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Lindsay N, Martin J, Adegboye D, Absoud M, Charman T, Tye C. Impact of and research priorities in early onset epilepsy: An investigation of parental concerns. Epilepsy Behav 2024; 156:109794. [PMID: 38733908 DOI: 10.1016/j.yebeh.2024.109794] [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: 11/08/2023] [Revised: 04/13/2024] [Accepted: 04/14/2024] [Indexed: 05/13/2024]
Abstract
[Background and aim] Early onset epilepsy is a neurological condition with significant developmental consequences, and presents affected children and families with challenges which pervade many aspects of family life. Whilst the concerns of parents and the impact on quality of life is well documented in qualitative research, little emphasis has been placed on the context of 'early onset', and the implications of these concerns for research priority setting. We aimed to explore parental perspectives regarding concerns and the impact of early onset epilepsy on the child and family, and to identify priorities for future paediatric epilepsy research. [Methods] The Brain development in Early Epilepsy: Parent Priorities (BEE-PP) project employed a mixed methods approach to collect information on parents' experience of having a child diagnosed with early onset epilepsy before 36 months old and aged up to 16 years old. Parents completed an online survey (n = 15) followed by a focus group (n = 5) to explore their main concerns regarding early onset epilepsy, the impact on family life and research priorities. [Results] A thematic analysis of the focus group data generated eight themes related to concerns of parents, the impact on the family and research priorities. The three main concerns identified were the expected trajectory of their child's development, a lack of seizure control following diagnosis and adverse behavioural side effects of medication. Within family life, early onset epilepsy had an impact on sibling autonomy and psychosocial adaptation, poorer parental wellbeing and restricted social and personal activities. The need for clearer information regarding their child's developmental trajectory, and managing the side effects of medication and their interactions with behaviour over time were topics of priority for future epilepsy research. [Interpretation] The impact of early onset epilepsy on the family is pervasive and requires the provision of appropriate healthcare service-led support for families to improve quality of life and children's adjustment to epilepsy. Regular monitoring of the concerns of parents and the impact of the diagnosis would be beneficial for addressing epilepsy-related and psychosocial needs of the wider family throughout their child's development. Implications for future research priority setting with regards to improved clinician-to-parent information sharing and managing the behavioural side effects of medication are discussed.
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Affiliation(s)
- Natasha Lindsay
- Department of Psychology, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.
| | - Jessica Martin
- Department of Psychology, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Dolapo Adegboye
- Department of Psychology, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Michael Absoud
- Department of Children's Neurosciences, Evelina London Children's Healthcare, Guy's and St Thomas' NHS Foundation Trust, London SE1 7EH, UK; Department of Women and Children's Health, Faculty of Life Sciences and Medicine, School of Life Course Sciences, King's College London, London, UK
| | - Tony Charman
- Department of Psychology, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Charlotte Tye
- Department of Psychology, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
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Tahmasbi S, Aein F. Explaining the Parenting Styles of Epileptic Children: A Content Analysis. IRANIAN JOURNAL OF CHILD NEUROLOGY 2024; 18:65-74. [PMID: 38988850 PMCID: PMC11231680 DOI: 10.22037/ijcn.v18i3.39664] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Accepted: 01/19/2024] [Indexed: 07/12/2024]
Abstract
Objectives Understanding the parenting practices of parents of children with epilepsy can be a practical guide for care and education planners to prevent mental disorders in these children. This study aimed to explain the parenting practices of parents of children with epilepsy in Shahrekord. Materials & Methods This study is a qualitative study with conventional content analysis. Participants in the study consisted of 20 mothers with epileptic children in Shahrekord, who were included in the study by purposive sampling method with maximum variance in terms of child age, number of family children, and child sex. The data collection method was a semi-structured interview using the interview guide. Data analysis was performed using a conventional content analysis at the same time as data collection. Interviews continued until data saturation was reached. Results The present study revealed five main themes in discipline methods, including over-support / over-protection, forcing to support, rejecting, parental conflict in discipline methods, and using harmful discipline methods. Conclusion In conclusion, the experiences of mothers in the present study show that using inappropriate discipline methods can have adverse effects on the mental-emotional and social health of the child in the future and raise the need to design educational interventions to empower parents of epileptic children in coping with parenting stress effectively.
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Affiliation(s)
- Simin Tahmasbi
- Department of nursing Faculty of Medical Sciences, Shahrekord Branch, Islamic Azad University, Shahrekord, Iran
| | - Fereshteh Aein
- Nursing, Community-oriented Nursing Midwifery Research Center, Shahrekord University of Medical Sciences, Shahrekord, Iran
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Ren Z, Yang C, Yu D. Cognitive deficiency, parental relationship, and coping strategies are related with anxiety and depression among parents of children with epilepsy. Chronic Dis Transl Med 2022; 8:229-237. [PMID: 36161201 PMCID: PMC9481879 DOI: 10.1002/cdt3.25] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2022] [Revised: 03/19/2022] [Accepted: 03/22/2022] [Indexed: 11/11/2022] Open
Affiliation(s)
- Zhengjia Ren
- Department of Clinical Psychology The Third Affiliated Hospital of Chongqing Medical University Chongqing 401120 China
| | - Chunsong Yang
- Department of Pharmacy, Evidence‐based Pharmacy Center, West China Second Hospital Sichuan University Chengdu Sichuan 610041 China
- Key Laboratory of Birth Defects and Related Diseases of Women and Children, Ministry of Education Sichuan University Chengdu Sichuan 610041 China
| | - Dan Yu
- Key Laboratory of Birth Defects and Related Diseases of Women and Children, Ministry of Education Sichuan University Chengdu Sichuan 610041 China
- Department of Medical Genetics, West China Second Hospital Sichuan University Chengdu Sichuan 610041 China
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Pediatric epilepsy and psychoeducational interventions: A review of the literature. Epilepsy Behav 2021; 121:108084. [PMID: 34107404 DOI: 10.1016/j.yebeh.2021.108084] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Revised: 05/09/2021] [Accepted: 05/18/2021] [Indexed: 11/22/2022]
Abstract
For many individuals, living with epilepsy is truly a family affair throughout the life span. When it comes to childhood epilepsy, the unpredictability of seizure patterns, comorbid conditions, the risk of sudden unexpected death in epilepsy (SUDEP), and societal stigma can be emotionally taxing on children and their primary caregivers. To this end, this article proposes to review psychoeducational interventions provided to primary caregivers of children with an epilepsy diagnosis and the impact of such interventions on general parental coping skills. There were three main themes identified (1) caregivers' knowledge and self-efficacy about seizure management; (2) parental epilepsy-related fears, anxiety, and stress; (3) parental sleep quality and SUDEP psychoeducation. Overall, considering research limitations, providing epilepsy-related psychoeducational interventions to primary caregivers of children with epilepsy seems to have promising evidence in the literature. After receiving such interventions, the studies show that caregivers' psychosocial outcomes improved; they become more empowered to manage their children's seizures and advocate for their children's psychosocial needs.
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Beesley RE, Walton C, Hindley D, Jameson H, Panwar N, Lew AR. Carer evaluations of paediatric epilepsy services with and without epilepsy specialist nurse provision. Seizure 2021; 91:174-180. [PMID: 34174691 DOI: 10.1016/j.seizure.2021.06.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Revised: 06/09/2021] [Accepted: 06/12/2021] [Indexed: 11/28/2022] Open
Abstract
PURPOSE To compare paediatric epilepsy services with and without Epilepsy Specialist Nurse (ESN) provision on measures of carer satisfaction and accessibility of service. METHODS In Study 1, carers in Northern England (n = 69 with an ESN, n = 27 without an ESN), completed the Parent Report of Psychosocial Care Scale to measure satisfaction with service provision. A measure of accessibility of service was also included. In Study 2, in depth semi-structured interviews with 58 carers (51 of whom had also participated in Study 1) were examined for talk related to accessibility of service. RESULTS In Study 1, Satisfaction with service levels were high across all areas, (ESN areas Mdn = 9.04, IQR = 1.48, non-ESN areas Mdn = 8.29, IQR = 2.41; maximum score = 10), but with carers from ESN areas over 3 times more likely to endorse scores at the median or above relative to non-ESN areas (OR = 3.28). For accessibility, carers in ESN areas were over 5 times more likely to have a median score or higher (ESN areas Mdn = 10, IQR = 0.45, non-ESN areas Mdn = 8.4, IQR = 5, OR = 5.43). In study 2 a majority of all carers reported having made at least one attempt to contact services between appointments, for a wide range of reasons, with timely resolution reported in ESN areas, but more variable resolution occurring in non-ESN areas. CONCLUSION Paediatric ESNs provide a critical and timely service to children with epilepsy and their carers.
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Affiliation(s)
- Rebekah E Beesley
- Psychology Department, Fylde College, Lancaster University, Lancaster LA1 4YF, United Kingdom.
| | - Chris Walton
- Psychology Department, Fylde College, Lancaster University, Lancaster LA1 4YF, United Kingdom.
| | - Daniel Hindley
- Bolton NHS Foundation Trust, Breightmet Health Centre, Breightmet Fold Lane, Bolton BL2 6NT, United Kingdom.
| | - Helen Jameson
- Bolton NHS Foundation Trust, Breightmet Health Centre, Breightmet Fold Lane, Bolton BL2 6NT, United Kingdom.
| | - Nitin Panwar
- Manchester University Foundation Trust, 1st Floor, Universal Sq., Devonshire St. North, Manchester, M12 6JH, United Kingdom.
| | - Adina R Lew
- Psychology Department, Fylde College, Lancaster University, Lancaster LA1 4YF, United Kingdom.
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Shihata SS, Abdullah TS, Alfaidi AM, Alasmari AA, Alfaidi TM, Bifari AE, Jamal WH, Rizk HA. Knowledge, perception and attitudes toward epilepsy among medical students at King Abdulaziz University. SAGE Open Med 2021; 9:2050312121991248. [PMID: 33614036 PMCID: PMC7871284 DOI: 10.1177/2050312121991248] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2020] [Accepted: 01/06/2021] [Indexed: 12/11/2022] Open
Abstract
Introduction: Epilepsy is a chronic neurological disorder characterized by repetitive
seizures which could occur in different forms depending on the site of brain
disturbance. It has both psychological as well as social effects resulting
in stigmatization and isolation of epileptic patients. Even though medical
students are considered a role model of well-educated communities, previous
studies showed that students lack the satisfactory knowledge and attitudes
toward epilepsy, so it is important to evaluate the concept of epilepsy and
to measure awareness and attitudes toward epileptic patients among medical
students of King Abdulaziz University. The aim of this study is to determine
knowledge, perception and attitudes toward epilepsy among medical students
at King Abdulaziz University. Methods: An observational cross-sectional study was conducted on 455 medical students
from Faculty of medicine, King Abdulaziz University, Jeddah, Saudi Arabia
(Western region) through a web-based survey in July 2018. The survey is
composed of many sections (demographic variables, knowledge, attitudes and
practices toward epilepsy). The survey was applied as a Google form and the
data were analyzed by IBM-SPSS for Windows, version 21.0. The chi-square
test of independence was used for data analysis. Results: Four hundred thirty-six out of 455 students (98.5%) were aware about
epilepsy. However, the level of knowledge varies depending on the
educational level of these students, because 88.5% of the students responded
that brain injury is the most common cause and 57.3% said it is a genetic
disease, while 3.7% stated that it was due to evil spirit. As a treatment
method, medication and God’s help were chosen by 95.8% and 57.8%,
respectively. Objection to marry an epileptic patient was the most common
negative attitude toward epileptics among the participants. Nonetheless, the
overall attitude was found to be positive. Conclusion: King Abdulaziz University medical students have had some misunderstandings
regarding causes, manifestations and treatment of epilepsy which could
affect their attitudes toward epileptic individuals. Educational programs
which include more clinical exposure to such common diseases are required to
improve students’ impressions of these diseases.
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Affiliation(s)
| | | | | | | | | | - Anas Essa Bifari
- Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Wisam H Jamal
- Faculty of Medicine, University of Jeddah, Jeddah, Saudi Arabia
| | - Hisham A Rizk
- Faculty of Medicine, University of Jeddah, Jeddah, Saudi Arabia
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Kinkar A, Alqarni D, Alghamdi A, Wali S, Alghamdi N, Saloom S, Aashi M. Parental Knowledge, Attitudes, and Behaviors Toward Their Epileptic Children at King Abdulaziz University Hospital: Cross-Sectional Study. Interact J Med Res 2020; 9:e12697. [PMID: 31958065 PMCID: PMC6997923 DOI: 10.2196/12697] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2018] [Revised: 09/24/2019] [Accepted: 09/26/2019] [Indexed: 12/03/2022] Open
Abstract
Background Epilepsy is a chronic disease characterized by periodic seizures that result from abnormal integrated firing impulses in the brain. It is one of the most common neurological disorders. Over the past few years, there has been increasing awareness about the effect that having a child with epilepsy has on parents and the reciprocal impact of parental knowledge and attitudes regarding epilepsy on the affected child. Objective This study aimed to assess parental knowledge, attitudes, and behavior toward their epileptic children. Methods A cross-sectional study was conducted in 2018 by the Pediatric Neurology Department of King Abdulaziz University Hospital, Jeddah, the Kingdom of Saudi Arabia. A sample size of 115 of 332 parents who have a child diagnosed with epilepsy and aged 18 years or younger were recruited for this study. Statistical analysis was performed using SPSS version 21. Data analysis was performed using an independent t test, a chi-square test, one-way analysis of variance, and correlation analysis. Results A total of 115 participants answered the questionnaire; of these, 65 (56.5%) were men, with an average age of 40.3 years, and the mean age of the children was 9.0 years. Overall, 85 (85/115, 73.9%) children were taken care of by both of their parents. The mean parental knowledge score was 7.49 (SD 2.08) out of 12, and it was significantly related to the educational level of the parent (P=.004). The knowledge question that was most frequently answered incorrectly was “Diagnosis of epilepsy is usually made based on at least two unprovoked seizures.” As only 28.7% (33/115) of participants chose the correct answer, mean parental attitude score was 26.51 (SD 4.284) out of 35, and there was no significant relation with the educational level of parents (P=.13); however, it was negatively correlated with the child’s age (P=.045). Mean parental behavioral score was 23.35 (SD 4.121) out of 35, and there was no significant relation with the educational level of the parents (P=.24). The most negatively answered question for the behavior section was “I can leave my child without supervision,” with a mean score of 2.25 (SD 1.09) out of 5. Gender did not play a significant role in parental knowledge, attitudes, or behavior (P=.44, P=.77, and P=.99, respectively). Conclusions Parental knowledge in our sample still needs improvement. Therefore, more awareness campaigns should be made for the community and for the parents of affected children to create a supportive environment for the children and help them thrive and develop.
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Affiliation(s)
- Abdulelah Kinkar
- Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Dalya Alqarni
- Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
| | | | - Sahal Wali
- Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Nasser Alghamdi
- Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Saeed Saloom
- Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Mooataz Aashi
- Department of Pediatrics, King Abdulaziz University Hospital, Jeddah, Saudi Arabia
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9
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Wagner JL, Modi AC, Guilfoyle SM, Junger KF, Weyand C, Smith G, Griffin M, Mucci G. Current behavioral health and cognitive screening practices in pediatric epilepsy. Epilepsy Behav 2019; 101:106214. [PMID: 31680024 DOI: 10.1016/j.yebeh.2019.03.019] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/12/2019] [Revised: 03/12/2019] [Accepted: 03/12/2019] [Indexed: 11/29/2022]
Abstract
PURPOSE Initiatives such as the Epilepsy Learning Healthcare System continue to advocate for standardized care and shared outcome data. Therefore, the current project aim was to gather information from epilepsy healthcare professionals, behavioral health professionals in particular, regarding their behavioral health and cognitive screening practices in pediatric patients with epilepsy. Information obtained will be used to assist in the development of new educational programs and platforms in the American Epilepsy Society (AES) and to inform the development of guidelines for behavioral healthcare of patients with pediatric epilepsy. SURVEY INFORMATION Twenty-five AES members representing 25 unique epilepsy programs across the United States participated in the survey. Findings are described in terms of three focus areas: (1) Systems, (2) Assessment, and (3) Intervention. Over 80% of respondents surveyed reported that they do conduct formal screenings, most commonly to determine if further evaluation is indicated (81%), inform treatment decisions (57.1%), and for developmental surveillance (33.3%). Assessment methods were fairly evenly split between nonstandardized informal questions (50%) and evidence-based broadband measures, with the Behavior Assessment System for Children (BASC), 2nd or 3rd Editions (40%) most commonly used. If behavioral health concerns are identified, referrals are often made for psychotherapy (48% in-house; 80% community-based), psychiatry (68% in-house; 48% community-based), and cognitive testing (88% neuropsychological testing; 36% for psychoeducational testing). Thirty-two percent refer for psychotropic medication management. CONCLUSION According to this survey, a number of epilepsy centers and clinics incorporate behavioral health screening; however, there is significant variability in assessments/measures used, who is administering them, and their purpose in the trajectory of treatment. These findings emphasize the need for standardization across centers in order to most effectively provide comprehensive care for youth with epilepsy.
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Affiliation(s)
| | - Avani C Modi
- Cincinnati Children's Hospital Medical Center, University of Cincinnati, Cincinnati, OH, USA
| | - Shanna M Guilfoyle
- Cincinnati Children's Hospital Medical Center, University of Cincinnati, Cincinnati, OH, USA
| | - Katherine F Junger
- Cincinnati Children's Hospital Medical Center, University of Cincinnati, Cincinnati, OH, USA
| | | | - Gigi Smith
- Medical University of South Carolina, Charleston, SC, USA
| | - Millie Griffin
- Medical University of South Carolina, Charleston, SC, USA
| | - Grace Mucci
- Children's Hospital of Orange County, Orange, CA, USA
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Greenshields S. An introduction to nursing children and young people with epilepsy. BRITISH JOURNAL OF NURSING (MARK ALLEN PUBLISHING) 2019; 28:1115-1117. [PMID: 31556727 DOI: 10.12968/bjon.2019.28.17.1115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Affiliation(s)
- Sarah Greenshields
- Lecturer in Children and Young People's Nursing, Northumbria University, Newcastle upon Tyne
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Rani A, Thomas PT. Parental Knoweldge, Attitude, and Perception about Epilepsy and Sociocultural Barriers to Treatment. J Epilepsy Res 2019; 9:65-75. [PMID: 31482058 PMCID: PMC6706645 DOI: 10.14581/jer.19007] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2019] [Revised: 06/20/2019] [Accepted: 06/28/2019] [Indexed: 01/22/2023] Open
Abstract
Background and Purpose The present study focused on assessing parental knowledge, attitudes, and perceptions about epilepsy as well as addressing the socio-cultural barriers to its treatment. Methods Data were collected from out-patient consultations in the neurology department of a tertiary referral center in South India. Parents of sixty children suffering from epilepsy in the age-group of 4-15 years were interviewed to explore their knowledge, attitudes, and perceptions about epilepsy. They were recruited in 2015 over a consecutive period of six months. The tools administered were: socio-demographic schedule; clinical profile; a knowledge, attitude, and perception questionnaire prepared by the researcher; and a few case studies with psychosocial interventions. Results The mean age of the parents who brought their children to the hospital was 37.2 years, with 71.7% being male, of which, 36% were educated up to secondary/intermediate level and were of lower socio-economic status. The mean age of the children with epilepsy was 8.4 years with 66.7% of them being male. Among them, 50% had the most commonly occurring generalized seizures and 26.7% had the co-morbid condition of cerebral palsy. Around 37.7% parents attributed the seizures to evil spirits or supernatural powers, 52.5% to mental illness, and 72.1% were influenced by their families to initially seek religio-spiritual or traditional treatment in desperation for a cure of the illness. In total, 91.8% of the parents visited holy places, made "mannats", or prayed in worship for hours for their child's recovery. Conclusions Creating awareness about epilepsy is important to address the socio-cultural barriers to its treatment and improve help-seeking behavior.
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Affiliation(s)
- Akanksha Rani
- Department of Psychiatric Social Work, National Institute of Mental Health and Neurosciences, Bengaluru, India
| | - Priya Treesa Thomas
- Department of Psychiatric Social Work, National Institute of Mental Health and Neurosciences, Bengaluru, India
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Puka K, Ferro MA, Anderson KK, Speechley KN. Prevalence and trajectories of depressive symptoms among mothers of children with newly diagnosed epilepsy: A longitudinal 10-year study. Epilepsia 2019; 60:358-366. [PMID: 30645767 DOI: 10.1111/epi.14638] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2018] [Accepted: 12/14/2018] [Indexed: 01/29/2023]
Abstract
OBJECTIVE Parental depression significantly impacts children's health and well-being. This study aimed to (1) estimate the prevalence of depressive symptoms, at six time points, among mothers over the first 10 years after their child was diagnosed with epilepsy; (2) identify trajectories of maternal depressive symptoms over time; and (3) identify baseline factors associated with each trajectory. METHODS Data came from the Health-Related Quality of Life in Children with Epilepsy Study (HERQULES), a Canada-wide prospective cohort study. Data on child, parent, and family characteristics were collected at the time of diagnosis, and follow-ups at 0.5, 1, 2, 8, and 10 years. Maternal depressive symptoms were measured using the Center for Epidemiological Studies Depression Scale. Trajectories of depressive symptoms were evaluated using latent class growth modeling, and multinomial logistic regression was used to identify baseline factors associated with each trajectory. RESULTS A total of 356 mothers participated in the study, of whom 57% scored in the at-risk range for major depression disorder (period-prevalence). Four unique trajectories were identified as follows: "Low-Stable" (29% of mothers), "Intermediate-Stable" (46%), "High-Stable" (20%), and "High-Decreasing" (5%). Positive family environment was consistently associated with a better trajectory of depressive symptoms over time; other significant factors included type of seizures, child cognitive comorbidity, maternal age, and maternal education. SIGNIFICANCE A substantial proportion of mothers of children with epilepsy are at risk for depression, and this risk is stable over the long term. Family environment at the time of diagnosis has long-term and persistent effects and may be an ideal target for interventions.
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Affiliation(s)
- Klajdi Puka
- Department of Epidemiology and Biostatistics, Western University, London, Ontario, Canada.,Children's Health Research Institute, Lawson Health Research Institute, London, Ontario, Canada
| | - Mark A Ferro
- School of Public Health and Health Systems, University of Waterloo, Waterloo, Ontario, Canada
| | - Kelly K Anderson
- Department of Epidemiology and Biostatistics, Western University, London, Ontario, Canada.,Children's Health Research Institute, Lawson Health Research Institute, London, Ontario, Canada.,Department of Psychiatry, Western University, London, Ontario, Canada
| | - Kathy N Speechley
- Department of Epidemiology and Biostatistics, Western University, London, Ontario, Canada.,Children's Health Research Institute, Lawson Health Research Institute, London, Ontario, Canada.,Department of Paediatrics, Western University, London, Ontario, Canada
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Faith MA, Mayes S, Pratt CD, Carter C. Improvements in Hope and Beliefs about Illness Following a Summer Camp for Youth with Chronic Illnesses. J Pediatr Nurs 2019; 44:56-62. [PMID: 30683282 DOI: 10.1016/j.pedn.2018.10.016] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2018] [Revised: 10/23/2018] [Accepted: 10/23/2018] [Indexed: 11/29/2022]
Abstract
This study evaluated changes in hope, attitude toward illness, and perceptions of illness benefit and burden following participation in a summer camp designed for youth with a variety of chronic illnesses. Participants were 62 youth campers (Age M = 13.45 years, SD = 2.41) with a variety of chronic illnesses. For youth who began camp low in hope about future goal attainment, participation in optional camp activities negatively predicted post-camp hope about future goal attainment. This relation was nonsignificant for campers who began camp high in hope. We found no significant changes in attitude toward illness or perceptions of illness benefit or burden. This study provides an important contribution to burgeoning research on summer camps designed for children with varying chronic illnesses. Findings were inconsistent with previous studies on chronic illness summer camp outcomes. Further work is needed to identify camp components that are related to desirable psychosocial outcomes for youth with chronic illnesses.
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Affiliation(s)
- Melissa A Faith
- Johns Hopkins All Children's Hospital, St. Petersburg, FL, USA; University of Texas Southwestern Medical Center, Dallas, TX, USA.
| | - Sunnye Mayes
- University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - Chelsea D Pratt
- University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Carrick Carter
- University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
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Puka K, Tavares TP, Anderson KK, Ferro MA, Speechley KN. A systematic review of quality of life in parents of children with epilepsy. Epilepsy Behav 2018; 82:38-45. [PMID: 29579553 DOI: 10.1016/j.yebeh.2018.03.008] [Citation(s) in RCA: 38] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2018] [Revised: 03/05/2018] [Accepted: 03/06/2018] [Indexed: 11/25/2022]
Abstract
OBJECTIVES This systematic review aimed to 1) describe the quality of life (QOL) of parents of children with childhood-onset epilepsy (CWE), 2) identify factors associated with parental QOL, and 3) evaluate the association between parents' QOL and children's psychological well-being. METHODS We conducted a comprehensive search of MEDLINE, EMBASE, and PsycINFO and conducted forward and backward citation tracking. A total of 15 articles met inclusion criteria. Parents' QOL was compared with population norms, healthy controls, and parents of children with other chronic conditions. Factors associated with parental QOL were systematically evaluated. RESULTS Heterogeneity in study design and reporting prevented a meta-analytic synthesis of results. The majority of studies found that parents of CWE had poorer QOL relative to healthy controls or population norms and similar QOL as parents of children with other chronic conditions. In addition, poorer parental QOL was consistently associated with greater parental anxiety and depressive symptoms and poorer socioeconomic status and child QOL. Mothers had poorer QOL relative to fathers. Seizure control was not consistently associated with parental QOL. Results highlight the impact of family environment and psychosocial factors. SIGNIFICANCE This review suggests that parents of CWE have compromised QOL. The results are in line with previous research showing the interdependent nature of psychosocial and medical factors, with psychosocial factors playing a critical role in child and parental QOL and well-being. Interventions targeting the family unit are warranted, and healthcare providers should be aware of the bidirectional relationship of epilepsy, family environment, and child/parent health and well-being.
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Affiliation(s)
- Klajdi Puka
- Department of Epidemiology & Biostatistics, Western University, London, ON, Canada; Children's Health Research Institute, Lawson Health Research Institute, London, ON, Canada.
| | - Tamara P Tavares
- Department of Neuroscience, Western University, London, ON, Canada; Brain and Mind Institute, London, ON, Canada
| | - Kelly K Anderson
- Department of Epidemiology & Biostatistics, Western University, London, ON, Canada; Children's Health Research Institute, Lawson Health Research Institute, London, ON, Canada; Department of Psychiatry, Western University, London, ON, Canada
| | - Mark A Ferro
- School of Public Health and Health Systems, University of Waterloo, Waterloo, ON, Canada
| | - Kathy N Speechley
- Department of Epidemiology & Biostatistics, Western University, London, ON, Canada; Children's Health Research Institute, Lawson Health Research Institute, London, ON, Canada; Department of Paediatrics, Western University, London, ON, Canada
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15
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Smith G, Modi AC, Johnson EK, Shegog R, Austin JK, Wagner JL. Measurement in pediatric epilepsy self-management: A critical review. Epilepsia 2018; 59:509-522. [PMID: 29322489 DOI: 10.1111/epi.13992] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/05/2017] [Indexed: 11/30/2022]
Abstract
Given the paucity of information available regarding self-management, the aims of this paper are to synthesize the literature on factors associated with and measures to assess self-management in pediatric epilepsy. INCLUSION CRITERIA youth birth to 18 years with a seizure disorder or an epilepsy diagnosis and/or their caregivers, published 1985-2014 in English, and conducted in countries with a very high human development index. The review was conducted in 6 phases: (1) identification of bibliographical search criteria and databases; (2) abstract assessment; (3) full article review; (4) organization of final citations into categories; (5) identification of predictors, potential mediators/moderators, and outcomes associated with self-management factors and categorization of factors as influences, processes, or behaviors across individual, family, community, and health care domains; and (6) critique of self-management instrument studies. Twenty-five studies that evaluated factors associated with self-management were identified. Individual and family-focused factors were the most commonly studied predictors of self-management, with psychosocial care needs and self-efficacy for seizure management identified as key factors associated with pediatric epilepsy self-management. Few studies have included mediator and moderator analyses. Measures of adherence were the most commonly used outcome. There has been a predominant focus on pediatric epilepsy influences and processes that are modifiable in nature, potentially at the expense of evidence for the role of community and health systems in pediatric epilepsy self-management. The 6 self-management instrument tools reported scientific rationale and good psychometric properties. Results highlight several key modifiable cognitive and behavioral targets for skills development: adherence, self-efficacy for seizure management, attitudes toward epilepsy, and family variables. Moving forward, a comprehensive pediatric epilepsy self-management model, well-validated measures of self-management behaviors, mediator/moderator designs to examine the complex relationships between predictors and pediatric epilepsy self-management outcomes, and studies examining the community and health care domains of self-management are necessary.
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Affiliation(s)
- Gigi Smith
- College of Nursing, Department of Pediatrics, Comprehensive Epilepsy Center, Medical University of South Carolina, Charleston, SC, USA
| | - Avani C Modi
- Center for Treatment Adherence and Self-Management, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Erica K Johnson
- School of Public Health, Health Promotion Research Center, University of Washington, Seattle, WA, USA
| | - Ross Shegog
- Center for Health Promotion and Prevention Research, UT Health School of Public Health, Houston, TX, USA
| | - Joan K Austin
- School of Nursing, Indiana University-Purdue University Indianapolis, Bloomington, IN, USA
| | - Janelle L Wagner
- College of Nursing, Department of Pediatrics, Comprehensive Epilepsy Center, Medical University of South Carolina, Charleston, SC, USA
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16
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Health-related quality of life in mothers of children with epilepsy: 10 years after diagnosis. Qual Life Res 2018; 27:969-977. [DOI: 10.1007/s11136-017-1778-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/27/2017] [Indexed: 10/18/2022]
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17
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Masri A, Aburahma S, Khasawneh A, Al Qudah A, Nafi O, Al Momani M, Khatib F. Parental knowledge and attitudes towards epilepsy -A study from Jordan. Seizure 2017; 53:75-80. [PMID: 29149668 DOI: 10.1016/j.seizure.2017.11.006] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2017] [Revised: 11/06/2017] [Accepted: 11/07/2017] [Indexed: 12/20/2022] Open
Abstract
PURPOSE To explore the knowledge, attitudes and behaviors of parents whose children were diagnosed with epilepsy. METHODS Cross-sectional questionnaire based study of parents who accompanied their children with epilepsy to the child neurology clinics at three university hospitals in Jordan. RESULTS Most parents (427, 90.3%) knew that epilepsy is not related to a psychiatric disease. Approximately half of the parents (245, 51.8%) used the internet as their source of knowledge, and most used Arabic websites. Searching the word epilepsy was rarely used (51, 10.8%). Most of the parents (428,90.5%) were not restricting their children from watching TV or from using the computer (358,75.5%).However, many parents (280,59.2%) were restricting them from participating in sports. Parents had negative attitudes towards epilepsy; 189 (40.0%)thought that epileptic children can have normal intelligence, and 292 (61.7%) thought that they can continue into higher education. Greater parental knowledge of epilepsy was found to be correlated with the parental education level (p<0.05).Positive attitudes and behaviors towards epilepsy were found to be correlated with a higher parental education level, control of epilepsy,an absence of associated co morbidities, a higher income and internet use (p<0.05). CONCLUSION This study sheds an important light on the current knowledge status and attitudes of parents of children with epilepsy, and is an invaluable tool for tailoring the delivery of information and support resources for families in our region.
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Affiliation(s)
- Amira Masri
- Department of Pediatrics, Division of Child Neurology, Faculty of Medicine, The University of Jordan, Jordan.
| | - Samah Aburahma
- Neuroscience Department, Faculty of Medicine, Jordan University of Science and Technology, Jordan.
| | - Aisha Khasawneh
- Department of Family Medicine, Faculty of Medicine, The University of Jordan, Jordan.
| | - Abdelkarim Al Qudah
- Department of Pediatrics, Division of Child Neurology, Faculty of Medicine, The University of Jordan, Jordan.
| | - Omar Nafi
- Pediatric Department, Faculty of Medicine, Mutah University, Jordan.
| | - Miral Al Momani
- Pediatric Department, Faculty of Medicine, Jordan University of Science and Technology, Jordan.
| | - Faisal Khatib
- Department of Biochemistry, Faculty of Medicine, The University of Jordan, Jordan.
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Mendes TP, Crespo CA, Austin JK. The psychological costs of comparisons: Parents' social comparison moderates the links between family management of epilepsy and children's outcomes. Epilepsy Behav 2017; 75:42-49. [PMID: 28826008 DOI: 10.1016/j.yebeh.2017.07.017] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2017] [Revised: 07/12/2017] [Accepted: 07/14/2017] [Indexed: 10/19/2022]
Abstract
Parents play a key role in how children deal with epilepsy. When diagnosed with health conditions, people seek comparison information from fellow patients and families, and this information has consequences for how they evaluate their situation. This study examined the moderating role of parents' social comparison orientation in the associations between family management (parental perceptions of family life difficulties and child's daily life) and adaptation outcomes of children with epilepsy (HRQoL and perceived stigma). Participants included 201 dyads of children with epilepsy and either their mother or father. The results showed that when parents perceived higher difficulties managing their child's epilepsy and/or reported that their child was more affected by this condition, children reported higher perceived stigma and worse HRQoL only when parents had a higher social comparison orientation. Our results are innovative in showing that when parents have a higher social comparison orientation, their children may be at increased risk of poorer outcomes.
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Affiliation(s)
- Teresa P Mendes
- Faculdade de Psicologia e de Ciências da Educação, Universidade de Coimbra, Portugal.
| | - Carla A Crespo
- Faculdade de Psicologia, Universidade de Lisboa, Portugal
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Neyaz HA, Aboauf HA, Alhejaili ME, Alrehaili MN. Knowledge and attitudes towards epilepsy in Saudi families. J Taibah Univ Med Sci 2017; 12:89-95. [PMID: 31435221 PMCID: PMC6695036 DOI: 10.1016/j.jtumed.2016.06.007] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2016] [Revised: 06/21/2016] [Accepted: 06/26/2016] [Indexed: 12/05/2022] Open
Abstract
OBJECTIVES Epilepsy is one of the most common paediatric neurological disorders. Lack of awareness regarding epilepsy among the general population influences the lives of epileptic children. Misconceptions and misinformation about epilepsy in children should be identified and corrected. The aim of this study was to assess the knowledge and attitudes towards epilepsy in families of epileptic children and families of normal children in Almadinah Almunawwarah, KSA. METHODS A cross-sectional study was conducted at Maternity and Children's Hospital from March 2015 to December 2015. A self-administered questionnaire was designed to collect data from the participant families. RESULTS Of 168 participants, 150 completed the questionnaire. These included 64 families of epileptic children and 86 families of normal children. Of all the responding families, 67 families (44.7%) thought that epilepsy was related to Jinn. Logistic regression analysis showed that this belief was dependent on the family education level (p = 0.004) and to the area of residence, either urban or rural (p = 0.04). In families of epileptic children, the link of epilepsy to Jinn was related to clinical factors, such as the type of epilepsy (p = 0.023), disease duration (p = 0.039), and duration of treatment (p = 0.028). CONCLUSIONS Our community still has misconceptions regarding epilepsy, even among families of epileptic children. Knowledge and attitudes toward epilepsy must be corrected. Planned programs and campaigns should be conducted in the form of mass society education.
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Affiliation(s)
- Hanan A. Neyaz
- Faculty of Medicine and General Surgery at Taibah University, Almadinah Almunawwarah, KSA
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20
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Hagemann A, Pfäfflin M, Nussbeck FW, May TW. The efficacy of an educational program for parents of children with epilepsy (FAMOSES): Results of a controlled multicenter evaluation study. Epilepsy Behav 2016; 64:143-151. [PMID: 27744243 DOI: 10.1016/j.yebeh.2016.09.027] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2016] [Accepted: 09/18/2016] [Indexed: 11/20/2022]
Abstract
OBJECTIVE The objective of this study was to evaluate the efficacy of the educational program FAMOSES (modular service package epilepsy for families) for parents of children with epilepsy. METHOD Parents of children with epilepsy from Germany and Austria were included in a controlled prospective multicenter study using a pre-post design. Participants of the FAMOSES program (FAMOSES group, n=148) completed a standardized questionnaire immediately before the program and six months later. The matched control group of parents not participating in the program (n=74, matching ratio 2:1) also answered the questionnaire twice, at an interval of six months. The questionnaire comprised epilepsy-specific outcome measures (e.g., knowledge, coping, fears) and disease-related variables (e.g., seizure frequency). The generalized estimation equation approach was used for statistical analysis. In addition, parents' satisfaction with the FAMOSES program was assessed six months after participation. RESULTS Parents of the FAMOSES group significantly improved in epilepsy-specific knowledge (group×time interaction: p<.001), coping (p<.01), epilepsy-related fears (p<.05), and in speaking about epilepsy with their child (p<.05) compared with the control group. No effects were found on disease-related variables. Nearly all of the participants rated the FAMOSES parents' program as "very good" (71%) or "good" (27%). CONCLUSION The efficacy of the FAMOSES parents' program was confirmed. The results indicate that imparting knowledge and the interactive approach help parents in coping with their child's epilepsy and reduce epilepsy-related fears.
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Affiliation(s)
- Anne Hagemann
- Department of Psychology, Bielefeld University, Germany.
| | | | | | - Theodor W May
- Department of Psychology, Bielefeld University, Germany; Society for Epilepsy Research, Bielefeld, Germany
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21
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Jones JE, Siddarth P, Almane D, Gurbani S, Hermann BP, Caplan R. Identification of risk for severe psychiatric comorbidity in pediatric epilepsy. Epilepsia 2016; 57:1817-1825. [PMID: 27739581 DOI: 10.1111/epi.13575] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/01/2016] [Indexed: 01/20/2023]
Abstract
OBJECTIVE This study identified items on the Child Behavior Checklist (CBCL) that predict those children and adolescents with epilepsy at highest risk for multiple psychiatric diagnoses. METHODS Three hundred twenty-eight children, ages 5-18 years, and their parents participated in separate structured psychiatric interviews about the children, which yielded Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition Text Revision (DSM-IV-TR) diagnoses. Parents completed the CBCL. The sample was divided into a younger (≤12 years, n = 214) group and an older (>12-18 years, n = 114) group. This study identified a reduced set of parent-reported CBCL items associated with Multiple Diagnoses versus Single Diagnosis versus No Diagnosis using chi-square tests and stepwise logistic regression. We then performed a generalized logistic regression with Multiple Diagnoses versus Single Diagnosis versus No Diagnosis as the dependent variable and the reduced CBCL set of items as predictors. We calculated the area under the ROC (receiver operating characteristic) curve (AUC) as a measure of diagnostic accuracy for pairwise comparisons. RESULTS For the younger group, seven items (clingy, cruelty/bullying, perfectionist, nervous, poor school work, inattentive, and sulks) had high diagnostic accuracy (AUC = 0.88), and for the older group, three items (disobedient at school, loner, and lies/cheats) had high accuracy (AUC = 0.91) when comparing children with multiple psychiatric diagnoses to children with no diagnosis. For both age groups, there was less diagnostic accuracy in identifying children with a single versus no diagnosis (AUC = 0.75 [young]; 0.70 [older]). SIGNIFICANCE These findings suggest that responses to these two subsets of parent-reported CBCL items should alert clinicians to children and adolescents with epilepsy at risk for multiple psychiatric diagnoses and in need of a psychiatric referral.
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Affiliation(s)
- Jana E Jones
- Department of Neurology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, U.S.A
| | - Prabha Siddarth
- Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, Los Angeles, California, U.S.A
| | - Dace Almane
- Department of Neurology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, U.S.A
| | - Suresh Gurbani
- Department of Pediatrics, University of California Irvine, Irvine, California, U.S.A
| | - Bruce P Hermann
- Department of Neurology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, U.S.A
| | - Rochelle Caplan
- Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, Los Angeles, California, U.S.A
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Ramsey RR, Ryan JL, Fedele DA, Mullins LL, Chaney JM, Wagner JL. Child Attitude Toward Illness Scale (CATIS): A systematic review of the literature. Epilepsy Behav 2016; 59:64-72. [PMID: 27096812 DOI: 10.1016/j.yebeh.2016.03.026] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2016] [Revised: 03/16/2016] [Accepted: 03/17/2016] [Indexed: 11/26/2022]
Abstract
OBJECTIVE The objective of this study was to systematically review the literature utilizing the Child Attitude Toward Illness Scale (CATIS) as a measure of illness attitudes within pediatric chronic illness, including epilepsy, and provide recommendations for its use. This review includes an examination of the psychometric properties of the CATIS and the relationship between the CATIS and psychological, academic, behavioral, and illness variables. METHOD Electronic searches were conducted using Medline and PsychINFO to identify twenty-two relevant publications. RESULTS The CATIS was identified as a reliable and valid self-report assessment tool across chronic illnesses, including pediatric epilepsy. Although originally developed for children ages 8-12, the CATIS has demonstrated reliability and validity in youth ages 8-22. The CATIS scores were reliably associated with cognitive appraisal variables and internalizing symptoms. Initial support exists for the relation between illness attitudes and externalizing behavior, academic functioning, and psychosocial care needs. Mixed findings were reported with regard to the relation between illness attitudes and demographic and disease variables, as well as both social and family functioning. CONCLUSION The CATIS is a psychometrically sound self-report instrument for measuring illness attitudes and demonstrates clinical utility for examining adjustment outcomes across chronic illnesses, particularly pediatric epilepsy.
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Affiliation(s)
- Rachelle R Ramsey
- Center for Adherence and Self-Management, Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, United States
| | - Jamie L Ryan
- Center for Adherence and Self-Management, Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, United States
| | - David A Fedele
- Department of Clinical and Health Psychology, University of Florida, United States
| | - Larry L Mullins
- Department of Psychology, Oklahoma State University, Stillwater, OK, United States
| | - John M Chaney
- Department of Psychology, Oklahoma State University, Stillwater, OK, United States
| | - Janelle L Wagner
- Comprehensive Epilepsy Center, College of Nursing, Department of Pediatrics, Medical University of South Carolina, United States.
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23
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Park SY, Ju HO. Knowledge, Attitude and Anxiety in Mothers of Children with Epilepsy. CHILD HEALTH NURSING RESEARCH 2016. [DOI: 10.4094/chnr.2016.22.1.54] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
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Austin JK, Haber LC, Dunn DW, Shore CP, Johnson CS, Perkins SM. Children with new onset seizures: A prospective study of parent variables, child behavior problems, and seizure occurrence. Epilepsy Behav 2015; 53:73-7. [PMID: 26520879 PMCID: PMC4674332 DOI: 10.1016/j.yebeh.2015.09.019] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2015] [Revised: 08/29/2015] [Accepted: 09/15/2015] [Indexed: 11/17/2022]
Abstract
OBJECTIVE Parent variables (stigma, mood, unmet needs for information and support, and worry) are associated with behavioral difficulties in children with seizures; however, it is not known how this relationship is influenced by additional seizures. This study followed children (ages 4-14 years) and their parents over a 24-month period (with data collected at baseline and 6, 12, and 24 months) and investigated the effect of an additional seizure on the relationship between parenting variables and child behavior difficulties. METHODS The sample was parents of 196 children (104 girls and 92 boys) with a first seizure within the past 6 weeks. Child mean age at baseline was 8 years, 3 months (SD 3 years). Data were analyzed using t-tests, chi-square tests, and repeated measures analyses of covariance. RESULTS Relationships between parent variables, additional seizures, and child behavior problems were consistent across time. Several associations between parent variables and child behavior problems were stronger in the additional seizure group than in the no additional seizure group. CONCLUSIONS Findings suggest that interventions that assist families to respond constructively to the reactions of others regarding their child's seizure condition and to address their needs for information and support could help families of children with continuing seizures to have an improved quality of life.
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Affiliation(s)
- Joan K. Austin
- Indiana University School of Nursing, Indianapolis, IN,Corresponding Author: Joan K. Austin, 3040 N Ramble Road West, Bloomington, IN, 47408,
| | | | - David W. Dunn
- Department of Psychiatry and Department of Neurology, Indiana University School of Medicine, Indianapolis, IN
| | | | - Cynthia S. Johnson
- Department of Biostatistics, Indiana University School of Medicine, Indianapolis, IN
| | - Susan M. Perkins
- Department of Biostatistics, Indiana University School of Medicine, Indianapolis, IN
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Determining patient needs: A partnership with South Carolina Advocates for Epilepsy (SAFE). Epilepsy Behav 2015; 51:294-9. [PMID: 26318792 DOI: 10.1016/j.yebeh.2015.08.007] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2015] [Revised: 08/04/2015] [Accepted: 08/05/2015] [Indexed: 11/21/2022]
Abstract
PURPOSE The purpose of this study was to collaborate with a community partner to administer a current needs assessment of persons with epilepsy (PWE) and determine the types of resources that PWE would like to access through the community partner. METHODS A self-report needs assessment survey was administered to caregivers and PWE across the state of South Carolina during a community partner educational workshop (n=20) and via secure software distributed through an email link (n=54). KEY FINDINGS The most frequently reported challenges (>50%) were concerns about finding time to participate in epilepsy community activities, the personal safety of the PWE, finding social connections or social support, finding mental or behavioral health services, and work concerns. However, top ranked concerns centered on personal safety (27.8%), lack of insurance/not enough money to pay for epilepsy treatment (15.3%), and difficulty with daily management of epilepsy (13.9%). Participants reported likely engagement with the epilepsy community partner via in-person meetings, over the phone, and through social media contacts; however, there were differences between PWE and caregivers regarding preferences for communication. Almost 60% endorsed that they would likely participate in a brief program to learn skills to manage their epilepsy daily. SIGNIFICANCE Persons with epilepsy in South Carolina continue to have many unmet needs and would access resources, if available, from a state-wide epilepsy community partner via various modes of communication.
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27
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Austin JK, Perkins SM, Dunn DW. A model for internalized stigma in children and adolescents with epilepsy. Epilepsy Behav 2014; 36:74-9. [PMID: 24866252 PMCID: PMC4096577 DOI: 10.1016/j.yebeh.2014.04.020] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2014] [Revised: 04/19/2014] [Accepted: 04/21/2014] [Indexed: 11/25/2022]
Abstract
OBJECTIVE Perceptions of stigma in children and adolescents with epilepsy are associated with higher rates of mental health problems. The purpose of this study was to test relationships in a model that identified variables most strongly associated with perceptions of stigma in children and adolescents with epilepsy. Our ultimate goal is to develop a theoretical foundation for future intervention research by identifying variables associated with perceptions of stigma that are potentially amenable to psychosocial interventions. METHODS Participants were 173 children and adolescents with epilepsy who were between 9 and 14 years of age. Data were collected in telephone interviews. Stigma was measured using a self-report scale. Data were analyzed using structural equation modeling. RESULTS Greater need for information and support, more fear and worry related to having epilepsy, greater seizure severity, and younger age were significantly associated with greater perceptions of stigma. Female gender, greater need for information and support, having at least one seizure in the past year, and lower self-efficacy for seizure management were significantly associated with more fear and worry related to having epilepsy. CONCLUSIONS Findings suggest that perceptions of stigma are associated with two variables that are amenable to psychosocial interventions: fear and worry about having epilepsy and need for information and support. Future research should test the efficacy of interventions that reduce fear and worry, provide information about epilepsy, and reduce need for support.
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Affiliation(s)
- Joan K. Austin
- Corresponding author; Joan K. Austin, PhD, RN, FAAN, Indiana University School of Nursing, 3040 N Ramble Road West, Bloomington, IN 47408, Tel: 812-332-8278,
| | - Susan M. Perkins
- Department of Biostatistics, Indiana University School of Medicine, Indianapolis, Indiana, U.S.A
| | - David W. Dunn
- Departments of Psychiatry and Neurology, Indiana University School of Medicine, Indianapolis, Indiana, U.S.A
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Smith G, Wagner J, Andrews J, Austin J, Mueller M, Carter E, Griesemer K. Caregiving in pediatric epilepsy: results of focus groups and implications for research and practice. Epilepsy Behav 2014; 34:34-41. [PMID: 24681383 DOI: 10.1016/j.yebeh.2014.03.002] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2013] [Revised: 02/28/2014] [Accepted: 03/02/2014] [Indexed: 11/28/2022]
Abstract
The process of caring for youth with epilepsy (YWEs) has been understudied. Previous research has identified that caregivers of YWEs report increased parenting stress, unanticipated caregiving responsibilities, and negative effects on family life. Using the adapted Caregiving Process Model, perceptions of the caregiving process were explored in four focus groups of caregivers of youth with epilepsy diagnosed at <1 year, between 1 and 5 years, and >5 years. Thematic analysis guided the data analysis. The prevalent theme that emerged during the data analysis was navigating the noncontingencies (lack of a perceived relationship between action and outcome, unpredictability). This was supported by the subthemes, namely, blessings and sacrifices, uncertainty today and tomorrow, constant vigilance, and caregiving is more than parenting. The focus groups displayed similarities and differences in caregiving perceptions across the three postdiagnosis time periods, providing support for conceptualization of the caregiving as multifactorial, multidirectional, and fluid process. With this knowledge, epilepsy health-care professionals are encouraged to promote patient and family centeredness, provide information on how to access community resources, and work with caregivers to enhance epilepsy self-management skills.
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Affiliation(s)
- Gigi Smith
- College of Nursing, Medical University of South Carolina, Charleston, SC, USA; Department of Neurosciences, Comprehensive Epilepsy Center, Medical University of South Carolina, Charleston, SC, USA.
| | - Janelle Wagner
- College of Nursing, Medical University of South Carolina, Charleston, SC, USA; Department of Neurosciences, Comprehensive Epilepsy Center, Medical University of South Carolina, Charleston, SC, USA
| | - Jeanette Andrews
- College of Nursing, University of South Carolina, Columbia, SC, USA
| | - Joan Austin
- School of Nursing, Indiana University, Indianapolis, IN, USA
| | - Martina Mueller
- College of Nursing, Medical University of South Carolina, Charleston, SC, USA
| | - Emma Carter
- Department of Neurosciences, Comprehensive Epilepsy Center, Medical University of South Carolina, Charleston, SC, USA
| | - Kimberly Griesemer
- Department of Neurosciences, Comprehensive Epilepsy Center, Medical University of South Carolina, Charleston, SC, USA
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Wagner JL, Levisohn PM, Onufer CN, Uchegbu GC, Fletcher L, Zupanc M, Browne M. Project Access: Strategies to improve care for children and youth with epilepsy: illustrations of recommendations in the IOM report on the epilepsies. Epilepsy Behav 2013; 29:121-7. [PMID: 23939036 DOI: 10.1016/j.yebeh.2013.06.036] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2013] [Revised: 06/21/2013] [Accepted: 06/24/2013] [Indexed: 11/27/2022]
Abstract
Project Access (PA), funded by the Maternal and Child Health Bureau (MCHB) of the Health Resources and Services Administration (HRSA), provided grants to state and local agencies to improve awareness, provide education, design, test, pilot and evaluate system changes, and improve quality of services and access to early diagnosis and comprehensive, coordinated health care and related services for children and youth with epilepsy residing in rural and medically underserved areas. In 2011, the Institute of Medicine of the National Academies (IOM) published a series of 13 recommendations addressing unmet psychosocial, medical, and public health needs of individuals with epilepsy, including children and youth. This paper examines the synergy between these two projects showing how the strategies utilized in the PA demonstration projects can address the IOM recommendations and how these recommendations can inform future initiatives for improving care for children and youth with epilepsy.
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Piskorska B, Miziak B, Czuczwar SJ, Borowicz KK. Safety issues around misuse of antiepileptics. Expert Opin Drug Saf 2013; 12:647-57. [DOI: 10.1517/14740338.2013.796363] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
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Valizadeh L, Barzegar M, Akbarbegloo M, Zamanzadeh V, Rahiminia E, Ferguson C. The relationship between psychosocial care and attitudes toward illness in adolescents with epilepsy. Epilepsy Behav 2013; 27:267-71. [PMID: 23453530 DOI: 10.1016/j.yebeh.2012.11.043] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2012] [Revised: 11/08/2012] [Accepted: 11/10/2012] [Indexed: 10/27/2022]
Abstract
Epilepsy is a significant health problem in Iran and other countries. Previous epilepsy studies conducted in Iran have often focused on physiological aspects and pharmacological therapy, and little attention has been paid to the psychological and social aspects of care, particularly in adolescence. This paper aims to fill this gap by assessing the relationship between psychosocial care and attitudes toward illness in adolescents with epilepsy. A descriptive correlational design was adopted, and 74 adolescents who experienced generalized seizures and were treated at the neurology clinic affiliated with the Tabriz University of Medical Sciences in 2010 were examined. The data were collected using instruments including (1) the patient demographic characteristics, (2) the Child Report of Psychosocial Care Scale, and (3) the Child's Attitude Toward Illness Scale. There was a significant positive correlation between psychosocial care and attitudes toward illness (p<.05). There is no evidence for routine psychological consultation for our sample; it would be helpful if psychological consultation with and without parents made available to adolescents with epilepsy.
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Affiliation(s)
- Leila Valizadeh
- Tabriz Pediatric Health Research Center, Nursing and Midwifery College, Tabriz University of Medical Sciences, Iran.
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Early screening and identification of psychological comorbidities in pediatric epilepsy is necessary. Epilepsy Behav 2012; 25:495-500. [PMID: 23153713 DOI: 10.1016/j.yebeh.2012.09.041] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/21/2012] [Revised: 09/27/2012] [Accepted: 09/29/2012] [Indexed: 11/24/2022]
Abstract
Youth with epilepsy often have co-occurring psychological symptoms that are due to underlying brain pathology, seizures, and/or antiepileptic drug side effects. The primary study aim was to compare the psychological comorbidities of youth with new-onset epilepsy versus chronic epilepsy. Primary caregivers of youth with either new-onset (n=82; M(age)=9.9±2.9) or chronic epilepsy (n=76; M(age)=12.8±3.3) completed the Behavioral Assessment Scale for Children-2nd Edition. Compared to those with new-onset epilepsy, the chronic group had significantly higher depressive and withdrawal symptoms, as well as lower activities of daily living. A higher proportion of youth with chronic epilepsy exhibited at-risk/clinically elevated depressive symptoms and difficulties with activities of daily living compared to the new-onset group. Proactive screening in youth with epilepsy to ensure timely identification of psychological symptoms and to guide early psychological intervention is warranted.
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Kubiski R. Perioperative care of the child with epilepsy. AORN J 2012; 95:635-44; quiz 645-7. [PMID: 22541774 DOI: 10.1016/j.aorn.2012.02.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2011] [Accepted: 02/17/2012] [Indexed: 10/28/2022]
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Pilot study of an integrated cognitive-behavioral and self-management intervention for youth with epilepsy and caregivers: Coping Openly and Personally with Epilepsy (COPE). Epilepsy Behav 2010; 18:280-5. [PMID: 20488757 DOI: 10.1016/j.yebeh.2010.04.019] [Citation(s) in RCA: 53] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2010] [Revised: 04/13/2010] [Accepted: 04/14/2010] [Indexed: 11/23/2022]
Abstract
The aim of this study was to pilot test an intervention based on empirically supported cognitive-behavioral techniques and theory-driven self-management content. The Coping Openly and Personally with Epilepsy (COPE) Program focused on enhancing coping skills, self-efficacy, and self-management to promote resilience in youth with epilepsy and their caregivers. Nine youth aged 10-15 and a parent completed several self-report measures pre- and post-intervention. Results revealed that parents did rate significant improvements in their children's coping skills following the COPE intervention. Further, compared with pre-assessment, children rated significant improvements in self-efficacy for seizure management. Child knowledge of epilepsy also significantly improved following the intervention. Two children reported mild suicidal ideation prior to the intervention, whereas no children reported ideation following the intervention. Results provide a foundation for further development of the COPE Program and suggest a randomized, controlled trial to examine the effectiveness of COPE for youth with epilepsy and their parents.
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