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Atan G, Oruç FG, Atan K. Assessment of stigmatization and self-esteem in patients with epilepsy. Epilepsy Behav 2024; 156:109847. [PMID: 38788660 DOI: 10.1016/j.yebeh.2024.109847] [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: 02/06/2024] [Revised: 04/08/2024] [Accepted: 05/16/2024] [Indexed: 05/26/2024]
Abstract
AIM This study was conducted to examine the relationship between stigmatization and self-esteem of patients with epilepsy. METHODS This cross-sectional study was conducted with 216 patients at a university hospital in Van, a province in eastern Turkey. The researcher prepared the data collection tools, including a personal information form, Jacoby Stigma Scale and the Rosenberg self-esteem scale, in line with the literature. The Jacoby stigma scale was applied to assess stigma. Data analysis was performed using t-test, one-way analysis of variance (ANOVA), and Tukey, LSD coefficient. RESULTS The mean total stigmatization score of patients with epilepsy was 21.11 ± 10.00, while the mean total self-esteem score was 20.26 ± 5.16. The study found a significant negative correlation between stigmatization and self-esteem scores (r = -0.411; p < 0.05). CONCLUSION The research study revealed that patient with epilepsy have a high perception of stigma and low selfesteem levels.
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Affiliation(s)
- Gülden Atan
- School of Health, Van Yüzüncü Yıl University, Van, TURKEY.
| | | | - Kemal Atan
- Dursun Odabaş Medical Center, Van Yüzüncü Yıl University, Van, TURKEY.
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Randi YM, Tedrus GMDAS, Nucci LB. Evaluation of social inclusion in Brazilian adult women with epilepsy: Perception of stigma and quality of life. Epilepsy Behav 2024; 156:109821. [PMID: 38704987 DOI: 10.1016/j.yebeh.2024.109821] [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: 01/02/2024] [Revised: 04/29/2024] [Accepted: 05/01/2024] [Indexed: 05/07/2024]
Abstract
Epilepsy is a chronic disease characterized by recurrent epileptic seizures that can affect the perception of stigma and compromise the quality of life of those living with it. In addition, sociodemographic factors such as employment and maintaining a job, education, and the autonomy to drive vehicles are often impaired. OBJECTIVE To assess the social inclusion of adult women with epilepsy in relation to the perception of stigma and quality of life, and the clinical aspects of the disease. METHODOLOGY Data from 70 adult Brazilian women with epilepsy regarding aspects related to their social inclusion were verified. Such data were linked to clinical aspects and scores from the questionnaires: Quality of Life in Epilepsy Inventory 31 (QOLIE-31) and the Epilepsy Stigma Scale (ESS), with a significance level of p < 0.05. RESULTS Average age of 45.5 years, 40 (57.1 %) women were divorced/single/widowed, 31 (44.3 %) women had less than 10 years of formal education, 32 (45.7 %) women had no income, and 57 (81.4 %) did not have a driver's license. The age at the time of the first seizure was 18 years, the seizures were focal in 46 (65.7 %) cases, and 26 (37.1 %) cases were seizure-free in the last year. A high number of women reported that the diagnosis of epilepsy negatively influenced aspects of autonomy such as the possession of a driver's license and going out alone. Longer duration of epilepsy was associated with lower education, not having children, and lower scores on the QOLIE-31. Higher scores on the QOLIE-31 were correlated with lower frequency of seizures and with the age at the time of the first seizure. Values in the dimension - energy and fatigue of the QOLIE-31 were significantly lower in the group with less independence compared to the other two groups with more independence, in latent class analyses (ANOVA, adjusted for age 42.1 ± 35.6 vs 57.2 ± 28.4 vs 73.9 ± 23.8, p = 0.0295). DISCUSSION Clinical aspects of epilepsy and having a partner, autonomy, and independence such as driving vehicles are factors that contribute to social inclusion and to the perception of a better quality of life for adult women with epilepsy. CONCLUSION It was observed that having a partner, autonomy, and independence such as driving vehicles are factors that contribute to social inclusion and to the perception of a better quality of life for adult women with epilepsy.
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Affiliation(s)
- Yara Maria Randi
- Postgraduate Program in Health Sciences. Pontifical Catholic University of Campinas - Campus II, Brazil.
| | | | - Luciana Bertoldi Nucci
- Postgraduate Program in Health Sciences. Pontifical Catholic University of Campinas - Campus II, Brazil.
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McLoughlin C, McWhirter L, Pisegna K, Tijssen MAJ, Tak LM, Carson A, Stone J. Stigma in functional neurological disorder (FND) - A systematic review. Clin Psychol Rev 2024; 112:102460. [PMID: 38905960 DOI: 10.1016/j.cpr.2024.102460] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2023] [Revised: 05/10/2024] [Accepted: 06/10/2024] [Indexed: 06/23/2024]
Abstract
OBJECTIVE The purpose of this systematic review was to evaluate stigma and Functional Neurological Disorder (FND) regarding: 1) prevalence and associated factors, 2) the nature and context of stigma in FND, and 3) stigma-reduction interventions. METHODS We searched four relevant databases from inception to December 2023, using search terms relevant to FND and stigma themes. We employed the method of synthesis by "aggregation and configuration" to synthesise and analyse the data into emergent themes. RESULTS We found 127 studies, spanning 148 countries, involving 18,886 participants. Of these, 4889 were patients, 13,123 were healthcare professionals, and 526 were caregivers. Quantitatively, stigma has been mainly studied in patients with functional seizures, and was higher than patients with epilepsy in three studies. Stigma experienced by patients is associated with poorer quality of life and caregiver burden. We found 10 themes and 29 subthemes revealing stigma as a systemic process, with intrapersonal, interpersonal and structural aspects. Few studies examined the perspective of caregivers, the public or online community. We identified six anti-stigma interventions. CONCLUSION Stigma in FND is a layered process, and affects patient quality of life and provision of care. Stigma needs to be addressed from the top structures, at governmental level, so that appropriate care pathways can be created, giving patients with FND parity of esteem with other medical conditions.
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Affiliation(s)
- Caoimhe McLoughlin
- Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, United Kingdom.
| | - Laura McWhirter
- Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, United Kingdom
| | | | - Marina A J Tijssen
- UMCG Expertise Centre Movement Disorders Groningen, University of Groningen, Groningen, the Netherlands
| | - Lineke M Tak
- Dimence Alkura, Specialist center Persistent Somatic Symptoms, Nico Bolkensteinlaan 65, 7416 SE Deventer, the Netherlands
| | - Alan Carson
- Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, United Kingdom
| | - Jon Stone
- Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, United Kingdom
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Di Gennaro G, Lattanzi S, Mecarelli O, Saverio Mennini F, Vigevano F. Current challenges in focal epilepsy treatment: An Italian Delphi consensus. Epilepsy Behav 2024; 155:109796. [PMID: 38643659 DOI: 10.1016/j.yebeh.2024.109796] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2023] [Revised: 03/18/2024] [Accepted: 04/14/2024] [Indexed: 04/23/2024]
Abstract
BACKGROUND Epilepsy, a globally prevalent neurological condition, presents distinct challenges in management, particularly for focal-onset types. This study aimed at addressing the current challenges and perspectives in focal epilepsy management, with focus on the Italian reality. METHODS Using the Delphi methodology, this research collected and analyzed the level of consensus of a panel of Italian epilepsy experts on key aspects of focal epilepsy care. Areas of focus included patient flow, treatment pathways, controlled versus uncontrolled epilepsy, follow-up protocols, and the relevance of patient-reported outcomes (PROs). This method allowed for a comprehensive assessment of consensus and divergences in clinical opinions and practices. RESULTS The study achieved consensus on 23 out of 26 statements, with three items failing to reach a consensus. There was strong agreement on the importance of timely intervention, individualized treatment plans, regular follow-ups at Epilepsy Centers, and the role of PROs in clinical practice. In cases of uncontrolled focal epilepsy, there was a clear inclination to pursue alternative treatment options following the failure of two previous therapies. Divergent views were evident on the inclusion of epilepsy surgery in treatment for uncontrolled epilepsy and the routine necessity of EEG evaluations in follow-ups. Other key findings included concerns about the lack of pediatric-specific research limiting current therapeutic options in this patient population, insufficient attention to the transition from pediatric to adult care, and need for improved communication. The results highlighted the complexities in managing epilepsy, with broad consensus on patient care aspects, yet notable divergences in specific treatment and management approaches. CONCLUSION The study offered valuable insights into the current state and complexities of managing focal-onset epilepsy. It highlighted many deficiencies in the therapeutic pathway of focal-onset epilepsy in the Italian reality, while it also underscored the importance of patient-centric care, the necessity of early and appropriate intervention, and individualized treatment approaches. The findings also called for continued research, policy development, and healthcare system improvements to enhance epilepsy management, highlighting the ongoing need for tailored healthcare solutions in this evolving field.
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Affiliation(s)
| | - Simona Lattanzi
- Neurological Clinic, Department of Experimental and Clinical Medicine, Marche Polytechnic University, Ancona, Italy
| | - Oriano Mecarelli
- Department of Human Neurosciences, Sapienza University, Rome (Retired) and Past President of LICE, Italian League Against Epilepsy, Rome, Italy
| | - Francesco Saverio Mennini
- Faculty of Economics, Economic Evaluation and HTA (EEHTA), CEIS, University of Rome "Tor Vergata", Rome, Italy; Institute for Leadership and Management in Health, Kingston University London, London, UK.
| | - Federico Vigevano
- Head of Paediatric Neurorehabilitation Department, IRCCS San Raffaele, Rome, Italy.
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Yeni K, Tulek Z, Cavusoglu A, Dunya CP, Erden SO, Bostan NS, Bebek N, Baykan B. Caregiver burden and its predictors in adult epilepsy patients. Epilepsy Behav 2024; 153:109685. [PMID: 38368790 DOI: 10.1016/j.yebeh.2024.109685] [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: 11/24/2023] [Revised: 02/02/2024] [Accepted: 02/03/2024] [Indexed: 02/20/2024]
Abstract
OBJECTIVE The aim of this study was to evaluate caregiver burden and factors associated with caregiver burden in caregivers of adults with epilepsy. MATERIALS AND METHODS This descriptive cross-sectional study was conducted with 107 patients with epilepsy and 107 their primary caregivers. Personal information form including sociodemographic data and Zarit Caregiver Burden Inventory (ZBI), were used for caregivers, and patient information form, Montreal Cognitive Assessment Scale (MoCA), Hospital Anxiety and Depression Scale (HADS), Epilepsy Quality of Life Scale (QoLIE-31) and Stigma Scale were used for patients. RESULTS Caregiver burden was found to be related to gender (p = 0.047), marital status (p = 0.008), income (p = 0.003), education level (p = 0.05) age at onset of epilepsy (p = 0.025) and type of therapy (p = 0.005). The scale scores for cognitive functions (p < 0.001), stigma (p < 0.001), anxiety (p = 0.001), depression (p = 0.005), and quality of life (p < 0.001) of the patient showed significant correlations with caregiver burden. In addition, caregiver burden was found to correlate with some caregiver characteristics such as caregivers' age (p = 0.041), gender (p < 0.001), education (p < 0.001), income (p = 0.001) and relationship with the patient (p = 0.016). Time spent on caregiving per day was also positively correlated with caregiving burden (p < 0.001). In regression analysis, the gender of the caregiver, the gender of the patient, the stigma level of patient, and the type of treatment were found to be predictors of care burden (p < 0.05, R2 = 0.61). CONCLUSION It was found that two-thirds of the families of patients with epilepsy experienced varying degrees of caregiver burden. In addition, it was determined that caregiver burden was associated with sociodemographic and numerous psychosocial factors of the patient as well as the caregiver. It is important that both the caregiver and the patient being cared for are closely evaluated in interventions to reduce the caregiver burden in patients with epilepsy.
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Affiliation(s)
- Kubra Yeni
- Ondokuz Mayis University, Faculty of Health Sciences, Samsun, Turkey.
| | - Zeliha Tulek
- Istanbul University-Cerrahpasa, Florence Nightingale Faculty of Nursing, Istanbul, Turkey
| | - Aysel Cavusoglu
- Istanbul University, Istanbul Medical Faculty, Department of Neurology, Istanbul, Turkey
| | | | - Sevda Ozturk Erden
- Istanbul University, Istanbul Medical Faculty, Department of Neurology, Istanbul, Turkey
| | - Nur Sena Bostan
- Istanbul University, Istanbul Medical Faculty, Department of Neurology, Istanbul, Turkey
| | - Nerses Bebek
- Istanbul University, Istanbul Medical Faculty, Department of Neurology, Istanbul, Turkey; Istanbul University, Center for Research in Epilepsy, Istanbul, Turkey
| | - Betul Baykan
- Istanbul University, Istanbul Medical Faculty, Department of Neurology, Istanbul, Turkey; Istanbul University, Center for Research in Epilepsy, Istanbul, Turkey
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Bröhl T, Rings T, Pukropski J, von Wrede R, Lehnertz K. The time-evolving epileptic brain network: concepts, definitions, accomplishments, perspectives. FRONTIERS IN NETWORK PHYSIOLOGY 2024; 3:1338864. [PMID: 38293249 PMCID: PMC10825060 DOI: 10.3389/fnetp.2023.1338864] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/15/2023] [Accepted: 12/19/2023] [Indexed: 02/01/2024]
Abstract
Epilepsy is now considered a network disease that affects the brain across multiple levels of spatial and temporal scales. The paradigm shift from an epileptic focus-a discrete cortical area from which seizures originate-to a widespread epileptic network-spanning lobes and hemispheres-considerably advanced our understanding of epilepsy and continues to influence both research and clinical treatment of this multi-faceted high-impact neurological disorder. The epileptic network, however, is not static but evolves in time which requires novel approaches for an in-depth characterization. In this review, we discuss conceptual basics of network theory and critically examine state-of-the-art recording techniques and analysis tools used to assess and characterize a time-evolving human epileptic brain network. We give an account on current shortcomings and highlight potential developments towards an improved clinical management of epilepsy.
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Affiliation(s)
- Timo Bröhl
- Department of Epileptology, University of Bonn Medical Centre, Bonn, Germany
- Helmholtz Institute for Radiation and Nuclear Physics, University of Bonn, Bonn, Germany
| | - Thorsten Rings
- Department of Epileptology, University of Bonn Medical Centre, Bonn, Germany
- Helmholtz Institute for Radiation and Nuclear Physics, University of Bonn, Bonn, Germany
| | - Jan Pukropski
- Department of Epileptology, University of Bonn Medical Centre, Bonn, Germany
| | - Randi von Wrede
- Department of Epileptology, University of Bonn Medical Centre, Bonn, Germany
| | - Klaus Lehnertz
- Department of Epileptology, University of Bonn Medical Centre, Bonn, Germany
- Helmholtz Institute for Radiation and Nuclear Physics, University of Bonn, Bonn, Germany
- Interdisciplinary Center for Complex Systems, University of Bonn, Bonn, Germany
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Letén HM, Karterud HN, Mengshoel AM. Individuals' invisible work continues after epilepsy surgery: A qualitative interview study. Epilepsy Res 2024; 199:107281. [PMID: 38101177 DOI: 10.1016/j.eplepsyres.2023.107281] [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: 04/19/2023] [Revised: 11/27/2023] [Accepted: 12/11/2023] [Indexed: 12/17/2023]
Abstract
OBJECTIVE How do persons with epilepsy (PWE) experience their everyday lives after epilepsy surgery? METHODS Qualitative thematic interviews were conducted with eight PWEs (30 to 60 years old). They were recruited when coming for post-operative control 1 to 5 years after epilepsy surgery. The interviews were transcribed. They were analysed by thematic analysis and inspired by Goffman who examines everyday life activities as a theatre play. RESULTS Before surgery, a substantial invisible and hidden work of adjustments was performed to prevent seizures, to secure help from others if seizures occurred, and to protect oneself from others' gaze during a seizure. This invisible work continued after surgery even for those who became seizure-free; but now for the purpose of protecting oneself from relapse of epilepsy. From the participants perspective there was no or minor change in daily activities among those not becoming seizure-free after surgery. In contrast, those who became seizure-free enjoyed the freedom to participate in social activities without planning or restrictions. CONCLUSIONS A striking finding was that daily life after surgery comprises considerably invisible work to protect a social self, and this preventive and protective invisible work continued, although those who became seizure-free were living an ordinary socially healthy life.
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Affiliation(s)
- Helene Myklebust Letén
- National Centre for Epilepsy (SSE), Neurological clinic, Oslo University Hospital, Norway.
| | - Hilde Nordahl Karterud
- National Centre for Epilepsy (SSE), Neurological clinic, Oslo University Hospital, Norway
| | - Anne Marit Mengshoel
- Department of Interdisciplinary Health Sciences, Institute of Health and Society, Medical Faculty, University of Oslo, Norway
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Kaur K, Sharma G, Dwivedi R, Nehra A, Parajuli N, Upadhyay AD, Deepak KK, Jat MS, Ramanujam B, Sagar R, Mohanty S, Tripathi M. Effectiveness of Yoga Intervention in Reducing Felt Stigma in Adults With Epilepsy: A Randomized Controlled Trial. Neurology 2023; 101:e2388-e2400. [PMID: 37940550 PMCID: PMC10752634 DOI: 10.1212/wnl.0000000000207944] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Accepted: 08/28/2023] [Indexed: 11/10/2023] Open
Abstract
BACKGROUND AND OBJECTIVES Persons with epilepsy are afflicted with comorbidities such as stigma, anxiety, and depression which have a significant impact on their quality of life. These comorbidities remain largely unaddressed in resource-limited countries. This randomized controlled trial (RCT) aimed to investigate whether yoga and psychoeducation were effective in reducing felt stigma (primary outcome), neuropsychiatric outcomes, and seizure frequency, as compared with sham yoga and psychoeducation in persons with epilepsy. METHODS This was an assessor-blinded, sham yoga-controlled RCT. Patients clinically diagnosed with epilepsy, aged 18-60 years, and scoring higher than the cutoff score for felt stigma as measured by the Kilifi Stigma Scale (KSS) in our population were randomly assigned to receive either yoga therapy plus psychoeducation (intervention) or sham yoga therapy plus psychoeducation (comparator) for a duration of 3 months. The primary outcome was a significant decrease in felt stigma as compared with the comparator arm as measured by the KSS. Primary and secondary outcomes (seizure frequency, quality of life, anxiety, depression, mindfulness, trait rumination, cognitive impairment, emotion regulation) were assessed at baseline, 3 months, and 6 months. Parametric/nonparametric analysis of covariance and the χ2 test were used to compare the 2 arms. RESULTS A total of 160 patients were enrolled in the trial. At the end of the follow-up period (6 months), the intervention arm reported significant reduction in felt stigma as compared with the control arm (Cohen's d = 0.23, 95% CI -0.08 to 0.55, p = 0.006). Significantly higher odds of >50% seizure reduction (odds ratio [OR] 4.11, 95% CI 1.34-14.69, p = 0.01) and complete seizure remission (OR 7.4, 95% CI 1.75-55.89, p = 0.005) were also observed in the intervention group. The intervention group showed significant improvement in symptoms of anxiety, cognitive impairment, mindfulness, and quality of life relative to the control group at the end of follow-up period (p < 0.05). DISCUSSION Yoga can alleviate the burden of epilepsy and improve the overall quality of life in epilepsy by reducing perceived stigma. TRIAL REGISTRATION INFORMATION Clinical Trials Registry of India (CTRI/2017/04/008385). CLASSIFICATION OF EVIDENCE This study provides Class I evidence that yoga reduces felt stigma in adult patients with epilepsy.
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Affiliation(s)
- Kirandeep Kaur
- From the Department of Neurology (K.K., R.D., B.R., M.T.), All India Institute of Medical Sciences, New Delhi; MEG Resource Facility (K.K.), National Brain Research Institute, Manesar; Centre for Integrative Medicine and Research (G.S., N.P., M.S.J., S.M.), Department of Cardiology (G.S.), Department of Neuropsychology (A.N.), Department of Biostatistics (A.D.U.), Department of Physiology (K.K.D.), and Department of Psychiatry (R.S.), All India Institute of Medical Sciences, New Delhi, India
| | - Gautam Sharma
- From the Department of Neurology (K.K., R.D., B.R., M.T.), All India Institute of Medical Sciences, New Delhi; MEG Resource Facility (K.K.), National Brain Research Institute, Manesar; Centre for Integrative Medicine and Research (G.S., N.P., M.S.J., S.M.), Department of Cardiology (G.S.), Department of Neuropsychology (A.N.), Department of Biostatistics (A.D.U.), Department of Physiology (K.K.D.), and Department of Psychiatry (R.S.), All India Institute of Medical Sciences, New Delhi, India
| | - Rekha Dwivedi
- From the Department of Neurology (K.K., R.D., B.R., M.T.), All India Institute of Medical Sciences, New Delhi; MEG Resource Facility (K.K.), National Brain Research Institute, Manesar; Centre for Integrative Medicine and Research (G.S., N.P., M.S.J., S.M.), Department of Cardiology (G.S.), Department of Neuropsychology (A.N.), Department of Biostatistics (A.D.U.), Department of Physiology (K.K.D.), and Department of Psychiatry (R.S.), All India Institute of Medical Sciences, New Delhi, India
| | - Ashima Nehra
- From the Department of Neurology (K.K., R.D., B.R., M.T.), All India Institute of Medical Sciences, New Delhi; MEG Resource Facility (K.K.), National Brain Research Institute, Manesar; Centre for Integrative Medicine and Research (G.S., N.P., M.S.J., S.M.), Department of Cardiology (G.S.), Department of Neuropsychology (A.N.), Department of Biostatistics (A.D.U.), Department of Physiology (K.K.D.), and Department of Psychiatry (R.S.), All India Institute of Medical Sciences, New Delhi, India
| | - Niranjan Parajuli
- From the Department of Neurology (K.K., R.D., B.R., M.T.), All India Institute of Medical Sciences, New Delhi; MEG Resource Facility (K.K.), National Brain Research Institute, Manesar; Centre for Integrative Medicine and Research (G.S., N.P., M.S.J., S.M.), Department of Cardiology (G.S.), Department of Neuropsychology (A.N.), Department of Biostatistics (A.D.U.), Department of Physiology (K.K.D.), and Department of Psychiatry (R.S.), All India Institute of Medical Sciences, New Delhi, India
| | - Ashish D Upadhyay
- From the Department of Neurology (K.K., R.D., B.R., M.T.), All India Institute of Medical Sciences, New Delhi; MEG Resource Facility (K.K.), National Brain Research Institute, Manesar; Centre for Integrative Medicine and Research (G.S., N.P., M.S.J., S.M.), Department of Cardiology (G.S.), Department of Neuropsychology (A.N.), Department of Biostatistics (A.D.U.), Department of Physiology (K.K.D.), and Department of Psychiatry (R.S.), All India Institute of Medical Sciences, New Delhi, India
| | - Kishore K Deepak
- From the Department of Neurology (K.K., R.D., B.R., M.T.), All India Institute of Medical Sciences, New Delhi; MEG Resource Facility (K.K.), National Brain Research Institute, Manesar; Centre for Integrative Medicine and Research (G.S., N.P., M.S.J., S.M.), Department of Cardiology (G.S.), Department of Neuropsychology (A.N.), Department of Biostatistics (A.D.U.), Department of Physiology (K.K.D.), and Department of Psychiatry (R.S.), All India Institute of Medical Sciences, New Delhi, India
| | - Man S Jat
- From the Department of Neurology (K.K., R.D., B.R., M.T.), All India Institute of Medical Sciences, New Delhi; MEG Resource Facility (K.K.), National Brain Research Institute, Manesar; Centre for Integrative Medicine and Research (G.S., N.P., M.S.J., S.M.), Department of Cardiology (G.S.), Department of Neuropsychology (A.N.), Department of Biostatistics (A.D.U.), Department of Physiology (K.K.D.), and Department of Psychiatry (R.S.), All India Institute of Medical Sciences, New Delhi, India
| | - Bhargavi Ramanujam
- From the Department of Neurology (K.K., R.D., B.R., M.T.), All India Institute of Medical Sciences, New Delhi; MEG Resource Facility (K.K.), National Brain Research Institute, Manesar; Centre for Integrative Medicine and Research (G.S., N.P., M.S.J., S.M.), Department of Cardiology (G.S.), Department of Neuropsychology (A.N.), Department of Biostatistics (A.D.U.), Department of Physiology (K.K.D.), and Department of Psychiatry (R.S.), All India Institute of Medical Sciences, New Delhi, India
| | - Rajesh Sagar
- From the Department of Neurology (K.K., R.D., B.R., M.T.), All India Institute of Medical Sciences, New Delhi; MEG Resource Facility (K.K.), National Brain Research Institute, Manesar; Centre for Integrative Medicine and Research (G.S., N.P., M.S.J., S.M.), Department of Cardiology (G.S.), Department of Neuropsychology (A.N.), Department of Biostatistics (A.D.U.), Department of Physiology (K.K.D.), and Department of Psychiatry (R.S.), All India Institute of Medical Sciences, New Delhi, India
| | - Sriloy Mohanty
- From the Department of Neurology (K.K., R.D., B.R., M.T.), All India Institute of Medical Sciences, New Delhi; MEG Resource Facility (K.K.), National Brain Research Institute, Manesar; Centre for Integrative Medicine and Research (G.S., N.P., M.S.J., S.M.), Department of Cardiology (G.S.), Department of Neuropsychology (A.N.), Department of Biostatistics (A.D.U.), Department of Physiology (K.K.D.), and Department of Psychiatry (R.S.), All India Institute of Medical Sciences, New Delhi, India
| | - Manjari Tripathi
- From the Department of Neurology (K.K., R.D., B.R., M.T.), All India Institute of Medical Sciences, New Delhi; MEG Resource Facility (K.K.), National Brain Research Institute, Manesar; Centre for Integrative Medicine and Research (G.S., N.P., M.S.J., S.M.), Department of Cardiology (G.S.), Department of Neuropsychology (A.N.), Department of Biostatistics (A.D.U.), Department of Physiology (K.K.D.), and Department of Psychiatry (R.S.), All India Institute of Medical Sciences, New Delhi, India.
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Lalatović S, Smiljanić I, Ristić AJ, Čvorović Đ, Golubović V, Parojčić A, Baščarević V, Krstić N, Milovanović M. Psychometric evaluation of the Serbian version of the Stigma Scale of Epilepsy (SSE). Epilepsy Behav 2023; 149:109520. [PMID: 37944288 DOI: 10.1016/j.yebeh.2023.109520] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2023] [Revised: 11/02/2023] [Accepted: 11/02/2023] [Indexed: 11/12/2023]
Abstract
OBJECTIVE To evaluate the psychometric properties of the Serbian-language version of the Stigma Scale of Epilepsy (SSE). METHODS The sample consisted of 108 patients with epilepsy (PWE) (60.2 % were female, age range: 19-67 years) and 102 students (86.3 % were female, age range: 18-47 years). The study encompassed two phases: (1) translation of the SSE into Serbian using the back-translation technique, and (2) evaluation of reliability and construct validity of the Serbian-language version of SSE. In addition to the SSE, the PWE filled out a Neurological Disorders Depression Inventory for Epilepsy (NDDI-E), Patient Health Questionnaire-9 (PHQ-9), and Generalized Anxiety Disorder-7 (GAD-7). The socio-demographic and clinical variables were noted for each patient by the semistructured interview. Besides completing the SSE, the students were asked if they knew anyone with epilepsy. The reliability of the questionnaire was tested by assessing the internal consistency of the scale (Cronbach's α), while construct validity was assessed by factor analysis, method of known-groups validation, and correlation analysis. RESULTS SSE demonstrates a satisfactory level of reliability in both samples, with Cronbach's α of 0.86 in the PWE sample and 0.90 in the student sample. Using exploratory factor analysis, four factors were identified in both samples, corresponding relatively well with the scale domains originally produced, with a few exceptions described. Adverse effects (AEs) of antiseizure medications (ASMs) and driving ability significantly influenced SSE scores, but there were no significant effects of other socio-demographic and clinical variables on epilepsy-related stigma in the PWE sample. In addition, depression severity significantly influenced SSE scores (based on NDDI-E cut-off score), with the SSE showing a positive association with PHQ-9 (r = 0.42, p < .001) and GAD-7 (r = 0.35, p < .001) as well. Regarding the student sample, the effects of personal knowledge of someone with epilepsy on SSE scores were found to be significant. Besides, students (M = 46.28, SD = 16.43) reported higher epilepsy-related stigma than patients (M = 40.66, SD = 17.01), t(208) = 2.43, p < .05, d = 0.34. CONCLUSION The Serbian version of the SSE has good psychometric properties and represents a useful tool for assessing epilepsy-related stigma in both patients and the general population.
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Affiliation(s)
- Staša Lalatović
- Faculty of Special Education and Rehabilitation, University of Belgrade, Visokog Stevana 2, 11000 Belgrade, Serbia
| | - Isidora Smiljanić
- Faculty of Medicine, University of Belgrade, Dr Subotića 8, 11000 Belgrade, Serbia
| | - Aleksandar J Ristić
- Faculty of Medicine, University of Belgrade, Dr Subotića 8, 11000 Belgrade, Serbia; Neurology Clinic, University Clinical Center of Serbia, Dr Subotića 6, 11000 Belgrade, Serbia
| | - Đurđica Čvorović
- Department for Epilepsy and Clinical Neurophysiology, Institute of Mental Health, Milana Kašanina 3, 11000 Belgrade, Serbia
| | - Violeta Golubović
- Department for Epilepsy and Clinical Neurophysiology, Institute of Mental Health, Milana Kašanina 3, 11000 Belgrade, Serbia
| | - Aleksandra Parojčić
- Department for Epilepsy and Clinical Neurophysiology, Institute of Mental Health, Milana Kašanina 3, 11000 Belgrade, Serbia
| | - Vladimir Baščarević
- Faculty of Medicine, University of Belgrade, Dr Subotića 8, 11000 Belgrade, Serbia; Neurosurgery Clinic, University Clinical Center of Serbia, Koste Todorovića 4, 11000 Belgrade, Serbia
| | - Nadežda Krstić
- Faculty of Special Education and Rehabilitation, University of Belgrade, Visokog Stevana 2, 11000 Belgrade, Serbia
| | - Maja Milovanović
- Faculty of Special Education and Rehabilitation, University of Belgrade, Visokog Stevana 2, 11000 Belgrade, Serbia; Department for Epilepsy and Clinical Neurophysiology, Institute of Mental Health, Milana Kašanina 3, 11000 Belgrade, Serbia.
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Ghebrehiwet M, Cox K, Nees D, Dunford B, Jacobsen SM, Bacani R, Vassar M. Inequities in Epilepsy: A Scoping Review. Neurol Clin Pract 2023; 13:e200211. [PMID: 37795499 PMCID: PMC10547471 DOI: 10.1212/cpj.0000000000200211] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2023] [Accepted: 08/21/2023] [Indexed: 10/06/2023]
Abstract
Objectives The objective of this study was to complete a scoping review of current literature surrounding health inequities in epilepsy while providing recommendations for future research. Methods During July 2022, we searched MEDLINE and Ovid Embase to find published articles pertaining to epilepsy and health inequities. Initially, authors received training. Authors then screened, and data were extracted in a masked duplicate manner. Studies published within the time frame of 2011-2021 in all countries were deemed appropriate. We screened 5,325 studies for titles and abstracts and then 56 studies for full text. We evaluated the inequities of race/ethnicity, sex or gender, income, occupation status, education level, under-resourced/rural population, and LGBTQ+. To summarize the data and descriptive statistics of our study, we used Stata 17.0 (StataCorp, LLC, College Station, TX). Results We obtained a sample size of 45 studies for study inclusion. The most reported health inequities were income (18/45, 40.0%), under-resourced/rural population (15/45, 33.3%), and race/ethnicity (15/45, 33.3%). The least reported health inequity was LGBTQ+ (0/45, 0.0%). Discussion The findings of our study suggest that gaps exist in literature concerning epilepsy and inequities. The inequities of income status, under-resourced/rural population, and race/ethnicity were examined the most, while LGBTQ+, occupation status, and sex or gender were examined the least. With the ultimate goal of more equitable and patient-centered care in mind, it is vital that future studies endeavor to fill in these determined gaps.
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Affiliation(s)
- Merhawit Ghebrehiwet
- Office of Medical Student Research (MG, KC, DN, BD, SMJ, RB, MV); and Department of Psychiatry and Behavioral Sciences (MV), Oklahoma State University Center for Health Sciences, Tulsa
| | - Katherine Cox
- Office of Medical Student Research (MG, KC, DN, BD, SMJ, RB, MV); and Department of Psychiatry and Behavioral Sciences (MV), Oklahoma State University Center for Health Sciences, Tulsa
| | - Danya Nees
- Office of Medical Student Research (MG, KC, DN, BD, SMJ, RB, MV); and Department of Psychiatry and Behavioral Sciences (MV), Oklahoma State University Center for Health Sciences, Tulsa
| | - Bryan Dunford
- Office of Medical Student Research (MG, KC, DN, BD, SMJ, RB, MV); and Department of Psychiatry and Behavioral Sciences (MV), Oklahoma State University Center for Health Sciences, Tulsa
| | - Samuel M Jacobsen
- Office of Medical Student Research (MG, KC, DN, BD, SMJ, RB, MV); and Department of Psychiatry and Behavioral Sciences (MV), Oklahoma State University Center for Health Sciences, Tulsa
| | - Rigel Bacani
- Office of Medical Student Research (MG, KC, DN, BD, SMJ, RB, MV); and Department of Psychiatry and Behavioral Sciences (MV), Oklahoma State University Center for Health Sciences, Tulsa
| | - Matt Vassar
- Office of Medical Student Research (MG, KC, DN, BD, SMJ, RB, MV); and Department of Psychiatry and Behavioral Sciences (MV), Oklahoma State University Center for Health Sciences, Tulsa
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Er D, Aktaş B. An investigation of stigma and self-management in individuals diagnosed with epilepsy. Epilepsy Behav 2023; 149:109494. [PMID: 37939497 DOI: 10.1016/j.yebeh.2023.109494] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Revised: 09/21/2023] [Accepted: 10/13/2023] [Indexed: 11/10/2023]
Abstract
AIM The complex nature of epilepsy disease confronts individuals with difficulties such as stigma. Stigma has a negative impact, particularly on individuals' coping with the disease. It is important for individuals diagnosed with epilepsy to adopt many self-management behaviors so that they can control these situations. This study aims to measure the stigma and self-management levels of individuals diagnosed with epilepsy and determine the relationship between stigma and self-management. METHODS This descriptive and associational study was conducted in the Neurology Outpatient Clinic of a Training and Research Hospital and 295 patients were included in the sample based on various inclusion criteria such as having a diagnosis of epilepsy for at least six months and not having any psychiatric disorder that would prevent reading and comprehension. Data were collected through the Descriptive Information Form, the Stigma Scale of Epilepsy, and the Epilepsy Self-Management Scale. Data analysis was performed using IBM SPSS Statistics Standard Concurrent User V 26 statistical package program. FINDINGS The Stigma Scale of Epilepsy total mean score was found 60.62 ± 15.40 in individuals diagnosed with epilepsy. The mean scores for the sub-scales were found 7.08 ± 2.20 for the false beliefs sub-scale, 18.86 ± 4.97 for the discrimination sub-scale, 21.64 ± 7.07 for the social isolation sub-scale, 8.46 ± 3.18 for the inadequacy sub-scale, and 5.45 ± 1.41 for the stigma resistance sub-scale. The ESMS total mean score of individuals diagnosed with epilepsy was found to be 140.54 ± 15.33. The mean scores for the ESMS sub-scales were 44.76 ± 4.29 for the medicine management sub-scale, 20.29 ± 5.98 for the information management sub-scale, 30.49 ± 4.80 for the safety management sub-scale, 23.95 ± 4.34 for the seizure management sub-scale, and 21.02 ± 4.65 for lifestyle management sub-scale. A significant and negative relationship was found between the Epilepsy Self-Management Scale (ESMS) and the Stigma Scale of Epilepsy. CONCLUSION This study found that individuals experienced a moderate level of stigma and had high levels of self-management. Stigma was found to decrease with the increase in the self-management level. In this regard, it is recommended to conduct intervention studies to increase self-management levels and reduce stigma for individuals diagnosed with epilepsy.
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Affiliation(s)
- Damla Er
- İzmir Tepecik Education and Research Hospital Neurology Department, İzmir, Turkey.
| | - Betül Aktaş
- İzmir Katip Çelebi University, Faculty of Health Sciences, Department of Public Health Nursing, İzmir, Turkey.
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Gotlieb EG, Blank L, Willis AW, Agarwal P, Jette N. Health equity integrated epilepsy care and research: A narrative review. Epilepsia 2023; 64:2878-2890. [PMID: 37725065 DOI: 10.1111/epi.17728] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Revised: 07/11/2023] [Accepted: 07/26/2023] [Indexed: 09/21/2023]
Abstract
BACKGROUND With the unanimous approval of the Intersectoral Global Action Plan on epilepsy and other neurological disorders by the World Health Organization in May 2022, there are strong imperatives to work towards equitable neurological care. AIMS Using epilepsy as an entry point to other neurologic conditions, we discuss disparities faced by marginalized groups including racial/ethnic minorities, Americans living in rural communities, and Americans with low socioeconomic status. MATERIALS AND METHODS The National Institute on Minority Health Disparities Research Framework (NIMHD) was used to conduct a narrative review through a health equity lens to create an adapted framework for epilepsy and propose approaches to working towards equitable epilepsy and neurological care. RESULTS In this narrative review, we identified priority populations (racial and ethnic minority, rural-residing, and low socioeconomic status persons with epilepsy) and outcomes (likelihood to see a neurologist, be prescribed antiseizure medications, undergo epilepsy surgery, and be hospitalized) to explore disparities in epilepsy and guide our focused literature search using PubMed. In an adapted NIMHD framework, we examined individual, interpersonal, community, and societal level contributors to health disparities across five domains: (1) behavioral, (2) physical/built environment, (3) sociocultural, (4) environment, and (5) healthcare system. We take a health equity approach to propose initiatives that target modifiable factors that impact disparities and advocate for sustainable change for priority populations. DISCUSSION To improve equity, healthcare providers and relevant societal stakeholders can advocate for improved care coordination, referrals for epilepsy surgery, access to care, health informatics interventions, and education (i.e., to providers, patients, and communities). More broadly, stakeholders can advocate for reforms in medical education, and in the American health insurance landscape. CONCLUSIONS Equitable healthcare should be a priority in neurological care.
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Affiliation(s)
- Evelyn G Gotlieb
- Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Leah Blank
- Icahn School of Medicine at Mount Sinai, New York, New York, USA
- Department of Population, Health Science and Policy and Institute for Healthcare Delivery Science, Icahn School of Medicine at Mount Sinai, New York, New York, USA
- Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Allison W Willis
- Departments of Neurology and Biostatistics, Epidemiology and Informatics, University of Pennsylvania
- Leonard Davis Institute, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Parul Agarwal
- Icahn School of Medicine at Mount Sinai, New York, New York, USA
- Department of Population, Health Science and Policy and Institute for Healthcare Delivery Science, Icahn School of Medicine at Mount Sinai, New York, New York, USA
- Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Nathalie Jette
- Icahn School of Medicine at Mount Sinai, New York, New York, USA
- Department of Population, Health Science and Policy and Institute for Healthcare Delivery Science, Icahn School of Medicine at Mount Sinai, New York, New York, USA
- Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, New York, USA
- Department of Clinical Neurosciences, University of Calgary, Calgary, Alberta, Canada
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13
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Kasradze S, Gogatishvili N, Lazariashvili M, Lomidze G, Sander JW. Validation of the Georgian version of a Stigma Scale of Epilepsy. Epilepsy Behav 2023; 148:109502. [PMID: 37897863 DOI: 10.1016/j.yebeh.2023.109502] [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: 08/02/2023] [Revised: 10/17/2023] [Accepted: 10/18/2023] [Indexed: 10/30/2023]
Abstract
INTRODUCTION Stigma Scale of Epilepsy (SSE), initially developed in Brazil, is accepted worldwide as a sensitive tool for assessing epilepsy-related stigma. We adapted and validated a Georgian version of SSE. MATERIALS AND METHODS The SSE originated in Brazil and was translated into Georgian by three independent experts through forward and backward translation. The final version was generated for validation after handling gross or conceptual inconsistencies between the source and the new format. We used Cronbach's alpha to assess the internal consistency of the Georgian version of SSE. To explore the construct of SSE subscales in the Georgian version, we used principal components and factor analysis. Varimax rotation was applied. The Kaiser-Meyer-Olkin Measure and Bartlett's test of sphericity were employed to assess the sampling adequacy. A probability <0.05 was considered statistically significant. RESULTS 87 adults, 32 (37 %) with epilepsy and 55 (63 %) without epilepsy were enrolled. The overall mean score of SSE was 19.5 (SD 10.1; min. 2, max. 53), and the differences between people with [20.7 (SD 8.9; min. 2, max. 53)] and without epilepsy [17.5 (SD 10.4; min. 3, max. 42)] were not statistically significant. Cronbach's alpha for the overall sample was 0.854; for the epilepsy cohort it was 0.876, and for individuals without epilepsy 0.823, indicating good SSE internal consistency. Kaiser-Meyer-Olkin Measure was 0.705 and Bartlett's test of sphericity was 926.2 (df 276; p < 0.001), suggesting acceptable sample adequacy. DISCUSSION The Georgian version of the SSE is a valid and reliable measurement tool for assessing epilepsy-related stigma determinants among the country's population.
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Affiliation(s)
- Sofia Kasradze
- Caucasus International University, 73 Chargali Str.,Tbilisi 0141, Georgia; Institute of Neurology and Neuropsychology, 83/11 Vazha-Pshavela Ave., Tbilisi 0186, Georgia
| | - Nino Gogatishvili
- Caucasus International University, 73 Chargali Str.,Tbilisi 0141, Georgia; Institute of Neurology and Neuropsychology, 83/11 Vazha-Pshavela Ave., Tbilisi 0186, Georgia
| | - Marine Lazariashvili
- Institute of Neurology and Neuropsychology, 83/11 Vazha-Pshavela Ave., Tbilisi 0186, Georgia; Ilia State University, 3/5 Kakutsa Cholokashvili Ave., Tbilisi 0162, Georgia
| | - Giorgi Lomidze
- European University, Faculty of Medicine, 17 Sarajishvili Str., Tbilisi 0189, Georgia.
| | - Josemir W Sander
- Department of Clinical & Experimental Epilepsy, UCL Queen Square Institute of Neurology, London WC1N 3BG, United Kingdom; Chalfont Centre for Epilepsy, Chalfont, St Peter SL9 0RJ, United Kingdom; Stichting Epilepsie Intellingen Nederland - SEIN, Heemstede 2103SW, Netherlands; Department of Neurology, West China Hospital, Sichuan University, Chengdu 610041, China
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14
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Yang TW, Kim YS, Kim DH, Yeom JS, Kwon OY. Felt stigma proportion in people living with epilepsy: A systematic review. Seizure 2023; 111:87-97. [PMID: 37556985 DOI: 10.1016/j.seizure.2023.07.025] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Accepted: 07/31/2023] [Indexed: 08/11/2023] Open
Abstract
PURPOSE Numerous inventories to identify felt stigma (FS) in people living with epilepsy (PLWE) have been developed. Past studies have mainly focused on the relationship between FS scores and clinical factors, making it challenging to delineate FS proportions and compare FS between groups. We aimed to integrate FS proportions in PLWE and compare them by continent. METHODS We searched MEDLINE, EMBASE, the Cochrane Library, Web of Science, and Scopus. Among the identified studies, we chose the ones providing an FS proportion measured by Jacoby's Stigma Scale (JSS) and its revised version (JSS-R) in PLWE. We applied the random-effects model. RESULTS A total of 63 datasets from 47 studies were included. There were 29,924 PLWE, with 14,323 of them experiencing FS. The overall FS proportion was 48.4%. Of these datasets, 51 used JSS, and 12 used JSS-R. The FS proportions were 44.9% for the former and 62.1% for the latter, with significant heterogeneity. In the intercontinental comparison with 51 datasets employing JSS, the difference in FS proportions was insignificant: 51.2% in Africa, 47.2% in Europe, 35.4% in Asia, and 28.8% in the Middle East. Furthermore, the meta-regression revealed that the year of each primary study did not influence the FS proportion. CONCLUSION Among PLWE, FS proportions depended on the choice of a measurement tool. When measured using JSS, the FS proportion was 44.9%, while it was 62.1% when evaluated with JSS-R. Even though the FS proportions were integrated differently, no substantial differences were observed between continents.
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Affiliation(s)
- Tae-Won Yang
- Department of Neurology, Gyeongsang National University College of Medicine, Jinju, Republic of Korea; Department of Neurology, Gyeongsang National University Changwon Hospital, Changwon, Republic of Korea
| | - Young-Soo Kim
- Department of Neurology, Gyeongsang National University College of Medicine, Jinju, Republic of Korea; Department of Neurology, Gyeongsang National University Hospital, Jinju, Republic of Korea
| | - Do-Hyung Kim
- Department of Neurology, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, Republic of Korea
| | - Jung Sook Yeom
- Department of Pediatrics, Gyeongsang National University College of Medicine, Jinju, Republic of Korea; Department of Pediatrics, Gyeongsang National University Hospital, Jinju, Republic of Korea
| | - Oh-Young Kwon
- Department of Neurology, Gyeongsang National University College of Medicine, Jinju, Republic of Korea; Department of Neurology, Gyeongsang National University Hospital, Jinju, Republic of Korea; Institute of Medical Science, Gyeongsang National University College of Medicine, Jinju, Republic of Korea.
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Okiah L, Olowo S, Iramiot SJ, Nekaka R, Ssenyonga LVN. Lived experiences of caregivers of persons with epilepsy attending an epilepsy clinic at a tertiary hospital, eastern Uganda: A phenomenological approach. PLoS One 2023; 18:e0274373. [PMID: 37463142 DOI: 10.1371/journal.pone.0274373] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2022] [Accepted: 06/21/2023] [Indexed: 07/20/2023] Open
Abstract
INTRODUCTION Epilepsy has been found to affect caregivers' quality of life, lifestyle, psychological health, social well-being, and working time. Caregivers in Uganda as in the rest of the world are important in assisting a person with epilepsy in complying with medical directions and are actively involved in communicating with healthcare professionals. Little is known about the lived experiences of caregivers of persons afflicted with epilepsy in Uganda. The purpose of this study was to determine the lived experiences of caregivers of persons with epilepsy attending the epilepsy clinic at Mbale regional referral hospital, eastern Uganda. METHODS AND MATERIALS The caregivers' lived experiences were elicited directly from them and their health workers who work with them in the care of the patients. Forty participants which consisted of 30 caregivers and 10 key informant health workers were selected for the study through purposive sampling. Face-to-face in-depth interviews with an unstructured interview guide were conducted to gather participants' information. The principal investigator conceptualized the interview guide, the guide was then reviewed by co-investigators, and revised and approved as the final data collection instrument after an extensive and comprehensive literature review. The interview guide comprised two sections; the first section comprised the questions that elicited the participants' social-demographic information. The second section comprised questions that explored caregivers' experiences of persons afflicted with epilepsy. Notations were taken and a digital recorder was used purposely for audio recordings. All interviews lasted for an hour and were audio-recorded with the participant's consent. An inductive thematic analysis was employed and adopted to identify the patterns emerging from the texts. RESULTS The caregivers majorly perceived epilepsy as a burden. Four main themes were revealed from the analysis and these are: psychological burdens which included, worries about the future of the patient, being looked down upon; social burdens which entailed, affected public relations, feelings of stigma; an economic burden which included interference with the source of income, affected productivity at work; and physical burdens which included, Feelings of uneasiness and disrupted sleep among others. CONCLUSION The caregivers majorly perceived epilepsy as a serious burden. This burden can be psychological, social, economic, and physical. Therefore, services and plans targeting patients with epilepsy need to consider the burden that caregivers encounter to comprehensively manage epilepsy.
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Affiliation(s)
- Lindah Okiah
- Department of Nursing, Busitema University Faculty of Health Sciences, Mbale, Uganda
| | - Samuel Olowo
- Department of Nursing, Busitema University Faculty of Health Sciences, Mbale, Uganda
| | - Stanely J Iramiot
- Department of Microbiology and Immunology, Busitema University Faculty of Health Sciences, Mbale, Uganda
| | - Rebecca Nekaka
- Department of Community and Public Health, Busitema University Faculty of Health Sciences, Mbale, Uganda
| | - Lydia V N Ssenyonga
- Department of Nursing, Busitema University Faculty of Health Sciences, Mbale, Uganda
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Winter SF, Walsh D, Grisold W, Jordan JT, Singhi P, Cross JH, Guekht A, Hawrot T, Destrebecq F, Feigin VL, Kariuki SM, Owolabi MO, Singh G, Dietrich J, Craven A, Amos A, Mehndiratta MM, Secco M, Baker GA, Sofia F. Uniting for global brain health: Where advocacy meets awareness. Epilepsy Behav 2023; 145:109295. [PMID: 37348407 DOI: 10.1016/j.yebeh.2023.109295] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/21/2023] [Revised: 05/26/2023] [Accepted: 05/30/2023] [Indexed: 06/24/2023]
Affiliation(s)
- Sebastian F Winter
- International Bureau for Epilepsy (IBE), Washington, DC, USA; OneNeurology Partnership, Brussels, Belgium; Department of Neurology, Massachusetts General Hospital and Harvard Medical School, Boston, USA.
| | - Donna Walsh
- International Bureau for Epilepsy (IBE), Washington, DC, USA; OneNeurology Partnership, Brussels, Belgium
| | | | - Justin T Jordan
- Department of Neurology, Massachusetts General Hospital and Harvard Medical School, Boston, USA
| | - Pratibha Singhi
- International Child Neurology Association (ICNA), Leuven, Belgium
| | - J Helen Cross
- International League Against Epilepsy (ILAE), Flower Mound, TX, USA
| | - Alla Guekht
- International League Against Epilepsy (ILAE), Flower Mound, TX, USA
| | - Tadeusz Hawrot
- OneNeurology Partnership, Brussels, Belgium; European Federation of Neurological Associations (EFNA), Brussels, Belgium
| | - Frédéric Destrebecq
- OneNeurology Partnership, Brussels, Belgium; European Brain Council (EBC), Brussels, Belgium; European Brain Foundation, Brussels, Belgium
| | - Valery L Feigin
- OneNeurology Partnership, Brussels, Belgium; National Institute for Stroke and Applied Neurosciences, Auckland University of Technology, Auckland, NZ
| | - Symon M Kariuki
- KEMRI-Wellcome Trust Research Programme, Kilifi 80108, Kenya; Department of Psychiatry, University of Oxford, Oxford, UK
| | - Mayowa O Owolabi
- Center for Genomic and Precision Medicine, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Gagandeep Singh
- Department of Neurology, Dayanand Medical College, Ludhiana 141001, Punjab, India; Department of Clinical & Experimental Epilepsy, UCL Queen Square Institute of Neurology, London, UK
| | - Jorg Dietrich
- Department of Neurology, Massachusetts General Hospital and Harvard Medical School, Boston, USA
| | - Audrey Craven
- European Brain Foundation, Brussels, Belgium; Migraine Association of Ireland (MAI), Dublin, Ireland
| | - Action Amos
- International Bureau for Epilepsy (IBE) - African Region
| | - Man Mohan Mehndiratta
- Department of Neurology, BLK Hospital, Rajendra Place, India; International Bureau for Epilepsy (IBE) - South East Asian Region
| | - Mary Secco
- International Bureau for Epilepsy (IBE), Washington, DC, USA
| | - Gus A Baker
- International Bureau for Epilepsy (IBE), Washington, DC, USA
| | - Francesca Sofia
- International Bureau for Epilepsy (IBE), Washington, DC, USA
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Şahin Yıldız Y, Dülger H, Kasapoğlu ES. Web-based training for future healthcare professionals who will care for elderly individuals with epilepsy receiving home care: A quasi-experimental study. Epilepsy Behav 2023; 145:109285. [PMID: 37295314 DOI: 10.1016/j.yebeh.2023.109285] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Revised: 05/16/2023] [Accepted: 05/23/2023] [Indexed: 06/12/2023]
Abstract
OBJECTIVE The need for home care for elderly people with epilepsy is increasing. This study aims to determine the knowledge and attitudes of the students and examine the effect of the web-based epilepsy education program given to health students who will care for elderly individuals with epilepsy receiving home care. METHODS This quasi-experimental study with a control group pre-post-test research design was conducted with 112 students (intervention: 32/control: 80) studying in the Department of Health Care Services (home care, elderly care) in Turkey. The sociodemographic information form, Epilepsy Knowledge Scale, and Epilepsy Attitude Scale were used for data collection. Web-based training in three two-hour sessions focusing on the medical and social aspects of epilepsy was applied to the intervention group in this study. RESULTS It was found that the epilepsy knowledge scale score of the intervention group increased from 5.56 (±4.96) to 13.15 (±2.56), and the epilepsy attitude scale score increased from 54.12 (±9.73) to 62.31 (±7.07) after the training. After the training; there was a significant difference in all items except the 5th item in the knowledge scale and the 14th item in the attitude scale (p < 0.05). SIGNIFICANCE In the study; it has been found that the web-based epilepsy education program provided increases students' knowledge and develops positive attitudes. This study will provide evidence for strategies to be developed to improve the quality of care for elderly patients with epilepsy who are cared for at home.
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Affiliation(s)
- Yasemin Şahin Yıldız
- Department of Home Patient Care, Vocational College of Health Services, University of Bartın, Bartın, Turkey.
| | - Hanifi Dülger
- Department of Midwifery, Faculty of Health Sciences, University of Bartın, Bartın, Turkey.
| | - Elçin Sebahat Kasapoğlu
- Department of Elderly Care, Vocational College of Health Services, University of Bartın, Bartın, Turkey.
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Javed T, Awan HA, Shahzad N, Ojla D, Naqvi HB, Arshad H, Owais SB, Abrar S. Unraveling the Myths Around Epilepsy: A Cross-Sectional Study of Knowledge, Attitude, and Practices Among Pakistani Individuals. Cureus 2023; 15:e39760. [PMID: 37398818 PMCID: PMC10311456 DOI: 10.7759/cureus.39760] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/30/2023] [Indexed: 07/04/2023] Open
Abstract
INTRODUCTION Across its historical trajectory, epilepsy has frequently been linked to evil forces, particularly in the sub-continent. This research was created to find out if educated Pakistanis still believe that epilepsy is caused by being possessed by spirits (Jinns). The objective of the study is to assess the knowledge, attitudes, and practices (KAP) regarding epilepsy within the educated populace of Pakistan. METHOD After approval from the Ethical Review Committee, a population-based cross-sectional design was conducted in Chakwal District, Pakistan between February 1, 2018, and June 1, 2020, to evaluate the general knowledge and attitudes of the public toward epilepsy. A non-probability convenience sampling technique was utilized to recruit participants from different socioeconomic backgrounds across Chakwal District, and only individuals aged 18 years or older with at least 12 years of education were eligible to participate. A previously validated structured questionnaire was used to document findings. The study focused on several variables, such as knowledge about epilepsy and the percentage of people who have witnessed seizures, as well as sources of knowledge, subjective causes of epilepsy, beliefs in cure, transmission, and treatment options. RESULTS The survey included 512 participants, and the age distribution was as follows: 18-29 years old accounted for 18% of the respondents, 30-44 years old accounted for 35%, and 45-60 years old accounted for 31%. There was a female predominance with a frequency of 312 (60.9%). When asked about their sources of knowledge about epilepsy, the majority of participants (59.57%) reported learning about epilepsy from friends and relatives. A smaller percentage (18.36%) reported learning about epilepsy from schools, while another 20.31% heard about epilepsy from media and relatives. CONCLUSION The results of this research show that the general populace of Pakistan has a serious dearth of comprehension and information about epilepsy. Participants frequently held misconceptions about epilepsy being a hereditary disease and a mental condition, highlighting the need for focused education and information efforts to dispel these falsehoods. The fact that most participants got their knowledge about epilepsy from peers and family also emphasizes the value of peer education and social networks in spreading awareness of the disease.
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Affiliation(s)
- Tahleel Javed
- Department of Neuropsychiatry, St Matthews Healthcare, Northampton, GBR
- Department of Neuropsychiatry, South London and Maudsley NHS Foundation Trust, London, GBR
| | - Hasan A Awan
- Department of Medicine, Nottingham University Hospitals NHS Trust, Nottingham, GBR
| | - Nahl Shahzad
- Department of Medicine, West Hertfordshire Teaching Hospitals NHS Trust, Watford, GBR
| | - Deewan Ojla
- Department of Medicine, Fauji Foundation Hospital, Rawalpindi, PAK
| | - Hanniya B Naqvi
- Department of Medicine, Combined Military Hospital, Rawalpindi, PAK
| | - Hafsah Arshad
- Department of Medicine, Combined Military Hospital, Rawalpindi, PAK
| | - Syeda B Owais
- Department of Neurology, Fauji Foundation Hospital, Rawalpindi, PAK
| | - Shazil Abrar
- Department of Medicine, Fauji Foundation Hospital, Rawalpindi, PAK
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Makhado TG, Lebese RT, Maputle MS. Incorporation of Epilepsy into Life Skills Education: Perceptions of Primary School Learners in Mpumalanga and Limpopo Province—A Qualitative Exploratory Study. CHILDREN 2023; 10:children10030569. [PMID: 36980128 PMCID: PMC10047888 DOI: 10.3390/children10030569] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Revised: 03/12/2023] [Accepted: 03/15/2023] [Indexed: 03/19/2023]
Abstract
Providing education on epilepsy is crucial, as this helps individuals to acquire the necessary knowledge and skills to effectively manage seizures while also reducing the stigma and misconceptions surrounding the condition. The aim of this research was to examine how learners perceive the integration of epilepsy education into life skills training. A descriptive-exploratory design was utilized for the study. The research took place in the provinces of Limpopo and Mpumalanga, located in South Africa, where primary schools in chosen rural communities were selected for the research. Six focus group discussions were conducted with learners aged 9 to 14 years in grades 4 to 7. Each group was comprised of six learners, resulting in a total of 36 individuals who satisfied the inclusion criteria. Data were collected from August to November 2022. Semi-structured interviews were utilized to collect data until saturation was reached. The collected data were analyzed with the assistance of ATLAS.ti. The study’s results underscore the significance of incorporating epilepsy education into life skills curricula at the primary school level, as revealed by two prominent themes that emerged: first, the reasons provided by students for the integration of epilepsy education into life skills training, and second, the preferred teaching methodologies for epilepsy education within the life skills curriculum as identified by learners. Trustworthiness and ethical consideration were ensured. It is recommended that guidelines for epilepsy life skills should be developed to enhance the wellbeing and academic performance of learners with epilepsy in primary schools in Mpumalanga and Limpopo provinces.
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Affiliation(s)
- Thendo Gertie Makhado
- Department of Advance Nursing Sciences, Faculty of Health Sciences, University of Venda, Thohoyandou 0950, South Africa
- Correspondence:
| | - Rachel Tsakani Lebese
- Research Office, Faculty of Health Sciences, University of Venda, Thohoyandou 0950, South Africa
| | - Maria Sonto Maputle
- Department of Advance Nursing Sciences, Faculty of Health Sciences, University of Venda, Thohoyandou 0950, South Africa
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Clifford LM, Brothers SL, Lang A. Self-Disclosure Patterns Among Children and Youth with Epilepsy: Impact of Perceived-Stigma. Adolesc Health Med Ther 2023; 14:27-43. [PMID: 36776152 PMCID: PMC9910097 DOI: 10.2147/ahmt.s336124] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Accepted: 01/19/2023] [Indexed: 02/05/2023] Open
Abstract
This review aimed to synthesize the minimal existing literature on the impact of perceived stigma on self-disclosure patterns among children and youth with epilepsy (YWE). Initial literature searches were conducted in PsycInfo, Scopus, Web of Science, and PubMed using search terms focused on epilepsy, pediatrics, disclosure, and/or stigma. Articles were included if they were original human research articles published in peer-reviewed journals that were accessible in English through Cincinnati Children's Hospital Medical Center Pratt Library and fit study aims. Thirteen articles, which primarily used qualitative self-report methodologies, fit the study's inclusion criteria. YWE report greater perceived stigma and lower illness disclosure compared to youth with other chronic health conditions. Across studies, perceived stigma was consistently identified as a barrier to YWE disclosing their epilepsy diagnosis. Consequences of perceived stigma included lower self-esteem, poorer perceived competency, lack of self-confidence, social withdrawal, and lower quality of life. YWE's reluctance to disclose epilepsy was associated with worry about differential treatment, negative impact on close relationships, negative impact on others' perceptions, and negative self-perceptions. While WHO and ILAE have identified stigma as contributing to higher disease burden in people with epilepsy and have highlighted the importance of prioritizing social policy focused on decreasing epilepsy-related stigma, progress has been incremental and much work remains. Future research is needed to understand socio-cultural factors perpetuating stigma among YWE in order to further develop, evaluate, and disseminate evidence-based clinical and education programming to combat epilepsy-related stigma.
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Affiliation(s)
- Lisa M Clifford
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA,Correspondence: Lisa M Clifford, Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children’s Hospital Medical Center, 3333 Burnet Ave, MLC 3015, Cincinnati, OH, 45229, USA, Tel +1 513 803 3409, Fax +1 513 636 7756, Email
| | - Shannon L Brothers
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA
| | - Amy Lang
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA
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21
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Kuramochi I, Iwayama T, Oga K, Shiganami T, Umemura T, Kobayashi S, Yasuda T, Yoshimasu H. Internet survey on knowledge and perceptions of epilepsy among the general public in Japan. Heliyon 2022; 8:e12254. [PMID: 36578391 PMCID: PMC9791342 DOI: 10.1016/j.heliyon.2022.e12254] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2022] [Revised: 10/26/2022] [Accepted: 12/02/2022] [Indexed: 12/24/2022] Open
Abstract
Objective To improve the life quality of people with epilepsy, it is necessary to provide comprehensive epilepsy care and disseminate accurate information related to epilepsy to the public. In Japan, reports of traffic accidents involving people with epilepsy started to draw attention in the media in 2011. Ever since that, the association between the image of epilepsy from the general public, "Epilepsy," and "Danger," was more robust in 2013. Since 2017, no previous surveys have examined the perceptions and knowledge of epilepsy among the public in Japan. As an essential source of information for epilepsy care, we conducted a nationwide Internet-based survey to elucidate the current state of knowledge and perceptions of epilepsy among the public without epilepsy in Japan. Methods We conducted an online survey from July 29 to August 2, 2021, with 213 respondents (115 male, 97 female, and one unidentified; mean age: 50.52 ± 12.34 years) registered with an online survey service in Japan. In this survey, we first questioned whether or not a respondent had epilepsy, and then those with epilepsy were excluded from participation. We collected basic demographic information, administered the Epilepsy Knowledge Scale (18 items), and asked the open-ended response question, "What kind of disease do you think epilepsy is? If you do not know, please describe epilepsy in your words." We adopted quantitative text analysis using KH Coder3 and co-occurrence network analysis to examine the connections between words. Results Among the respondents, 92% have heard of epilepsy, and 26.8% have observed an epileptic seizure before the survey. The knowledge scale yields an average score of 27.96 ± 21.3 (out of 100), with the question with the highest percentage of correct responses being "People with epilepsy are just as capable as other people" at 51.64%. The question with the lowest percentage of correct responses was "If the person with epilepsy only has seizures during sleep, the person can have a driver's license," at 9.85%. The average number of Japanese characters responding to open-ended text questions was 10.45 ± 8.87 characters (including Kanji, Hiragana, and Katakana). We found that the word "froth" appeared more frequently with experience of observing a seizure, and the words "occur" and "brain" appeared more frequently with higher knowledge of epilepsy. Furthermore, comparing the sources of information from what they learned about epilepsy, the words "seizure," "faint," and "consciousness" appeared more frequently in school, with family and friends, and in newspapers and television, respectively. Conclusion We identified the level of knowledge and perceptions of epilepsy among the general public in Japan in 2021. By analyzing the qualitative aspects of open-ended text responses, we gathered information that might be useful for informing the public of future efforts to provide accurate information related to epilepsy.
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Affiliation(s)
- Izumi Kuramochi
- Department of Psychiatry, Saitama Medical Center, Saitama Medical University, Saitama, Japan,Mara Hospital, Bethel Epilepsy Center, Bielefeld University, Bielefeld, Germany,Corresponding author.
| | - Takayuki Iwayama
- Department of Psychiatry, Saitama Medical Center, Saitama Medical University, Saitama, Japan,Department of Psychology, Showa Women's University, Tokyo, Japan
| | - Koko Oga
- Department of Psychiatry, Saitama Medical Center, Saitama Medical University, Saitama, Japan,Department of Nursing, Saitama Medical Center, Saitama Medical University, Saitama, Japan
| | - Takafumi Shiganami
- Department of Psychiatry, Saitama Medical Center, Saitama Medical University, Saitama, Japan
| | - Tomoki Umemura
- Department of Psychiatry, Saitama Medical Center, Saitama Medical University, Saitama, Japan
| | - Sayaka Kobayashi
- Department of Psychiatry, Saitama Medical Center, Saitama Medical University, Saitama, Japan
| | - Takaaki Yasuda
- Department of Psychiatry, Saitama Medical Center, Saitama Medical University, Saitama, Japan
| | - Haruo Yoshimasu
- Department of Psychiatry, Saitama Medical Center, Saitama Medical University, Saitama, Japan
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22
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Mecarelli O, Di Gennaro G, Vigevano F. Unmet needs and perspectives in management of drug resistant focal epilepsy: An Italian study. Epilepsy Behav 2022; 137:108950. [PMID: 36347069 DOI: 10.1016/j.yebeh.2022.108950] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2022] [Revised: 10/04/2022] [Accepted: 10/07/2022] [Indexed: 11/07/2022]
Abstract
This study aimed to evaluate the consensus level between a representative group of Italian neurologists and people with Drug-Resistant Epilepsy (DRE) regarding a series of statements about different aspects involved in the management of epilepsy to identify the unmet needs of the People with Epilepsy (PwE) and the future perspectives for the management of this disease. This observational study was conducted using a classic Delphi technique. A 19-statement questionnaire was administered anonymously through an online platform to a panel of expert clinicians and a panel of PwE, analyzing three main topics of interest: drug resistance, access to care, and PwE's experience. The consensus was achieved on 8 of the 19 statements administered to the panel of medical experts and on 4 of the 14 submitted to the panel of PwE, particularly on the definition of DRE and its consequences on treatment, Quality of Life (QoL), and autonomy of PwE. Most of the items, however, did not reach a consensus and highlighted the lack of a shared univocal view on some topics, such as accessibility to care throughout the country and the role of emerging tools such as telemedicine, narrative medicine, and digital devices. In many cases, the two panels expressed different views on the statements. The results outlined many fields of possible intervention, such as the need for educational initiatives targeted at physicians and PwE - for example, regarding telemedicine, digital devices, and narrative medicine - as well as the spread of better knowledge about epilepsy among the general population, in order to reduce epilepsy stigma. Institutions, moreover, could take a cue from this survey to develop facilities aimed at enhancing PwE's autonomy and promoting more equal access to care throughout the country.
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Affiliation(s)
- Oriano Mecarelli
- Department of Human Neurosciences, Sapienza University, Rome and Past President of LICE, Italian League Against Epilepsy, Rome, Italy.
| | | | - Federico Vigevano
- Department of Neuroscience, Bambino Gesù Children's Hospital, IRCCS, Full Member of European Reference Network EpiCARE, Rome, Italy.
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23
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The WHO intersectoral global action plan and epilepsy cascade target: Towards a roadmap for implementation. Seizure 2022; 103:148-150. [DOI: 10.1016/j.seizure.2022.09.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Accepted: 09/28/2022] [Indexed: 11/27/2022] Open
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Wolf P. Has stigma changed? The image of epilepsy in literature. An essay. Epilepsy Behav 2022; 137:108921. [PMID: 36283291 DOI: 10.1016/j.yebeh.2022.108921] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2022] [Revised: 09/12/2022] [Accepted: 09/12/2022] [Indexed: 01/05/2023]
Abstract
Stigma is perhaps the most important sociopsychological burden for people with epilepsy (PWE), and literature both reflects and influences societal attitudes including stigma. To study how representations of stigma have changed over time could provide interesting insights. Traditionally, often repeated stigmatizing aspects include possession, insanity and crime, the weak, dependent and miserable epileptic, unfitness for marriage and reproduction, unreliability, but also special gifts. Many works present characters with epilepsy as inferior, outsiders, or misers. Recently, however, changes became apparent. First, several books addressed and criticized stigmatization of PWE. This was followed by works with positive characters, even role models, both women and men. They are independent, competent, sexually active, and attractive. Some indulge in sports, arts, or advanced technologies. Several are based on first-hand knowledge of people with epilepsy, and some belong to the field of autofiction. Optimistic literary categories like romance or coming-of-age are increasingly met, often with a first-person narrator. Whereas traditional epilepsy metaphors often indicate vulnerability, emotional instability, and weirdness, newer literature increasingly uses electricity metaphors. These represent power, excitement, and modernity. Another frequent new destigmatizing feature are olfactory auras that create a positive atmosphere. Along with comparable destigmatizing features in present popular music, recent developments in literature may represent a parallel to an emerging change in public opinions on epilepsy to which they could contribute an emotional dimension.
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Affiliation(s)
- Peter Wolf
- Danish Epilepsy Centre Filadelfia, Dianalund, Denmark; Postgraduation Programme in Clinical Medicine, Federal University of Santa Catarina, Florianópolis, SC, Brazil; Vilnius University, Faculty of Medicine, Institute of Clinical Medicine, Clinic of Neurology and Neurosurgery, Lithuania.
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25
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On epilepsy perception: Unravelling gaps and issues. Epilepsy Behav 2022; 137:108952. [PMID: 36306590 DOI: 10.1016/j.yebeh.2022.108952] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Revised: 10/09/2022] [Accepted: 10/10/2022] [Indexed: 01/05/2023]
Abstract
Epilepsy is one of the most common neurological diseases, but it can sometimes be under-reported or have a time delay in diagnosis. This data is not surprising if we consider that a person often seeks medical attention only after presenting a generalized tonic-clonic seizure. Epilepsy diagnostic delay is caused by several factors: under-reporting by patients, under-diagnosed epileptic manifestations by inexperienced clinicians, and lack of time in the emergency setting. The consequences of this delay are increased accidents, a high rate of premature mortality, and economic expanses for the healthcare system. Moreover, people with epilepsy have a higher probability of comorbidities than the general population, such as mood disorders or cognitive problems. Along with recurrent seizures, these comorbid diseases promote isolation and stigmatization of people with epilepsy, who suffer from discrimination at school, in the workplace, and even in social relationships. Public awareness of epilepsy and its comorbidities is necessary to prevent diagnostic delays and overcome social and professional iniquities for people with epilepsy.
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Kuramochi I, Iwayama T, Oga K, Shiganami T, Umemura T, Kobayashi S, Yasuda T, Yoshimasu H. A study of factors influencing self-stigma in people with epilepsy: A nationwide online questionnaire survey in Japan. Epilepsia Open 2022; 7:792-801. [PMID: 36225097 PMCID: PMC9712466 DOI: 10.1002/epi4.12661] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Accepted: 10/07/2022] [Indexed: 12/30/2022] Open
Abstract
OBJECTIVE Epilepsy carries a significant stigma. While there is some evidence that self-stigma accompanies a lack of knowledge about epilepsy, there are no studies in Japan. This study aimed to determine factors contributing to self-stigma in Japan. METHODS We conducted an online questionnaire survey. Three hundred and ten patients completed the questionnaire (mean age of 47.8 ± 11.9) in contrast to the total registered users on the questionnaire site as 28 315 from Jul 29 to Aug 2, 2021. We asked about demographic variables, satisfaction with treatment, limitations in life, support status, seizure frequency, the Epilepsy Self-Stigma Scale (ESSS), the Rosenberg Self-Esteem Scale (RSES), and the Epilepsy Knowledge Scale (EKS). We conducted the statistical analysis on self-stigma, self-esteem, knowledge of epilepsy, and seizure frequency associations by Spearman's rank correlation. RESULTS The mean value of the EKS was 40.19 ± 18.75, the ESSS was 17.69 ± 6.25, and the RSES was 26.02 ± 6.13. We identified a significant moderate negative correlation between self-esteem and self-stigma (P < .001, ρ = -.423), a significant weak positive correlation between self-esteem and knowledge (P = .005, ρ = .177), and a significant weak negative correlation between seizure frequency and self-stigma (P < .001, ρ = -.162). Of the 186 respondents who were working or studying, 91 (49%) participants had experienced any discrimination due to epilepsy. The use of psychosocial support, that is, participating in epilepsy self-help groups and educational programs, was 5.8%. SIGNIFICANCE There was no correlation between the strength of self-stigma and the knowledge, while there was a positive correlation between self-esteem and knowledge (P = .005, ρ = .177). There was a negative and weak correlation between seizure frequency and self-stigma (p < .001, ρ = -.162). These results suggest that sufficient knowledge may improve the self-esteem and thus reduce the self-stigma. In addition, short-term treatment for seizure control is insufficient to reduce self-stigma. The dissemination for people to enable sufficient epilepsy knowledge and positive perceptions of epilepsy by increasing self-efficacy throughout a lifetime may reduce self-stigma.
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Affiliation(s)
- Izumi Kuramochi
- Department of Psychiatry, Saitama Medical CenterSaitama Medical UniversitySaitamaJapan,Mara Hospital, Bethel Epilepsy CenterBielefeld UniversityBielefeldGermany
| | - Takayuki Iwayama
- Department of Psychiatry, Saitama Medical CenterSaitama Medical UniversitySaitamaJapan,Department of PsychologyShowa Women's UniversityTokyoJapan
| | - Koko Oga
- Department of Psychiatry, Saitama Medical CenterSaitama Medical UniversitySaitamaJapan,Department of Nursing, Saitama Medical CenterSaitama Medical UniversitySaitamaJapan
| | - Takafumi Shiganami
- Department of Psychiatry, Saitama Medical CenterSaitama Medical UniversitySaitamaJapan
| | - Tomoki Umemura
- Department of Psychiatry, Saitama Medical CenterSaitama Medical UniversitySaitamaJapan
| | - Sayaka Kobayashi
- Department of Psychiatry, Saitama Medical CenterSaitama Medical UniversitySaitamaJapan
| | - Takaaki Yasuda
- Department of Psychiatry, Saitama Medical CenterSaitama Medical UniversitySaitamaJapan
| | - Haruo Yoshimasu
- Department of Psychiatry, Saitama Medical CenterSaitama Medical UniversitySaitamaJapan
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Lalatović S, Milovanović M, Krstić N. Stigma and its association with health-related quality of life in adults with epilepsy. Epilepsy Behav 2022; 135:108874. [PMID: 35973375 DOI: 10.1016/j.yebeh.2022.108874] [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: 05/03/2022] [Revised: 07/15/2022] [Accepted: 08/03/2022] [Indexed: 11/18/2022]
Abstract
OBJECTIVE To explore the presence of felt and enacted stigma in people with epilepsy (PWE), members of a self-governing epilepsy organization and to evaluate the influence of both types of stigma on health-related quality of life (HRQoL) in PWE. METHODS Participants were 55 PWE (age range: 18-53 years), members of a non-governmental organization (further "NGO"). The sociodemographic and epilepsy-related variables were collected through structured interviews designed for the purpose of the study. Felt stigma was assessed with the Epilepsy Stigma Scale (ESS) and enacted stigma with the Questionnaire for episodes of discrimination against PWE. Quality of Life in Epilepsy Inventory (QOLIE-31) (Serbian version) was used for the evaluation of HRQoL. RESULTS The mean ESS score was 33.93 ± 14.50. Felt stigma was significantly associated with the male gender and the number of antiepileptic drugs (AEDs). Participants' mean score on the Questionnaire for episodes of discrimination was 2.80 ± 2.78. Enacted stigma was significantly correlated with male gender and number of AEDs, as well as with older age/longer duration of the disorder. Felt stigma scores were positively correlated with enacted stigma scores (p < 0.001), but only felt stigma scores were negatively related to QOLIE-31 overall score (p = 0.01). The combination of AEDs, seizure frequency, and felt stigma best explained the HRQoL in PWE (p < 0.001). CONCLUSION Felt and enacted stigma are moderately related, but only felt stigma appears to be a significant predictor of the deteriorating HRQoL in this sample. Interventions targeting felt stigma should be considered a part of comprehensive epilepsy care as well as educating the wider community about epilepsy.
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Affiliation(s)
- Staša Lalatović
- Faculty of Special Education and Rehabilitation, University of Belgrade, Visokog Stevana 2, 11000 Belgrade, Serbia.
| | - Maja Milovanović
- Faculty of Special Education and Rehabilitation, University of Belgrade, Visokog Stevana 2, 11000 Belgrade, Serbia; Department for Epilepsy and Clinical Neurophysiology, Institute of Mental Health, Milana Kašanina 3, 11000 Belgrade, Serbia.
| | - Nadežda Krstić
- Faculty of Special Education and Rehabilitation, University of Belgrade, Visokog Stevana 2, 11000 Belgrade, Serbia.
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Hohmann L, Berger J, Kastell SU, Holtkamp M. Perceived epilepsy-related stigma is linked to the socioeconomic status of the residence. Front Public Health 2022; 10:952585. [PMID: 36091545 PMCID: PMC9459334 DOI: 10.3389/fpubh.2022.952585] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Accepted: 08/11/2022] [Indexed: 01/24/2023] Open
Abstract
Purpose Epilepsy is one of the most common neurological disorders with high costs for the healthcare systems and great suffering for patients. Beyond seizures, psychosocial comorbidities can have detrimental effects on the well-being of people with epilepsy. One source of social stress and reduced quality of life is epilepsy-related stigma that often occurs, e.g., due to public misconceptions or myths. Stigma has individual biological, psychological and social correlates. Moreover, environmental factors like living in remote areas are associated with stigma. However, little is known about the link between the social structure of the residence and stigma in epilepsy. Thus, we investigated the association between the structural socioeconomic status (SES) and perceived stigma in an urban epilepsy population. Methods This prospective, cross-sectional study examined 226 adult in-patients with epilepsy from Berlin. Multiple regression analyses were performed to check the relationship between structural SES and stigma controlling for individual-level demographic, clinical, psychological and social factors. Continuous social indices (SI) of the districts and neighborhoods ("SI district" and "SI neighborhood") of Berlin were used to measure different levels of structural SES. Non-linear relationships are tested by grouping the SI in quartiles. Results Both indicators of structural SES were independently linked to stigma (p = 0.002). For "SI district", we identified a non-linear relationship with patients from the most deprived quartile feeling less stigmatized compared to those in the second (p < 0.001) or least deprived quartile (p = 0.009). Furthermore, more restrictions of daily life (p < 0.001), unfavorable income (p = 0.009) and seizure freedom in the past 6 months (p = 0.05) were related to increased stigma. A lower "SI neighborhood" was associated with higher stigma (p = 0.002). Conclusion Strategies to reduce epilepsy-related stigma need to consider the sociostructural living environment on different regional levels. Unfavorable relations with the immediate living environment may be directly targeted in patient-centered interventions. Non-linear associations with the structural SES of broader regional levels should be considered in public education programs. Further research is needed to examine possible underlying mechanisms and gain insight into the generalizability of our findings to other populations.
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Affiliation(s)
- Louisa Hohmann
- Epilepsy-Center Berlin-Brandenburg, Institute for Diagnostics of Epilepsy, Evangelisches Krankenhaus Königin Elisabeth Herzberge, Berlin, Germany,Epilepsy-Center Berlin-Brandenburg, Department of Neurology, Charité–Universitätsmedizin Berlin, Berlin, Germany,*Correspondence: Louisa Hohmann
| | - Justus Berger
- Epilepsy-Center Berlin-Brandenburg, Institute for Diagnostics of Epilepsy, Evangelisches Krankenhaus Königin Elisabeth Herzberge, Berlin, Germany
| | - Shirley-Uloma Kastell
- Epilepsy-Center Berlin-Brandenburg, Institute for Diagnostics of Epilepsy, Evangelisches Krankenhaus Königin Elisabeth Herzberge, Berlin, Germany
| | - Martin Holtkamp
- Epilepsy-Center Berlin-Brandenburg, Institute for Diagnostics of Epilepsy, Evangelisches Krankenhaus Königin Elisabeth Herzberge, Berlin, Germany,Epilepsy-Center Berlin-Brandenburg, Department of Neurology, Charité–Universitätsmedizin Berlin, Berlin, Germany
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29
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Governance of the clinical pathway and management of the patient suffering from epilepsy and drug-resistant epilepsy. GLOBAL & REGIONAL HEALTH TECHNOLOGY ASSESSMENT 2022; 9:4-9. [PMID: 36628125 PMCID: PMC9796603 DOI: 10.33393/grhta.2022.2418] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2022] [Accepted: 05/30/2022] [Indexed: 01/13/2023] Open
Abstract
Epilepsy is a diffuse chronic neurological disease affecting around 50 million people worldwide. The diagnostic criteria by the International League against Epilepsy must be fulfilled to diagnose the disease, which is characterized by brief and transient episodes of abnormal neuronal activity involving one or both hemispheres, depending on the epilepsy type. The diagnosis of epilepsy should be properly and timely made because patients suffering from the disease are affected not only by seizure recurrence but also by epilepsy-related psychiatric and/or cognitive comorbidities that may have a huge impact with severe professional and social implications. It is of vital importance to define a specific governance model that has to be virtuously applied into the different phases of the clinical pathway of the patients with epilepsy in order to guarantee them the best model of care possible.
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Lang J, Jeschke S, Müller RM, Herziger B, Bertsche T, Neininger MP, Bertsche A. Knowledge and attitudes towards epilepsy: A survey of people with epilepsy. Epilepsy Res 2022; 184:106964. [PMID: 35691219 DOI: 10.1016/j.eplepsyres.2022.106964] [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: 03/27/2022] [Revised: 05/18/2022] [Accepted: 06/02/2022] [Indexed: 11/19/2022]
Abstract
PROBLEM Many studies focus on knowledge and attitudes of unaffected people towards epilepsy and people with epilepsy (PWE). The perspective of PWE themselves is much less explored. METHODS We invited PWE in Germany to answer a questionnaire on their knowledge and attitudes towards epilepsy and PWE. RESULTS The questionnaire was completed by 230 PWE (median age: 40 years; min./max.: 19/83; 66 % female). Of PWE, 22 % thought that PWE are more helpful, and 10 % thought that PWE are friendlier than other people. Nevertheless, reservations about relationships and friendships with other PWE existed: of the participants, only 74 % would definitely go on a date with another PWE, and 90 % would definitely include another PWE they liked into their circle of friends. Swimming was judged as more dangerous for PWE than for healthy people by 71 % of PWE. Of PWE, 86 % correctly assumed it was not useful to hold a person having a seizure to the ground. Putting a solid object in the mouth was considered not useful by 85 % of PWE. Of PWE, 20 % would definitely administer an available emergency medication if another PWE had a seizure. For 67 % of PWE, certain preconditions should have to be fulfilled such as an available document with instructions. Of PWE, 11 % stated they would not administer an available emergency medication if another PWE had a seizure. CONCLUSION Although positive attitudes of PWE towards other PWE exist, we also found some reservations calling for psychosocial support. Most PWE had sufficient knowledge about risks of certain activities and about measures to be taken during a seizure. Nevertheless, a small group of PWE showed knowledge gaps. Thus, educational support still seems essential.
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Affiliation(s)
- J Lang
- Neuropaediatrics, University Hospital for Children and Adolescents, Ernst-Heydemann-Straße 8, Rostock 18057, Germany.
| | - S Jeschke
- Neuropaediatrics, University Hospital for Children and Adolescents, Ernst-Heydemann-Straße 8, Rostock 18057, Germany.
| | - R M Müller
- Neuropaediatrics, University Hospital for Children and Adolescents, Ernst-Heydemann-Straße 8, Rostock 18057, Germany.
| | - B Herziger
- Neuropaediatrics, University Hospital for Children and Adolescents, Ernst-Heydemann-Straße 8, Rostock 18057, Germany.
| | - T Bertsche
- Clinical Pharmacy, Institute of Pharmacy, Medical Faculty, Leipzig University, and Drug Safety Center, Leipzig University and Leipzig University Hospital, Bruederstrasse 32, Leipzig 04103, Germany.
| | - M P Neininger
- Clinical Pharmacy, Institute of Pharmacy, Medical Faculty, Leipzig University, and Drug Safety Center, Leipzig University and Leipzig University Hospital, Bruederstrasse 32, Leipzig 04103, Germany.
| | - A Bertsche
- Neuropaediatrics, University Hospital for Children and Adolescents, Ernst-Heydemann-Straße 8, Rostock 18057, Germany.
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Mao L, Wang K, Zhang Q, Wang J, Zhao Y, Peng W, Ding J. Felt Stigma and Its Underlying Contributors in Epilepsy Patients. Front Public Health 2022; 10:879895. [PMID: 35558541 PMCID: PMC9087196 DOI: 10.3389/fpubh.2022.879895] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2022] [Accepted: 03/28/2022] [Indexed: 11/13/2022] Open
Abstract
Objective To explore the correlated clinical and psychological factors of stigmatization and investigate the relationship between stigma and white matter abnormalities in epilepsy patients. Methods Stigmatization was obtained by a three-item stigma scale in 256 epilepsy patients with genetic or unknown etiology. Personality and quality of life (QOL) were assessed by Eysenck Personality Questionnaire (EPQ) and QOL-31 questionnaire respectively. One hundred and fourteen of them were performed Hamilton Depression Scale-17 (HAMD) and scanned with diffusion tensor imaging in 3T MRI. Fractional anisotropy (FA) values of frontotemporal contact fibers were calculated. Results There were about 39.8% patients felt stigma, with the highest score (Score 3) in 8.2% (21/256). Stigma scores were significantly negatively correlated with education (P < 0.01), age of onset (P < 0.05), extraversion score of EPQ (P < 0.01), total and all the subscale QOL scores (P < 0.001), and positively correlated with duration (P < 0.01), HAMD score (P < 0.001), neuroticism score of EPQ (P < 0.001). We found negative correlation between stigma scores and FA values of right superior longitudinal fasciculus and left cingulum (P < 0.05). Logistic regression results showed that FA value of left cingulum (P = 0.011; OR = 0.000), social function (P = 0.000; OR = 0.935) of QOL, and neuroticism score of EPQ (P = 0.033; OR = 1.123) independently correlated to felt stigma. Conclusion Felt stigma in epilepsy patients was found to be correlated with neuroticism, depression, and deficient social function of QOL, which might be predisposed by the impairment of the left cingulum. Our results provide preliminary evidence for the underlying neural circuits in stigmatization.
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Affiliation(s)
- Lingyan Mao
- Department of Neurology, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Keying Wang
- Teachers College, Columbia University, New York, NY, United States
| | - Qianqian Zhang
- Department of Neurology, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Jing Wang
- Department of Neurology, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Yanan Zhao
- Department of Neurology, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Weifeng Peng
- Department of Neurology, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Jing Ding
- Department of Neurology, Zhongshan Hospital, Fudan University, Shanghai, China
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Gosain K, Samanta T. Understanding the Role of Stigma and Misconceptions in the Experience of Epilepsy in India: Findings From a Mixed-Methods Study. FRONTIERS IN SOCIOLOGY 2022; 7:790145. [PMID: 35633838 PMCID: PMC9136008 DOI: 10.3389/fsoc.2022.790145] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Accepted: 04/11/2022] [Indexed: 06/15/2023]
Abstract
It is surprising that although 12 million people in India suffer from epilepsy this remains a thoroughly under-researched area in the sociology of health and practice. We address this intellectual and policy neglect by reviewing the social, psychological and legal challenges governing the lives of people living with epilepsy (PWE) by paying particular attention to negotiations in arranged marriages and employment. Drawing on the analytical frameworks of the sociological study of stigma, critical race theory and paying attention to the cultural models of health and suffering, this study utilized a combination of (online) survey data (N = 100) and in-depth qualitative interviews (N = 10) with PWE and their families. The online survey was administered to map the level of awareness about epilepsy and its clinical management among the general population, whereas the in-depth interviews were conducted to understand the experience, self-perception and everyday struggles of those diagnosed with the condition. Findings from the survey on non-PWE suggest a general lack of awareness and fearful misconceptions around epilepsy related seizures. In-depth interviews with PWEs revealed concealment (of the illness) as a dominant coping strategy to attenuate the social alienation and rejection associated with epilepsy. Further, PWE participants reported persistent discrimination, harassment and prejudiced understanding of diminished cognitive capacities at workplaces as a result of cultural myths and popular representations of epilepsy-related seizures. The study also demonstrated the significance of institutional support groups in assisting PWE to cope with symbolic violence and forge solidarities. We conclude with reflections on the ethical dilemmas faced by medical practitioners while dealing with social-medical interventions of epilepsy treatment. Overall, results from this study undergird the significance to revisit the social-moral as well as legal frameworks that persistently restrict opportunities for PWE in India. In an attempt to reimagine inclusive futures regardless of disease, disability and affliction, we attempt to move beyond the biomedical gaze and instead privilege stories of individual personhood, struggles and aspirations.
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Affiliation(s)
- Kritika Gosain
- Department of Humanities and Social Sciences, Indian Institute of Technology Gandhinagar, Gandhinagar, India
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Tu H, Gong G, Zhang S, Fu Y, Wang T, Chu Q, Hu S, Wang K, Zhu C, Fan Y. The association between illness perception and quality of life among Chinese adults with epilepsy: The mediating role of coping style. Epilepsy Behav 2022; 130:108677. [PMID: 35398723 DOI: 10.1016/j.yebeh.2022.108677] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Revised: 03/13/2022] [Accepted: 03/19/2022] [Indexed: 11/19/2022]
Abstract
OBJECTIVE To evaluate the associations between illness perception, quality of life (QOL), and coping style among patients with epilepsy (PWE), and to establish the behavior of coping style as a mediator of the interplay between illness perception and QOL. METHODS A cross-sectional study of 135 adult Chinese PWE was performed. All patients completed clinical and demographic questionnaires, the Chinese version of the Revised Illness Perception Questionnaire (CIPQ-R), the quality of life in epilepsy-31 inventory (QOLIE-31), and the Simplified Coping Style Questionnaire (SCSQ). Collected data were assessed through correlation analyses, structural equation modeling (SEM), and multiple stepwise linear regression assessments. RESULTS These patients exhibited a mean QOLIE-31 total score of 46.9 points, consistent with moderately low QOL. Under model III (F = 9.447, p < 0.01, R2 = 0.486), all included variables were found to explain 48.6% of the observed variation in QOL, with illness perception and coping style, respectively, explaining 27.3% and 7% of such variation. SEM findings illustrated that the total influence value of illness perception on QOL was 77.5% (β = -0.775, p < 0.001). Moreover, the illness perception was found to have a direct impact on QOL (β = -0.620, p = 0.001), negative coping (β = 0.309, p < 0.001), and positive coping (β = -0.265, p = 0.014), with negative coping (β = -0.256, p = 0.003), and positive coping (β = 0.288, p = 0.006) also having a direct impact on such QOL. Positive and negative coping styles also served as mediators of an indirect relationship between illness perception and QOL (β = -0.27*0.29 + 0.31* - 0.26 = -0.159, p = 0.001), with coping style thus serving as a significant mediator of the association between QOL and illness perception. The mediating impact of coping style on QOL accounted for 20.5% (-0.159/-0.775) of the total influence. CONCLUSION Both coping style and illness perception were detected to be significantly correlated with the QOL of Chinese adult PWE, with coping style serving as a mediator of the association between QOL and illness perception in this patient population. As such, when seeking to control seizures, medical workers should assess illness perceptions and coping styles among PWE as quickly as possible in order to select the optimal interventions most likely to improve the QOL of these patients.
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Affiliation(s)
- Houmian Tu
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University. 81 Meishan Road, Hefei, Anhui Province 230032, PR China; Department of Neurology, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui Province 230032, PR China
| | - Guiping Gong
- Department of Neurology, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui Province 230032, PR China
| | - Sichen Zhang
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University. 81 Meishan Road, Hefei, Anhui Province 230032, PR China
| | - Yuansheng Fu
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University. 81 Meishan Road, Hefei, Anhui Province 230032, PR China
| | - Ting Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University. 81 Meishan Road, Hefei, Anhui Province 230032, PR China
| | - Qinshu Chu
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University. 81 Meishan Road, Hefei, Anhui Province 230032, PR China
| | - Shaohua Hu
- Nursing Department, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui Province 230032, PR China
| | - Kai Wang
- Department of Neurology, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui Province 230032, PR China
| | - Chunyan Zhu
- The School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei 230032, PR China.
| | - Yinguang Fan
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University. 81 Meishan Road, Hefei, Anhui Province 230032, PR China.
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Erratum. Epilepsia 2022; 63:1283-1284. [PMID: 35301711 DOI: 10.1111/epi.17219] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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