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

The evaluation of the training, "the approach to epilepsy and epileptic seizure," which was given to teachers in Türkiye

INTRODUCTION

Epilepsy is the most common neurological disorder among humans after headaches. According to the World Health Organization, approximately 50-65 million individuals were diagnosed with epilepsy throughout the world, and around two million new cases of epilepsy are added to this figure every year.

METHODS

Designed as descriptive and cross-sectional research, this study was performed on 132 elementary school teachers. Training on epilepsy and epileptic seizure was given to teachers. The pretest and posttest research data were collected with the face-to-face interview method. In this process, the epilepsy knowledge scale was used as well as a survey form that had questions designed to find out about teachers' personal characteristics. The Statistical Package for Social Science 25.0 was utilized in the statistical analysis of research data. In the research, the statistical significance was identified if the p-value was below.05 (p < .05).

RESULTS

Of all teachers participating in the study, 59.1% were female, 90.2% were married, and 47.7% witnessed an epilepsy seizure before. The mean of teachers' pretest epilepsy knowledge scores was 8.43 ± 4.31 points before the training while the mean of their posttest epilepsy knowledge scores was 12.65 ± 2.48 points after the training. The difference between the means of pretest and posttest scores was statistically significant (p = .000). After the training, there was a statistically significant increase in means of scores obtained by teachers from each item of the epilepsy knowledge scale (p < .05).

CONCLUSIONS

As there was a statistically significant improvement in levels of teachers' knowledge about both epilepsy and epileptic seizure after the training, it is recommended that the training about the approach to epilepsy and epileptic seizure be given to all teachers, and additionally, including these topics in the course curricula of universities is recommended.

Teachers' Negative Attitudes and Limited Health Literacy Levels as Risks for Low Awareness of Epilepsy in Turkey

OBJECTIVES

For students with epilepsy, schools are a critical environment for managing the disease properly. This study examined awareness of epilepsy, attitudes toward epilepsy, and health literacy among school teachers in Turkey.

METHODS

This study was conducted in a city in Turkey with 1408 public school teachers from June 2021 to September 2021.

RESULTS

The median scores of the scales were 5, 29, and 32 for epilepsy awareness, epilepsy attitudes, and health literacy, respectively. Epilepsy awareness was higher in women, and epilepsy attitudes were more positive in women than men (p<0.05). While epilepsy awareness was higher in primary school teachers, epilepsy attitudes were more positive in secondary school teachers (p<0.05). Epilepsy awareness was lower in secondary school teachers (odds ratio [OR], 1.27; p<0.05), those who did not have an individual with epilepsy in their family/social environment (OR, 1.57; p<0.001), those who did not have a student with epilepsy in their class (OR, 1.45; p<0.05), and in those who had not witnessed an epilepsy seizure (OR,1.19; p<0.05). Compared to those with positive attitudes regarding epilepsy, epilepsy awareness was 1.36 times lower in those with negative attitudes (p<0.001). Epilepsy awareness was 1.92 times lower in those with limited health literacy than those with adequate health literacy (p<0.001).

CONCLUSIONS

In this study, low epilepsy awareness, negative epilepsy attitudes, and limited health literacy were common among teachers. The findings from this study suggest that panels, workshops, and health training on epilepsy should be organized for school teachers and included at regular intervals in certified first-aid practices.

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

OBJECTIVE

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

METHODS

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

RESULTS

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

CONCLUSIONS

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

Epilepsy Smart Schools: Educational intervention improves knowledge, attitude, and practices regarding epilepsy among school teachers

INTRODUCTION

Discrimination and stigma associated with epilepsy in schools impact the academic and mental aptitude of children with epilepsy. Teachers pre-sensitized to seizures exhibit a positive attitude along with better knowledge about epilepsy. The aim was to assess the impact of an interactive one-day educational workshop regarding epilepsy on the prevalent knowledge, attitude, and practices toward epilepsy among school teachers.

METHODS

Conducted in December 2021 in a tertiary care teaching hospital of rural background in Northern India, this cross-sectional study included school teachers from government schools of Faridkot district of Punjab. The intervention consisted of a one-day interactive workshop on epilepsy and school health consisting of 100 minutes of lectures (4 lectures each of 25 minutes), 60 minutes of role plays, and 20 minutes of active discussion with participants (5 minutes after each session). The lectures were prepared using World Health Organization's Mental Health Gap (WHO's mhGAP) guidelines and elucidated knowledge regarding epilepsy and skills to provide first aid to seizures. School teachers were assessed on a pre and post-test structured questionnaire to assess their knowledge of, attitude, and practices regarding epilepsy before and immediately after the intervention.

RESULTS

Two hundred and thirty teachers participated and the majority were from government primary schools, mean age was 43 ± 7 years and females (n = 121,53%) outnumbered males. Commonly reported sources of information regarding epilepsy by school teachers were family and friends (n = 91,40%) followed by social (n = 82, 36%) and public media (n = 81,35%), and the least common were doctors (n = 56,24%) and healthcare workers (n = 29, 13%). Fifty-six percent (n = 129) had witnessed seizures in either a stranger(n = 84,37%), family, or friend (n = 31,13%) and student of their class(n = 14,6%). Post-educational intervention, significant improvement was seen in the knowledge of and attitude regarding epilepsy including recognizing subtle features of epilepsy like blank stare (pre/post = 5/34) and transient change in behavior (pre/post = 16/32), non-contagiousness of epilepsy (pre/post = 158/187)and belief that children with epilepsy have normal intelligence (pre/post = 161/191) and a significant decrease in a number of teachers who thought that they need more time and attention in class (pre/post = 181/131). Post-educational sessions, significantly more number of teachers would allow children with epilepsy in their classroom (pre/post = 203/227), follow correct ways to provide first aid for seizures, and would allow their participation in all extracurricular activities even in high-risk outdoor games like swimming (pre/post = 4/36) and deep sea diving (pre/post = 7/18).

CONCLUSION

The educational intervention had a positive impact on the knowledge, practices, and attitude regarding epilepsy but had a few, unexpected reverse effects as well. A single workshop may not be aptly adequate to provide accurate information regarding epilepsy. Sustained efforts in this direction are needed at the national and global level to develop the concept of "Epilepsy Smart Schools".

Self-Disclosure Patterns Among Children and Youth with Epilepsy: Impact of Perceived-Stigma

This review aimed to synthesize the minimal existing literature on the impact of perceived stigma on self-disclosure patterns among children and youth with epilepsy (YWE). Initial literature searches were conducted in PsycInfo, Scopus, Web of Science, and PubMed using search terms focused on epilepsy, pediatrics, disclosure, and/or stigma. Articles were included if they were original human research articles published in peer-reviewed journals that were accessible in English through Cincinnati Children's Hospital Medical Center Pratt Library and fit study aims. Thirteen articles, which primarily used qualitative self-report methodologies, fit the study's inclusion criteria. YWE report greater perceived stigma and lower illness disclosure compared to youth with other chronic health conditions. Across studies, perceived stigma was consistently identified as a barrier to YWE disclosing their epilepsy diagnosis. Consequences of perceived stigma included lower self-esteem, poorer perceived competency, lack of self-confidence, social withdrawal, and lower quality of life. YWE's reluctance to disclose epilepsy was associated with worry about differential treatment, negative impact on close relationships, negative impact on others' perceptions, and negative self-perceptions. While WHO and ILAE have identified stigma as contributing to higher disease burden in people with epilepsy and have highlighted the importance of prioritizing social policy focused on decreasing epilepsy-related stigma, progress has been incremental and much work remains. Future research is needed to understand socio-cultural factors perpetuating stigma among YWE in order to further develop, evaluate, and disseminate evidence-based clinical and education programming to combat epilepsy-related stigma.

Knowledge of Epilepsy and seizure first aid among teachers in Jeddah, Saudi Arabia

PURPOSE

Epilepsy is one of the most common neurological disorders, with a national prevalence of 6.54/1000. The majority of the patients are adolescents and at risk of experiencing a seizure in school. Consequently, schoolteachers would be among the first health care providers. Thus, teachers' knowledge and practice are imperative for the students' safety and development. We aimed to assess the knowledge of epilepsy and seizure first aid among teachers at all educational levels in Jeddah, Saudi Arabia.

METHOD

A cross-sectional study using a self-administered validated questionnaire was distributed to teachers to assess their necessary demographic data and their knowledge about epilepsy and seizure first aid by using Chi-square test to find significant associations.

RESULTS

Our sample included 822 teachers, 54.1% of the respondents were male, and 45.7% female. The majority of participants had moderate knowledge of epilepsy and lacked first aid training. Most participants recognized epilepsy as a neurological disorder, and 42.2% have witnessed a seizure in school. Our study showed a significant relationship between knowledge score and qualification (P-value = 0.037) as well as knowledge score and witnessing a seizure (P-value = 0.046).

CONCLUSION

The knowledge score shows that teachers in Jeddah have moderate knowledge of epilepsy, and approximately one-tenth have taken first aid training. We recommend educational campaigns on epilepsy and first aid courses targeting students and teachers in schools.

Teachers' experiences of managing children with epilepsy in school: A qualitative study

BACKGROUND

School is the second most important environment for children second to the family. An increasing number of children with epilepsy (CWE) are able to go back to school to continue to study after treatment. In school, CWE can be involved in studies and activities, which is conducive to their growth. However, CWE have to face more barriers than other children in school, such as cognitive impairment, poor attendance, school absenteeism, and learning disability. What is more, even if CWE have been taking antiepileptic medicines, they still have a risk of seizure. Therefore, it is important to ensure the safety of CWE in the school. Teachers play a significant part in managing CWE in school, so we aimed to deeply explore the experiences of school teachers in managing CWE during school.

METHOD

Purposive sampling was used to recruit teachers (n = 17) who cared for children with epilepsy in their class. Semi-structured interviews were used to access qualitative data. Framework analysis was used to analyze qualitative data.

RESULT

Five major themes emerged after analyzing: the recognition of epilepsy, the attitude to children with epilepsy, the barriers to communicate with parents about epilepsy, the reaction to a seizure, and the need for training.

CONCLUSION

The findings of this qualitative study reported teachers' knowledge of and attitude toward epilepsy, the barriers for them to communicate with parents, the reaction to seizure, and the need for training. Although teachers know little about epilepsy, they have a positive attitude toward CWE. There are many obstacles in terms of the communication between teachers and parents. Parents' cover-ups and teachers' lack of professional training will put teachers and CWE at risk. In view of the fact that teachers and parents are not professionals, it is necessary for hospitals to play a coordinating role between the two.

Brief video enhances teacher trainees' knowledge of epilepsy

OBJECTIVE

Relative to the general population, children with epilepsy (CWE) demonstrate difficulties in aspects of cognition and mental health. Previous studies have found that teachers have poor knowledge about epilepsy, which may lead to inadequate management of CWE's comorbidities and seizures, potentially impacting CWE's school performance, social development, and safety. The current study aimed to evaluate whether a brief training program improves teachers' epilepsy knowledge.

METHOD

Participants included pre-service teachers enrolled in the Faculty of Education at Western University (London, Ontario, Canada). There were no exclusion criteria. Pre-service teachers completed a questionnaire evaluating their experiences and knowledge of epilepsy prior to, and two weeks following, the training program. The training program consisted of a 10.5-min video and booklet that described the characteristics of seizures, seizure first aid, and the cognitive, psychological, and social consequences of epilepsy.

RESULTS

Pre-service teachers' knowledge about epilepsy, seizure safety, and common comorbidities associated with epilepsy significantly improved after participating in the training program. Furthermore, pre-service teachers indicated greater self-reported knowledge about epilepsy and greater preparedness to handle a seizure in the classroom.

CONCLUSION

The results of the current study demonstrated that a brief, cost-effective training program significantly enhances teachers' knowledge about epilepsy, seizure safety, and the comorbidities associated with epilepsy. Enhancing teachers' knowledge about epilepsy has the potential to improve children's academic and social success in school.

Nurse teachers’ knowledge about epilepsy and communication issues between schools and medical institutions: A nationwide questionnaire survey in Japan

Objective

Methods

Results

Significance

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

PURPOSE

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

OBJECTIVES

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

MATERIAL AND METHODS

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

RESULTS

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

CONCLUSION

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

WITHDRAWN: Teachers and epilepsy: What they know, do not know, and need to know: A cross-sectional study of Taif City

This article has been withdrawn at the request of the author(s) and/or editor. The Publisher apologizes for any inconvenience this may cause. The full Elsevier Policy on Article Withdrawal can be found at https://www.elsevier.com/about/our-business/policies/article-withdrawal.

Who is the bigger stigmatizor?: The loved one or the society

OBJECTIVE

Epilepsy has long been considered by the society as a dangerous and frightening spiritual possession or even a contagious disease. This results in an unavoidable embarrassment for both the patient and the family leading to social isolation, seclusion, and secretiveness about the diagnosis. The aim of this study was to determine the stigmatizing level of the general Turkish population and to compare these results with the stigmatizing level of the patients' relatives group (PRG).

METHODS

This is a substudy of our main study which aimed to develop two scales for the quantification of the stigma level in patients with epilepsy (PWE) and their relatives [Stigma Scale for Epilepsy (SSE) -Self Report (SR) and -Informant Report (IR)]. First-degree relatives of the patients had been included in the main study. For the present study, 202 healthy people who were caregivers and relatives of neurologic patients other than epilepsy were recruited for the control group (CG). A sociodemographic and clinical data form and SSE-IR scale were administered to the CG as well. The relationship between sociodemographic characteristics and SSE-IR scores was evaluated, and a regression analysis was performed in order to analyze sociodemographic factors contributing to SSE-IR scores. Stigmatizing levels were compared between PRG and CG. Statistical analysis was performed using Statistical Package for the Social Sciences version 22.0 software.

RESULTS

Comparison of stigma scores among different sociodemographic strata of the CG showed that there was a statistically significant difference in terms of educational status and occupation (p < 0.01). Multivariate linear regression analysis revealed that education accounted for 10.8% and 8.9% of the variance in the SSE-IR scale respectively in the PRG and the CG. Prejudgment scores and total scores of the PRG were significantly higher than those of the CG. There was no statistically significant difference between two groups in terms of discrimination and false beliefs subscales scores. The proportion of highly stigmatizor participants in the PRG was statistically significantly higher than that of the CG.

DISCUSSION/CONCLUSIONS

This study showed us that the stigmatization levels in a group of subjects drawn from general population without acquaintance of epilepsy were lower than the relatives of the patients. This result may be partially explained by the ambivalent attitudes of the relatives, as those high scores may stem from not only enacted but also the felt stigma that they were experiencing themselves. It must be a warning sign for both of all the clinicians treating epilepsy and national association against epilepsy, as well as public health officials to increase efforts for awareness raising.

What Saudi teachers know about epilepsy: A cross-sectional study of Tabuk City

PURPOSE

This study was conducted to evaluate awareness, knowledge, and attitudes of teachers toward the disease in Tabuk City in north Saudi Arabia and identify areas in which training and education are required.

METHOD

Data were collected from 349 school teachers using a structured 28-item questionnaire. Data were collected between December 2017 and May 2018 in Tabuk City.

RESULTS

In general, the study shows a negative trend in knowledge and attitude toward epilepsy. The majority of the participants (84%) have read or heard about epilepsy, and more than half (67%) had witnessed a seizure. Epilepsy was considered contagious and psychological by 1.7% and 56%, respectively. Regarding attitude, 68% would not approve a son/daughter marriage to a person with epilepsy. This attitude correlates to the level of education as the percentage is higher for those who hold a Bachelor's or Master's degree, p < 0.05. Even though 84% of the participants reported knowing how to help a patient during a seizure, the majority of the participants had incorrect procedures, holding the legs and arms and believing that smelling onions is helpful to end the seizure. Moreover, almost half of the participants (46%) believed that a person with epilepsy cannot be successful in high-ranking professions. This belief was found to be more common in females than their counterparts, p < 0.05.

CONCLUSION

School teachers' knowledge about epilepsy needs improvement. A focus on educational interventions about epilepsy are needed to develop a well-informed and tolerant community.

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

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

Knowledge, attitudes, and first-aid measures about epilepsy among primary school teachers in northern Iran

OBJECTIVE

To assess knowledge, attitudes, and first-aid measures about epilepsy among primary school teachers.

METHOD

This cross-sectional study was conducted with participation of 342 primary school teachers during September 2016 to January 2017 in cities of Babol and Qaem-Shahr in Mazandaran Province in northern Iran. Primary schools were selected using simple random sampling. Data were collected through interviews using a structured questionnaire. The knowledge section included general knowledge, causes, symptoms, seizure triggers, first-aid measures, and recommended treatments. The Likert scale was used for the attitudes section. Answers about first-aid measures were categorized as helpful or harmful.

RESULTS

The level of total knowledge score of 25 (7.7%) teachers was very high, 140 (43.3%) high, 141 (43.8%) moderate, and 17 (5.2%) low. The mean score about general knowledge was as follows: 6.1 (1.9), range = 0-9; causes 6.3 (1.9), range = 0-10; symptoms of seizures 8.5 (2.5), range = 0-12; and first-aid measures 6.8 (2.0), range = 0-11. Some 83% knew not taking anticonvulsants regularly could trigger seizures, and all teachers said a person with epilepsy should go see a physician. Attitudes were generally positive except for marriage and having children. The level of first-aid measures score of 8 (7.2) teachers was very high, 79 (70.5) high, 25 (22.3) low. Teachers with teaching experience at special schools took more helpful measures CONCLUSIONS: The knowledge of teachers about epilepsy was insufficient, attitudes toward people with epilepsy were generally positive, and first-aid measures at the last witnessed seizure were fairly helpful. Having teaching experience in special schools had a positive influence over knowledge and taking appropriate first-aid measure at time of the last witnessed seizure.

The challenges that parents of children with epilepsy face: A qualitative study

OBJECTIVE

This qualitative study explored the challenges that Greek parents/caregivers of children with controlled epilepsy (CwE) face regarding the disorder.

METHODS

Interviews were conducted based on open-ended questions guided by a review of the literature. A total of 91 parents/caregivers were recruited by neurologists at the neurology clinics of two Athens public hospitals. A hermeneutic phenomenological approach was used to explore parent/caregiver experiences. The data were grouped and analyzed through a textual interpretation.

RESULTS

Two key challenges were identified for parents of CwE: the disclosure of epilepsy and the absence of adequate information about coping with epilepsy. Parents in Greece were hesitant to reveal their child's epilepsy to school staff and their wider social milieu. Also, although satisfied with the patient-centered approach they experienced with their hospital doctor, parents/caregivers found that they needed more education about the existing sources of psychosocial and emotional support to cope with their child's epilepsy personally and as a family. Finally, the parents/caregivers who let their child know about the epilepsy and discussed the implications with the child found that parent-child communication improved.

CONCLUSION

This study provides valuable insight into the impact of epilepsy on parents of CwE, which might help hospital and school staff support families with greater understanding, sensitivity, and skill. The findings suggest that Greek authorities should staff hospitals and schools with experts and more systematically advertise sources of information about epilepsy and ways to cope with it.