1
|
Abildgaard Hansen O, Clemensen J, Beier CP, Pors Klinting G, Smith AC, Kaas Larsen M. Being an adolescent with epilepsy during the transition from pediatric to adult hospital care: A qualitative descriptive study. Epilepsy Behav 2024; 155:109780. [PMID: 38640727 DOI: 10.1016/j.yebeh.2024.109780] [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: 02/21/2024] [Revised: 04/02/2024] [Accepted: 04/04/2024] [Indexed: 04/21/2024]
Abstract
BACKGROUND The transition from pediatric to adult care is challenging for adolescent patients despite numerous recommendations in recent decades. However, the perspective of the patients is sparsely investigated. AIM To explore the experiences and needs of adolescents with epilepsy (AWE) during the transition from pediatric to adult hospital care. METHODS We conducted 15 semi-structured interviews with AWEs aged 13-20 years and 10 h of field observations of consultations. Interviews were audio-recorded, transcribed, anonymized, and entered into NVivo (version 12, QSR International) with the transcribed field notes. Data were analyzed using systematic text condensation. RESULTS Three themes were identified: (1) Navigating epilepsy in everyday life; (2) The difficult balance between concealment and openness about epilepsy; and (3) Being seen as an individual and not an illness. AWEs' needs in transition are closely associated with their experiences and perceptions of illness, treatment, consultations, and seizures. Notably, AWEs reveal a significant concern about being overlooked beyond their medical condition in appointments. CONCLUSIONS This study highlights the vulnerability and challenges of AWEs transitioning to adult care. Overall, AWEs seek understanding, acceptance, and autonomy in managing their epilepsy and transitioning to adult care. Their experiences underscore the importance of holistic support and communication in healthcare settings. A concerted effort from healthcare professionals (HCP) is necessary to foster the recognition of AWEs as individuals with distinct personalities, needs, and capabilities.
Collapse
Affiliation(s)
- Ole Abildgaard Hansen
- Department of Neurology, Odense University Hospital, Odense, Denmark; Open Patient Data Explorative Network, Odense University Hospital/Department of Clinical Research, University of Southern Denmark, Odense, Denmark; Centre for Innovative Medical Technology, University of Southern Denmark, Denmark.
| | - Jane Clemensen
- Centre for Innovative Medical Technology, University of Southern Denmark, Denmark; Hans Christian Andersen Hospital for Children and Adolescents, Odense University Hospital, Odense, Denmark
| | - Christoph P Beier
- Department of Neurology, Odense University Hospital, Odense, Denmark; Centre for Innovative Medical Technology, University of Southern Denmark, Denmark
| | | | - Anthony C Smith
- Centre for Innovative Medical Technology, University of Southern Denmark, Denmark; Centre for Online Health, The University of Queensland, Australia; Centre for Health Services Research, The University of Queensland, Australia
| | - Malene Kaas Larsen
- Department of Surgery, Odense University Hospital, Odense, Denmark; Clinical Institute, University of Southern Denmark, Odense, Denmark
| |
Collapse
|
2
|
Wu Z, Li X, Huang Y, Huang K, Xiao B, Chi Y, Feng L, Yang H. Effects of a Nurse-Led Cognitive Behavioral Intervention for Parents of Children With Epilepsy. Pediatr Neurol 2024; 154:70-78. [PMID: 38552337 DOI: 10.1016/j.pediatrneurol.2024.03.003] [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: 12/20/2022] [Revised: 02/18/2024] [Accepted: 03/03/2024] [Indexed: 04/15/2024]
Abstract
BACKGROUND This study aimed to evaluate the effects of a nurse-led cognitive behavioral intervention for parents of children with epilepsy (CWE). METHODS The study recruited 238 CWE from the neurology ward of Xiangya Hospital from March 2019 to August 2022. According to the interventions after discharge, the children and their parents were randomly divided into 117 parent-child dyads in the intervention group and 121 parent-child dyads in the control group. The seizure severity and treatment compliance in CWE as well as the parents' psychological states and satisfaction with the care provided by nurses were compared before and after intervention. RESULTS The follow-up six months after discharge showed that the seizure frequency among CWE in the intervention group was significantly less than the controls (P = 0.048). Compared with the controls, the intervention group also reported fewer symptoms of anxiety and depression, better sleep quality, and more positive attitudes toward epilepsy, as well as higher nursing satisfaction (P < 0.001). The correlation analysis indicated the correlation of CWE's seizure severity was correlated with the compliance, parents' psychological states, and parents' satisfaction with the care provided by nurses. CONCLUSIONS The adoption of the nurse-led cognitive behavioral intervention on parents of CWE can improve the parents' mental health status and their satisfaction with the nurses, which can have a positive association with the seizure severity of CWE. In light of this information, this nursing intervention may be a new method for the long-term disease management of CWE.
Collapse
Affiliation(s)
- Zhongling Wu
- Department of Neurology, Xiangya Hospital of Central South University, Changsha, Hunan, China; Department of Clinical Nursing Teaching and Research Section, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Xiaolei Li
- Department of Cardiology, Laizhou People's Hospital, Yantai, Shandong, China
| | - Yuanxin Huang
- Department of Neurology, Xiangya Hospital of Central South University, Changsha, Hunan, China; Department of Clinical Nursing Teaching and Research Section, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Kailing Huang
- Department of Neurology, Xiangya Hospital of Central South University, Changsha, Hunan, China; Department of Neurology, National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Bo Xiao
- Department of Neurology, Xiangya Hospital of Central South University, Changsha, Hunan, China; Department of Neurology, National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Yunfang Chi
- Department of Cardiology, Laizhou People's Hospital, Yantai, Shandong, China
| | - Li Feng
- Department of Neurology, Xiangya Hospital of Central South University, Changsha, Hunan, China; Department of Neurology, National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan, China; Department of Neurology, Xiangya Hospital, Central South University (Jiangxi Branch), Nanchang, Jiangxi, China.
| | - Haojun Yang
- Department of Anesthesiology, Xiangya Hospital of Central South University, Changsha, Hunan, China.
| |
Collapse
|
3
|
Mercier A, Dorris L. A systematic review of psychosocial interventions for children and young people with epilepsy. Eur J Paediatr Neurol 2024; 49:35-44. [PMID: 38364750 DOI: 10.1016/j.ejpn.2024.02.002] [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: 10/06/2023] [Revised: 02/03/2024] [Accepted: 02/05/2024] [Indexed: 02/18/2024]
Abstract
BACKGROUND Epilepsy is a lifelong neurological disorder that has a profound impact on the lives of millions of children and young people throughout the world, and is linked with mental ill-health and a poorer quality of life. Psychosocial interventions have showed promise for children and young people with epilepsy (CYPE), however there is an absence of large-scale RCT's that would add robustness to the evidence base. The present systematic review provides an update and extension of findings from an earlier review by Corrigan et al. to assess the state of the literature in 2023. METHODS The present systematic review carried out a search of six electronic databases. Forward and backward chaining was carried out on review articles as well as the studies returned through the search to source additional studies. In total, ten articles were included in this review and appraised for quality using the Crowe Critical Appraisal Tool (CCAT). RESULTS Forty percent (4/10) of the included studies were rated as high quality according to the CCAT, which represents a significant proportional increase since Corrigan et al.'s review. A meta-analysis of results was not possible due to significant methodological heterogeneity, and the variability of outcome measures, however effect sizes were reported or calculated for the majority of studies (7/10), which facilitated comparison. Despite the issues of relatively small samples, there are promising findings with regard to psychosocial interventions increasing epilepsy knowledge, coping strategies, self-efficacy, and quality of life markers. CONCLUSIONS There is a growing evidence base supporting the efficacy of psychosocial interventions for children and young people with epilepsy. This evidence base is also increasing in quality. Particular components of treatment that prove to be effective include psychoeducation, components based on cognitive behavioural therapy principles, as well as mindfulness techniques. This aligns with the evidence-based recommendations for adult populations. Intervention goals centre around improving quality of life, reducing symptom distress, and increasing knowledge and skills. The instruments used to measure these outcomes are predominantly standardised, however remain heterogeneous between studies which impacts the overall robustness of the evidence base.
Collapse
Affiliation(s)
| | - Liam Dorris
- School of Health and Wellbeing, University of Glasgow, UK; Paediatric Neurosciences Research Group, Royal Hospital for Children, Glasgow, UK.
| |
Collapse
|
4
|
Orr E, Whitney R, Nandeesha N, Kossoff EH, RamachandranNair R. Ketogenic Diet: Parental Experiences and Expectations. J Child Neurol 2024; 39:45-54. [PMID: 38314711 PMCID: PMC11083737 DOI: 10.1177/08830738241227066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2023] [Revised: 10/07/2023] [Accepted: 12/31/2023] [Indexed: 02/07/2024]
Abstract
BACKGROUND The ketogenic diet may be difficult for some patients and their families to implement and can impact physical, emotional, and social well-being. METHODS Through principles of fundamental qualitative description, we completed an exploratory study on parents' experiences and expectations on the use and efficacy of the ketogenic diet for children with medically refractory epilepsy. RESULTS Seventeen parents (10 mothers and 7 fathers) of 12 children with epilepsy participated. At the time of the interview, parents had experienced an average of 25 months of ketogenic diet treatment for their child (range 2 months to 98 months). Half of the caregivers learned about the ketogenic diet from their neurologist, whereas the remainder had heard about it from another source (ie, the internet). Most caregivers' (n = 13) diet expectations were related to seizure control. However, child development (n = 5) and quality of life (n = 5) were also crucial to some. Physical impacts of the diet were most commonly gastrointestinal for children (n = 9). Social and emotional effects were noted in some older children with typical development. Most caregivers described negative impacts on finances (n = 15), relationships (n = 14), and emotional well-being (ie, stress) (n = 12). Caregivers benefited from the ketogenic diet team's regular communication, close follow-up, and family-centered care. CONCLUSIONS Despite the impacts that the ketogenic diet may have on caregivers' emotional and social well-being, the positive impacts of the diet were felt to outweigh any perceived risks. Effects (both positive and negative) on quality of life and child development (eg, social, emotional, cognitive) are essential for caregivers and require additional investigation.
Collapse
Affiliation(s)
- Elizabeth Orr
- Department of Nursing, Faculty of Applied Health Sciences, Brock University, St. Catharines, Canada
| | - Robyn Whitney
- Division of Neurology, Department of Paediatrics, McMaster University, Hamilton, Canada
| | | | - Eric H. Kossoff
- Departments of Neurology and Pediatrics, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | | |
Collapse
|
5
|
Jack SM, Phoenix M. Qualitative health research in the fields of developmental medicine and child neurology. Dev Med Child Neurol 2022; 64:830-839. [PMID: 35156198 DOI: 10.1111/dmcn.15182] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/18/2021] [Revised: 01/04/2022] [Accepted: 01/24/2022] [Indexed: 11/29/2022]
Abstract
This invited review introduces the principles of qualitative health research (QHR) to the fields of developmental medicine and child neurology to facilitate the conduct of applied qualitative research. It provides practical guidance on how to write a study purpose statement aligned with the foci of QHR and then articulate an overarching research question using the Emphasis-Purposeful sample-Phenomenon of interest-Context framework. Guidance for health researchers on how to select a study design that aligns with the practice, education, or policy goals of applied QHR is provided. This is followed by strategies to guide decision-making with respect to purposeful sampling, selecting data collection methods, and identifying the most appropriate analytic approach to code and synthesize the data. Findings from QHR studies can be used conceptually or instrumentally to provide new insights or inform decisions within the discipline of developmental medicine and child neurology. While qualitive findings are increasingly valued in the field, designing studies that demonstrate methodological congruence is one strategy to improve the overall quality and trustworthiness of discipline specific QHR.
Collapse
Affiliation(s)
- Susan M Jack
- School of Nursing, McMaster University, Hamilton, Ontario, Canada.,Offord Centre for Child Studies, McMaster University, Hamilton, Ontario, Canada
| | - Michelle Phoenix
- School of Rehabilitation Science, McMaster University, Hamilton, Ontario, Canada.,CanChild, McMaster University, Hamilton, Ontario, Canada.,Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, Canada
| |
Collapse
|
6
|
Deegbe DA, Tshabalala AM, Aziato L, Casteleijn D. Meanings of quality of life among people living with epilepsy in Ghana; a qualitative exploratory study. Epilepsy Behav 2022; 129:108527. [PMID: 35168123 DOI: 10.1016/j.yebeh.2021.108527] [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: 09/02/2021] [Revised: 12/20/2021] [Accepted: 12/20/2021] [Indexed: 11/30/2022]
Abstract
PURPOSE The purpose of this study was to explore the meanings of quality of life among people living with epilepsy (PLWE) in Ghana. METHODS An exploratory-qualitative study design was adopted. Face-to-face in-depth interviews, using a semi-structured interview guide, were conducted on 15 PLWE who were purposively selected for the study. The interviews were audio recorded and transcribed verbatim. The content analysis approach was then used to analyze the data. RESULTS Four themes - "acceptance", "support", "seizure control", and "self-reliance" emerged from the study as meanings of Quality of life (QoL). Quality of life meant unconditional acceptance from family, friends, acquaintances at home, school, and work, and by the public despite epilepsy. Receiving support in the form of protection from injury during a seizure, financial assistance to meet individual and family demands, emotional warmth, and spiritual support through prayers and encouragement, was QoL for PLWE. Achievement of control over seizures and being self-reliant in terms of selfcare and daily activities in addition to having some form of financial independence meant QoL. CONCLUSION Meanings of quality of life among PLWE is associated with being accepted and supported by family and friends as well as being in control of seizures and attaining a status of independence.
Collapse
Affiliation(s)
- David Atsu Deegbe
- Department of Mental Health Nursing, School of Nursing and Midwifery, University of Ghana, P.O. Box LG 43, Legon, Accra, Ghana.
| | - Amme Mardulate Tshabalala
- Department of Nursing Education, Faculty of Health Sciences, University of the Witwatersrand, 7 York Road, Parktown, 2193 Johannesburg, South Africa.
| | - Lydia Aziato
- Department of Adult Health, School of Nursing and Midwifery, University of Ghana, P.O. Box LG 43, Legon, Accra, Ghana.
| | - Daleen Casteleijn
- Department of Occupational Therapy, School of Therapeutic Sciences, University of the Witwatersrand, 7 York Road, Parktown, 2193 Johannesburg, South Africa.
| |
Collapse
|