Psychometric evaluation of the Epilepsy-related Fears in Parents Questionnaire

The effect of illness-related fears of parents of children with epilepsy during the COVID-19 period on their children's seizure self-efficacy

BACKGROUND

Seizure-related self-efficacy is the belief individuals have that they can perform the necessary actions to cope effectively with their seizures. Determining, developing, strengthening, and maintaining the perception of self-efficacy in children with epilepsy facilitates the child's disease management and their ability to cope with it. This study aimed to assess the impact of epilepsy-related parental fears during the COVID-19 period on the seizure self-efficacy of their children.

METHODS

A total of 321 children with epilepsy and their parents participated in this descriptive, correlational, and cross-sectional study. Data were collected through the Descriptive Information Form, the Seizure Self-Efficacy Scale for Children (SSES-C), and the Epilepsy-Related Fears in Parents Questionnaire (EFPQ). Descriptive statistics, including frequency, percentage, and mean scores, were used to analyze the characteristics of the children and their parents. The Shapiro-Wilk test was utilized to assess the normality of the scale data. Pearson correlation analysis examined the relationship between parents' epilepsy-related fears and their children's seizure self-efficacy, while multiple regression analysis determined the effect of parental fears on children's seizure self-efficacy.

RESULTS

The mean age of children included in the study was 12.65±2.37 years. Analysis revealed a strong and significant negative correlation between parents' epilepsy-related fears during the COVID-19 period and the seizure self-efficacy of their children. In the model created with regression analysis, The mean scores of parents on the short-term fears of parents about epilepsy of the EFPQ explained 85 % of children's seizure self-efficacy. The mean scores of parents on the long-term fears of parents about epilepsy of the EFPQ explained 85 % of children's seizure self-efficacy. It was determined that all of these variables together explained 85 % of the seizure self-efficacy of children with epilepsy.

CONCLUSION

The findings of the study underscore the importance of addressing parents' fears regarding epilepsy, emphasizing the need for healthcare professionals to be aware of and provide support for these concerns. Future studies should focus on interventions to enhance the seizure self-efficacy of children with epilepsy.

Knowledge and Fears of Parents of Children Diagnosed with Epilepsy

PURPOSE

Describe the knowledge and fears of parents of children diagnosed with epilepsy in the hospital and clinic settings.

DESIGN AND METHODS

Descriptive, comparative study design. Knowledge was measured with the 16-item Epilepsy Knowledge Scale and epilepsy-related fears was operationalized by the Epilepsy-related Fears in Parents Questionnaire (EFPQ) addressing short and long-term fears. The sample included 40 parents of children diagnosed with epilepsy who were cared for on a pediatric ortho/neuro hospital unit (N = 27) or pediatric neurology clinic (N = 13).

RESULTS

Parents were middle aged adults (mean 39 years), mostly mothers with 80% college education. Their children ranged in ages from less than one to 18 years of age (Mean = 8.5) across a variety of ethnic backgrounds who were most often diagnosed with epilepsy at a young age (<1 year to 3 years). Percentage of correct answers ranged from 31% (5 correct) to 100% (16 correct); mean 12 correct or 75%. Subjects/parents were afraid! They had many fears: Short-term (possible range 8-40) with responses ranging from 9 to 40 (mean 28); Future/long-term (possible range 9-45) ranging from 9 to 45 (mean 32). They were afraid when their child is in the care of others - something might happen, and their child could die during a seizure. There was no statistically significant difference in responses between hospital or clinic parents.

DISCUSSION

Parents who participated in this study were knowledgeable but fearful with immediate and long term concerns.

PRACTICE IMPLICATIONS

Nurses need to provide verbal and written education materials. Address triggers. Talk to parents about their fears related to epilepsy. Identify parental support. Validate parents' skills in knowing what to do when their child has a seizure.

Psychometric Properties of the Turkish Version of the Epilepsy-Related Fears in Parents Questionnaire

PURPOSE

Epilepsy affects both children and their parents, as it is a chronic disease with recurrent seizures. Parents play a key role in acceptance of the diagnosis of epilepsy by the child and compliance of the child with its treatment. Therefore, the perceptions and experiences of parents about this process are critical. The Epilepsy-Related Fears in Parents Questionnaire is one such instrument, and it has been used to measure the epilepsy-related fear experienced by parents who had children with epilepsy in Germany. This study aimed to analyze the psychometric properties of the Epilepsy-Related Fears in the Parents Questionnaire in Turkey.

DESIGN AND METHODS

The study was conducted on 403 parents using a descriptive correlational method. The Sociodemographic Information Form and Epilepsy-Related Fears in Parents Questionnaire were used to gather data. Data analysis and evaluation were performed using factor analysis, Cronbach's alpha, and item-total score correlation.

RESULTS

Seventeen items were recorded on the main scale and other items on two subscales. The two subscales recorded a variance of 55.695%. Turkish Cronbach's alpha coefficient recorded a total of 0.929. Because of confirmatory factor analysis, the model fit index results were recorded as follows: 0.94 as the Goodness-of-Fit Index and 0.92 as the Comparative Fit Index.

CONCLUSIONS

The study determined that the Turkish version of the Epilepsy-Related Fears in Parents Questionnaire was a valid and reliable measurement tool.

PRACTICE IMPLICATIONS

All health professionals can use this scale to evaluate fears of parents who have children diagnosed with epilepsy.

Pilot trial of "Epi-school" group psychosocial education program for patients with epilepsy and their relatives in Japan

INTRODUCTION

In epilepsy treatment, it is important for patients with epilepsy (PWE) to have accurate knowledge of epilepsy and to actively engage in treatment. In Japan, there are a few facilities for implementing learning programs for PWE, and their long-term usefulness has not been established. We conducted a pilot group psychosocial education program for PWE and their relatives in Japan.

METHODS

Participants were PWE and their relatives who were 18 years old or older, were able to consent to participate in the study, and who were visiting the outpatient clinic of Saitama Medical Center from September 2019 to March 2020. As an intervention, we created a psychosocial educational program called "Epi-school" for PWE and their relatives, consisting of three sessions. Outcomes included patients' quality of life (QOL) measured with the epilepsy-31-P (QOLIE-31P), Rosenberg self-esteem scale (RSES), Stigma scale for chronic neurological disease (SSCI-8), and Epilepsy knowledge scale, before and after Epi-school. In addition, in a free-form questionnaire, we collected the impressions of patients and their relatives regarding the experience of participating in a group psychosocial education program.

RESULTS

We examined 11 patients (two males, nine females) and 12 relatives (four males, eight females) who participated in Epi-school during the target period. The analyses revealed that only the scales measuring knowledge about epilepsy in the effect index showed significant increases in both patients and relatives after the program compared with before the program (patients: F [1,5.30] = 13.65, P < .05; relatives: F [1,4] = 17.50, P < .05). Moreover, a large effect size (d = 0.85) was obtained in patients, and a large effect size (d = 1.03) was obtained in relatives. In the open-ended questionnaire after participating in Epi-school, respondents reported changes in the psychological state of patients in the "learning epilepsy knowledge and coping methods", including changes in "acquired knowledge of illness" and "acquisition of coping with psychological aspects". Furthermore, it reports of "discovery/surprise", "thanks to medical staff", "interaction with other patients/relatives", and "new anxiety". In addition, "positive thoughts on treatment", "hopes for the future", "expectations for interaction with medical staff", "expectations for interaction with colleagues with the same disease", and "coming out of epilepsy" were reported. Regarding the psychological state of relatives after participating in Epi-school, it revealed "thanks to medical staff", "interactions with other patients/relatives", and "awareness of and remarks about other patients' statements". The results also revealed responses including "positive thoughts about treatment", "expectations of medical care", and "expectations of the community".

DISCUSSION

The results confirmed that Epi-school led to improved knowledge, and psychological changes, including improved QOL and positive acceptance of epilepsy. Participants' awareness about epilepsy appeared to improve through encounters with other participants' attitudes toward epilepsy, possibly changing via the ways participants interacted. It is important to promote understanding of epilepsy, enhance the effects of treatment, and reduce psychosocial restrictions.

CONCLUSIONS

Epi-school may be useful as part of epilepsy treatment to improve the QOL of PWE by making it easier for patients and their relatives to develop acceptance of living with epilepsy. The main limitation in the current study was the small sample size and the lack of a control group. In future studies, we plan to further investigate the usefulness of psychosocial education programs in Japan, including Epi-school, by increasing the sample size, including a control comparison, and collecting more comprehensive data. We hope that the current findings will encourage the provision of appropriate medical insurance funding for patient learning programs in Japan.

Designing and psychometric evaluation of disease-related fear scale (D-RFS) in adults with epilepsy: A sequential exploratory mixed methods design

BACKGROUND

Disease-related fear is one of the important diagnoses of healthcare providers in caring for people with epilepsy whose conceptual dimensions should be discovered and investigated. To this end, it is necessary to provide healthcare providers with appropriate tools to assess fears related to the disease in accordance with the sociocultural milieu of each community.

AIM

The purpose of this study was to design and psychometrically evaluate the disease-related fear scale (D-RFS) in adults with epilepsy.

METHODS

This study was of a sequential exploratory mixed methods design conducted in Iran in 2019. In the item generation phase, inductive (face-to-face, semi-structured interviews with 14 adult patients with epilepsy) and deductive (literature review) were used. In the item reduction, integration of qualitative and literature reviews and scale evaluation were performed. For the scale evaluation, face validity, content validity, construct validity [exploratory factor analysis (EFA) (n = 367) and confirmatory factor analysis (CFA) (n = 250)], and convergent and divergent validity and reliability (internal consistency and stability) were investigated.

RESULTS

After the qualitative phase and literature review, 40 items were codified. After investigation of the qualitative and quantitative face validity, 7 items were deleted. Two items were deleted due to content validity ratio (CVR) of less than 0.56 and one item due to content validity index (CVI) of less than 0.78. Finally, a 30-item scale was obtained, and its construct validity was assessed. Kaiser-Meyer-Olkin (KMO) index was 0.85, and Bartlett's test of sphericity was 7237.504, P < 0. 001. The results of CFA showed that the bivariate model of the D-RFS (fear of seizure consequences and fear of the disease's long-term consequences) had the most appropriate fitness to the data. Convergent and divergent validity results showed that the values of composite reliability (CR) and average variance extracted (AVE) for the two factors were greater than 0.7 and 0.5, respectively, and the AVE for each factor was greater than CR. Internal consistency of the first and second factors were obtained 0.891 and 0.910, respectively. Cronbach's alpha coefficient for the total scale was obtained 0.921. The results of test-retest reliability showed that there was a significant agreement between the scores of the test and retest (P < .001).

CONCLUSION

The D-RFS has an acceptable factorial structure, and its internal consistency was confirmed by different approaches. This scale is a valid and reliable tool for assessing disease-related fear in patients with epilepsy. The simplicity of the items and the appropriate time to complete the scale can be considered as its strengths.