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Sarac E, Yildiz E. The effect of epilepsy self-management on productivity at work. Epilepsy Behav 2024; 157:109839. [PMID: 38820679 DOI: 10.1016/j.yebeh.2024.109839] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2024] [Revised: 05/07/2024] [Accepted: 05/11/2024] [Indexed: 06/02/2024]
Abstract
BACKGROUND Epilepsy is a significant public health concern and the most common neurological disorder. Lack of understanding of the disease may magnify the challenges faced by employees with epilepsy, including effective management of symptoms, and full participation in workplace and work productivity. AIM Study aimed to evaluate epilepsy self-management skills of working individuals with epilepsy and to determine the impact of it on productivity at work. METHODS The study adopted a cross-sectional design and involved 111 individuals with epilepsy. Data collection was carried out using a socio-demographic characteristics form, the "Epilepsy Self-Management Scale" and the "Endikot Work Productivity Scale." RESULTS The average age was 35.76 ± 3.39 in the study. The majority of the participants (57.7 %) were women. Additionally, 33.3 % were private sector employee, and 39.6 % held a bachelor's degree. The mean score of the Epilepsy Self Management Scale was 3.91 ± 0.15, the total score of Endikot Work Productivity Scale was 39.84 ± 6.33. A negative significant correlation was observed between epilepsy self management and work productivity. Moreover, women (3.94 ± 0.17) and healthcare workers (3.97 ± 0.06) had higher scores of epilepsy self management. While men (40.43 ± 0.15) demonstrated higher productivity scores, public servants (35.61 ± 0.34) had lower scores compared to others (p < 0.05). CONCLUSIONS The findings of this study suggest that improved self-management of epilepsy among working individuals leads to increased work productivity. The epilepsy-management skills of women and healthcare workers was higher. Furthermore, men exhibited lower productivity levels, while woman and public servants displayed higher.
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Affiliation(s)
- Elif Sarac
- Ministry of National Defense, The Directorate of Management Services, Ankara, Turkiye.
| | - Esra Yildiz
- Ataturk University, Nursing Faculty, Public Health Nursing Department, Erzurum, Turkiye.
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Modi A, Wagner J. Letter to Dr. Steve Schacter. Epilepsy Behav 2022; 137:108746. [PMID: 36460602 DOI: 10.1016/j.yebeh.2022.108746] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Accepted: 05/12/2022] [Indexed: 12/05/2022]
Affiliation(s)
- Avani Modi
- Cincinnati Children's Hospital Medical Center, Cincinnati, OH, United States
| | - Janelle Wagner
- Medical University of South Carolina College of Nursing, United States
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Behavioral health screening in pediatric epilepsy: Which measures commonly used in the United States are 'good enough'? Epilepsy Behav 2022; 134:108818. [PMID: 35841809 DOI: 10.1016/j.yebeh.2022.108818] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Revised: 06/08/2022] [Accepted: 06/23/2022] [Indexed: 11/22/2022]
Abstract
PURPOSE To improve evidence-based implementation of behavioral health screening measures in pediatric epilepsy care, guidance is needed in the selection and interpretation of evidence-based screening measures. Therefore, the goals of this project were to (1) evaluate the clinical utility and psychometric properties of screening instruments frequently used in the United States (US) for anxiety, depression, and behavior problems in youth with epilepsy (YWE), and (2) provide guidance around selection and interpretation of these behavioral health screening measures. METHOD The critique was conducted in three phases: (1) identification of articles based on search criteria; (2) full review of articles for eligibility assessment; (3) evaluation of screening measures and organization into Tiers. Nine behavioral health measures frequently used to screen for anxiety, depression, and disruptive behaviors in the US were selected for evaluation. PubMed, CINAHL, Medline, and APA databases were searched using the following search terms: [target area] + [screening measure] + epilepsy + children [youth], [adolescents]. Inclusion/exclusion criteria for articles were as follows: (1) focused on YWE, (2) written in English, and (3) conducted in the US. Once articles were selected, Hunsley and Mash's criteria were used to evaluate and categorize the screening measures' psychometric properties, which have clear relevance to clinical practice. Measures were also classified into three tiers by the level of validation according to established evidence-based criteria. RESULTS Forty-one unique papers were identified through the literature search and assessed as eligible. Evaluation of screening measures revealed only two psychometrically sound measures that met criteria for Tier 1, the NDDI-E-Y and the Pediatric NeuroQoL-Depression, both depression screening measures. Several additional depression screening measures met criteria for Tier 2 (CDI-2, BASC-2-Depression Scale, and CBCL Withdrawn/Depressed Scale). Anxiety screening measures have not been validated in pediatric epilepsy and thus only met the criteria for Tier 2 (BASC-2 Anxiety Scale, CBCL DSM-IV Oriented Anxiety Problems Scale, MASC). Similarly for disruptive behaviors, two measures met Tier 2 criteria (BASC-2 Externalizing Problems Index, CBCL Externalizing Problems Index). CONCLUSION Strides have been made in the validation of behavioral health screening measures for YWE; however, continued research in this area is necessary to validate existing psychometrically sound measures and to develop and evaluate epilepsy-specific measures in the pediatric epilepsy population.
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Samanta D, Elumalai V, Hoyt ML, Modi AC, Sajatovic M. A qualitative study of epilepsy self-management barriers and facilitators in Black children and caregivers in Arkansas. Epilepsy Behav 2022; 126:108491. [PMID: 34929473 PMCID: PMC8764703 DOI: 10.1016/j.yebeh.2021.108491] [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: 10/15/2021] [Revised: 12/01/2021] [Accepted: 12/01/2021] [Indexed: 01/03/2023]
Abstract
OBJECTIVES To identify facilitators and barriers of epilepsy self-management practices among Black children and caregivers. METHODS Qualitative semi-structured in-depth interviews were conducted with 11 child-caregiver dyads (11 children with epilepsy and 11 caregivers). A deductive-inductive analysis was undertaken to describe the range of barriers and facilitators significant to participants. RESULTS The barriers and facilitators were classified into 3 management themes: epilepsy-specific knowledge and information, treatment, and lifestyle. Within these themes, several important subthemes were identified. Two subthemes related to knowledge barriers emerged: children and caregivers' limited understanding and retention of complex written and spoken information and variable training and confidence in seizure first-aid. In contrast, facilitators for introducing and encouraging access to epilepsy self-management concepts were participants' eagerness to learn about this topic and a keen interest in using educational materials enriched with visual aids on a phone platform as an adjunct to in-person education. The second theme revealed various practical barriers to optimum treatment adherence, including mistrust of the healthcare system. In comparison, caregivers' collaborative approach and innovative strategies were identified as facilitators for treatment adherence. Finally, the lifestyle management barriers included a lack of defined processes to adopt healthy behaviors and challenges with disclosing epilepsy. Facilitators of this theme were comprised of building a team around the child to foster wellbeing and making healthy habits a fun and joyful experience for children. DISCUSSION Qualitative evidence in this study highlights caregivers' mistrust in the healthcare system and the lack of community support. Culturally competent interventions may improve access to and quality and utilization of self-management programs in Black children and families while reducing disparities.
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Affiliation(s)
- Debopam Samanta
- Neurology Division, Department of Pediatrics, University of Arkansas for Medical Sciences, Little Rock, AR, USA.
| | - Vimala Elumalai
- Division of Neurology, Arkansas Children’s Hospital, United States of America
| | - Megan Leigh Hoyt
- Division of Neurology, Arkansas Children’s Hospital, United States of America
| | - Avani C. Modi
- Department of Pediatrics, Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children’s Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Martha Sajatovic
- Neurological and Behavioral Outcomes Center, Case Western Reserve University School of Medicine and University Hospitals Cleveland Medical Center, Cleveland, Ohio,Department of Psychiatry, Case Western Reserve University School of Medicine and University Hospitals Cleveland Medical Center, Cleveland, Ohio
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Ongchuan Martin S, Sadeghifar F, Snively BM, Alexander H, Kimball J, Conner K, O'Donovan CA, Munger Clary HM. Positive anxiety or depression screen despite ongoing antidepressant prescription in people with epilepsy: A large cross-sectional analysis. Epilepsy Behav Rep 2022; 20:100572. [PMID: 36411879 PMCID: PMC9674492 DOI: 10.1016/j.ebr.2022.100572] [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: 07/23/2022] [Revised: 10/30/2022] [Accepted: 11/05/2022] [Indexed: 11/09/2022] Open
Abstract
Purpose While antidepressants are recommended to manage anxiety or depression in epilepsy, limited effectiveness data exist in real-world epilepsy samples, and prior work indicated frequent positive screens despite antidepressant prescription. In response, this study evaluates factors associated with positive anxiety or depression screen during ongoing antidepressant prescription. Methods Clinical and sociodemographic characteristics were collected among consecutive adult epilepsy clinic patients completing validated anxiety and depression instruments. The sample was divided by presence vs absence of existing antidepressant prescription at time of screening. Among those on an antidepressant, multivariable logistic regression was performed on pre-selected characteristics to evaluate for association with positive anxiety and/or depression screen. Pre-selected characteristics included: antidepressant dose, antidepressant prescriber specialty, antiseizure medications (number, potential psychotropic effects), seizure frequency, employment, visit no-shows, and medical insurance. Results Of 563 people with epilepsy, 152 had evidence of antidepressant prescription at time of screening and 73/152(48%) had positive anxiety and/or depression screen. Multivariable modeling demonstrated low antidepressant dose and no-show visit(s) were associated with positive screens (adjusted OR 2.29, CI 1.00-5.48 and 3.11, 1.26-8.22 respectively). Conclusion Low antidepressant dose and factors potentially associated with adherence (visit no-shows) may contribute to persistent anxiety and/or depression among epilepsy patients on an antidepressant.
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Affiliation(s)
| | - Fatemeh Sadeghifar
- Department of Neurology, Wake Forest University School of Medicine, Winston-Salem, NC, USA
| | - Beverly M Snively
- Department of Biostatistics and Data Science, Wake Forest University School of Medicine, Winston-Salem, NC, USA
| | - Halley Alexander
- Department of Neurology, Wake Forest University School of Medicine, Winston-Salem, NC, USA
| | - James Kimball
- Department of Psychiatry, Wake Forest Unversity School of Medicine, Winston-Salem, NC, USA
| | - Kelly Conner
- Department of Neurology, Wake Forest University School of Medicine, Winston-Salem, NC, USA
| | - Cormac A O'Donovan
- Department of Neurology and Internal Medicine, Wake Forest University School of Medicine, Winston-Salem, NC, USA
| | - Heidi M Munger Clary
- Department of Neurology, Wake Forest University School of Medicine, Winston-Salem, NC, USA
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Schulman-Green D, Feder SL, Montano AR, Batten J, Tan H, Hoang K, Grey M. Use of the self- and family management framework and implications for further development. Nurs Outlook 2021; 69:991-1020. [PMID: 34183187 DOI: 10.1016/j.outlook.2021.05.009] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2021] [Revised: 04/20/2021] [Accepted: 05/02/2021] [Indexed: 02/05/2023]
Abstract
BACKGROUND The Self- and Family Management Framework (SFMF) was created in 2006 and revised in 2015 to guide research on self- and family management of chronic conditions. There has been no review of use of the SFMF. PURPOSE We reviewed articles citing the SFMF to identify the frequency and nature of use. METHOD We conducted a citation analysis, searching Web of Science, Scopus, and Google Scholar databases and extracted key data from identified articles. FINDINGS Of 126 articles, 84(66%) cited the 2006 SFMF, 37(29%) cited the 2015 SFMF, and 6(5%) cited both. The SFMF was used most to inform study design. Users noted strengths (e.g., considers family context) and limitations (e.g., non-specification of patient- family caregiver synergies) of the framework. DISCUSSION The SFMF has been used broadly to guide research on self- and family management of chronic conditions. Findings will inform development of a third version of the SFMF.
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Affiliation(s)
| | | | | | | | - Hui Tan
- Yale New Haven Health Bridgeport Hospital, Bridgeport, CT
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Munger Clary HM, Salpekar JA. Should adult neurologists play a role in the management of the most common psychiatric comorbidities? Practical considerations. Epilepsy Behav 2019; 98:309-313. [PMID: 30471892 PMCID: PMC6614011 DOI: 10.1016/j.yebeh.2018.10.020] [Citation(s) in RCA: 8] [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: 08/19/2018] [Revised: 10/10/2018] [Accepted: 10/13/2018] [Indexed: 11/17/2022]
Abstract
Despite the high prevalence and negative impact of psychiatric comorbidities on the life of adults with epilepsy, significant unmet mental health care need exists because of a variety of factors, including poor access to mental health care providers. A potential solution to address access barriers is neurologist-driven diagnosis and management of common psychiatric conditions in epilepsy, of which mood and anxiety disorders are the most common. In this manuscript, patient selection criteria and practical treatment strategies are outlined for common mood and anxiety disorders that can be safely managed by neurologists. This article is part of the Special Issue "Obstacles of Treatment of Psychiatric Comorbidities in Epilepsy".
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Affiliation(s)
- Heidi M Munger Clary
- Department of Neurology, Wake Forest School of Medicine, Winston-Salem, North Carolina, United States of America.
| | - Jay A Salpekar
- Departments of Psychiatry and Neurology, Johns Hopkins University, Baltimore, MD, United States of America
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Philippot A, Meerschaut A, Danneaux L, Smal G, Bleyenheuft Y, De Volder AG. Impact of Physical Exercise on Symptoms of Depression and Anxiety in Pre-adolescents: A Pilot Randomized Trial. Front Psychol 2019; 10:1820. [PMID: 31440186 PMCID: PMC6694801 DOI: 10.3389/fpsyg.2019.01820] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2019] [Accepted: 07/23/2019] [Indexed: 11/13/2022] Open
Abstract
Aim The intensity of the most appropriate exercise to use in depressed youth is unclear due to differences in methodology and the lack of evidence documenting the effect of physical activity in children. Therefore, the authors of this study attempted to document the effectiveness of different training intensities to reduce symptoms of depression and anxiety in pre-teens. Methods The study included twenty-seven, randomly selected pre-adolescents (aged between 9–11 years of age) all of whom had Primary education. The participants were enrolled and, over a 5-week period, were subject to either intensive or low-to-moderate exercise programs four times a week. Psychological self-reports, as well as physical examinations, were conducted before and after such programs in blinded assessments. Psychological effects were considered the primary outcome, whilst physical condition was secondary. Results Four subjects were lost and twenty-three were analyzed. General linear model with 2 criteria revealed significant changes (p = 0.05) in trait anxiety symptoms over time in the low-to-moderate intensity group (LMIG). Within group changes followed a significant decrease in levels of anxiety (38.82 ± 2.20 to 33.36 ± 2.83, p = 0.004) and depression (10.36 ± 2.83 to 6.73 ± 1.88, p = 0.006) related symptoms amongst those in the LMIG. Interpretation This study indicated that depression and anxiety symptoms were reduced amongst a non-clinical sample of Primary educated pre-adolescents when they were subject to a low-to-moderate exercise program. The program focused on associating movement with pleasure, encouraged positive and non-competitive interactions between participants. Clinical Trial Registration www.ClinicalTrials.gov, identifier NCT02970825, autumn 2016, updated May 7, 2018 (https://clinicaltrials.gov/ct2/show/NCT02970825).
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Affiliation(s)
- Arnaud Philippot
- MSL-In Laboratory, Institute of Neuroscience, Université catholique de Louvain, Brussels, Belgium.,Psychiatric Hospital, AREA+, Epsylon ASBL, Brussels, Belgium
| | - Alexandre Meerschaut
- MSL-In Laboratory, Institute of Neuroscience, Université catholique de Louvain, Brussels, Belgium
| | - Laura Danneaux
- MSL-In Laboratory, Institute of Neuroscience, Université catholique de Louvain, Brussels, Belgium
| | - Gauthier Smal
- MSL-In Laboratory, Institute of Neuroscience, Université catholique de Louvain, Brussels, Belgium
| | - Yannick Bleyenheuft
- MSL-In Laboratory, Institute of Neuroscience, Université catholique de Louvain, Brussels, Belgium
| | - Anne G De Volder
- MSL-In Laboratory, Institute of Neuroscience, Université catholique de Louvain, Brussels, Belgium.,Pediatric Neurology Service, Cliniques Universitaires Saint-Luc, Brussels, Belgium
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Use of a Systematic Consultation Process to Facilitate Nursing Research Projects: An Exemplar. CLIN NURSE SPEC 2018; 32:249-259. [PMID: 30095524 DOI: 10.1097/nur.0000000000000396] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE/OBJECTIVES The purpose of this article is to describe the use of a well-established, 5-stage consultation process, to advise a research team on planning strategies to engage domestic violence shelters (DVSs) as community partners in their study. The research team is testing a health promotion intervention for teens living in shelters with their parent and needed to enlist shelters as sites to recruit teens and conduct the intervention. Consultation aims were to (a) identify highly promising strategies described in peer-reviewed literature for identifying, recruiting, and collaborating with community organizations in research and (b) identify DVSs that would potentially serve as effective community partners for the study. METHODS A clinical nurse specialist and a public health master's degree student led the consultation. The consultation process included (a) a systematic review of 29 peer-reviewed articles about research or program evaluation studies that engaged community partners and (b) a comprehensive online search of information about DVSs. OUTCOMES Consultants identified 104 strategies used in studies to engage community partners and 10 specific DVSs most likely to effectively engage in the study. CONCLUSION Clinical nurse specialists are well situated to provide consultation to research teams and should follow well-established consultation processes and systematic data collection procedures.
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Buntinx WHE, Tan IY, Aldenkamp AP. Support values through the eyes of the patient: An exploratory study into long-term support of persons with refractory epilepsy. Epilepsy Behav 2018; 82:155-163. [PMID: 29625367 DOI: 10.1016/j.yebeh.2018.02.031] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2017] [Revised: 01/05/2018] [Accepted: 02/11/2018] [Indexed: 10/17/2022]
Abstract
A significant group of persons affected by refractory epilepsy require a wide range of long-term support from professionals as well as informal support givers. To enhance person-centeredness, it is important to know which patient values are associated with long-term support. An Internet survey produced a total of 1176 statements from 289 persons with epilepsy for analysis. Statements were expressed in the respondent's own words and were related to positive experiences (704) as well as possible areas of improvement (472) regarding the support received in the past six months. Thematic summaries of the survey results were presented to four focus groups of persons with epilepsy and proxies with a request to formulate the most important patient values which should be observed in long-term support. In iterative sessions with a panel of epilepsy experts, a framework of twelve value domains was formulated, organized in four major value clusters. An example of how these value domains can be operationalized for use in practice is next presented as a checklist to help evaluate the support patients with long-term support needs actually receive. Correspondingly, two sets of reflective questions were formulated for informal and professional support givers for the purpose of evaluating and improving person-centeredness in their support practices.
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Affiliation(s)
- Wil H E Buntinx
- Governor Kremers Center, Maastricht University Medical Center, Maastricht, The Netherlands.
| | - In Yu Tan
- Epilepsy Center Kempenhaeghe, Heeze, The Netherlands
| | - Albert P Aldenkamp
- Epilepsy Center Kempenhaeghe, Heeze, The Netherlands; Maastricht University Medical Center, Maastricht, The Netherlands
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Mahendran M, Speechley KN, Widjaja E. Systematic review of unmet healthcare needs in patients with epilepsy. Epilepsy Behav 2017; 75:102-109. [PMID: 28843210 DOI: 10.1016/j.yebeh.2017.02.034] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2016] [Revised: 02/06/2017] [Accepted: 02/13/2017] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Patients with epilepsy (PWE) are more likely to have unmet healthcare needs than the general population. This systematic review assessed the reasons for unmet needs in PWE. METHODS Medline, Embase, PsycINFO, Cochrane, and Web of Science databases were searched using keywords relating to unmet healthcare needs, treatment barriers, and access to care. The search included all countries, adult and pediatric populations, survey and qualitative studies, but excluded non-English articles and articles published before 2001. Reasons for unmet needs were extracted. RESULTS Nineteen survey and 22 qualitative studies were included. Three survey and five qualitative studies excluded patients with comorbidities. There were twice as many studies on unmet mental healthcare needs than unmet physical care needs in PWE. Poor availability of health services, accessibility issues, and lack of health information contributed to unmet needs in both Western and developing countries. Lack of health services, long wait lists, uncoordinated care, and difficulty getting needed health information were prevalent in the United States (US) as well as countries with a universal healthcare system. However, unmet needs due to costs of care were reported more commonly in studies from the US. SIGNIFICANCE This systematic review identified reasons for unmet needs in PWE across different countries, which will inform specific interventions required to address these unmet needs. Unmet needs may have been underestimated due to exclusion of PWE with comorbidities in some studies. Additional studies are needed to understand the contribution of comorbidities on unmet needs and their interaction with caregiver and family factors.
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Affiliation(s)
- Mayuri Mahendran
- Department of Epidemiology & Biostatistics, Schulich School of Medicine and Dentistry, Western University, Kresge Building, Room K201, London, Ontario N6A 5C1, Canada
| | - Kathy N Speechley
- Department of Epidemiology & Biostatistics, Schulich School of Medicine and Dentistry, Western University, Kresge Building, Room K201, London, Ontario N6A 5C1, Canada; Department of Paediatrics, Western University, London, Ontario, Canada; Children's Hospital, 800 Commissioners Road East, Rm B1-437, London, Ontario N6A 5W9, Canada
| | - Elysa Widjaja
- Division of Neurology, Hospital for Sick Children, 555 University Avenue, Toronto, Ontario M5G 1X8, Canada; Diagnostic Imaging, Hospital for Sick Children, 555 University Avenue, Toronto, Ontario M5G 1X8, Canada.
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12
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Myers L, Lancman M, Laban-Grant O, Lancman M, Jones J. Socialization characteristics in persons with epilepsy. Epilepsy Behav 2017; 72:99-107. [PMID: 28575775 DOI: 10.1016/j.yebeh.2017.04.036] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2016] [Revised: 03/16/2017] [Accepted: 04/22/2017] [Indexed: 10/19/2022]
Abstract
OBJECTIVE The purpose of this report was to describe social behaviors and preferences in adults with epilepsy, including self-reported use of various socialization media (face-to-face and indirect communication) as well as perceived social barriers. METHODS 1320 consecutive persons with epilepsy (PWEs) confirmed through inpatient video-EEG monitoring were administered a questionnaire on the day of their first appointment. The questionnaire was designed to assess preferences in socialization practices, frequency of interpersonal contact, use of social media, and perceived barriers to socialization. The survey was developed to gain a better understanding of the socialization behaviors and preferences of our patients for the future development of customized activities in our wellness program. RESULTS Our sample revealed higher rates of unemployment and single status as compared to the US Census of 2012. With regard socialization however, many were quite social (86% reported daily/weekly communication with friends and family via telephone, 71% saw relatives in person weekly, 68% saw friends weekly, and 65% reported using the computer daily/weekly to socialize). Facebook® was the preferred on-line social media. Indoor/solitary activities were most common with 63% stating they watch TV/read/use the computer followed by physical exercise and spending time outdoors (36%). The frequency of socialization with friends, relatives, and coworkers decreased with the respondents' age and the longer the respondent had carried the diagnosis of epilepsy. Respondents who were taking a greater number of AEDs or were considered refractory were less likely to consider participating in socialization-enhancing activities. The primary barriers to socialization that respondents endorsed were driving prohibition and medication side-effects. Respondents expressed the greatest interest in online support groups or educational programs (31%), office-based support groups (25%), and volunteering (19%). CONCLUSION Although the respondents indicate that they do face barriers to socialization, a majority report frequent communication with relatives and friends via phone, in-person and social media. When designing wellness interventions with this group of patients in the future, online, as well as face to face options for support appear to be desired by a number of PWEs.
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Affiliation(s)
- Lorna Myers
- Northeast Regional Epilepsy Group, United States.
| | | | | | | | - Jace Jones
- Northeast Regional Epilepsy Group, United States
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13
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Crooks RE, Bell M, Patten SB, Wiebe S, Holroyd-Leduc J, Bulloch AG, Macrodimitris S, Mackie A, Sauro KM, Federico P, Jetté N. Mind the gap: Exploring information gaps for the development of an online resource hub for epilepsy and depression. Epilepsy Behav 2017; 70:18-23. [PMID: 28407525 DOI: 10.1016/j.yebeh.2017.03.005] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2016] [Revised: 01/27/2017] [Accepted: 03/05/2017] [Indexed: 10/19/2022]
Abstract
PURPOSE Depression is common in epilepsy, and is often under-detected and under-treated. The motivation to create a depression eHub for persons with epilepsy is to connect them to the best available online resources to effectively manage their depression. The study sought to: 1) identify facilitators and barriers to accessing resources related to management of epilepsy and/or depression and 2) discuss gaps in available resources (free and in the public domain) and 3) identify suggestions for future content. METHODS Semi-structured interviews were conducted with ten patients with epilepsy and a history of depression. Using inductive analysis, two team members engaged in a process of textual open-coding utilizing a conventional content analysis approach whereby content was conceptually clustered based on the research questions. A phenomenological framework was applied to describe the phenomenon of online health resource access and utilization from the perspective of people with epilepsy. RESULTS Facilitators to the use of online resources included information credibility, thoughtful organization, and accessibility of resources. Barriers included difficulties finding and piecing together information from many different sites. Patients reported difficulty having the motivation to seek out resources while depressed, which was compounded by feelings of stigma, social isolation, and lack of control. Gaps in resources included a lack of information about living with epilepsy day-to-day and resources for family and friends. Suggested content included information to raise awareness about epilepsy and depression; questionnaires to screen for symptoms of depression; stories of other patients with epilepsy and depression via video or moderated forums; current research and news; local community resources; and tools and strategies to manage depression in epilepsy. CONCLUSIONS There is a gap in accessible resources for patients with epilepsy and depression as well as barriers that include epilepsy-related restrictions, depression-related impairments, lack of awareness, and stigmatization. These results should be used to guide the development of e-Health resources for patients with epilepsy.
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Affiliation(s)
- Rachel E Crooks
- Department of Clinical Neurosciences, Cumming School of Medicine, University of Calgary, Room 1195, Foothills Hospital, 1403-29 Street NW, Calgary, Alberta T2N 2T9, Canada; Hotchkiss Brain Institute, Cumming School of Medicine, University of Calgary, Health Research Innovation Centre, Room 1A10, 3330 Hospital Drive NW, Calgary, Alberta T2N 4N1, Canada
| | - Meaghan Bell
- Department of Clinical Neurosciences, Cumming School of Medicine, University of Calgary, Room 1195, Foothills Hospital, 1403-29 Street NW, Calgary, Alberta T2N 2T9, Canada; Hotchkiss Brain Institute, Cumming School of Medicine, University of Calgary, Health Research Innovation Centre, Room 1A10, 3330 Hospital Drive NW, Calgary, Alberta T2N 4N1, Canada
| | - Scott B Patten
- Hotchkiss Brain Institute, Cumming School of Medicine, University of Calgary, Health Research Innovation Centre, Room 1A10, 3330 Hospital Drive NW, Calgary, Alberta T2N 4N1, Canada; Department of Community Health Sciences & O'Brien Institute for Public Health, Cumming School of Medicine, University of Calgary, 3rd Floor TRW Building, 3280 Hospital Drive NW, Calgary, AB T2N 4Z6, Canada; The Mathison Centre for Mental Health Research & Education, Cumming School of Medicine, University of Calgary, TRW Building, 3280 Hospital Drive NW, Calgary, Alberta T2N 4Z6, Canada; Department of Psychiatry, Cumming School of Medicine, University of Calgary, 1403-29 Street NW, Calgary, Alberta T2N 2T9, Canada
| | - Samuel Wiebe
- Department of Clinical Neurosciences, Cumming School of Medicine, University of Calgary, Room 1195, Foothills Hospital, 1403-29 Street NW, Calgary, Alberta T2N 2T9, Canada; Hotchkiss Brain Institute, Cumming School of Medicine, University of Calgary, Health Research Innovation Centre, Room 1A10, 3330 Hospital Drive NW, Calgary, Alberta T2N 4N1, Canada; Department of Community Health Sciences & O'Brien Institute for Public Health, Cumming School of Medicine, University of Calgary, 3rd Floor TRW Building, 3280 Hospital Drive NW, Calgary, AB T2N 4Z6, Canada
| | - Jayna Holroyd-Leduc
- Hotchkiss Brain Institute, Cumming School of Medicine, University of Calgary, Health Research Innovation Centre, Room 1A10, 3330 Hospital Drive NW, Calgary, Alberta T2N 4N1, Canada; Department of Community Health Sciences & O'Brien Institute for Public Health, Cumming School of Medicine, University of Calgary, 3rd Floor TRW Building, 3280 Hospital Drive NW, Calgary, AB T2N 4Z6, Canada; Department of Medicine, Cumming School of Medicine, University of Calgary, 1403-29 Street NW, Calgary, Alberta T2N 2T9, Canada
| | - Andrew G Bulloch
- Hotchkiss Brain Institute, Cumming School of Medicine, University of Calgary, Health Research Innovation Centre, Room 1A10, 3330 Hospital Drive NW, Calgary, Alberta T2N 4N1, Canada; Department of Community Health Sciences & O'Brien Institute for Public Health, Cumming School of Medicine, University of Calgary, 3rd Floor TRW Building, 3280 Hospital Drive NW, Calgary, AB T2N 4Z6, Canada; The Mathison Centre for Mental Health Research & Education, Cumming School of Medicine, University of Calgary, TRW Building, 3280 Hospital Drive NW, Calgary, Alberta T2N 4Z6, Canada; Department of Psychiatry, Cumming School of Medicine, University of Calgary, 1403-29 Street NW, Calgary, Alberta T2N 2T9, Canada
| | - Sophia Macrodimitris
- Department of Psychiatry, Cumming School of Medicine, University of Calgary, 1403-29 Street NW, Calgary, Alberta T2N 2T9, Canada
| | - Aaron Mackie
- Department of Psychiatry, Cumming School of Medicine, University of Calgary, 1403-29 Street NW, Calgary, Alberta T2N 2T9, Canada
| | - Khara M Sauro
- Department of Clinical Neurosciences, Cumming School of Medicine, University of Calgary, Room 1195, Foothills Hospital, 1403-29 Street NW, Calgary, Alberta T2N 2T9, Canada; Hotchkiss Brain Institute, Cumming School of Medicine, University of Calgary, Health Research Innovation Centre, Room 1A10, 3330 Hospital Drive NW, Calgary, Alberta T2N 4N1, Canada; Department of Community Health Sciences & O'Brien Institute for Public Health, Cumming School of Medicine, University of Calgary, 3rd Floor TRW Building, 3280 Hospital Drive NW, Calgary, AB T2N 4Z6, Canada
| | - Paolo Federico
- Department of Clinical Neurosciences, Cumming School of Medicine, University of Calgary, Room 1195, Foothills Hospital, 1403-29 Street NW, Calgary, Alberta T2N 2T9, Canada; Hotchkiss Brain Institute, Cumming School of Medicine, University of Calgary, Health Research Innovation Centre, Room 1A10, 3330 Hospital Drive NW, Calgary, Alberta T2N 4N1, Canada
| | - Nathalie Jetté
- Department of Clinical Neurosciences, Cumming School of Medicine, University of Calgary, Room 1195, Foothills Hospital, 1403-29 Street NW, Calgary, Alberta T2N 2T9, Canada; Hotchkiss Brain Institute, Cumming School of Medicine, University of Calgary, Health Research Innovation Centre, Room 1A10, 3330 Hospital Drive NW, Calgary, Alberta T2N 4N1, Canada; Department of Community Health Sciences & O'Brien Institute for Public Health, Cumming School of Medicine, University of Calgary, 3rd Floor TRW Building, 3280 Hospital Drive NW, Calgary, AB T2N 4Z6, Canada.
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14
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Helmers SL, Kobau R, Sajatovic M, Jobst BC, Privitera M, Devinsky O, Labiner D, Escoffery C, Begley CE, Shegog R, Pandey D, Fraser RT, Johnson EK, Thompson NJ, Horvath KJ. Self-management in epilepsy: Why and how you should incorporate self-management in your practice. Epilepsy Behav 2017; 68:220-224. [PMID: 28202408 PMCID: PMC5381244 DOI: 10.1016/j.yebeh.2016.11.015] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2016] [Accepted: 11/07/2016] [Indexed: 11/29/2022]
Affiliation(s)
| | - Rosemarie Kobau
- Centers for Disease Control and Prevention, Epilepsy Program, Atlanta, GA.
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15
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Successful health communication in epileptology. Seizure 2017; 44:7-10. [DOI: 10.1016/j.seizure.2016.10.005] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2016] [Accepted: 10/03/2016] [Indexed: 11/23/2022] Open
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16
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Wagner JL, Ferguson PL, Kellermann T, Smith G, Brooks B. Behavioral health referrals in pediatric epilepsy. Epilepsy Res 2016; 127:72-77. [PMID: 27565414 DOI: 10.1016/j.eplepsyres.2016.08.017] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2015] [Revised: 07/28/2016] [Accepted: 08/14/2016] [Indexed: 10/21/2022]
Abstract
The purpose of this study was to examine the feasibility of a behavioral health referral protocol and barriers to behavioral health care in a pediatric epilepsy clinic. A sample of 93 youth with epilepsy ages 10-17 and caregivers completed behavioral health and seizure severity measures during a routine epilepsy clinic visit. Key findings are that 47 (50.5%) of the youth screened positive for a behavioral health referral, and 35 of these youth were referred for behavioral health services. However, only 20% made and presented for the behavioral health appointment. The most commonly cited barrier for accessing and utilizing behavioral health care was stigma related- a mental health label for the child. The significance of this study lies in the revelation that solely screening for and educating caregivers about behavioral health symptoms and providing behavioral health referral information is not an ideal model. Instead, stigma related barriers point to the necessity of continued integrated physical and behavioral health care within the pediatric epilepsy visit.
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Affiliation(s)
- Janelle L Wagner
- College of Nursing, Medical University of South Carolina, Charleston, SC, USA; Comprehensive Epilepsy Program, Medical University of South Carolina, Charleston, SC, USA; Department of Pediatrics, Medical University of South Carolina, Charleston, SC, USA.
| | - Pamela L Ferguson
- Division of General Surgery, Medical University of South Carolina, Charleston, SC, USA
| | - Tanja Kellermann
- Department of Neurosciences, Medical University of South Carolina, Charleston, SC, USA
| | - Gigi Smith
- College of Nursing, Medical University of South Carolina, Charleston, SC, USA; Comprehensive Epilepsy Program, Medical University of South Carolina, Charleston, SC, USA; Department of Pediatrics, Medical University of South Carolina, Charleston, SC, USA
| | - Byron Brooks
- Department of Psychology, East Tennessee State University, Johnson City, TN, USA
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