The relationship between psychosocial care and attitudes toward illness in adolescents with epilepsy

Health beliefs on type 2 diabetes: a methodological research for development and psychometric evaluation of "DIABA" (Diabetes-related Instrument to Assess Beliefs of Adolescents) health beliefs on type 2 diabetes

BACKGROUND

Several reports have shown an increase in the number of type-2 diabetics among adolescents creating an extra burden for this age group. However, there is no instrument assessing adolescents' attitude toward this disease. This study aims at designing a psychometric tool for assessing adolescents' health beliefs regarding type-2 diabetes.

RESEARCH DESIGN AND METHODS

In this methodological research, 770 boy and girl adolescents (between 13 and 15) from Tehran participated through multistage sampling. The Inclusion criteria were: junior high school students, students' willingness for participation and not suffering from type-1 or type-2 diabetes. The questionnaire was designed by extensive literature review and the related existing questionnaires, as well as considering the research team's comments. The validity of the questionnaire was determined through face and content validity. The construct validity was determined through exploratory and confirmatory factor analysis. Reliability was measured via internal consistency coefficient (ICC) and internal consistency reliability was measured by Cronbach Alpha. SPSS 16 and EQS6.1 were used for data analysis.

RESULTS

The pool of questions had 57 items, and by removing similar (23 questions) or inappropriate sentences (8 questions), a draft questionnaire with 26 questions was designed. No items were removed in the face validity phase. Based on the results of CVR and CVI, six items and 4 items in the exploratory factor analysis were removed. Finally, a questionnaire with 16 items in 4 dimensions of perceived self-efficacy, behavioral beliefs, perceived susceptibility and perceived severity was obtained. The results of confirmatory factor analysis confirmed the model. The internal consistency coefficient was confirmed measuring Cronbach Alpha at 0.78 and ICC = 0.73.

CONCLUSION

The questionnaire designed can be employed as a reliable and valid instrument to assess the psychological perceptions and health beliefs of adolescents with respect to type-2 diabetes.

Evaluation of disease related attitudes and quality of LIFE in children with chronic illness

AIM

This study was conducted as a descriptive method in order to evaluate the attitudes towards illness of children with chronic diseases and their quality of life.

METHOD

The population of the study consisted of children with a chronic illness who were admitted to the pediatrics outpatient clinic of a hospital located in a province in the north-east of Turkey. The sample of the study consisted of 105 children who came to the hospital between October 2020 and June 2022, who met the criteria, and whose permission was obtained from themselves and their families. The study data were collected by using the 'Introductory Information Form', the 'Pediatric Quality of Life Inventory (PedsQL) (8-12 and 13-18 years)' and the 'Child Attitude Towards Illness Scale (CATIS)'. Data were analyzed using the SPSS for Windows 22 package program.

RESULTS

The mean age of the children who participated in the study was 13.90 ± 2.55 and 73.3% of them were in the adolescent age group. The average PedsQL total score of the children participating in the research was 64.59 ± 18.99 and the average CATIS total score was 3.05 ± 0.71.

CONCLUSION

It was determined that as the quality of life of the children with chronic diseases in the study increased, their attitudes towards their diseases became more positive.

PRACTICE IMPLICATIONS

While caring for children with chronic diseases, nurses should consider that supporting the child's quality of life positively affects the child's attitude towards the disease.

The effect of simulation-based education on childhood epileptic seizure management knowledge, skills, and attitudes of nursing students

BACKGROUND

Lack of knowledge about epileptic seizure management and negative attitudes toward children with epilepsy among nursing students may negatively affect the quality of healthcare services they deliver.

AIM

This study aimed to examine the effect of training given to nursing students using simulation and standard child mannequins on their childhood epileptic seizure management knowledge, skills, and attitudes.

METHODS

Participants (n = 72) were recruited from a Nursing Faculty in Izmir, Turkey. Students were randomly assigned to the intervention and control groups (n = 36 in each). The intervention group received simulation-based training on epilepsy while the control group received standard child mannequin training on epilepsy. One week after the training, the students were asked to demonstrate their epileptic seizure management knowledge and skills on a simulation model or a standard child mannequin. During this process, they were observed and assessed by two independent observers on the basis of a list of epileptic seizure management skills. All participants completed the personal information form, the Epilepsy and Epileptic Seizure Management Knowledge Test, and the Epilepsy Knowledge and Attitude Scale before, and after the training, McNemar's test, repeated measure ANOVA (intravenous), dependent t-test, chi-square test, Fisher's exact test, independent t-test, Pearson's correlation analysis, and Pearson's chi-square test were used to compare the groups. Intraclass correlation coefficient (ICC) was used to evaluate the consistency between observers.

RESULTS

The epilepsy knowledge scale mean scores of both groups significantly increased after their respective trainings (p < 0.001), but the difference between the groups was not statistically significant (p = 0.829). There was no statistically significant difference between the pre- and posttraining epilepsy attitude scale mean scores of the control group (p = 0.630), however, a statistically significant increase was observed in the epilepsy attitude scale mean score of the intervention group (p = 0.008). In addition, both groups' self-confidence in epileptic seizure management significantly increased after the training (p = 0.000).

CONCLUSIONS

Simulation-based training was beneficial for students insofar as it helped them to develop positive attitudes toward epilepsy.

The current and emerging therapeutic approaches in drug-resistant epilepsy management

Epilepsy is a neurologic disorder consisting of recurrent spontaneous seizures. Antiepileptic drugs administration is the most commonly used therapeutic strategy in the management of epilepsy. However, 20-30% of epilepsy patients have seizure episodes that are not controlled by these medicines (drug-resistant epilepsy). The management of drug-resistant epilepsy, especially in the children, is challenging and can cause economic and social problems, and lower the patients' quality of life, cognition, and mood. Several therapeutic approaches for drug-resistant epilepsy are available including surgical methods, neurostimulation treatments, and diet therapies which lead to diminishing the epileptic seizures. An increasing number of novel and potential therapeutic approaches such as gene therapy, gene editing, cell therapy, exosome therapy, and molecular network targeting have also been explored. The present study is aimed to review these current and emerging therapeutic approaches for drug-resistant epilepsy.

Exploring the role of knowledge of condition and psycho-social profiles of young people with epilepsy during transition

Transitioning from paediatric to adult care can be a particularly challenging time for young people with epilepsy and research has shown that there are a range of factors which may influence a young person's ability to successfully cope with this difficult time. The following study aimed to explore the psychosocial characteristics of this transitioning population, as well as investigate how knowledgeable the young person and their parent/carer are of their own condition throughout transition. Young people with epilepsy were recruited from two specialist epilepsy clinics in the North West and allocated to one of three groups; Group 1 pre-transition, Group 2 transitioning, and Group 3 post-transition. Results found that the young person's knowledge increased significantly throughout transition, whilst parent/carer's knowledge decreased. In addition, anxiety was found to be significantly lower in Group 2 (transitioning group) compared to Group 1 (pre-transition) and Group 3 (post-transition) and a number of significant gender differences were also identified across the groups. The study highlights the importance of considering all relevant psychosocial factors, such as anxiety, gender and the degree of knowledge the individual holds of their own condition during the transition process in order to develop psycho-educational programmes and transition pathways.

Developing from child to adult: Risk factors for poor psychosocial outcome in adolescents and young adults with epilepsy

INTRODUCTION

Childhood-onset epilepsy during the years of transition to adulthood may affect normal social, physical, and mental development, frequently leading to psychosocial and health-related problems in the long term.

OBJECTIVE

This study aimed to describe the main characteristics of patients in transition and to identify risk factors for poor psychosocial outcome in adolescents and young adults with epilepsy.

METHODS

Patients with epilepsy, 15-25years of age, who visited the Kempenhaeghe Epilepsy Transition Clinic from March 2012 to December 2014 were included (n=138). Predefined risk scores for medical, educational/occupational status, and independence/separation/identity were obtained, along with individual risk profile scores for poor psychosocial outcome. Multivariate linear regression analysis and discriminant analysis were used to identify variables associated with an increased risk of poor long-term psychosocial outcome.

RESULTS

Demographic, epilepsy-related, and psychosocial variables associated with a high risk of poor long-term outcome were lower intelligence, higher seizure frequency, ongoing seizures, and an unsupportive and unstable family environment. Using the aforementioned factors in combination, we were able to correctly classify the majority (55.1%) of the patients regarding their risk of poor psychosocial outcome.

CONCLUSION

Our analysis may allow early identification of patients at high risk of prevention, preferably at pretransition age. The combination of a chronic refractory epilepsy and an unstable family environment constitutes a higher risk of transition problems and poor outcome in adulthood. As a consequence, early interventions should be put into place to protect youth at risk of poor transition outcome.