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Biresaw MS, Vitrai J, Halász P, Correa V, Szűcs A. Changes in public attitude toward epilepsy in Hungary since 1994. A multicriteria weighting analysis. Epilepsia Open 2024; 9:1042-1050. [PMID: 38546973 PMCID: PMC11145619 DOI: 10.1002/epi4.12935] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2024] [Revised: 03/13/2024] [Accepted: 03/19/2024] [Indexed: 06/04/2024] Open
Abstract
OBJECTIVE To assess the adult Hungarian population's knowledge about and attitude toward epilepsy and compare the present findings with previous ones in 1994 and 2000. METHODS We performed a cross-sectional survey of the Hungarian adult population from 28th February to 8th March 2023. A non-probability quota sampling with a random walk method was used. We applied the computer-assisted personal interviewing (CAPI) method and used a multicriteria weighting procedure to correct for bias along the main sociodemographic variables. To detect changes over time, we used chi-squared tests, and to analyze the effect of sociodemographic characteristics, we applied multivariate logistic regression. RESULTS One thousand participants (53.1% women, mean age 48.1 ± 16.75 years) representing Hungary's population were interviewed yielding a response rate of 80.3%. 26.3% knew someone with epilepsy (55.9% in 1994 and 51.9% in 2000), and 30.8% saw an epileptic seizure (58% in 1994 and 55.3% in 2000). Compared to the young, fewer adults and elderly people knew someone with epilepsy or had seen a seizure. Like in 1994 and 2000, 16.6% reported objection to their children's interaction with people with epilepsy; however, in the present study, significantly fewer people opposed their children marrying or working together with epileptic people, indicating a change in attitude (p < 0.0001). Rural residents had less objection to their children's interaction with people with epilepsy (p < 0.05). People with secondary education objected significantly more often than those with primary education to their children's interaction (p = 0.037), marriage to people with epilepsy (p = 0.043), or their having equal employment (p = 0.008). Higher education people were as "permissive" as those with primary education. SIGNIFICANCE Certain parameters of familiarity and attitude markers of the Hungarian population toward epilepsy have improved. These tendencies are promising, but work is still needed; our results will hopefully evoke educational programs and campaigns against negative attitudes. PLAIN LANGUAGE SUMMARY The knowledge of the Hungarian population about epilepsy and their attitude toward people with epilepsy has been improved since 1994. People from rural areas have shown more acceptance for people with epilepsy. Those people who completed secondary education were significantly more prone to stigmatization than those with primary education.
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Affiliation(s)
- Mengesha Srahbzu Biresaw
- Department of Behavioral SciencesDoctoral School of Mental Health SciencesSemmelweis UniversityBudapestHungary
| | - József Vitrai
- Department of Preventive Health Sciences, Faculty of Health and Sport SciencesSzéchenyi István UniversityGyőrHungary
| | - Péter Halász
- Department of Preventive Health SciencesSzentágothai Doctoral SchoolSemmelweis UniversityBudapestHungary
| | - Vivian Correa
- Department of Behavioral SciencesDoctoral School of Mental Health SciencesSemmelweis UniversityBudapestHungary
| | - Anna Szűcs
- Department of Behavioral SciencesSemmelweis UniversityBudapestHungary
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Moon HJ, Lee H, Yoon D, Koo YS, Shin JY, Lee SY. Premature Mortality and Causes of Death Among People With Epilepsy: A Nationwide Population-Based Incident Cohort Study. Neurology 2023; 100:e2060-e2070. [PMID: 36948594 PMCID: PMC10186245 DOI: 10.1212/wnl.0000000000207212] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Accepted: 02/07/2023] [Indexed: 03/24/2023] Open
Abstract
BACKGROUND AND OBJECTIVES People with epilepsy (PWE) are at risk of premature death with considerable variability according to the study population. We aimed to estimate the risk and causes of death in PWE according to age, disease severity, disease course, comorbidities, and socioeconomic status in Korea. METHODS We conducted a nationwide population-based retrospective cohort study using the National Health Insurance database linked with the national death register. Newly treated PWE from 2008 to 2016 who were identified by antiseizure medication (ASM) prescriptions and diagnostic codes for epilepsy/seizure were included and observed until 2017. We assessed all-cause and cause-specific crude mortality rates and standardized mortality ratios (SMRs). RESULTS Among 138,998 PWE, 20,095 deaths were identified, and the mean follow-up period was 4.79 years. The SMR was 2.25 in the overall group of PWE, with a higher value in the younger age group at diagnosis and a shorter time interval after diagnosis. The SMR in the monotherapy group was 1.56, while that in the group with 4 or more ASMs was 4.93. PWE without any comorbidities had an SMR of 1.61. PWE who were rural residents had a higher SMR than those who were urban residents (2.47 vs 2.03, respectively). The causes of death among PWE were cerebrovascular disease (18.9%, SMR 4.50), malignant neoplasms outside the CNS (15.7%, SMR 1.37), malignant neoplasms of the CNS (6.7%, SMR 46.95), pneumonia (6.0%, SMR 2.08), and external causes (7.2%, SMR 2.17), including suicide (2.6%, SMR 2.07). Epilepsy itself and status epilepticus accounted for 1.9% of the overall death. The excess mortality associated with pneumonia and external causes was persistently high, whereas the excess mortality associated with malignancy and cerebrovascular diseases tended to decrease with increasing time since diagnosis. DISCUSSION This study showed excess mortality in PWE, even in those without comorbidities and those receiving monotherapy. Regional disparities and sustained risks of deaths from external causes over 10 years imply potential points of intervention. In addition to active control of seizures, education about injury prevention, monitoring for suicidal ideation, and efforts to improve accessibility to epilepsy care are all required to reduce mortality.
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Affiliation(s)
- Hye-Jin Moon
- From the Department of Neurology (H.-J.M.), Soonchunhyang University Bucheon Hospital, Soonchunhyang University College of Medicine; Department of Biohealth Regulatory Science (H.L., D.Y., J.-Y.S.), School of Pharmacy, Sungkyunkwan University, Suwon; Department of Neurology (Y.S.K.), Asan Medical Center, Seoul; Samsung Advanced Institute for Health Sciences & Technology (SAIHST) (J.-Y.S.), Sungkyunkwan University, Seoul; Department of Neurology (S.-Y.L.), College of Medicine, Kangwon National University, Chuncheon; and Interdisciplinary Graduate Program in Medical Bigdata Convergence (S.-Y.L.), Kangwon National University, Chuncheon, South Korea
| | - Hyesung Lee
- From the Department of Neurology (H.-J.M.), Soonchunhyang University Bucheon Hospital, Soonchunhyang University College of Medicine; Department of Biohealth Regulatory Science (H.L., D.Y., J.-Y.S.), School of Pharmacy, Sungkyunkwan University, Suwon; Department of Neurology (Y.S.K.), Asan Medical Center, Seoul; Samsung Advanced Institute for Health Sciences & Technology (SAIHST) (J.-Y.S.), Sungkyunkwan University, Seoul; Department of Neurology (S.-Y.L.), College of Medicine, Kangwon National University, Chuncheon; and Interdisciplinary Graduate Program in Medical Bigdata Convergence (S.-Y.L.), Kangwon National University, Chuncheon, South Korea.
| | - Dongwon Yoon
- From the Department of Neurology (H.-J.M.), Soonchunhyang University Bucheon Hospital, Soonchunhyang University College of Medicine; Department of Biohealth Regulatory Science (H.L., D.Y., J.-Y.S.), School of Pharmacy, Sungkyunkwan University, Suwon; Department of Neurology (Y.S.K.), Asan Medical Center, Seoul; Samsung Advanced Institute for Health Sciences & Technology (SAIHST) (J.-Y.S.), Sungkyunkwan University, Seoul; Department of Neurology (S.-Y.L.), College of Medicine, Kangwon National University, Chuncheon; and Interdisciplinary Graduate Program in Medical Bigdata Convergence (S.-Y.L.), Kangwon National University, Chuncheon, South Korea
| | - Yong Seo Koo
- From the Department of Neurology (H.-J.M.), Soonchunhyang University Bucheon Hospital, Soonchunhyang University College of Medicine; Department of Biohealth Regulatory Science (H.L., D.Y., J.-Y.S.), School of Pharmacy, Sungkyunkwan University, Suwon; Department of Neurology (Y.S.K.), Asan Medical Center, Seoul; Samsung Advanced Institute for Health Sciences & Technology (SAIHST) (J.-Y.S.), Sungkyunkwan University, Seoul; Department of Neurology (S.-Y.L.), College of Medicine, Kangwon National University, Chuncheon; and Interdisciplinary Graduate Program in Medical Bigdata Convergence (S.-Y.L.), Kangwon National University, Chuncheon, South Korea
| | - Ju-Young Shin
- From the Department of Neurology (H.-J.M.), Soonchunhyang University Bucheon Hospital, Soonchunhyang University College of Medicine; Department of Biohealth Regulatory Science (H.L., D.Y., J.-Y.S.), School of Pharmacy, Sungkyunkwan University, Suwon; Department of Neurology (Y.S.K.), Asan Medical Center, Seoul; Samsung Advanced Institute for Health Sciences & Technology (SAIHST) (J.-Y.S.), Sungkyunkwan University, Seoul; Department of Neurology (S.-Y.L.), College of Medicine, Kangwon National University, Chuncheon; and Interdisciplinary Graduate Program in Medical Bigdata Convergence (S.-Y.L.), Kangwon National University, Chuncheon, South Korea.
| | - Seo-Young Lee
- From the Department of Neurology (H.-J.M.), Soonchunhyang University Bucheon Hospital, Soonchunhyang University College of Medicine; Department of Biohealth Regulatory Science (H.L., D.Y., J.-Y.S.), School of Pharmacy, Sungkyunkwan University, Suwon; Department of Neurology (Y.S.K.), Asan Medical Center, Seoul; Samsung Advanced Institute for Health Sciences & Technology (SAIHST) (J.-Y.S.), Sungkyunkwan University, Seoul; Department of Neurology (S.-Y.L.), College of Medicine, Kangwon National University, Chuncheon; and Interdisciplinary Graduate Program in Medical Bigdata Convergence (S.-Y.L.), Kangwon National University, Chuncheon, South Korea.
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Woldegeorgis BZ, Anjajo EA, Korga TI, Yigezu BL, Bogino EA, Tema HT, Alemu HB, Boda TI, Daba DA, Gobena N, Obsa MS. Ethiopians' knowledge of and attitudes toward epilepsy: A systematic review and meta-analysis. Front Neurol 2023; 14:1086622. [PMID: 36925943 PMCID: PMC10011168 DOI: 10.3389/fneur.2023.1086622] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2022] [Accepted: 02/10/2023] [Indexed: 03/08/2023] Open
Abstract
Background Epilepsy remains one of the world's most common neurological diseases, but it appears to be widely misunderstood, particularly in under-resourced countries like Ethiopia. Improving individuals' knowledge and attitude toward epilepsy is critical for reducing the multifaceted impacts of epilepsy. Therefore, in this study, we sought to estimate the pooled levels of good knowledge and a favorable attitude toward epilepsy and also identify the associated factors using available data collected from different segments of the population. Methods Articles were searched in international electronic databases. A standardized Microsoft Excel spreadsheet and STATA software version 16 were used for data extraction and analysis, respectively. The Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) checklist was used to write this report. The random-effect meta-analysis model was used to estimate Der Simonian-Laird's pooled effect. Statistical heterogeneity of the meta-analysis was checked via Higgins and Thompson's I 2 statistics (0-100%), and Cochran's Q test at P < 0.10. Subgroups, based on the study regions, and sensitivity analyses were also performed. Publication bias was examined subjectively using funnel plots and objectively using the nonparametric rank correlation test of Begg and the regression-based test of Egger for small study effects with P < 0.05 considered to indicate potential publication bias. Furthermore, the Trim-and-fill method of Duval and Tweedie was used to explore sources of publication bias for the favorable level of attitudes toward epilepsy. Result A total of 12 studies with 6,373 study participants and 10 studies with 5,336 study participants were included to estimate the pooled level of good epilepsy knowledge and favorable attitudes respectively. The overall estimated levels of good epilepsy knowledge and favorable attitudes toward epilepsy among Ethiopians were 47.37% [(95% CI: 35.00, 59.74), I 2 = 99.2, P < 0.001] and 46.83%[(95% CI: 32.75, 60.90), I 2 = 99.2, P < 0.001] respectively. Subgroup analysis revealed that the pooled level of good epilepsy knowledge was 48.51% [(95% CI: 38.95, 58.06), I 2 = 95.6%, P < 0.001] in the Amhara region. Conclusion In the current review, we found out that there is a huge knowledge gap and an unfavorable level of attitudes towardepilepsy, which demand immediate public health action as well as a targeted policy intervention.
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Affiliation(s)
| | | | | | - Berhanu Lijalem Yigezu
- Department of Obstetrics and Gynecology, Wolaita Sodo University, Wolaita Sodo, Ethiopia
| | - Efa Ambaw Bogino
- Department of Dermatovenereology, Wolaita Sodo University, Wolaita Sodo, Ethiopia
| | | | - Henok Berhanu Alemu
- Department of Internal Medicine, Wolaita Sodo University, Wolaita Sodo, Ethiopia
| | - Tesfalem Israel Boda
- Department of Internal Medicine, Wolaita Sodo University, Wolaita Sodo, Ethiopia
| | | | - Negeso Gobena
- Department of Anesthesia, Hawasa University, Hawassa, Ethiopia
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Dual burdens of felt stigma and depressive symptoms in patients with epilepsy: Their association with social anxiety, marriage, and employment. Epilepsy Behav 2022; 134:108782. [PMID: 35914436 DOI: 10.1016/j.yebeh.2022.108782] [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: 03/10/2022] [Revised: 05/29/2022] [Accepted: 05/30/2022] [Indexed: 11/21/2022]
Abstract
PURPOSE The present study evaluated whether patients with epilepsy with dual conditions of felt stigma and depressive symptoms are more strongly associated with social anxiety, being unmarried, and being unemployed than those with depressive symptoms or felt stigma alone. METHODS This multicenter, cross-sectional study evaluated subjects using the Stigma Scale-Revised, the Patient Health Questionnaire-9, and the six-item versions of the Social Interaction Anxiety Scale, and the companion Social Phobia Scale. Subjects were grouped by depressive symptoms and felt stigma into four groups. Multivariate logistic regression analyses were performed. RESULTS The 298 subjects included 173 men and 125 women. Of these subjects, 35 (11.7%) had depressive symptoms alone, 33 (11.1%) had stigma alone, and 27 (9.1%) had both depressive symptoms and felt stigma. Multivariate logistic regression analyses showed that, compared with the control group having neither depressive symptoms nor felt stigma, the odds ratios (ORs) for social interaction anxiety and social phobia were highest in the group of dual conditions (OR 18.7 and 13.5, respectively), followed by the depression-alone (OR 7.7 and 4.6, respectively) and stigma-alone (OR 5.0 and 2.8, respectively) groups. Similarly, the ORs for being unmarried (OR 29.2) and unemployed (OR 3.1) were significant only in the group of dual conditions. In addition, male sex and younger age were independently associated with being unmarried whereas seizures recurring ≥1 per month were independently associated with being unemployed. CONCLUSIONS Dual conditions of felt stigma and depressive symptoms may be more strongly associated with social anxiety, being unmarried, and being unemployed than depressive symptoms or felt stigma alone in patients with epilepsy.
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Girma B, Nigussie J, Tamir T, Bekele E. Public knowledge toward Epilepsy and its determinants in Ethiopia: A systematic review and meta-analysis. Epilepsy Behav 2022; 133:108764. [PMID: 35690571 DOI: 10.1016/j.yebeh.2022.108764] [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: 02/09/2022] [Revised: 05/11/2022] [Accepted: 05/17/2022] [Indexed: 11/27/2022]
Abstract
BACKGROUND Epilepsy is a global problem that affects all countries and people of all ages. However, the disease burden is high in low- and middle-income countries. Poor public knowledge of epilepsy increases the rate of stigma and discrimination. However, in our country, there is a scarcity of summarized evidence about the level of public knowledge toward epilepsy. Therefore, to fill this gap, conducting this review and meta-analysis has a preponderant significance. METHODS Articles were explored from PubMed, PsycINFO, Hinari, Science Direct, web of science, and African journal of online (AJOL) databases, Google, and Google scholar. For data extraction and analysis purposes, Microsoft Excel spreadsheet and STATA software version 16 were used. To write this report, we used the Preferred Reporting Items for systematic reviews and Meta-Analysis. To assess the pooledmagnitudeof public knowledge toward epilepsy, we used arandom-effects meta-analysis model. We checked the Heterogeneity by I2. To detect publication bias, Begg's test, Egger's test, and funnel plot were conducted. Furthermore, subgroup analysis was conducted. Association was expressed through a pooled odds ratio with a 95% confidence interval. RESULT Our review and meta-analysis included 9 studies with 5658 participants. The pooled magnitude of poor knowledge toward epilepsy was 48.54% [95% CI (33.57, 63.51)]. I2 was 99.4% (P < 0.01). Begg's and Egger's test results were 0.92 and 0.06, respectively. Cannot read and write OR: 2.86 [95 CI (2.04, 4.00]) and not witnessing seizure episode OR: 3.00 [95% CI (2.46, 3.66)]) were significant determinants of poor knowledge. CONCLUSION In this review and meta-analysis, around half of the participants had poor knowledge about epilepsy. Individuals who cannot read and write, and could not witness seizure episodes had more likely to have poor knowledge toward epilepsy as compared to their counterparts. Health education through different methods should be provided to the public, and our educational system should focus on this global problem. Furthermore, it is better to give training for community key informants.
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Affiliation(s)
- Bekahegn Girma
- Dilla University, College of Medicine and Health Science, Department of Nursing, Dilla, Ethiopia.
| | - Jemberu Nigussie
- Dilla University, College of Medicine and Health Science, Department of Nursing, Dilla, Ethiopia
| | - Takla Tamir
- Dilla University, College of Medicine and Health Science, Department of Nursing, Dilla, Ethiopia
| | - Etaferaw Bekele
- Dilla University, College of Medicine and Health Science, Department of Nursing, Dilla, Ethiopia
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Kwon CS, Jacoby A, Ali A, Austin J, Birbeck GL, Braga P, Cross JH, de Boer H, Dua T, Fernandes PT, Fiest KM, Goldstein J, Haut S, Lorenzetti D, Mifsud J, Moshe S, Parko KL, Tripathi M, Wiebe S, Jette N. Systematic review of frequency of felt and enacted stigma in epilepsy and determining factors and attitudes toward persons living with epilepsy-Report from the International League Against Epilepsy Task Force on Stigma in Epilepsy. Epilepsia 2022; 63:573-597. [PMID: 34985782 DOI: 10.1111/epi.17135] [Citation(s) in RCA: 33] [Impact Index Per Article: 16.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Revised: 11/09/2021] [Accepted: 11/10/2021] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To review the evidence of felt and enacted stigma and attitudes toward persons living with epilepsy, and their determining factors. METHODS Thirteen databases were searched (1985-2019). Abstracts were reviewed in duplicate and data were independently extracted using a standardized form. Studies were characterized using descriptive analysis by whether they addressed "felt" or "enacted" stigma and "attitudes" toward persons living with epilepsy. RESULTS Of 4234 abstracts, 132 met eligibility criteria and addressed either felt or enacted stigma and 210 attitudes toward epilepsy. Stigma frequency ranged broadly between regions. Factors associated with enacted stigma included low level of knowledge about epilepsy, lower educational level, lower socioeconomic status, rural areas living, and religious grouping. Negative stereotypes were often internalized by persons with epilepsy, who saw themselves as having an "undesirable difference" and so anticipated being treated differently. Felt stigma was associated with increased risk of psychological difficulties and impaired quality of life. Felt stigma was linked to higher seizure frequency, recency of seizures, younger age at epilepsy onset or longer duration, lower educational level, poorer knowledge about epilepsy, and younger age. An important finding was the potential contribution of epilepsy terminology to the production of stigma. Negative attitudes toward those with epilepsy were described in 100% of included studies, and originated in any population group (students, teachers, healthcare professionals, general public, and those living with epilepsy). Better attitudes were generally noted in those of younger age or higher educational status. SIGNIFICANCE Whatever the specific beliefs about epilepsy, implications for felt and enacted stigma show considerable commonality worldwide. Although some studies show improvement in attitudes toward those living with epilepsy over time, much work remains to be done to improve attitudes and understand the true occurrence of discrimination against persons with epilepsy.
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Affiliation(s)
- Churl-Su Kwon
- Departments of Neurosurgery, Neurology and Population Health Sciences & Policy, Icahn School of Medicine, New York, New York, USA
| | - Ann Jacoby
- Department of Public Health and Policy, University of Liverpool, Liverpool, UK
| | - Amza Ali
- Kingston Public Hospital and University of the West Indies, Kingston, Jamaica
| | - Joan Austin
- Indiana University School of Nursing, Indianapolis, Indiana, USA
| | - Gretchen L Birbeck
- Epilepsy Division, University of Rochester, Rochester, New York, USA
- Epilepsy Care Team, Chikankata Hospital, Mazabuka, Zambia
| | - Patricia Braga
- Facultad de Medicina, Institute of Neurology, Universidad de la República, Montevideo, Uruguay
| | - J Helen Cross
- Developmental Neurosciences Programme, UCL-NIHR BRC Great Ormond Street Institute of Child Health, London, UK
| | - Hanneke de Boer
- SEIN - Epilepsy Institute in the Netherlands Foundation, Heemstede, The Netherlands
| | - Tarun Dua
- Department of Mental Health and Substance Abuse, World Health Organization, Geneva, Switzerland
| | - Paula T Fernandes
- Department of Sport Science, Faculty of Physical Education, UNICAMP, Campinas, Brazil
| | - Kirsten M Fiest
- Department of Critical Care Medicine and Department of Community Health Sciences, Hotchkiss Brain Institute, O'Brien Institute for Public Health, University of Calgary, Calgary, Alberta, Canada
| | - Jonathan Goldstein
- Departments of Neurology and Population Health Sciences & Policy, Icahn School of Medicine, New York, New York, USA
| | - Sheryl Haut
- Saul R. Korey Department of Neurology, Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, New York, USA
| | - Diane Lorenzetti
- Department of Community Health Sciences, University of Calgary and Health Sciences Library, University of Calgary, Calgary, Alberta, Canada
| | - Janet Mifsud
- Department of Clinical Pharmacology and Therapeutics, Faculty of Medicine and Surgery, University of Malta, Msida, Malta
| | - Solomon Moshe
- Saul R. Korey Department of Neurology, Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, New York, USA
- Department of Pediatrics and Dominick P. Purpura Department of Neuroscience, Albert Einstein College of Medicine, Bronx, New York, USA
| | - Karen L Parko
- Department of Neurology, University of California at San Francisco, San Francisco, California, USA
- Epilepsy Center, San Francisco VA Medical Center, San Francisco, California, USA
| | - Manjari Tripathi
- Department of Neurology, All India Institute of Medical Sciences, New Delhi, India
| | - Samuel Wiebe
- Department of Clinical Neurosciences and Department of Community Health Sciences, Hotchkiss Brain Institute, O'Brien Institute for Public Health, University of Calgary, Calgary, Alberta, Canada
| | - Nathalie Jette
- Departments of Neurology and Population Health Sciences & Policy, Icahn School of Medicine, New York, New York, USA
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Zhang Q, Li W, Li E, Yang X, Hao N, Yan B, Zhou D, Hao X. Disease awareness and dietary habits of patients with epilepsy in western China: a cross-sectional study. ACTA EPILEPTOLOGICA 2021. [DOI: 10.1186/s42494-021-00065-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
The optimal management of epilepsy includes engaging patients through education on knowledge of the disease, its treatment and diet control.
Methods
This was a cross-sectional survey-based cohort study, aimed to investigate the awareness of epilepsy in Chinese patients and to understand their dietary habits. Participants were consecutively enrolled from epileptic patients treated in a single epilepsy center from October 1, 2019 to February 29, 2020. A self-reported questionnaire (Cronbach’s α = 0.758) consisting of 3 parts was sent to 407 patients with epilepsy. The questionnaire included items on demographic information, epilepsy features, awareness of epilepsy treatment and dietary habits.
Results
About half of the patients (53.8%, 219/407) thought epilepsy was curable and only 80% knew that the first choice of treatment is medication. While 58.6% of the patients with low educational level preferred the use of antiepileptic drugs (p = 0.014), 52.7% believed that the medication should not be stopped immediately after seizure control (p = 0.026), especially after surgery (40.5%, p = 0.011). Patients with lower household monthly incomes had less awareness of the use of antiepileptic drugs than patients with higher incomes: only 39.2 and 49.8% of patients with lower incomes thought that the drugs could be stopped after epilepsy surgery or seizure control, respectively, compared to 51.6 and 66.1% with higher incomes. Alcohol (86.2%), caffeine (56.8%) and strong tea (49.1%) were top three foods considered by the patients to be avoided to prevent seizures. Approximately 30.2% of patients identified at least one food that made them susceptible to seizures.
Conclusions
Patient education on epilepsy, antiepileptic drugs and diet for management of seizures should be provided especially to patients with less education, lower income or inaccurate beliefs of epilepsy in Western China.
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Oumer M, Girma A, Ayeligne A. Epilepsy knowledge, attitude, practice, and associated factors among primary, secondary, and preparatory schoolteachers in Lay-Armachiho District, Northwest Ethiopia. Epilepsy Behav 2020; 112:107387. [PMID: 32858362 DOI: 10.1016/j.yebeh.2020.107387] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/24/2020] [Revised: 07/26/2020] [Accepted: 07/26/2020] [Indexed: 12/01/2022]
Abstract
Epilepsy is one of the most common neurological disorders encountered worldwide. It is poorly understood by the community, and it has been associated with numerous beliefs and misconceptions. Social stigma towards epilepsy is common in developing countries especially in Ethiopia, and its social, economic, and psychological consequences have become a major public health problem. The aim of this study was to assess epilepsy knowledge, attitude, practice, and associated factors among primary, secondary, and preparatory schoolteachers in Lay-Armachiho District, Northwest Ethiopia. An institution-based cross-sectional study design was conducted with 568 teachers working in ten schools of the district, using self-administered questionnaires. Descriptive analysis, binary, and multivariable logistic regression analyses were applied to analyze the data. In this study, 52.8% of the teachers had good knowledge (confidence interval (CI): 48.7, 56.9), 52.1% of the teachers had an unfavorable attitude (CI: 48.0, 56.2), and 55.3% of the teachers had a poor practice towards epilepsy (CI: 51.2, 59.3). After adjusting for covariates, being a male (adjusted odds ratio (AOR) = 1.5), urban resident (AOR = 2.4), degree holder (AOR = 2.3), above fourteen years teaching experience (AOR = 2.1), family history of epilepsy (AOR = 15.2), and previous first aid training (AOR = 1.8) were positively associated with the knowledge of epilepsy. The odds of having a positive attitude for epilepsy were 3.1 and 3.4 times higher among the teachers whose age is above 42 years and degree holders, respectively. Moreover, the odds of having a good practice for epilepsy were 2.1, 3.5, and 1.7 times higher among teachers of degree holders, a history of previous first aid training, and a history of providing first aid for students with epilepsy in the time of need, respectively. The main findings indicated that the majority of schoolteachers had good knowledge about, but unfavorable attitude and poor practice towards epilepsy. Therefore, the authors recommend that incorporating special need course in the educational curriculum with the help of first aid training and health promotion intervention to all levels of schoolteachers is very important.
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Affiliation(s)
- Mohammed Oumer
- Department of Epidemiology, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Amhara, Ethiopia; Department of Human Anatomy, School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, Amhara, Ethiopia.
| | - Amanuel Girma
- Department of Human Anatomy, School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, Amhara, Ethiopia
| | - Anteneh Ayeligne
- Department of Human Anatomy, School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, Amhara, Ethiopia
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Qiu L, Shen L, Wang J, Ren F, Xu M, Jiang F, Sheng X, Li F, Li F. Knowledge and attitudes among preschools staff in Shanghai, China, regarding epilepsy. BMC Pediatr 2020; 20:477. [PMID: 33050899 PMCID: PMC7550838 DOI: 10.1186/s12887-020-02376-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2020] [Accepted: 10/07/2020] [Indexed: 12/02/2022] Open
Abstract
Background Epilepsy is one of the most common neurological problems among children. The aim of this survey was to assess the knowledge and attitude among preschool staff in Shanghai regarding epilepsy. Methods A cross-sectional survey was carried out among the staff at selected preschools. A stratified random sampling method was first used to identify suitable subjects. Data were obtained using a self-completed questionnaire. A standardized collection of demographic information was performed, and participants were given a questionnaire about their knowledge and attitudes regarding epilepsy. Results A total of 1069 subjects completed the questionnaire. In this survey, 387 (36.2%) staff members had previously participated in related training. 17.6% of teachers knew how to provide appropriate first aid for seizures. Correct responses regarding first aid for seizures, such as laying the person on his or her side (24.9%), moving harmful objects out of the way (20.7%), protecting the head (36.1%), waiting until the seizure ends (7.9%), and dialing the emergency number (40.1%), were low. The staff members had different attitudes towards children with epilepsy: some subjects had a positive attitude, some had a negative attitude. Conclusions The level of first-aid knowledge among preschool staff in Shanghai relevant to epilepsy was low. There is an urgent need to educate staff about epilepsy and appropriate first-aid practices for seizures.
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Affiliation(s)
- Liyan Qiu
- Department of developmental behavioral pediatric & children healthcare, MOE-Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, 1665 Kongjiang Rd, Shanghai, 200092, China
| | - Lixiao Shen
- Department of developmental behavioral pediatric & children healthcare, MOE-Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, 1665 Kongjiang Rd, Shanghai, 200092, China
| | - Junli Wang
- Department of developmental behavioral pediatric & children healthcare, MOE-Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, 1665 Kongjiang Rd, Shanghai, 200092, China
| | - Fang Ren
- Department of developmental behavioral pediatric & children healthcare, MOE-Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, 1665 Kongjiang Rd, Shanghai, 200092, China
| | - Mingyu Xu
- Department of developmental behavioral pediatric & children healthcare, MOE-Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, 1665 Kongjiang Rd, Shanghai, 200092, China
| | - Fan Jiang
- Department of Developmental and Behavioral Pediatrics, Shanghai Pediatric Translational Research Institute, Shanghai Children's Medical Center, Shanghai Jiao Tong University, MOE-Shanghai Key Laboratory of Children's Environmental Health, 1678 Dongfang Rd, Shanghai, 200127, China
| | - Xiaoyang Sheng
- Department of developmental behavioral pediatric & children healthcare, MOE-Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, 1665 Kongjiang Rd, Shanghai, 200092, China
| | - Fei Li
- Department of developmental behavioral pediatric & children healthcare, MOE-Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, 1665 Kongjiang Rd, Shanghai, 200092, China
| | - Feng Li
- Department of developmental behavioral pediatric & children healthcare, MOE-Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, 1665 Kongjiang Rd, Shanghai, 200092, China.
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10
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Egawa M, Hara K, Ikeda M, Kono E, Miyashita S, Miyasaka N, Inaji M, Maehara T, Yoshida M. Role of obstetricians in promoting pregnancy-related knowledge among women with epilepsy in Japan. Epilepsy Behav 2020; 111:107176. [PMID: 32599429 DOI: 10.1016/j.yebeh.2020.107176] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2020] [Revised: 05/13/2020] [Accepted: 05/20/2020] [Indexed: 11/16/2022]
Abstract
The importance of informing women with epilepsy (WWE) of pregnancy-related issues when they are of reproductive age is well recognized. However, in Japan, education on pregnancy-related issues for these patients is insufficient. Obstetricians encounter patients who have self-discontinued their medications upon realizing they are pregnant. In this study, we aimed to assess the needs and understand knowledge levels regarding pregnancy-related issues among Japanese WWE. We contacted 400 board-certified epileptologists and asked them to administer our questionnaire to their patients; 51 responses were analyzed. Among all participating WWE, 100% were taking medication at the time of the study, 34% had given birth, and 63% expressed a desire to have children in the near future. Additionally, the median questionnaire score on pregnancy-related matters was as low as 9.5 out of 13 points. Only 31% of WWE knew that the mode of delivery is not always cesarean delivery. Among WWE, 62.7% stated that they had received counseling about pregnancy-related matters. Opinions differed regarding the optimum timing for counseling according to whether patients had received counseling. As for topics WWE wished to have explained to them, inheritance of epilepsy by their children ranked highly. The average satisfaction level with counseling was 5.6 of 7 points. Regarding satisfaction with counseling, there was a significant difference between WWE who expressed a desire to receive information from obstetricians and those who did not. In summary, we believe that our study shows that Japanese WWE remain ill-informed about pregnancy-related issues and that existing counseling must be revised. Obstetricians must play a role in preconception counseling.
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Affiliation(s)
- Makiko Egawa
- Department of Nutrition and Metabolism in Cardiovascular Disease, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Japan.
| | - Keiko Hara
- Department of Respiratory and Nervous System Science, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Japan; Hara Clinic, Yokohama, Japan
| | - Masami Ikeda
- Faculty of Education and Humanities, Department of Psychology, Jumonji University, Japan
| | - Eri Kono
- Comprehensive Reproductive Medicine, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Japan
| | - Susumu Miyashita
- Division of Maternal and Fetal Medicine, Perinatal Medicine Center, Dokkyo Medical University, Japan
| | - Naoyuki Miyasaka
- Comprehensive Reproductive Medicine, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Japan
| | - Motoki Inaji
- Department of Neurosurgery, Tokyo Medical and Dental University, Japan
| | - Taketoshi Maehara
- Department of Neurosurgery, Tokyo Medical and Dental University, Japan
| | - Masayuki Yoshida
- Department of Life Science and Bioethics, Graduate School of Medicine, Tokyo Medical and Dental University, Japan
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11
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Murthy MKS, Rajaram P, Mudiyanuru KS, Palaniappan M, Govindappa L, Dasgupta M. Potential for Increased Epilepsy Awareness: Impact of Health Education Program in Schools for Teachers and Children. J Neurosci Rural Pract 2020; 11:119-124. [PMID: 32140014 PMCID: PMC7055637 DOI: 10.1055/s-0039-3399479] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023] Open
Abstract
Background
Epilepsy, although a common disorder, yet is highly stigmatized. Under this condition, children with epilepsy are more vulnerable to stigmatization, social isolation, lack of support, and psychological and emotional problems. Thus, there is an immediate need of literature focusing on intervention studies to change the attitudes of school teachers and children.
Methods
The study was conducted with the objectives to evaluate knowledge, attitude, and practices (KAP) about epilepsy among school teachers and children; provide educational training program to teachers; and check the efficacy of training program imparted by teacher and trainer.
Results
Repeated measure of analysis of variance shows that knowledge (
F
= 1,134.875,
p
< 0.001), attitude (
F
= 2,429.909,
p
< 0.001), and practice (
F
= 2,205.122,
p
< 0.001) are significantly different between pre- and posttests indicated by Pillai’s trace test. Similarly, from the Pillai’s test, knowledge (
F
= 49.317,
p
< 0.001), attitude (
F
= 125.304,
p
< 0.001), and practice (
F
= 178.697,
p
< 0.001) are significantly different among teachers, trainer imparting training to children, and teachers imparting training to children. It is seen that KAP scores significantly differ between two time points and across the three groups. Among all the groups, teachers imparting training to children had high level of practice.
Conclusion
Inclusion of health education programs in the textbooks and health education schemes for teachers and school children are crucial ways to bring a change in their attitude, behavior, and practices toward epilepsy.
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Affiliation(s)
- Meena Kolar Sridara Murthy
- Department of Mental Health Education, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
| | - Prakashi Rajaram
- Department of Psychiatric Social Work, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
| | | | - Marimuthu Palaniappan
- Department of Biostatistics, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
| | - Lakshmana Govindappa
- Department of Social Work, School of Social and Behavioral Sciences, Central University of Karnataka, Gulbarga, Karnataka, India
| | - Madhuporna Dasgupta
- Department of Mental Health Education, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
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12
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Bahou Y, Alzghoul L, Alajloni EM, Albliwi MA, Alsabatin NO, Toubah YK. Knowledge and awareness among patients with epilepsy observed at Jordan University Hospital. Epilepsy Behav 2020; 102:106697. [PMID: 31812903 DOI: 10.1016/j.yebeh.2019.106697] [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: 08/21/2019] [Revised: 11/06/2019] [Accepted: 11/08/2019] [Indexed: 10/25/2022]
Abstract
The objective of this study was to assess the level of knowledge and awareness about epilepsy among patients with epilepsy (PWE) and to determine the correlation with sociodemographic and disease-related factors. A prospective cross-sectional study was set, and it included PWE attending the adult neurology clinic at Jordan University Hospital (JUH), Amman, Jordan. A structured questionnaire was utilized, which consisted of 3 parts: sociodemographic factors, disease characteristics, and an epilepsy knowledge scale - the Epilepsy Knowledge Profile-General (E.K.P-G) scale. There was a total of 108 patients, 43 males and 65 females with an age range from 16 to 63 years. The average score of the subjects in the E.K.P-G scale was 16.4/34 (48%). Twenty out of the 34 questions were answered correctly by less than 50% of the respondents. There was an overall poor understanding of the etiology of epilepsy. A higher E.K.P-G score was significantly correlated with higher levels of education, higher household income, controlled seizures for more than 2 years, and living in urban areas. On the other hand, there was no significant correlation between the level of knowledge and age, gender, marital status, occupational status, type of seizure, duration of epilepsy, source of information, number of antiepileptic drugs (AEDs), and family history of epilepsy. In conclusion, the study showed a significant lack of knowledge about epilepsy among PWE at JUH. A public educational program is necessary in Jordan to educate PWE about their disorder.
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Affiliation(s)
- Yacoub Bahou
- Neurology Section, Internal Medicine Department, Jordan University Hospital, Amman, Jordan.
| | - Loai Alzghoul
- Department of Physiology and Biochemistry, School of Medicine, The University of Jordan, Amman, Jordan
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13
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Narita Y, Hamano SI. Understanding of and misunderstandings regarding epilepsy: A survey of teachers in schools for special needs education in Japan. Epilepsy Behav 2019; 96:160-164. [PMID: 31150994 DOI: 10.1016/j.yebeh.2019.04.023] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2019] [Revised: 04/14/2019] [Accepted: 04/14/2019] [Indexed: 10/26/2022]
Abstract
The present study surveyed the understanding of epilepsy and attitudes toward epilepsy among teachers in Japanese schools for special needs education. An adapted version of a self-reported questionnaire, consisting of 27 questions, was sent to 3474 teachers at all schools for special needs education in Saitama Prefecture. The response rate to the questionnaire was 62%, corresponding to 2109 valid responses. The responses to three basic questions were as follows: 99% had heard about "epilepsy", 90% had seen epileptic seizures, and 63% had an acquaintance who had epilepsy. Numerous questionnaire items gave low correct answer rates for knowledge- and attitude-related questions. Correct responses to knowledge questions and a positive attitude toward epilepsy were associated with whether individuals had acquaintance with epilepsy, experience seeing a seizure, and read or heard about epilepsy. There was skepticism and uncertainty about whether people with epilepsy should be allowed to drive, likely due to vague fears of the risks of driving with epilepsy. According to our results, knowledge about epilepsy does not necessarily lead to a positive attitude. However, respondents who had acquaintances with epilepsy were most likely to demonstrate a positive attitude. Thus, familiarity is an essential factor in the likelihood of having a positive attitude toward epilepsy. Therefore, it is essential for teachers to understand how to manage and respond to epilepsy. There were a variety of concerns related to people with epilepsy driving. This finding highlights the importance of disseminating correct information on the risks of driving with epilepsy.
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Affiliation(s)
- Yuri Narita
- Division of Psychology, Center for Child Health and Human Development, Saitama Children's Medical Center, Saitama, Japan.
| | - Shin-Ichiro Hamano
- Division of Neurology, Saitama Children's Medical Center, Saitama, Japan
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14
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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.
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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.
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15
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Nagamori C, Hara K, Ohta K, Akaza M, Sumi Y. Longitudinal investigation into implicit stigma of epilepsy among Japanese medical students before and after mass media coverage of car accidents associated with people with epilepsy. Epilepsy Behav 2017. [PMID: 28623756 DOI: 10.1016/j.yebeh.2017.05.008] [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] [Indexed: 12/31/2022]
Abstract
OBJECTIVE Public attitudes and stigma toward epilepsy may limit patient motivation for treatment and participation in social activities. Stigma research requiring individuals to report personal beliefs is useful but is subject to social desirability bias. Self-reporting methods often do not capture implicit attitudes; therefore, in this study, implicit stigma was measured using the implicit association test (IAT), which is a word sorting task to minimize this bias. Recently, in Japan, several serious car accidents caused by people with epilepsy (PWE) resulted in pedestrian fatalities. Traffic accidents involving PWE have been reported extensively and repeatedly in the media since 2011. The present study aimed to examine differences in implicit stigma toward epilepsy among medical students in 2010, 2013, and 2016. METHODS We recruited 41 medical students in 2010, 44 medical students in 2013 and 42 medical students in 2016. We investigated the strength of conceptual associations between the words "Epilepsy" or "Hypertension", and "Safety" or "Danger" in the IAT. RESULTS The association between the words "Epilepsy" and "Danger" was stronger in 2013 compared with that in 2010; however, the association was weaker in 2016 compared with that in 2013. There was no significant difference between 2010 and 2016. CONCLUSION The change in IAT results between 2010 and 2013 might be due to the traffic accident involving PWE in Japan. However, the result in 2016 might indicate that the implicit attitudes toward epilepsy were improved to the same level as those in 2010.
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Affiliation(s)
- Chizuko Nagamori
- Tokyo Medical and Dental University, Graduate School of Health Care Sciences, 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8519, Japan
| | - Keiko Hara
- Tokyo Medical and Dental University, Graduate School of Health Care Sciences, 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8519, Japan; Hara Clinic, Yokohama, Kanagawa, Japan.
| | - Katsuya Ohta
- Tokyo Medical and Dental University, Graduate School of Health Care Sciences, 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8519, Japan; Onda Daini Hospital, Matsudo, Chiba, Japan
| | - Miho Akaza
- Tokyo Medical and Dental University, Graduate School of Health Care Sciences, 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8519, Japan
| | - Yuki Sumi
- Tokyo Medical and Dental University, Graduate School of Health Care Sciences, 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8519, Japan
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16
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Shon YM, Joung WJ. [Illness Experience of Married Korean Women with Epilepsy]. J Korean Acad Nurs 2017; 47:289-304. [PMID: 28706165 DOI: 10.4040/jkan.2017.47.3.289] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2016] [Revised: 02/23/2017] [Accepted: 03/13/2017] [Indexed: 11/09/2022]
Abstract
PURPOSE The purpose of this study was to understand and describe the illness experience of married Korean women with epilepsy. METHODS Data were collected during 2015~2016 through individual in-depth interviews with 12 married women with epilepsy. Verbatim transcripts were analyzed using Giorgi's phenomenological analysis to uncover the meaning of the illness experience of the participants. RESULTS The study results showed that the illness experience of married Korean women with epilepsy was clustered into a specific description of situated structure and a general description of situated structure. Six themes from 20 meaning units were identified: 1) Undermined self-esteem with stigma of being epileptic; 2) Limited social interaction; 3) Suffering sorrow as a 'disqualified being'; 4) Shuttling back and forth across the boundary between healthy and epileptic; 5) Desperate struggle to meet the expectation of given role; 6) Self-empowering through self-restriction and realization. CONCLUSION The findings from this study show that both the enacted and felt stigma of epilepsy impact on the life of married Korean women with epilepsy. Although the participants face social and interpersonal restriction and prejudices, they try their best to fulfill their role rather than to be cared for as patients. As the stigma and hardships of the participants are related to lack of knowledge, health professionals should focus not just on clinical intervention but also on providing targeted educational programs and counseling for these women to dispel the stigma of the disease and to increase their quality of life.
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Affiliation(s)
- Young Min Shon
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Woo Joung Joung
- Research Institute of Nursing Science, Seoul National University, Seoul, Korea.
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17
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Tekle-Haimanot R, Preux PM, Gerard D, Worku DK, Belay HD, Gebrewold MA. Impact of an educational comic book on epilepsy-related knowledge, awareness, and attitudes among school children in Ethiopia. Epilepsy Behav 2016; 61:218-223. [PMID: 27372962 DOI: 10.1016/j.yebeh.2016.05.002] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2016] [Revised: 05/02/2016] [Accepted: 05/03/2016] [Indexed: 10/21/2022]
Abstract
INTRODUCTION Epilepsy is of worldwide public health importance because it is common, often accompanied by physical and cognitive disabilities, and is widely stigmatized. The incidence of epilepsy in Ethiopia was reported to be 64/100,000 population and a prevalence of 520/100,000 population. A minority of subjects is treated, and religious and sociocultural beliefs influence the nature of treatment and care. One approach to support the development of positive attitudes toward individuals with disabilities is through the use of comics. Comics have been effective in creating awareness and educating about epilepsy. MATERIAL AND METHODS We conducted a cross-sectional study among randomly selected students from two preparatory schools (one from a city and the other from a rural area) in June 2014. We collected information using a structured KAP questionnaire before and after reading a comic book. The comic book relevance was assessed by 40 health professionals. RESULT One hundred sixteen students from urban and 110 from rural high schools were enrolled in the present study with an age distribution of 31.9% in 16-17years, 48.7% in 18-19years, and 19.5% in 20+years. Thirty percent of the urban school was male compared with sixty-five percent of the rural school. The comic book was recommended as useful educational material to be distributed among school children by 90% of interviewed health professionals (internists, neurologist, psychiatrists, residents, GPs, and nurses). CONCLUSION The comic book was appreciated by the Ethiopian high school students. After brief exposure to the comic book, students could extract a great deal of information, it could change misconceptions and provide correct information about epilepsy, and can be an effective approach to epilepsy awareness creation. Health professionals found the comic book to be very informative and recommended its distribution to students, teachers, nurses, libraries, and community/religious leaders. Illustrations were Ethiopian-oriented.
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Affiliation(s)
| | - Pierre Marie Preux
- INSERM, Univ. Limoges, CHU Limoges, UMR_S 1094, Tropical Neuroepidemiology, Institute of Neuroepidemiology and Tropical Neurology, CNRS FR 3503 GEIST, F-87000 Limoges, France.
| | - Daniel Gerard
- Access to Medicines Department, Sanofi, Gentilly, France.
| | - Dawit Kibru Worku
- Bahir Dar University, Department of Internal Medicine, Bahir Dar 79, Ethiopia.
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18
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Lee SY, Chung SE, Kim DW, Eun SH, Kang HC, Cho YW, Yi SD, Kim HD, Jung KY, Cheong HK. Estimating the Prevalence of Treated Epilepsy Using Administrative Health Data and Its Validity: ESSENCE Study. J Clin Neurol 2016; 12:434-440. [PMID: 27273925 PMCID: PMC5063869 DOI: 10.3988/jcn.2016.12.4.434] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2016] [Revised: 02/27/2016] [Accepted: 02/29/2016] [Indexed: 12/03/2022] Open
Abstract
Background and Purpose Few of the epidemiologic studies of epilepsy have utilized well-validated nationwide databases. We estimated the nationwide prevalence of treated epilepsy based on a comprehensive medical payment database along with diagnostic validation. Methods We collected data on patients prescribed of antiepileptic drugs (AEDs) from the Health Insurance Review and Assessment service, which covers the entire population of Korea. To assess the diagnostic validity, a medical records survey was conducted involving 6,774 patients prescribed AEDs from 43 institutions based on regional clusters and referral levels across the country. The prevalence of treated epilepsy was estimated by projecting the diagnostic validity on the number of patients prescribed AEDs. Results The mean positive predictive value (PPV) for epilepsy was 0.810 for those prescribed AEDs with diagnostic codes that indicate epilepsy or seizure (Diagnosis-E), while it was 0.066 for those without Diagnosis-E. The PPV tended to decrease with age in both groups, with lower values seen in females. The prevalence was 3.84 per 1,000, and it was higher among males, children, and the elderly. Conclusions The prevalence of epilepsy in Korea was comparable to that in other East Asian countries. The diagnostic validity of administrative health data varies depending on the method of case ascertainment, age, and sex. The prescriptions of AEDs even without relevant diagnostic codes should be considered as a tracer for epilepsy.
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Affiliation(s)
- Seo Young Lee
- Department of Neurology, Kangwon National University College of Medicine, Chuncheon, Korea
| | - Soo Eun Chung
- Department of Social and Preventive Medicine, Sungkyunkwan University School of Medicine, Suwon, Korea
| | - Dong Wook Kim
- Department of Neurology, Konkuk University, School of Medicine, Seoul, Korea
| | - So Hee Eun
- Department of Pediatrics, Korea University College of Medicine, Ansan, Korea
| | - Hoon Chul Kang
- Department of Pediatrics, Yonsei University College of Medicine, Seoul, Korea
| | - Yong Won Cho
- Department of Neurology, Keimyung University School of Medicine, Daegu, Korea
| | | | - Heung Dong Kim
- Department of Pediatrics, Yonsei University College of Medicine, Seoul, Korea
| | - Ki Young Jung
- Department of Neurology, Seoul National University College of Medicine, Seoul, Korea.
| | - Hae Kwan Cheong
- Department of Social and Preventive Medicine, Sungkyunkwan University School of Medicine, Suwon, Korea.
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Kolar Sridara Murthy M, Govindappa L, Sinha S. Outcome of a school-based health education program for epilepsy awareness among schoolchildren. Epilepsy Behav 2016; 57:77-81. [PMID: 26926070 DOI: 10.1016/j.yebeh.2016.01.016] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2015] [Revised: 01/01/2016] [Accepted: 01/15/2016] [Indexed: 11/18/2022]
Abstract
BACKGROUND A diagnosis of epilepsy has a major effect on children; especially among schoolchildren. Studies have shown that a significant proportion of teachers and students have negative attitude and misunderstanding towards epilepsy making it difficult for a child with epilepsy. At the same time, there is a dearth is dearth of literature regarding interventions to bring about a change in the attitudes of children. METHODOLOGY The aim of the present study was to study the outcome of a school-based health education program for epilepsy awareness among schoolchildren. The objectives were to assess the level of knowledge, attitude, and practices about epilepsy and relationship among these variables. A total of 70 children, from 8th-10th grades were selected randomly for the study. For the study purpose, knowledge, attitude, and practices of epilepsy instrument were developed and face validated by experts. RESULTS Results show that the mean, median, and mode age of the respondents in the study were 14.55 (±1.33), 15, and 14 years, respectively. The gender distribution of the respondents was 54.9% boys and 45.1% girls. With regard to knowledge, attitude, and practices in epilepsy, knowledge strongly and positively correlated with attitude (p=0.001, r=.423) and practice domains (p=0.001, r=.486). Postattitude and (p=0.001, r=.338) practice were positively correlated, which shows that positive attitude brings positive practice. Hence, it is concluded that a training program brings desirable change in the knowledge, attitude, and practice domains among children. CONCLUSION Health education programs for schoolchildren are very important to bring changes in their attitude, behavior, and practices.
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Affiliation(s)
- Meena Kolar Sridara Murthy
- Department of Mental Health Education, National Institute of Mental Health and Neuro Sciences [NIMHANS], Hosur Road, Bangalore, Karnataka 560029, India.
| | - Lakshmana Govindappa
- Department of Social Work, Central University of Karnataka, Kadaganchi, Aland Road, Gulbarga, Karnataka 585 367, India.
| | - Sanjib Sinha
- Department of Neurology, National Institute of Mental Health and Neuro-Sciences (NIMHANS), Hosur Road, Bangalore, Karnataka 560029, India.
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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.
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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.
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Employability in people with epilepsy: A systematic review. Epilepsy Res 2015; 116:67-78. [DOI: 10.1016/j.eplepsyres.2015.06.016] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2015] [Revised: 06/12/2015] [Accepted: 06/23/2015] [Indexed: 11/20/2022]
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Teferi J, Shewangizaw Z. Assessment of knowledge, attitude, and practice related to epilepsy: a community-based study. Neuropsychiatr Dis Treat 2015; 11:1239-46. [PMID: 26056455 PMCID: PMC4446018 DOI: 10.2147/ndt.s82328] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Religious and sociocultural beliefs influence the nature of treatment and care received by people with epilepsy. Many communities in Africa and other developing nations believe that epilepsy results from evil spirits, and thus, treatment should be through the use of herbaceous plants from traditional doctors and religious leadership. Community-based cross-sectional study designs were used to assess the knowledge, attitude, and practice related to epilepsy and its associated factors by using a pretested, semi-structured questionnaire among 660 respondents living in Sululta Woreda, Oromia, Ethiopia. According to the results of this study, 59.8% of the respondents possessed knowledge about epilepsy, 35.6% had a favorable attitude, and 33.5% of them adopted safe practices related to epilepsy. The following factors had significant association to knowledge, attitude, and practice related to epilepsy: being rural dwellers, living alone, those with more years of formal education, heard information about epilepsy, distance of health facility from the community, had witnessed an epileptic seizure, age range from 46 years to 55 years, had heard about epilepsy, prior knowledge of epilepsy, occupational history of being self-employed or a laborer, history of epilepsy, and history of epilepsy in family member. The findings indicated that the Sululta community is familiar with epilepsy, has an unfavorable attitude toward epilepsy, and unsafe practices related to epilepsy, but has a relatively promising knowledge of epilepsy.
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Affiliation(s)
- Jalle Teferi
- Addis Ababa Health Bureau, Zewuditu Specialized Hospital, Addis Ababa, Ethiopia
| | - Zewdu Shewangizaw
- College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia
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Kim DW, Lee SY, Chung SE, Cheong HK, Jung KY. Clinical characteristics of patients with treated epilepsy in Korea: a nationwide epidemiologic study. Epilepsia 2013; 55:67-75. [PMID: 24299173 DOI: 10.1111/epi.12469] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/13/2013] [Indexed: 11/28/2022]
Abstract
OBJECTIVE Although a number of epidemiologic studies have been conducted on the prevalence and incidence of epilepsy around the world, only a few studies have investigated the clinical characteristics of patients with epilepsy in a population-based sample. The purpose of the present study was to describe the clinical characteristics of treated patients with epilepsy in Korea via a nationwide medical records survey. METHODS The study population was obtained through a nationwide database registered to the Health Insurance Review and Assessment service. Patients were recruited from clinics and hospitals in each cluster according to region and referral level by random selection from a preallocated sample of patients. All patients were being treated with antiepileptic drug medication with or without a diagnosis code for epilepsy or seizure between January 2009 and December 2009. Among the 6,436 selected patients, 2,150 met the diagnostic criteria for epilepsy and were included in our survey on the clinical characteristics of patients who were with treated epilepsy. RESULTS The proportion of male patients with epilepsy in this study was higher (1,226; 57.0%) than that of female patients. In addition, 10.6% of patients were first diagnosed with epilepsy in 2009, and 53.6% of patients experienced at least one seizure over the course of 2009; 78.1% were classified as having localization-related epilepsy, whereas 7.3% were considered to have generalized epilepsy. Thirty-five percent of patients were thus classified as idiopathic or cryptogenic cases. The most common cause of symptomatic epilepsy was trauma (10.0%), followed by stroke (9.6%), central nervous system (CNS) infection (5.7%), and hippocampal sclerosis (4.9%). SIGNIFICANCE This is the first nationwide study of the clinical characteristics of treated epilepsy in Korea using a national database validated by medical records survey. The etiologies of epilepsy and epilepsy syndrome classifications were comparable to those previously reported in other developed countries.
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Affiliation(s)
- Dong Wook Kim
- Department of Neurology, Konkuk University School of Medicine, Seoul, Korea
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Bagić D, Mastilica M, Bagić A. A five-year follow-up study of the general public awareness and perception of epilepsy in Croatia. Epilepsy Behav 2012; 25:200-7. [PMID: 23032133 DOI: 10.1016/j.yebeh.2012.06.030] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2012] [Revised: 06/20/2012] [Accepted: 06/23/2012] [Indexed: 11/29/2022]
Abstract
Public reception of epilepsy in Croatia was re-assessed in 2009, 5 years after an initial survey, by interviewing 1000 randomly selected adults. Ninety-two percent (-5.0%) of the respondents had heard about epilepsy, 47% (-7.9%) knew someone with epilepsy, and 38.6% (-6.0%) had witnessed a seizure. Interviewees were quite ready to accept a person with epilepsy. Almost 8% (+1.1%) would object if their child played with a child with epilepsy, and 77.8% (+1.8%) believed that a child with epilepsy could succeed as well as a child without epilepsy. Although 45.9% (-6.6%) would approach a person having a seizure and help, 36.1% (+3.0%) would also call "911." Citizens of Croatia re-declared a high tolerance toward people with epilepsy and positive attitude toward children with epilepsy. Experiential factors remained strong predictors of more positive attitudes. A more prominent role of patients and implementation of social marketing in addressing a large persisting degree of prejudice and stigmatization worldwide are warranted.
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Affiliation(s)
- Dragan Bagić
- The Faculty of Humanities and Social Sciences, Department of Sociology, University of Zagreb, 10000 Zagreb, Croatia.
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Characteristics of patients with epilepsy who use a website providing healthcare information about epilepsy in South Korea. Epilepsy Behav 2012; 25:156-61. [PMID: 23032122 DOI: 10.1016/j.yebeh.2012.06.002] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2012] [Revised: 06/01/2012] [Accepted: 06/03/2012] [Indexed: 11/22/2022]
Abstract
We studied characteristics of epilepsy patients who use 'Epilia', a healthcare website for epilepsy patients, and the impact of 'Epilia' on patient satisfaction and attitude about epilepsy. A total of 153 epilepsy patients from 'Epilia' (online group) and 367 patients from epilepsy clinics (offline group) were recruited. A survey was done to investigate their socio-demographic, epilepsy-related, and psychological characteristics, as well as attitude alterations after beginning to use 'Epilia'. Factors affecting attitude were also identified in the online group. Online group had more severe and more frequent seizures, more adverse effects, more anxiety and depression, and worse quality of life than offline group. Online group patients who are more satisfied, who take two or more antiepileptic drugs, who visit to 'Epilia' more and longer had a greater positive attitude change than those without these characteristics. A healthcare website can contribute to self-management by providing useful information and education for epilepsy patients.
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Lim KS, Wu C, Choo WY, Tan CT. Development and validation of a public attitudes toward epilepsy (PATE) scale. Epilepsy Behav 2012; 24:207-12. [PMID: 22564888 DOI: 10.1016/j.yebeh.2012.03.038] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2012] [Revised: 03/26/2012] [Accepted: 03/27/2012] [Indexed: 12/01/2022]
Abstract
INTRODUCTION A quantitative scale of public attitudes toward epilepsy is essential to determine the magnitude of social stigma against epilepsy. This study aims to develop and validate a cross-culturally applicable scale of public attitudes toward epilepsy. METHODS A set of questions was selected from questionnaires identified from a literature review, following which a panel review determined the final version, consisting of 18 items. A 1-5 Likert scale was used for scoring. Additional questions, related to perception of the productivity of people with epilepsy and of a modified epilepsy stigma scale, were added as part of construct validation. One hundred and thirty heterogeneous respondents were collected, consisting of various age groups, ethnicity and occupation status levels. RESULTS After item and factor analyses, the final version consisted of 14 items. Psychometric properties of the scale were first determined using factor analysis, which revealed a general and a personal domain, with good internal consistency (Cronbach's coefficient 0.868 and 0.633, respectively). Construct validation was demonstrated. The mean score for the personal domain was higher than that for the general domain (2.72±0.56 and 2.09±0.59, respectively). The mean scores of those with tertiary education were significantly lower for the general domain, but not for the personal domain. Age was positively correlated with the mean scores in the personal domain, but not in the general domain. CONCLUSION This scale is a reliable and valid scale to assess public attitudes toward epilepsy, in both the general and personal domains.
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Affiliation(s)
- Kheng-Seang Lim
- Division of Neurology, Department of Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.
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Saengsuwan J, Boonyaleepan S, Srijakkot J, Sawanyawisuth K, Tiamkao S. Factors associated with knowledge and attitudes in persons with epilepsy. Epilepsy Behav 2012; 24:23-9. [PMID: 22503426 DOI: 10.1016/j.yebeh.2012.03.006] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2012] [Revised: 03/05/2012] [Accepted: 03/06/2012] [Indexed: 11/28/2022]
Abstract
Treating persons with epilepsy (PWE) in developing countries may be different from elsewhere. Knowledge and attitudes of PWE are known to be associated with seizure control. This study aims to evaluate factors related with the knowledge and attitudes of PWE in northeastern Thailand. A cross-sectional survey using questionnaires and interviews was undertaken at the Khon Kaen University epilepsy clinic. The questionnaire comprised 22 questions (14 knowledge questions and 8 attitude questions). Two hundred three PWE participated in the study with a mean age of 36.5 years. Four factors were significantly associated with the knowledge about epilepsy, which included education level, age, epilepsy duration, and a history of experiencing antiepileptic medication side effects. In addition, there were four factors significantly associated with the attitudes about epilepsy, which included seizure control, education level, epilepsy duration, and marital status. There is a need to provide more education, preferably community based, to help PWE obtain more accurate information.
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Ferrari CMM, Castro LHM, Settervall CHC, de Moura RM, Coutinho PA, Oshiro IES, Alves RB, de Sousa RMC. Validity and reliability of the Portuguese version of the Epilepsy Medication Treatment Complexity Index for Brazil. Epilepsy Behav 2011; 21:467-72. [PMID: 21664877 DOI: 10.1016/j.yebeh.2011.04.054] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2011] [Revised: 04/14/2011] [Accepted: 04/17/2011] [Indexed: 12/26/2022]
Abstract
We evaluated the reliability and validity of a Brazilian-Portuguese version of the Epilepsy Medication Treatment Complexity Index (EMTCI). Interrater reliability was evaluated with the intraclass correlation coefficient (ICC), and validity was evaluated by correlation of mean EMTCI scores with the following variables: number of antiepileptic drugs (AEDs), seizure control, patients' perception of seizure control, and adherence to the therapeutic regimen as measured with the Morisky scale. We studied patients with epilepsy followed in a tertiary university-based hospital outpatient clinic setting, aged 18 years or older, independent in daily living activities, and without cognitive impairment or active psychiatric disease. ICCs ranged from 0.721 to 0.999. Mean EMTCI scores were significantly correlated with the variables assessed. Higher EMTCI scores were associated with an increasing number of AEDs, uncontrolled seizures, patients' perception of lack of seizure control, and poorer adherence to the therapeutic regimen. The results indicate that the Brazilian-Portuguese EMTCI is reliable and valid to be applied clinically in the country. The Brazilian-Portuguese EMTCI version may be a useful tool in developing strategies to minimize treatment complexity, possibly improving seizure control and quality of life in people with epilepsy in our milieu.
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Affiliation(s)
- Carla Maria Maluf Ferrari
- Department of Neurology, Hospital das Clinicas da Faculdade de Medicina de São Paulo, São Paulo, Brazil.
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Lua PL, Neni WS. Awareness, knowledge, and attitudes with respect to epilepsy: an investigation in relation to health-related quality of life within a Malaysian setting. Epilepsy Behav 2011; 21:248-54. [PMID: 21576038 DOI: 10.1016/j.yebeh.2011.03.039] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2011] [Revised: 03/27/2011] [Accepted: 03/30/2011] [Indexed: 11/28/2022]
Abstract
The influence of awareness, knowledge, and attitudes (AKA) on the health-related quality of life (HRQoL) of patients with epilepsy has not been widely established. The aims of this preliminary study were to (1) assess general AKA and HRQoL levels, (2) correlate AKA and HRQoL levels, and (3) compare the HRQoL of patients with epilepsy with different AKA levels. A cross-sectional sample of outpatients with epilepsy were recruited from the Neurology Clinic, Hospital Sultanah Nur Zahirah, Kuala Terengganu, Malaysia. Data analysis was carried out using the Statistical Package for Social Sciences Version 15 employing descriptive and nonparametric statistics. On written consent, included patients completed the Malay AKA Epilepsy and the Malay Quality of Life in Epilepsy-30 (MQOLIE-30) instruments. Across all patients, both AKA levels (median: 80.0, range: 0-170) and overall HRQoL (median 51.5; range 15-97) were moderate. Awareness was significantly correlated only with Seizure Worry (r(s)=+0.29, p<0.05), whereas Knowledge was not significantly linked to any domain. However, Attitudes was significantly correlated with all domains (r(s)=+0.35 to +0.47, p<0.01) except Medication Effects and Seizure Worry. Patients with good AKA levels (Total Score ≥ median) experienced significantly better Overall Quality of Life and Cognitive Functioning (p<0.05). Findings showed that AKA may play an important role in influencing patients' HRQoL, suggesting that epilepsy treatment efforts should also focus on enhancing AKA through epilepsy awareness to improve health outcomes.
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Affiliation(s)
- Pei Lin Lua
- Centre for Clinical and Quality of Life Studies, Faculty of Medicine and Health Sciences, Universiti Sultan Zainal Abidin, Kuala Terengganu, Malaysia.
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Yang R, Wang W, Snape D, Chen G, Zhang L, Wu J, Baker GA, Zheng X, Jacoby A. Stigma of people with epilepsy in China: views of health professionals, teachers, employers, and community leaders. Epilepsy Behav 2011; 21:261-6. [PMID: 21606005 PMCID: PMC3127044 DOI: 10.1016/j.yebeh.2011.04.001] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2011] [Revised: 03/30/2011] [Accepted: 04/01/2011] [Indexed: 11/24/2022]
Abstract
To identify possible sources of stigma of epilepsy in key informant groups, "mini-ethnographic" studies were conducted in rural and urban locations in China. Data collected from 45 semistructured interviews and 8 focus group discussions (6 persons each) were analyzed to investigate the world experienced by people with epilepsy. Underpinned by a social constructionist approach to data analysis, emerging themes were identified with the use of computer-assisted data analysis (NVivo 8). A hierarchical model was then constructed, to include practical level issues (attitudes toward risk, attitudes toward costs of epilepsy) and cultural level issues (contrast between rurality and tradition and urbanization and modernity in the Chinese context). The analysis enriches current research on factors and sources of stigma of epilepsy and highlights issues for future practice.
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Affiliation(s)
- Rongrong Yang
- Institute of Population Research, Peking University, China
| | - Wenzhi Wang
- Department of Neuroepidemiology, Beijing Neurosurgical Institute, Beijing, China
| | - Dee Snape
- Institute of Psychology, Health and Society, University of Liverpool, UK
| | - Gong Chen
- Institute of Population Research, Peking University, China
| | - Lei Zhang
- Institute of Population Research, Peking University, China
| | | | - Gus A Baker
- Division of Neurosciences, University of Liverpool, UK
| | - Xiaoying Zheng
- Institute of Population Research, Peking University, China,Corresponding Authors, Xiaoying Zheng, PhD, MD, Institute of Population Research/WHO Collaborating Centre, Peking University, Beijing 100871, China, , Telephone: 0086 10 62759185, Facsimile: 0086 10 62751974, Ann Jacoby, PhD, Department of Health Inequalities and the Social Determinants of Health, Institute of Psychology, Health and Society, Whelan Building, The Quadrangle, Brownlow Hill, Liverpool, UK, L69 3GB, , Telephone: 0044 151 794 5602/5943, Facsimile: 0044 151 794 5588
| | - Ann Jacoby
- Institute of Psychology, Health and Society, University of Liverpool, UK,Corresponding Authors, Xiaoying Zheng, PhD, MD, Institute of Population Research/WHO Collaborating Centre, Peking University, Beijing 100871, China, , Telephone: 0086 10 62759185, Facsimile: 0086 10 62751974, Ann Jacoby, PhD, Department of Health Inequalities and the Social Determinants of Health, Institute of Psychology, Health and Society, Whelan Building, The Quadrangle, Brownlow Hill, Liverpool, UK, L69 3GB, , Telephone: 0044 151 794 5602/5943, Facsimile: 0044 151 794 5588
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Ducci RD, Cirino RH, de Oliveira RA, Twardowschy CA, Chomatas ER, Kowacs PA. Analysis of 621 death certificates issued from 1998 to 2007 in Curitiba, Brazil, mentioning epilepsy, epileptic seizures and/or status epilepticus. Seizure 2011; 20:406-8. [DOI: 10.1016/j.seizure.2011.01.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2010] [Revised: 01/18/2011] [Accepted: 01/27/2011] [Indexed: 10/18/2022] Open
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Lee SA, Yim SB, Rho YI, Chu M, Park HM, Lee GH, Park SP, Jung DS. Factors contributing to Korean teachers' attitudes toward students with epilepsy. Epilepsy Behav 2011; 20:378-81. [PMID: 21256815 DOI: 10.1016/j.yebeh.2010.11.021] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2010] [Revised: 11/23/2010] [Accepted: 11/25/2010] [Indexed: 11/16/2022]
Abstract
We investigated factors contributing to teachers' attitudes toward students with epilepsy. Data were collected from 604 teachers in Korea. The questionnaire included the Scale of Attitudes Toward Persons with Epilepsy (ATPE) and a demographic and teaching experience survey. In stepwise linear regression analysis, ATPE Knowledge scores (P<0.001) and prior experience teaching a student with epilepsy (P=0.001) were identified as significant factors for ATPE Attitude scores. The ATPE Knowledge scores accounted for 50.1% of the variance in the Attitude scores, and experience teaching a student with epilepsy accounted only for 1.0%. Our finding that teachers' knowledge is the most important factor influencing teacher's attitudes toward epilepsy indicates that teachers should be provided with information about epilepsy universally, across geographic settings, educational levels, and experience levels.
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Affiliation(s)
- Sang-Ahm Lee
- Department of Neurology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea.
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