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Ayar D, Bektas M, Ünalp A, Yılmaz Ü, Kos FM, Okur TD, Kırkgöz HH, Yanar S. The effect of illness-related fears of parents of children with epilepsy during the COVID-19 period on their children's seizure self-efficacy. Arch Pediatr 2024; 31:326-332. [PMID: 38853083 DOI: 10.1016/j.arcped.2024.02.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Revised: 01/08/2024] [Accepted: 02/03/2024] [Indexed: 06/11/2024]
Abstract
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.
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Affiliation(s)
- Dijle Ayar
- Alanya Alaaddin Keykubat University Faculty of Health Science, Pediatric Nursing Department, Alanya, Turkey.
| | - Murat Bektas
- Dokuz Eylul University Faculty of Nursing, Pediatric Nursing Department, Izmir, Turkey
| | - Aycan Ünalp
- University of Health Sciences Turkey, Izmir Faculty of Medicine, Behçet Uz Children's Education and Research Hospital, Department of Pediatrics, Division of Pediatric Neurology, Izmir, Turkey
| | - Ünsal Yılmaz
- University of Health Sciences Turkey, Izmir Faculty of Medicine, Behçet Uz Children's Education and Research Hospital, Department of Pediatrics, Division of Pediatric Neurology, Izmir, Turkey
| | - Fulya Merve Kos
- Bilecik Şeyh Edebali University Faculty of Health Science, Bilecik, Turkey
| | - Tuncay Derya Okur
- University of Health Sciences Turkey, Behçet Uz Children's Education and Research Hospital, Department of Pediatrics, Division of Pediatric Neurology, Izmir, Turkey
| | - Hatice Hilal Kırkgöz
- University of Health Sciences Turkey, Behçet Uz Children's Education and Research Hospital, Department of Pediatrics, Division of Pediatric Neurology, Izmir, Turkey
| | - Saliha Yanar
- University of Health Sciences Turkey, Behçet Uz Children's Education and Research Hospital, Department of Pediatrics, Division of Pediatric Neurology, Izmir, Turkey
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Dal-Pai J, Dos Santos MP, Donida NDS, Cesarino MR, de Oliveira VHMS, Nunes ML. Health consequences and daily life modifications in children and adolescents with epilepsy during the COVID-19 pandemic - a systematic review: Running Title: Covid-19 Pandemic in Children/Adolescents with Epilepsy. Seizure 2023; 108:102-115. [PMID: 37146514 PMCID: PMC10140054 DOI: 10.1016/j.seizure.2023.04.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2023] [Revised: 04/21/2023] [Accepted: 04/25/2023] [Indexed: 05/07/2023] Open
Abstract
PURPOSE To describe the impact of the COVID-19 pandemic on the health care and daily life of children and adolescents with epilepsy. METHODS This systematic review followed the preferred reporting items guidelines and was registered on the PROSPERO platform (CRD42021255931). The PECO (Patient, Exposure, Comparison, Outcome) framework criteria were as follows: people with epilepsy (0-18 years old); exposed to the COVID-19 pandemic; and outcomes, including epilepsy type, time of clinical diagnosis, seizure exacerbation, treatment and medications, need for emergency because of seizures, sleep, behavior, comorbidities and/or concerns, social and/or economic impact, insurance status, electronic device use, telemedicine, and distance learning. Literature searches for cross-sectional and longitudinal studies were conducted on Embase and PubMed. The methodological quality of identified studies was assessed using the Newcastle‒Ottawa Scale (NOS). RESULTS Data were extracted from 23 eligible out of 597 identified articles and included 31,673 patients. The mean NOS scores for cross-sectional study design was 3.84/10, and for longitudinal, it was 3.5/8 stars. Seizure exacerbations were reported in three studies, difficulties with access to anti-seizure medications in two, changes in dosage in five, and visit postponed or cancelation in five studies. Problems with sleep were highlighted in three, issues related to distance learning in two, an increased time spent on electronic devices in three, and increased behavioral problems in eight studies. Telemedicine, when available, was described as useful and supporting patient's needs. CONCLUSION The pandemic affected the health care and lifestyle of young individuals with epilepsy. The main problems described revolved around seizure control, accessing anti-seizure medication, sleep and behavioral complains.
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Affiliation(s)
- Janise Dal-Pai
- Brain Institute of Rio Grande do Sul - Pontifical Catholic University of Rio Grande do Sul (InsCer / PUCRS), Porto Alegre, Brazil
| | - Michele Paula Dos Santos
- Extension and Management of Continuing Education Activities Program - Pontifical Catholic University of Rio Grande do Sul (PEGA / PUCRS), Porto Alegre, Brazil
| | - Natalie da Silveira Donida
- Extension and Management of Continuing Education Activities Program - Pontifical Catholic University of Rio Grande do Sul (PEGA / PUCRS), Porto Alegre, Brazil
| | - Matheus Ribeiro Cesarino
- Extension and Management of Continuing Education Activities Program - Pontifical Catholic University of Rio Grande do Sul (PEGA / PUCRS), Porto Alegre, Brazil
| | - Victor Hugo Midões Santana de Oliveira
- Extension and Management of Continuing Education Activities Program - Pontifical Catholic University of Rio Grande do Sul (PEGA / PUCRS), Porto Alegre, Brazil.
| | - Magda Lahorgue Nunes
- Professor of Neurology, School of Medicine - Pontifical Catholic University of Rio Grande do Sul (InsCer / PUCRS), Porto Alegre, Brazil.
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Modi AC, Patel AD, Mara CA, Schmidt M, Tenney JR, Stevens J. Pilot randomized controlled clinical trial of an adherence social norms intervention for adolescents with epilepsy. Epilepsy Behav 2023; 140:109082. [PMID: 36731289 PMCID: PMC9998352 DOI: 10.1016/j.yebeh.2022.109082] [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: 11/07/2022] [Revised: 12/21/2022] [Accepted: 12/31/2022] [Indexed: 02/03/2023]
Abstract
OBJECTIVE Non-adherence to anti-seizure medications (ASMs) is common for adolescents with epilepsy, with potentially devastating consequences. Existing adherence interventions in epilepsy do not meet the unique challenges faced by adolescents. Leveraging social norms capitalizes on the increased importance of peer influence while simultaneously targeting the low motivation levels of many adolescents. The current study examined the feasibility, acceptability, and satisfaction of a social norms adherence intervention in adolescents with epilepsy. METHODS A pilot RCT of a mHealth social norms intervention was conducted with adolescents with epilepsy who demonstrated non-adherence (≤95% adherence) during baseline. Adolescents were randomized to either (1) mHealth social norms (reminders, individualized and social norms adherence feedback) or (2) control (reminders and individualized adherence feedback). Primary outcomes included feasibility, acceptability, and satisfaction. Exploratory outcomes included electronically monitored adherence, seizure severity, and health-related quality of life (HRQOL). RESULTS One hundred four adolescents were recruited (53% female; Mage = 15.4 ± 1.4 years; 81% White: Non-Hispanic; 5% Black, 10% Bi/Multiracial; 2% White: Hispanic; 1% Other: Hispanic; 1% Bi/Multiracial-Hispanic). Forty-five percent screen-failed due to high adherence, 16% withdrew, and 38% were randomized to treatment (n = 19) or control (n = 21). Recruitment (75%), retention (78%), and treatment satisfaction were moderately high. Engagement with the intervention was moderate, with 64% of participants engaging with intervention notifications. Exploratory analyses revealed that after controlling for COVID-19 impact, the social norms intervention group maintained higher adherence over time compared to the control group. Small to moderate effect sizes were noted for seizure severity and HRQOL between groups. CONCLUSION This pilot intervention appeared feasible and acceptable. Increases in adherence in the treatment versus control group were modest, but a future larger more adequately powered study is needed to detect effects. Notably, it appeared the COVID pandemic influenced adherence behaviors during our trial.
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Affiliation(s)
- Avani C Modi
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, 3333 Burnet Ave., Cincinnati, OH 45229, United States; University of Cincinnati, College of Medicine, Cincinnati, OH, United States.
| | - Anup D Patel
- Nationwide Children's Hospital, 700 Children's Drive, Near East Office Building, 3rd Floor, Columbus, OH 43205, United States; The Ohio State, Department of Pediatrics, 700 Children's Drive, Near East Office Building, 3rd Floor, Columbus, OH 43205, United States.
| | - Constance A Mara
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, 3333 Burnet Ave., Cincinnati, OH 45229, United States; University of Cincinnati, College of Medicine, Cincinnati, OH, United States.
| | - Matthew Schmidt
- College of Education, University of Florida, 2423 Normal Hall, Gainesville, FL 32611, United States.
| | - Jeffrey R Tenney
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, 3333 Burnet Ave., Cincinnati, OH 45229, United States; University of Cincinnati, College of Medicine, Cincinnati, OH, United States.
| | - Jack Stevens
- Nationwide Children's Hospital, 700 Children's Drive, Near East Office Building, 3rd Floor, Columbus, OH 43205, United States; The Ohio State, Department of Pediatrics, 700 Children's Drive, Near East Office Building, 3rd Floor, Columbus, OH 43205, United States.
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Andraus M, Thorpe J, Tai XY, Ashby S, Hallab A, Ding D, Dugan P, Perucca P, Costello D, French JA, O'Brien TJ, Depondt C, Andrade DM, Sengupta R, Delanty N, Jette N, Newton CR, Brodie MJ, Devinsky O, Helen Cross J, Li LM, Silvado C, Moura L, Cosenza H, Messina JP, Hanna J, Sander JW, Sen A. Impact of the COVID-19 pandemic on people with epilepsy: Findings from the Brazilian arm of the COV-E study. Epilepsy Behav 2021; 123:108261. [PMID: 34481281 PMCID: PMC8457887 DOI: 10.1016/j.yebeh.2021.108261] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2021] [Revised: 08/01/2021] [Accepted: 08/02/2021] [Indexed: 12/13/2022]
Abstract
UNLABELLED The COVID-19 pandemic has had an unprecedented impact on people and healthcare services. The disruption to chronic illnesses, such as epilepsy, may relate to several factors ranging from direct infection to secondary effects from healthcare reorganization and social distancing measures. OBJECTIVES As part of the COVID-19 and Epilepsy (COV-E) global study, we ascertained the effects of COVID-19 on people with epilepsy in Brazil, based on their perspectives and those of their caregivers. We also evaluated the impact of COVID-19 on the care delivered to people with epilepsy by healthcare workers. METHODS We designed separate online surveys for people with epilepsy and their caregivers. A further survey for healthcare workers contained additional assessments of changes to working patterns, productivity, and concerns for those with epilepsy under their care. The Brazilian arm of COV-E initially collected data from May to November 2020 during the country's first wave. We also examined national data to identify the Brazilian states with the highest COVID-19 incidence and related mortality. Lastly, we applied this geographic grouping to our data to explore whether local disease burden played a direct role in difficulties faced by people with epilepsy. RESULTS Two hundred and forty-one people returned the survey, 20% were individuals with epilepsy (n = 48); 22% were caregivers (n = 53), and 58% were healthcare workers (n = 140). Just under half (43%) of people with epilepsy reported health changes during the pandemic, including worsening seizure control, with specific issues related to stress and impaired mental health. Of respondents prescribed antiseizure medication, 11% reported difficulty taking medication on time due to problems acquiring prescriptions and delayed or canceled medical appointments. Only a small proportion of respondents reported discussing significant epilepsy-related risks in the previous 12 months. Analysis of national COVID-19 data showed a higher disease burden in the states of Sao Paulo and Rio de Janeiro compared to Brazil as a whole. There were, however, no geographic differences observed in survey responses despite variability in the incidence of COVID-19. CONCLUSION Our findings suggest that Brazilians with epilepsy have been adversely affected by COVID-19 by factors beyond infection or mortality. Mental health issues and the importance of optimal communication are critical during these difficult times. Healthcare services need to find nuanced approaches and learn from shared international experiences to provide optimal care for people with epilepsy as the direct burden of COVID-19 improves in some countries. In contrast, others face resurgent waves of the pandemic.
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Affiliation(s)
- Maria Andraus
- Department of Internal Medicine, Faculty of Medicine, Neurology Service, Epilepsy Program, Clementino Fraga Filho University Hospital, Federal University of Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | - Jennifer Thorpe
- Oxford Epilepsy Research Group, NIHR Biomedical Research Centre, Nuffield Department of Clinical Neurosciences, John Radcliffe Hospital, Oxford OX3 9DU, UK; SUDEP Action, 18 Newbury Street, Wantage, Oxfordshire OX12 8DA, UK
| | - Xin You Tai
- Oxford Epilepsy Research Group, NIHR Biomedical Research Centre, Nuffield Department of Clinical Neurosciences, John Radcliffe Hospital, Oxford OX3 9DU, UK
| | - Samantha Ashby
- SUDEP Action, 18 Newbury Street, Wantage, Oxfordshire OX12 8DA, UK
| | - Asma Hallab
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health. Department of Psychiatry and Psychotherapy, Campus Benjamin Franklin, Berlin, Germany
| | - Ding Ding
- Institute of Neurology, Fudan University Huashan Hospital, Shanghai, China
| | - Patricia Dugan
- Department of Neurology, NYU Grossman School of Medicine, USA
| | - Piero Perucca
- Department of Neuroscience, Central Clinical School, The Alfred Hospital, Monash University, Melbourne, Australia & Departments of Medicine and Neurology, The Royal Melbourne Hospital, The University of Melbourne, Melbourne, Australia
| | - Daniel Costello
- Epilepsy Service, Cork University Hospital & College of Medicine and Health, University College Cork, Ireland
| | | | - Terence J O'Brien
- Department of Neuroscience, Central Clinical School, The Alfred Hospital, Monash University, Melbourne, Australia & Departments of Medicine and Neurology, The Royal Melbourne Hospital, The University of Melbourne, Melbourne, Australia
| | - Chantal Depondt
- Department of Neurology, Hôpital Erasme - Université Libre de Bruxelles, Brussels, Belgium
| | - Danielle M Andrade
- Adult Epilepsy Genetics Program, Toronto Western Hospital, University of Toronto, Toronto, Canada
| | | | - Norman Delanty
- Beaumont Hospital, and School of Pharmacy and Biomolecular Sciences, FutureNeuro Research Centre, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Nathalie Jette
- Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, USA
| | - Charles R Newton
- Oxford Epilepsy Research Group, NIHR Biomedical Research Centre, Nuffield Department of Clinical Neurosciences, John Radcliffe Hospital, Oxford OX3 9DU, UK; University Department of Psychiatry, University of Oxford, UK
| | - Martin J Brodie
- Epilepsy Unit, West Glasgow Ambulatory Care Hospital-Yorkhill, Glasgow, UK
| | - Orrin Devinsky
- Department of Neurology, NYU Grossman School of Medicine, USA
| | - J Helen Cross
- UCL NIHR BRC Great Ormond Street Institute of Child Health, London, UK; Young Epilepsy, St Pier's Lane, Dormansland, Lingfield RH7 6P, UK
| | - Li M Li
- Brazilian Institute of Neuroscience and Neurotechnology, Department of Neurology of School of Medical Sciences, Unicamp, Campinas, SP, Brazil
| | - Carlos Silvado
- Comprehensive Epilepsy Program - EEG - Epilepsy Unit - Hospital de Clinicas, Federal University of Parana, Curitiba, PR, Brazil
| | - Luis Moura
- Production Engineering Program, Fuzzy Logic Laboratory - Labfuzzy, Coordination of Post Graduate Engineering Programs - COPPE, Federal University of Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | - Harvey Cosenza
- Production Engineering Program, Fuzzy Logic Laboratory - Labfuzzy, Coordination of Post Graduate Engineering Programs - COPPE, Federal University of Rio de Janeiro, Rio de Janeiro, RJ, Brazil; Department of Engineering - REG, Science and Technology Institute - ICT, Fluminense Federal University - UFF, Campus Rio das Ostras, RJ, Brazil
| | - Jane P Messina
- School of Geography and the Environment, University of Oxford, UK; Oxford School of Global and Area Studies, University of Oxford, Oxford, UK
| | - Jane Hanna
- SUDEP Action, 18 Newbury Street, Wantage, Oxfordshire OX12 8DA, UK
| | - Josemir W Sander
- UCL Queen Square Institute of Neurology, Queen Square, London WC1N 3BG & Chalfont Centre for Epilepsy, Chalfont St Peter SL9 0RJ, UK; Stichting Epilepsie Instellingen Nederland (SEIN), Heemstede, Netherlands
| | - Arjune Sen
- Oxford Epilepsy Research Group, NIHR Biomedical Research Centre, Nuffield Department of Clinical Neurosciences, John Radcliffe Hospital, Oxford OX3 9DU, UK.
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Kuroda N, Kubota T. Psychological impact of the COVID-19 pandemic for patients with epilepsy: A systematic review and meta-analysis. Epilepsy Behav 2021; 124:108340. [PMID: 34600283 PMCID: PMC9760102 DOI: 10.1016/j.yebeh.2021.108340] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Revised: 09/10/2021] [Accepted: 09/12/2021] [Indexed: 01/08/2023]
Abstract
OBJECTIVE To investigate psychological comorbidities in patients with epilepsy during the coronavirus disease 2019 (COVID-19) pandemic. METHOD A systematic review and meta-analysis approach was used to comprehensively search MEDLINE, CENTRAL, EMBASE, and ClinicalTrials.gov databases for relevant studies. Studies that reported psychological stress in patients with epilepsy during the COVID-19 pandemic were included. Psychological comorbidities were defined as anxiety, depression, and sleep disturbance. Pooled proportions of psychological comorbidities with 95% confidence intervals (CIs) were assessed using a random-effects model. The quality of assessment for each study, heterogeneity between the studies, and publication bias were also evaluated. RESULTS A total of 28 studies with 7959 patients/caregivers were included in the meta-analysis. The pooled proportions of anxiety/worry, depression/bad mood, and sleep disturbance were 38.9% (95% CI: 31.3-46.7); I2 = 97%; p < 0.01, 30.9% (95% CI: 23.3-38.9), I2 = 97%; p < 0.01, and 36.5% (95% CI: 28.3-45.1), I2 = 97%, p < 0.01, respectively. CONCLUSION Although the heterogeneity was high, our results showed a relatively high incidence of psychological comorbidities. Therefore, clinicians need to intervene early in the stress of patients with epilepsy to prevent worsening of stress, which can result in seizure worsening.
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Affiliation(s)
- Naoto Kuroda
- Department of Pediatrics, Wayne State University, Detroit, MI, USA; Department of Epileptology, Tohoku University Graduate School of Medicine, Sendai, Japan.
| | - Takafumi Kubota
- Department of Neurology, Tohoku University Graduate School of Medicine, Sendai, Japan
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