels. The sample comprised 231 people residing in urban (107) or in rural (124) areas. The median and interquartile range of scores for epilepsy awareness and stigma were, respectively, -1 (-3; +1) and +1 (-1; +6). Poor education was the only significant predictor of unsatisfactory awareness (p=0.0131), while education and residency were significantly associated with stigma (p<0.0001 and p=0.0004). Rural people were mostly in the highest stigma level (44.2%) and urban people in the lowest stigma level (60.4%). Misconception and negative attitudes towards epilepsy among Zambian people reflect poor education and rural residency.
Collapse
Affiliation(s)
- Elisabetta Pupillo
- Departement of Neurosciences, IRCSS - Istituto di Ricerche Farmacologiche "Mario Negri", Milano, Italy
| | | | - Paolo Messina
- Departement of Neurosciences, IRCSS - Istituto di Ricerche Farmacologiche "Mario Negri", Milano, Italy
| | - Ettore Beghi
- Departement of Neurosciences, IRCSS - Istituto di Ricerche Farmacologiche "Mario Negri", Milano, Italy.
| |
Collapse
|
42
|
|
43
|
Mehta S, Tyagi A, Tripathi R, Kumar M. Study of Inter-relationship of Depression, Seizure Frequency and Quality of Life of People with Epilepsy in India. Ment Illn 2014; 6:5169. [PMID: 25478138 PMCID: PMC4253398 DOI: 10.4081/mi.2014.5169] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2013] [Accepted: 02/25/2014] [Indexed: 12/02/2022] Open
Abstract
Epilepsy is a chronic neurological disorder that can have profound physical, social and psychological consequences. We aimed to assess the clinical predictors of quality of life of people with epilepsy. We recruited 31 patients suffering from epilepsy in this cross-sectional study. Their clinical profile was recorded. Quality Of Life in Epilepsy (QOLIE-31) was used to assess quality of life of our patients. Depression was screened by Neurological Disorders Depression Inventory in Epilepsy (NDDI-E). Among all the clinical variables, only seizure frequency significantly correlated with seizure worry (P=0.002), emotional well-being (P=0.026) and social functions (P=0.013) subscales of QOLIE-31. NDDIE score showed a significant negative correlation with all the subscales of QOLIE-31 except medication effects (P=0.993). A significant positive correlation was also noted between seizure frequency and NDDI-E score (r=0.417, P=0.020). Seizure frequency and depression are the most important predictors of quality of life in epilepsy patients. The management of patients with epilepsy should not only be aimed at just preventing seizures but the treating clinicians should also be cognizant about depression which itself can significantly affect the quality of life of patients.
Collapse
Affiliation(s)
- Shubham Mehta
- Department of Psychiatry, SMS Medical College , Jaipur, Rajasthan, India
| | - Alok Tyagi
- Department of Psychiatry, SMS Medical College , Jaipur, Rajasthan, India
| | - Richa Tripathi
- Department of Psychiatry, SMS Medical College , Jaipur, Rajasthan, India
| | - Mahesh Kumar
- Department of Psychiatry, SMS Medical College , Jaipur, Rajasthan, India
| |
Collapse
|
44
|
Otte WM, Nhaga AA, Tchuda DL, Abna B, van der Maas F. Cultural beliefs among people with epilepsy or physical impairment in Guinea-Bissau: Differences and similarities. Epilepsy Behav 2013; 29:504-7. [PMID: 24094843 DOI: 10.1016/j.yebeh.2013.09.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2013] [Revised: 09/02/2013] [Accepted: 09/04/2013] [Indexed: 10/26/2022]
Abstract
People living with a disability in sub-Saharan Africa have poorer health outcomes, lower educational successes, less economic participation, and higher levels of poverty than people without disability. Disability-inclusive development promotes the involvement of people with disabilities in programs that reduce these inequalities. This requires a good understanding of how individuals with disability perceive their condition. In this study, we identified cultural beliefs among 31 individuals with epilepsy or physical impairment, known to a community-based rehabilitation service in Guinea-Bissau, using face-to-face interviews. We related these beliefs to religious background and type of disability. We found poor knowledge of and attitudes towards disability among persons with epilepsy and physical impairment. Cultural beliefs were significantly shaped by religious background. Islamic respondents were more positive about their disability as compared to Christians and traditional believers. A better understanding of cultural beliefs among people with disabilities may help to launch and adapt disability-inclusive community-based rehabilitation services.
Collapse
Affiliation(s)
- Willem M Otte
- Community-based Rehabilitation Effata, Waddinxveen, The Netherlands; Department of Pediatric Neurology, Rudolf Magnus Institute of Neuroscience, University Medical Center Utrecht, The Netherlands; Biomedical MR Imaging and Spectroscopy Group, Image Sciences Institute, University Medical Center Utrecht, The Netherlands.
| | | | | | | | | |
Collapse
|
45
|
Elafros MA, Sakubita-Simasiku C, Atadzhanov M, Haworth A, Chomba E, Birbeck GL. Stigma and psychiatric morbidity among mothers of children with epilepsy in Zambia. Int Health 2013; 5:288-94. [PMID: 24214528 DOI: 10.1093/inthealth/iht028] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Epilepsy-associated stigma contributes substantially to the social, medical, and economic burden of disease for people with epilepsy (PWE), but little is known about its impact on caregivers of PWE. METHODS To better understand stigma experienced by caregivers of PWE, factors that influence caregiver stigma, and the effect of stigma on a caregiver's psychologic well being, we interviewed 100 caregivers of children with epilepsy in Zambia. Questions assessed maternal knowledge, attitudes, and practices related to epilepsy, maternal stigma, mother's proxy report of child stigma, and maternal psychiatric morbidity. RESULTS Of 100 mothers, 39 (39%) indicated that their child was stigmatized because of his or her epilepsy. Maternal proxy report of child stigma was highly correlated with maternal stigma (OR: 5.4, p=0.04), seizure frequency (p=0.03) and seizure severity (p=0.01). One in five of 100 mothers (20%) reported feeling stigmatized because of their child's epilepsy. Higher maternal stigma was associated with lower familial and community support (ORs: 65.2 and 34.7, respectively; both p<0.0001) as well as higher psychiatric morbidity (OR: 1.2; p=0.002). Formal education and epilepsy knowledge were associated with decreased maternal stigma (ORs: 0.8 and 0.7, respectively; both p<0.001). CONCLUSIONS One in five mothers of PWE feel stigmatized because of their child's epilepsy. As maternal stigma is associated with psychiatric morbidity, educating caregivers about epilepsy and screening for anxiety and depression are warranted.
Collapse
Affiliation(s)
- Melissa A Elafros
- Michigan State University, International Neurologic & Psychiatric Epidemiology Program (INPEP), East Lansing, Michigan, USA
| | | | | | | | | | | |
Collapse
|
46
|
Hosseini N, Sharif F, Ahmadi F, Zare M. Patients' perception of epilepsy and threat to self-identity: a qualitative approach. Epilepsy Behav 2013; 29:228-33. [PMID: 23995695 DOI: 10.1016/j.yebeh.2013.06.003] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2013] [Accepted: 06/03/2013] [Indexed: 10/26/2022]
Abstract
INTRODUCTION A clinical diagnosis of epilepsy often carries a silent social stigma and is associated with metaphysical forces. This qualitative study aimed to explore the Iranian patients' perception of epilepsy where clinical aspects are more benign than the social implications with long-term psychological consequences. Historically, epilepsy has been known as a form of insanity, madness, sorcery, and possession by evil spirits. METHOD Thirty participants consisting of 21 patients with epilepsy, 5 family members, and 4 medical staff were selected from urban and rural medical and health care centers, hospitals, physician offices, outpatient clinics, and the Iranian Epilepsy Association. Unstructured and semistructured interviews were applied to obtain data. Transcribed interviews and field notes were analyzed using qualitative content analysis method. FINDINGS Categories and subcategories emerged from the participants' perceptions of epilepsy and its disruptive effects on their self-identity. The main categories derived from data were 1) a different perspective about epilepsy, 2) self-debasement, and 3) being a burden. The major theme found in this study was "identity loss". CONCLUSION Our study results highlight the importance of public awareness among community members and healthcare professionals on how patients with epilepsy experience their disease with psychosocial implications. Understanding patients' perspectives can be essential to developing a comprehensive and holistic care plan for patients with epilepsy and addressing their multidimensional needs.
Collapse
Affiliation(s)
- Nazafarin Hosseini
- Social Determinants of Health Research Center, Faculty of Nursing, Yasuj University of Medical Sciences, Yasuj, Iran
| | | | | | | |
Collapse
|
47
|
Alaqeel A, Alebdi F, Sabbagh AJ. Epilepsy: What do health-care professionals in Riyadh know? Epilepsy Behav 2013; 29:234-7. [PMID: 24034673 DOI: 10.1016/j.yebeh.2013.07.009] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2013] [Accepted: 07/13/2013] [Indexed: 11/19/2022]
Abstract
PURPOSE The objective of this study was to report on the knowledge of epilepsy, as well as attitudes and practices toward individuals with epilepsy, among health-care professionals in Riyadh, the capital city of Saudi Arabia. METHODS A survey consisting of 23 questions pertaining to epilepsy awareness was distributed to health education workers (n=51), nutritionists (n=56), physicians (n=265), dentists (n=58), pharmacists (n=41), nurses (n=224), physiotherapists (n=65), and fifth-year medical students (n=62) in three tertiary hospitals in Riyadh. RESULTS Of the 822 respondents who completed the questionnaire, 100% had heard about epilepsy, and 92.6% would allow their children to interact with an individual who has epilepsy. However, 67% of respondents would not want their children to marry an individual with epilepsy, 97.9% of respondents believed that individuals with epilepsy should have the same employment opportunities as the general population, 10.5% believe that supernatural power is the cause of epilepsy, 67.2% did not know how to deal with an individual experiencing an epileptic episode, and 56% did not know that surgery was a treatment option for individuals with epilepsy in Saudi Arabia. Of the 822 respondents, 39% would not abide by a physician's advice not to operate a motor vehicle because of their illness, 91% of whom cited problems with the public transportation system as a reason for disregarding the doctor's advice. When asked if the participants had access to any information on how to deal with epilepsy during their professional training, 60.3% had access to such information during their graduate studies. Ninety-eight percent of those with access to this information were physicians and health-care educators (p<0.001). Physicians and health-care educators were significantly more aware of epilepsy than any of the other groups. CONCLUSION The level of epilepsy awareness among health-care professionals in Riyadh needs improvement.
Collapse
Affiliation(s)
- Ahmed Alaqeel
- Division of Neurosurgery, Department of Surgery, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | | | | |
Collapse
|
48
|
Mbewe EK, Uys LR, Birbeck GL. The impact of a short depression and anxiety screening tool in epilepsy care in primary health care settings in Zambia. Am J Trop Med Hyg 2013; 89:873-4. [PMID: 24062482 DOI: 10.4269/ajtmh.13-0062] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
Up to 60% of the 50 million persons with epilepsy (PWE) worldwide have depression and anxiety and 80% of PWE live in low-income regions. Common psychiatric comorbidities are often unrecognized and undertreated. We developed and validated a 10-item screening tool for the detection of depression and anxiety at primary healthcare clinics in Zambia in which the baseline detection rate among PWE was 1%. We trained primary care clinic workers in selected clinics to use this screening tool. A retrospective chart review was conducted for 120 consecutive PWE who received care one month after training. Detection improved from 1% to 49%, and treatment was frequently initiated. Of the 120 screened, 59 (49.2%) scored above cutoff point of 18. Of these persons, 43 (73.0%) were positive for depression, 16 (23.0%) were positive for anxiety, 38 (64.4%) received counseling, 18 (30.5%) received antidepressants, and 3 (5.1%) were referred to a psychiatrist. Use of this screening tool resulted in improved mental health care for PWE.
Collapse
Affiliation(s)
- Edward K Mbewe
- Department of Mental Health and Clinical Psychiatry, Chainama College of Health Sciences, Lusaka, Zambia; School of Nursing and Public Health University of Kwa Zulu Natal, Durban, South Africa; Epilepsy Care Team, Chikankata Hospital, Mazabuka, Zambia; University of Rochester, Department of Neurology, Epilepsy Division, Rochester, New York
| | | | | |
Collapse
|
49
|
Norsa'adah B, Zainab J, Knight A. The quality of life of people with epilepsy at a tertiary referral centre in Malaysia. Health Qual Life Outcomes 2013; 11:143. [PMID: 23972031 PMCID: PMC3765436 DOI: 10.1186/1477-7525-11-143] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2013] [Accepted: 08/06/2013] [Indexed: 11/10/2022] Open
Abstract
Background Epilepsy, a chronic disorder of brain characterised by a predisposition to generate epileptic seizures, has an effect on the psychosocial well-being of sufferers. Measuring the quality of life (QOL) of people with epilepsy (PWE) is increasingly recognized as an important component of clinical management. QOL measures differ between countries and there is limited information regarding PWE in Malaysia. The aim of this study was to determine the health related QOL and its relationship with the presence of seizures in PWE at a Malaysian tertiary referral center. Methods A total of 106 adults with epilepsy attending the weekly neurology clinic of Universiti Sains Malaysia Hospital were interviewed in this cross-sectional study. The QOL was measured using a validated Malay translated version of the Quality of Life in Epilepsy Scale-31 (QOLIE-31). Analysis of covariance was used for data analysis. Results The mean age was 31.8 years old (standard deviation (SD) 11.0) and 56.6% were females. The mean total score of QOLIE-31was 68.9 (SD 15.9). The highest subscale score was the medication effects with a mean of 79.4 (SD 28.5) and the lowest was seizure worry with 47.5 (SD 25.0). Respondents who had one or more seizures in the past four weeks had significantly lower mean score of QOL [63.4, 95% CI: 59.2, 67.5] than those who had no seizure [mean score 73.5, 95% CI: 69.3, 77.9] after adjusting for age, sex, treatment, duration and age at onset of epilepsy [F test =11.215, p = 0.001, R2 = 0.159]. All the sub-scales of QOL showed significant moderate correlation with the frequency of seizures except for cognitive functioning. Conclusions Worrying about seizure had the major contribution on QOL, while medication effect had the least. This study confirms the importance of seizure control for a better QOL in Malaysian patients with epilepsy.
Collapse
|
50
|
Understanding of and attitudes towards people with epilepsy among community-based rehabilitation volunteers in Guinea-Bissau. Epilepsy Behav 2013; 28:196-200. [PMID: 23770632 DOI: 10.1016/j.yebeh.2013.05.013] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2013] [Revised: 04/17/2013] [Accepted: 05/10/2013] [Indexed: 11/22/2022]
Abstract
BACKGROUND Community-based epilepsy care programs improve access to epilepsy treatment in resource-poor settings. Community volunteers are important to these services. Most studies on familiarity with, understanding of, and attitudes towards people with epilepsy (PWE), however, ignore these volunteers. METHODS We explored these issues among 15 community volunteers involved in a community-based rehabilitation child epilepsy service recently initiated in Guinea-Bissau using face-to-face interviews. RESULTS We found that the volunteers had a reasonable understanding of epilepsy, moderate attitudes towards PWE, and a good understanding of difficulties PWE encounter in society. CONCLUSION Evaluation of understanding and attitudes of community volunteers may be useful to improve low-cost community-based epilepsy programs. A correct understanding of epilepsy among community volunteers may increase effective treatment of and support to children with epilepsy through community-based epilepsy programs.
Collapse
|