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Stirling RE, Nurse ES, Payne D, Naim-Feil J, Coleman H, Freestone DR, Richarson MP, Brinkmann BH, D'Souza WJ, Grayden DB, Cook MJ, Karoly PJ. User experience of a seizure risk forecasting app: A mixed methods investigation. Epilepsy Behav 2024; 157:109876. [PMID: 38851123 DOI: 10.1016/j.yebeh.2024.109876] [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: 05/30/2024] [Accepted: 06/02/2024] [Indexed: 06/10/2024]
Abstract
OBJECTIVE Over recent years, there has been a growing interest in exploring the utility of seizure risk forecasting, particularly how it could improve quality of life for people living with epilepsy. This study reports on user experiences and perspectives of a seizure risk forecaster app, as well as the potential impact on mood and adjustment to epilepsy. METHODS Active app users were asked to complete a survey (baseline and 3-month follow-up) to assess perspectives on the forecast feature as well as mood and adjustment. Post-hoc, nine neutral forecast users (neither agreed nor disagreed it was useful) completed semi-structured interviews, to gain further insight into their perspectives of epilepsy management and seizure forecasting. Non-parametric statistical tests and inductive thematic analyses were used to analyse the quantitative and qualitative data, respectively. RESULTS Surveys were completed by 111 users. Responders consisted of "app users" (n = 58), and "app and forecast users" (n = 53). Of the "app and forecast users", 40 % believed the forecast was accurate enough to be useful in monitoring for seizure risk, and 60 % adopted it for purposes like scheduling activities and helping mental state. Feeling more in control was the most common response to both high and low risk forecasted states. In-depth interviews revealed five broad themes, of which 'frustrations with lack of direction' (regarding their current epilepsy management approach), 'benefits of increased self-knowledge' and 'current and anticipated usefulness of forecasting' were the most common. SIGNIFICANCE Preliminary results suggest that seizure risk forecasting can be a useful tool for people with epilepsy to make lifestyle changes, such as scheduling daily events, and experience greater feelings of control. These improvements may be attributed, at least partly, to the improvements in self-knowledge experienced through forecast use.
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Affiliation(s)
- Rachel E Stirling
- Department of Biomedical Engineering, University of Melbourne, Melbourne, Victoria, Australia; Graeme Clark Institute of Biomedical Engineering, University of Melbourne, Melbourne, Victoria, Australia.
| | - Ewan S Nurse
- Graeme Clark Institute of Biomedical Engineering, University of Melbourne, Melbourne, Victoria, Australia; Seer Medical, Melbourne, Victoria, Australia; Department of Medicine, St Vincent's Hospital Melbourne, The University of Melbourne, Australia.
| | | | - Jodie Naim-Feil
- Department of Biomedical Engineering, University of Melbourne, Melbourne, Victoria, Australia; Graeme Clark Institute of Biomedical Engineering, University of Melbourne, Melbourne, Victoria, Australia.
| | - Honor Coleman
- Melbourne School of Psychological Sciences, The University of Melbourne, Melbourne, Victoria, Australia; Epilepsy Research Centre, Department of Medicine (Austin Health), University of Melbourne, Victoria, Melbourne, Australia; Department of Neuroscience, Faculty of Medicine, Nursing & Health Science, Monash University, Melbourne, Australia.
| | | | | | | | - Wendyl J D'Souza
- Department of Medicine, St Vincent's Hospital Melbourne, The University of Melbourne, Australia.
| | - David B Grayden
- Department of Biomedical Engineering, University of Melbourne, Melbourne, Victoria, Australia; Graeme Clark Institute of Biomedical Engineering, University of Melbourne, Melbourne, Victoria, Australia; Department of Medicine, St Vincent's Hospital Melbourne, The University of Melbourne, Australia.
| | - Mark J Cook
- Graeme Clark Institute of Biomedical Engineering, University of Melbourne, Melbourne, Victoria, Australia; Seer Medical, Melbourne, Victoria, Australia; Department of Medicine, St Vincent's Hospital Melbourne, The University of Melbourne, Australia.
| | - Philippa J Karoly
- Department of Biomedical Engineering, University of Melbourne, Melbourne, Victoria, Australia; Graeme Clark Institute of Biomedical Engineering, University of Melbourne, Melbourne, Victoria, Australia.
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Kanner AM, Carrazana E, Munger Clary HM, Rabinowicz AL, Faught E. Anticipatory anxiety of seizures in epilepsy: A common, complex, and underrecognized phenomenon? Epileptic Disord 2024; 26:273-281. [PMID: 38624139 DOI: 10.1002/epd2.20224] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2023] [Revised: 03/01/2024] [Accepted: 03/30/2024] [Indexed: 04/17/2024]
Abstract
The diagnosis of epilepsy is associated with loss of predictability, which invariably results in the fear of when and if future seizures will occur. For a subset of patients with epilepsy (PWE), there may be a pathological persistent fear of seizure occurrence, resulting in limitations to daily activities through avoidant behaviors. Paradoxically, the research of anticipatory anxiety of seizures (AAS; also referred to as seizure phobia) has been practically nonexistent and, not surprisingly, this condition remains underrecognized by clinicians. The available data are derived from three small case series of patients followed in tertiary epilepsy centers. In this study, we review the available data on the reported clinical manifestations of AAS in PWE, and of the potential role of variables associated with it, such as personal and family psychosocial and psychiatric history and epilepsy-related variables. In addition, we review the need for the creation of screening tools to identify patients at risk of AAS and discuss potential treatment strategies, which could be considered as part of the comprehensive management for PWE.
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Affiliation(s)
- Andres M Kanner
- Comprehensive Epilepsy Center, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Enrique Carrazana
- Neurelis, Inc., San Diego, California, USA
- John A. Burns School of Medicine, University of Hawaii, Honolulu, Hawaii, USA
| | - Heidi M Munger Clary
- Department of Neurology, Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA
| | | | - Edward Faught
- Emory Epilepsy Program, Emory University School of Medicine, Atlanta, Georgia, USA
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Alkorashy HA, Alotaibi HA. Locus of Control and Self-Directed Learning Readiness of Nursing Students during the COVID-19 Pandemic: A Cross-Sectional Study from Saudi Arabia. NURSING REPORTS 2023; 13:1658-1670. [PMID: 38133113 PMCID: PMC10745838 DOI: 10.3390/nursrep13040137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2023] [Revised: 11/22/2023] [Accepted: 11/28/2023] [Indexed: 12/23/2023] Open
Abstract
BACKGROUND Coronavirus disease (COVID-19) has caused one of the worst global pandemics in recent decades. It has disrupted education systems worldwide, leading to a forced shift from traditional face-to-face to blended or fully distanced learning, requiring a higher level of student readiness for self-directed learning (SDL) and a more internal locus of control (LOC). OBJECTIVE This study explored the relationship between locus of control and level of readiness for SDL among Saudi nursing students and whether the COVID-19 pandemic has impacted this relationship. METHODS A cross-sectional correlational descriptive study was conducted to survey 277 Saudi nursing students enrolled in the bachelor program at one of the reputable universities in Saudi Arabia. An E-questionnaire containing two scales, the Self-Directed Learning Readiness Scale for Nursing Education, and the Locus of Control Scale, was used to collect data in addition to the selected participants' characteristics. RESULTS Nursing students had a moderate-to-low level of readiness for SDL (mean = 144.0), and the majority had an external LOC. There was a significant association between locus of control and level of readiness for self-directed learning (r = 0.19 *, p = 0.001), and the internal locus of control was more significantly associated with self-directed learning (r = 0.22 *, p = 0.0001) than with external locus of control. CONCLUSION The study findings indicate a propensity of respondents indicating an external locus of control, whereas most of the respondents' reported levels of readiness ranged between low and moderate across all dimensions of self-directed learning. This study was not registered.
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Affiliation(s)
- Hanan A. Alkorashy
- Nursing Administration & Education Department, College of Nursing, King Saud University, Riyadh 11362, Saudi Arabia
- Nursing Administration Department, Faculty of Nursing, Alexandria University, Alexandria 21526, Egypt
| | - Hanan A. Alotaibi
- Maternal and Child Health Nursing Department, College of Nursing, King Saud University, Riyadh 11362, Saudi Arabia;
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O'Hara K, Dewar S, Bougher G, Dean P, Misra SN, Desai J. Overcoming barriers to the management of seizure clusters: ease of use and time to administration of rescue medications. Expert Rev Neurother 2023; 23:425-432. [PMID: 37126472 DOI: 10.1080/14737175.2023.2206568] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/02/2023]
Abstract
INTRODUCTION Patients with epilepsy can experience seizure clusters (acute repetitive seizures), defined as intermittent, stereotypic episodes of frequent seizure activity that are distinct from typical seizure patterns. There are three FDA-approved rescue medications, diazepam rectal gel, midazolam nasal spray, and diazepam nasal spray, that can be administered to abort a seizure cluster in a nonmedical, community setting. Despite their effectiveness and safety, rescue medications are underutilized, and patient/caregiver experiences and perceptions of ease of use may constitute a substantial barrier to greater utilization. AREAS COVERED The literature on rescue medications for seizure clusters is reviewed, including the effectiveness and safety, with an emphasis on ease and timing of treatment and associated outcomes. Barriers to greater utilization of rescue medication and the role of seizure action plans are discussed. EXPERT OPINION Intranasal rescue medications are easier to use and can be administered more rapidly than other routes (rectal, intravenous). Importantly, rapid administration of intranasal rescue medications has been associated with shorter durations of seizure activity as compared with rectal/intravenous routes. Intranasal rescue medications are also easy to use and socially acceptable. These factors potentially remove or reduce barriers to use and optimize the management of seizure clusters.
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Affiliation(s)
- Kathryn O'Hara
- Department of Neurology, Virginia Commonwealth University, Richmond, VA, USA
| | - Sandra Dewar
- Department of Neurology, Virginia Commonwealth University, Richmond, VA, USA
| | - Genei Bougher
- Northwest Florida Clinical Research Group, LLC, Gulf Breeze, FL, USA
- Child Neurology Center of Northwest Florida, Gulf Breeze, FL, USA
| | - Patricia Dean
- Comprehensive Epilepsy Center, Nicklaus Children's Hospital, Miami, FL, USA
| | - Sunita N Misra
- Clinical Development & Medical Affairs, Neurelis, Inc, San Diego, CA, USA
| | - Jay Desai
- Division of Neurology, Children's Hospital Los Angeles, Los Angeles, CA, USA
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The Style of Coping with Stress, the Health-Related Locus of Control, and the Level of Mindfulness of Patients with Chronic Somatic Diseases in Comparison to Healthy People. Healthcare (Basel) 2022; 10:healthcare10091752. [PMID: 36141364 PMCID: PMC9498608 DOI: 10.3390/healthcare10091752] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Revised: 09/04/2022] [Accepted: 09/09/2022] [Indexed: 11/17/2022] Open
Abstract
Background: Psychological factors may be involved in both the development and treatment of somatic diseases. Our study aimed to evaluate the style of coping with stress, health-related locus of control, and level of mindfulness of adult patients with the most common chronic somatic diseases compared with healthy subjects. Methods: 502 chronically ill people were examined (M = 49.27; SD = 14.25), including 288 women and 214 men. The control group consisted of 117 healthy people (M = 45.66; SD = 17.86). The diagnostic survey involved using the Coping Inventory for Stressful Situations (CISS), Multidimensional Health Locus of Control Scale (MHLC), and Mindful Attention Awareness Scale (MAAS). Results: Differences between the clinical and control groups were demonstrated for MHLC: Internal (p < 0.001), Powerful Others (p < 0.05), and Chance (p < 0.001); CISS: Task (p < 0.001) and Avoidance (p < 0.05); and MAAS (p < 0.01). Conclusion: People with chronic somatic diseases, compared to healthy people, have a stronger external and weaker internal health-related locus of control, lower level of task and avoidance style for coping with stress, and lower level of mindfulness.
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