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Choi S, Bang KS. Health-related quality of life in children with epilepsy: a concept analysis. CHILD HEALTH NURSING RESEARCH 2023; 29:84-95. [PMID: 36760115 PMCID: PMC9925299 DOI: 10.4094/chnr.2023.29.1.84] [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: 12/11/2022] [Accepted: 01/05/2023] [Indexed: 02/05/2023] Open
Abstract
PURPOSE This study aimed to conduct a concept analysis of health-related quality of life in children with epilepsy to promote conceptual clarification and facilitate mutual understanding of the concept. METHODS Walker and Avant's concept analysis method was adopted. RESULTS Health-related quality of life in children with epilepsy consists of six attributes: health status, inner strength, close relationships, resource-rich community, social acceptance, and changeability. According to the ecological system paradigm, these attributes are structured into five dimensions: organism, microsystem, macrosystem, exosystem, and chronosystem. These dimensions provide a comprehensive approach to the relationship between children with epilepsy and their environment. Epilepsy and interactions with multilevel ecological systems that are directly and indirectly related to children with epilepsy precede the concept, followed by positive and negative affective responses. CONCLUSION The findings of this study may support effective communication in various practice settings, thereby contributing to the health and well-being of children with epilepsy, as well as the development and expansion of interventions to improve their health-related quality of life.
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Affiliation(s)
- Sinyoung Choi
- Graduate Student, Center for Human-Caring Nurse Leaders for the Future by Brain Korea 21 (BK 21) Four Project, College of Nursing, Seoul National University, Seoul, Korea
| | - Kyung-Sook Bang
- Professor, College of Nursing ․ The Research Institute of Nursing Science, Seoul National University, Seoul, Korea,Corresponding author Kyung-Sook Bang College of Nursing, Seoul National University, 103 Daehak-ro, Jongno-gu, Seoul 03080, Korea TEL: +82-2-740-8819 FAX: +82-2-765-4103 E-MAIL:
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Eaton C, Yong K, Walter V, Mbizvo GK, Rhodes S, Chin RF. Stimulant and non-stimulant drug therapy for people with attention deficit hyperactivity disorder and epilepsy. Cochrane Database Syst Rev 2022; 7:CD013136. [PMID: 35844168 PMCID: PMC9289704 DOI: 10.1002/14651858.cd013136.pub2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND Attention Deficit Hyperactivity Disorder (ADHD) can co-occur in up to 40% of people with epilepsy. There is debate about the efficacy and tolerability of stimulant and non-stimulant drugs used to treat people with ADHD and co-occurring epilepsy. OBJECTIVES To assess the effect of stimulant and non-stimulant drugs on children and adults with ADHD and co-occurring epilepsy in terms of seizure frequency and drug withdrawal rates (primary objectives), as well as seizure severity, ADHD symptoms, cognitive state, general behaviour, quality of life, and adverse effects profile (secondary objectives). SEARCH METHODS We searched the following databases on 12 October 2020: Cochrane Register of Studies (CRS Web), MEDLINE (Ovid, 1946 to 9 October 2020), CINAHL Plus (EBSCOhost, 1937 onwards). There were no language restrictions. CRS Web includes randomised or quasi-randomised controlled trials from PubMed, Embase, ClinicalTrials.gov, the World Health Organization International Clinical Trials Registry Platform (ICTRP), the Cochrane Central Register of Controlled Trials (CENTRAL), and the Specialised Registers of Cochrane Review Groups including Epilepsy. SELECTION CRITERIA: We included randomised controlled trials of stimulant and non-stimulant drugs for people of any age, gender or ethnicity with ADHD and co-occurring epilepsy. DATA COLLECTION AND ANALYSIS We selected articles and extracted data according to predefined criteria. We conducted primary analysis on an intention-to-treat basis. We presented outcomes as risk ratios (RRs) with 95% confidence intervals (CIs), except for individual adverse effects where we quoted 99% CIs. We conducted best- and worst-case sensitivity analyses to deal with missing data. We carried out a risk of bias assessment for each included study using the Cochrane risk of bias tool and assessed the overall certainty of evidence using the GRADE approach. MAIN RESULTS We identified two studies that matched our inclusion criteria: a USA study compared different doses of the stimulant drug osmotic-release oral system methylphenidate (OROS-MPH) with a placebo in 33 children (mean age 10.5 ± 3.0 years), and an Iranian study compared the non-stimulant drug omega-3 taken in conjunction with risperidone and usual anti-seizure medication (ASM) with risperidone and ASM only in 61 children (mean age 9.24 ± 0.15 years). All children were diagnosed with epilepsy and ADHD according to International League Against Epilepsy and Diagnostic and Statistical Manual of Mental Disorders, fourth edition, criteria, respectively. We assessed both studies to be at low risk of detection and reporting biases, but assessments varied from low to high risk of bias for all other domains. OROS-MPH No participant taking OROS-MPH experienced significant worsening of epilepsy, defined as: 1. a doubling of the highest 14-day or highest two-day seizure rate observed during the 12 months before the trial; 2. a generalised tonic-clonic seizure if none had been experienced in the previous two years; or 3. a clinically meaningful intensification in seizure duration or severity (33 participants, 1 study; low-certainty evidence). However, higher doses of OROS-MPH predicted an increased daily risk of a seizure (P < 0.001; 33 participants, 1 study; low-certainty evidence). OROS-MPH had a larger proportion of participants receiving 'much improved' or 'very much improved' scores for ADHD symptoms on the Clinical Global Impressions for ADHD-Improvement tool (33 participants, 1 study; low-certainty evidence). OROS-MPH also had a larger proportion of people withdrawing from treatment (RR 2.80; 95% CI 1.14 to 6.89; 33 participants, 1 study; moderate-certainty evidence). Omega-3 Omega-3 with risperidone and ASM were associated with a reduction in mean seizure frequency by 6.6 seizures per month (95% CI 4.24 to 8.96; 56 participants, 1 study; low-certainty evidence) and an increase in the proportion of people achieving 50% or greater reduction in monthly seizure frequency (RR 2.79, 95% CI 0.84 to 9.24; 56 participants, 1 study; low-certainty evidence) compared to people on risperidone and ASM alone. Omega-3 with risperidone and ASM also had a smaller proportion of people withdrawing from treatment (RR 0.65, 95% CI 0.12 to 3.59; 61 participants, 1 study; low-certainty evidence) but a larger proportion of people experiencing adverse drug events (RR 1.40, 95% CI 0.44 to 4.42; 56 participants, 1 study; low-certainty evidence) compared to people on risperidone and ASM alone. AUTHORS' CONCLUSIONS In children with a dual-diagnosis of epilepsy and ADHD, there is some evidence that use of the stimulant drug OROS-MPH is not associated with significant worsening of epilepsy, but higher doses of it may be associated with increased daily risk of seizures; the evidence is of low-certainty. OROS-MPH is also associated with improvement in ADHD symptoms. However, this treatment was also associated with a large proportion of treatment withdrawal compared to placebo. In relation to the non-stimulant drug omega-3, there is some evidence for reduction in seizure frequency in children who are also on risperidone and ASM, compared to children who are on risperidone and ASM alone. Evidence is inconclusive whether omega-3 increases or decreases the risk of adverse drug events. We identified only two studies - one each for OROS-MPH and omega-3 - with low to high risk of bias. We assessed the overall certainty of evidence for the outcomes of both OROS-MPH and omega-3 as low to moderate. More studies are needed. Future studies should include: 1. adult participants; 2. a wider variety of stimulant and non-stimulant drugs, such as amphetamines and atomoxetine, respectively; and 3. additional important outcomes, such as seizure-related hospitalisations and quality of life. Clusters of studies which assess the same drug - and those that build upon the evidence base presented in this review on OROS-MPH and omega-3 - are needed to allow for meta-analysis of outcomes.
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Affiliation(s)
- Chris Eaton
- Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK
- Medical Research Council Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, UK
| | - Kenneith Yong
- Department of Clinical Neurosciences, Royal Hospital for Children and Young People, Edinburgh, UK
| | - Victoria Walter
- Muir Maxwell Epilepsy Centre, Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK
| | | | - Sinead Rhodes
- Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK
| | - Richard Fm Chin
- Muir Maxwell Epilepsy Centre, Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK
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Mayor R, Gunn S, Reuber M, Simpson J. Experiences of stigma in people with epilepsy: A meta-synthesis of qualitative evidence. Seizure 2021; 94:142-160. [PMID: 34915348 DOI: 10.1016/j.seizure.2021.11.021] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2021] [Revised: 11/15/2021] [Accepted: 11/19/2021] [Indexed: 02/08/2023] Open
Abstract
OBJECTIVE Stigma is reported to cause as much distress and effect on quality of life for individuals with epilepsy as the physical symptoms of seizures. Existing quantitative reviews have focused on describing levels of stigma in epilepsy, but no qualitative review has been undertaken despite the increasing number of relevant studies. We provide a qualitative synthesis to aid the understanding of stigma experiences in adults with epilepsy across different sociocultural contexts. METHODS A systematic database search yielded an initial set of 3,032 relevant papers, of which 28 were included. A meta-synthesis was conducted according to a meta-ethnographic approach which has been adapted for health research. RESULTS Five themes were generated: 1) Societal negative perceptions of epilepsy result in discrimination and rejection; 2) Internal attributions of blame lead to negative self-perception and shame; 3) Stigma impacts everyday life and contributes to reliance on others; 4) Stigma is managed through concealment and avoidance; 5) Support from others is beneficial but dependant on own and others' understandings of epilepsy. These themes highlighted the key individual experiences of epilepsy stigma, which appeared to some degree culture-specific. Culturally-informed misconceptions of epilepsy were readily internalised, resulting in emotional challenges and affecting participants' lives. Strategies for coping with this were also described. SIGNIFICANCE This synthesis characterised the experiences of stigma among adults with epilepsy and highlighted key similarities and differences in these experiences across sociocultural contexts. Educational programmes to inform communities about epilepsy hold importance going forward.
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Affiliation(s)
- Rebecca Mayor
- Division of Health Research, Lancaster University, Lancaster, LA1 4YT, UK
| | - Sarah Gunn
- Department of Neuroscience, Psychology and Behaviour, Leicester University, Leicester, LE1 7RH, UK
| | - Markus Reuber
- Academic Neurology Unit, University of Sheffield, Royal Hallamshire Hospital, Glossop Road, Sheffield, S10 2JF, UK
| | - Jane Simpson
- Division of Health Research, Lancaster University, Lancaster, LA1 4YT, UK
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Penovich PE, Stern JM, Becker DA, Long L, Santilli N, McGuire L, Peck EY. Epilepsy Treatment Complacency in Patients, Caregivers, and Health Care Professionals. Neurol Clin Pract 2021; 11:377-384. [PMID: 34824892 PMCID: PMC8610521 DOI: 10.1212/cpj.0000000000001066] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2020] [Accepted: 01/27/2021] [Indexed: 11/22/2022]
Abstract
Objective To explore the perspectives of adult patients with epilepsy, caregivers, and health care professionals (HCPs) on treatment for seizures and treatment decisions, we developed and administered the STEP Survey (Seize the Truth of Epilepsy Perceptions). Methods Participants were recruited from online panel M3 and by Rare Patient Voice and completed the self-administered online STEP Survey. Analysis of variance and chi-square tests were used for group comparisons. Results The STEP Survey was completed by 400 adult patients, 201 caregivers, and 258 HCPs. Patients estimated reporting 45% of their seizures to their HCP, whereas caregivers estimated 83% and HCPs estimated 73% were reported. The most common reason for not reporting seizures was that the seizures were not serious enough to mention (patients 57%; caregivers 66%). A minority of patients (25%) and caregivers (30%) were very or extremely likely to ask their HCP about changing antiseizure medication (ASM) in the next 12 months. The HCP was most frequently selected by patients, caregivers, and HCPs as the person who initiates discussion of changing ASMs (patients 73%/caregivers 66%/HCPs 75%) and increasing ASM dosage (patients 77%/caregivers 68%/HCPs 81%). A majority of patients (65%) and caregivers (68%) somewhat or strongly agreed that they do not change ASMs due to fear of getting worse. HCPs perceive this fear less often, stating that 50% of their patients feel afraid when a second ASM was added. Conclusions Improved reporting of all seizures, discussion of treatment changes, and the impact of fear on treatment decisions provide opportunities to reduce complacency and optimize patient outcomes.
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Affiliation(s)
- Patricia E Penovich
- Minnesota Epilepsy Group (PEP), Saint Paul; Department of Neurology (JMS), University of California at Los Angeles; Penn Epilepsy Center (DAB), Hospital of the University of Pennsylvania, Philadelphia; Department of Neurology (LL), The Ohio State University Medical Center, Columbus; Human Care Systems Inc. (NS), San Francisco, CA; MedVal Scientific Information Services (LM), Princeton, NJ; and Health Division (EYP), Kantar Health, New York, NY
| | - John M Stern
- Minnesota Epilepsy Group (PEP), Saint Paul; Department of Neurology (JMS), University of California at Los Angeles; Penn Epilepsy Center (DAB), Hospital of the University of Pennsylvania, Philadelphia; Department of Neurology (LL), The Ohio State University Medical Center, Columbus; Human Care Systems Inc. (NS), San Francisco, CA; MedVal Scientific Information Services (LM), Princeton, NJ; and Health Division (EYP), Kantar Health, New York, NY
| | - Danielle A Becker
- Minnesota Epilepsy Group (PEP), Saint Paul; Department of Neurology (JMS), University of California at Los Angeles; Penn Epilepsy Center (DAB), Hospital of the University of Pennsylvania, Philadelphia; Department of Neurology (LL), The Ohio State University Medical Center, Columbus; Human Care Systems Inc. (NS), San Francisco, CA; MedVal Scientific Information Services (LM), Princeton, NJ; and Health Division (EYP), Kantar Health, New York, NY
| | - Lucretia Long
- Minnesota Epilepsy Group (PEP), Saint Paul; Department of Neurology (JMS), University of California at Los Angeles; Penn Epilepsy Center (DAB), Hospital of the University of Pennsylvania, Philadelphia; Department of Neurology (LL), The Ohio State University Medical Center, Columbus; Human Care Systems Inc. (NS), San Francisco, CA; MedVal Scientific Information Services (LM), Princeton, NJ; and Health Division (EYP), Kantar Health, New York, NY
| | - Nancy Santilli
- Minnesota Epilepsy Group (PEP), Saint Paul; Department of Neurology (JMS), University of California at Los Angeles; Penn Epilepsy Center (DAB), Hospital of the University of Pennsylvania, Philadelphia; Department of Neurology (LL), The Ohio State University Medical Center, Columbus; Human Care Systems Inc. (NS), San Francisco, CA; MedVal Scientific Information Services (LM), Princeton, NJ; and Health Division (EYP), Kantar Health, New York, NY
| | - Lynanne McGuire
- Minnesota Epilepsy Group (PEP), Saint Paul; Department of Neurology (JMS), University of California at Los Angeles; Penn Epilepsy Center (DAB), Hospital of the University of Pennsylvania, Philadelphia; Department of Neurology (LL), The Ohio State University Medical Center, Columbus; Human Care Systems Inc. (NS), San Francisco, CA; MedVal Scientific Information Services (LM), Princeton, NJ; and Health Division (EYP), Kantar Health, New York, NY
| | - Eugenia Y Peck
- Minnesota Epilepsy Group (PEP), Saint Paul; Department of Neurology (JMS), University of California at Los Angeles; Penn Epilepsy Center (DAB), Hospital of the University of Pennsylvania, Philadelphia; Department of Neurology (LL), The Ohio State University Medical Center, Columbus; Human Care Systems Inc. (NS), San Francisco, CA; MedVal Scientific Information Services (LM), Princeton, NJ; and Health Division (EYP), Kantar Health, New York, NY
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Vacca M, Fernandes M, Spanetta M, Placidi F, Izzi F, Lombardo C, Mercuri NB, Liguori C. Depressive symptoms in patients with epilepsy and clinically associated features in a single tertiary center. Neurol Sci 2021; 43:1965-1974. [PMID: 34528181 PMCID: PMC8860796 DOI: 10.1007/s10072-021-05589-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2021] [Accepted: 08/26/2021] [Indexed: 11/30/2022]
Abstract
Although depressive symptoms are the most common psychiatric comorbidity in epilepsy, they remain underestimated and untreated in a large proportion of patients. The purpose of this study was to evaluate depression severity and related clinical features in people with epilepsy using a well-reliable self-report index of mood, the Beck Depression Inventory-II (BDI-II). One-hundred seventeen adult patients with epilepsy were recruited from a tertiary epilepsy center and completed the BDI-II. A single-item analysis of the 21 questions of the BDI-II was computed and differences between women and men in each depressive symptom were evaluated. Correlation and regression analyses were used to identify clinical features associated with the severity of depression. Results showed gender differences in some items, with women reporting overall higher depression severity than men. The most common symptoms regarded domains of sleeping patterns, tiredness, and loss of energy. Regression evidence suggested that being female, having an epilepsy duration < 10 years, as well as being treated with psychotropic drugs and reporting generalized seizure, were associated with higher depression severity. Despite its cross-sectional nature, this study reinforces the importance of investigating and possibly treating depressive symptoms in adult patients with epilepsy, since they negatively impact well-being, daytime activities, and sleep. Further studies identifying pharmacological and non-pharmacological treatments for depression in epilepsy need to be planned.
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Affiliation(s)
| | - Mariana Fernandes
- Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
| | - Matteo Spanetta
- Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
| | - Fabio Placidi
- Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy.,Epilepsy Center, Neurology Unit, University Hospital of Rome Tor Vergata, Rome, Italy
| | - Francesca Izzi
- Epilepsy Center, Neurology Unit, University Hospital of Rome Tor Vergata, Rome, Italy
| | | | - Nicola Biagio Mercuri
- Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy.,Epilepsy Center, Neurology Unit, University Hospital of Rome Tor Vergata, Rome, Italy.,IRCSS Santa Lucia Foudantion, Rome, Italy
| | - Claudio Liguori
- Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy. .,Epilepsy Center, Neurology Unit, University Hospital of Rome Tor Vergata, Rome, Italy.
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Shi Y, Liu S, Wang J, Li C, Zhang J. Stigma experienced by patients with epilepsy: A systematic review and meta-synthesis of qualitative studies. Epilepsy Behav 2021; 118:107926. [PMID: 33862535 DOI: 10.1016/j.yebeh.2021.107926] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2020] [Revised: 03/03/2021] [Accepted: 03/03/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND Epilepsy, one of the most common and serious chronic neurological diseases, is accompanied by a series of complex psychosocial problems. A number of qualitative studies have investigated the stigma experiences among patients with epilepsy (PWE). However, the findings are different and complementary to a certain degree. We conducted a systematic review to investigate and synthesize existing qualitative research findings to fully identify stigma experienced by PWE. The aim was to develop anti-stigma interventions and reduce any adverse sequelae. OBJECTIVE To synthesize qualitative evidence on the stigma experiences of PWE. METHODS This was a systematic review and qualitative evidence synthesis guided by the Joanna Briggs Methodology. Systematic literature search for primary studies was conducted in PubMed, PsychINFO, EMBASE, and Web of Science databases until December 2019. Findings from the included qualitative studies were extracted, assessed for quality, and aggregated using meta-synthesis. RESULTS Twenty-six studies were included in the review. Four distinct synthesized findings were identified from the original researches: 'stigma experienced in daily life'; 'stigma perceived from others'; 'psychological reactions to stigma'; and 'strategies to address stigma'. CONCLUSION The present meta-synthesis thoroughly investigated the stigma experienced by PWE. The findings suggest that appropriate multi-level interventions targeting the general public, health professionals, caregivers, and patients themselves are warranted to reduce the harmful impacts of stigma.
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Affiliation(s)
- Ying Shi
- School of Nursing, Sun Yat-sen University, Guangzhou, China
| | - Sha Liu
- Department of Hematology, Union Hospital Affiliated to Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Jingjing Wang
- Department of Nursing, Internal Hospital of Tianjin Medical University General Hospital, Tianjin, China
| | - Chen Li
- Department of Neurology, The First Affiliated Hospital of Jinan University, Guangzhou, China
| | - June Zhang
- School of Nursing, Sun Yat-sen University, Guangzhou, China.
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Epilepsy self-management during a pandemic: Experiences of people with epilepsy. Epilepsy Behav 2020; 111:107238. [PMID: 32593874 PMCID: PMC7316066 DOI: 10.1016/j.yebeh.2020.107238] [Citation(s) in RCA: 43] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2020] [Accepted: 06/03/2020] [Indexed: 12/22/2022]
Abstract
The purpose of this descriptive study was to, from the perspective of adult people with epilepsy (PWE) and caregivers of PWE, explore the effects of the current pandemic and resulting societal changes on epilepsy self-management. Ninety-four respondents completed a mixed-methods quantitative and qualitative survey focused on their epilepsy self-management experiences during the coronavirus disease-19 (COVID-19) pandemic. Respondents noted significant disruption in epilepsy self-management. Lack of ability to obtain medications or see epilepsy providers, as well as increased stress, social isolation, and changes in routine were all reported as troublesome, and more than one-third of the sample reported an increase in seizure frequency since the onset of the pandemic. Suggestions are given regarding how to support PWE during future COVID-19 outbreaks and to better prepare PWE and their caregivers for any life-altering events, such as a pandemic, with robust self-management skills that will allow them to maintain the highest level of function possible.
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Quarells RC, Spruill TM, Escoffery C, Shallcross A, Montesdeoca J, Diaz L, Payano L, Thompson NJ. Depression self-management in people with epilepsy: Adapting project UPLIFT for underserved populations. Epilepsy Behav 2019; 99:106422. [PMID: 31371202 PMCID: PMC7432961 DOI: 10.1016/j.yebeh.2019.07.023] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/21/2019] [Accepted: 07/05/2019] [Indexed: 01/27/2023]
Abstract
Data from the 2015 National Health Interview Survey found that the prevalence of active epilepsy has increased to three million adults. Although findings have been mixed, some research indicates that Blacks and Hispanics share a higher burden of epilepsy prevalence compared with non-Hispanic whites. Moreover, depression is a common comorbid condition among people with epilepsy (PWE), affecting up to 55% of the epilepsy population. Widespread use and increased public health impact of evidence-based self-management interventions is critical to reducing disease burden and may require adapting original interventions into more culturally relevant versions for racial and ethnic minority groups. Project UPLIFT provides access to mental health self-management skills training that is distance-delivered, does not interfere with medication management, and has been shown to be effective in reducing depressive symptoms. This paper presents the process of exploring the adaptation of Project UPLIFT for Black and Hispanic PWE and herein suggests that evidence-based interventions can be successfully adapted for new populations or cultural settings through a careful and systematic process. Additional key lessons learned include the importance of community engagement and that language matters. Ultimately, if the adapted Project UPLIFT intervention produces positive outcomes for diverse populations of PWE, it will extend the strategies available to reduce the burden of depression. Implementing evidence-based interventions such as Project UPLIFT is critical to reducing disease burden; however, their delivery may need to be tailored to the needs and culture of the populations of interest.
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Affiliation(s)
- Rakale C Quarells
- Morehouse School of Medicine, 720 Westview Drive, SW, Atlanta, GA 30310, United States.
| | - Tanya M Spruill
- NYU School of Medicine, Department of Population Health, 180 Madison Ave, 7th Floor, New York, NY 10016, United States
| | - Cam Escoffery
- Department of Behavioral Sciences and Health Education, Rollins School of Public Health, Emory University, Atlanta, GA 30322, United States
| | - Amanda Shallcross
- NYU School of Medicine, Department of Population Health, 180 Madison Ave, 7th Floor, New York, NY 10016, United States
| | - Jacqueline Montesdeoca
- NYU School of Medicine, Department of Population Health, 180 Madison Ave, 7th Floor, New York, NY 10016, United States
| | - Laura Diaz
- NYU School of Medicine, Department of Population Health, 180 Madison Ave, 7th Floor, New York, NY 10016, United States
| | - Leydi Payano
- NYU School of Medicine, Department of Population Health, 180 Madison Ave, 7th Floor, New York, NY 10016, United States
| | - Nancy J Thompson
- Department of Behavioral Sciences and Health Education, Rollins School of Public Health, Emory University, Atlanta, GA 30322, United States
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9
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Walter V, Mbizvo GK, Chin RFM. Stimulant and non-stimulant drug therapy for people with attention deficit hyperactivity disorder and epilepsy. Hippokratia 2018. [DOI: 10.1002/14651858.cd013136] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Victoria Walter
- University of Edinburgh; Muir Maxwell Epilepsy Centre, Centre for Clinical Brain Sciences; 20 Sylvan Place Edinburgh Scotland UK EH9 1UW
| | - Gashirai K Mbizvo
- University of Edinburgh; Muir Maxwell Epilepsy Centre, Centre for Clinical Brain Sciences; 20 Sylvan Place Edinburgh Scotland UK EH9 1UW
| | - Richard FM Chin
- University of Edinburgh; Muir Maxwell Epilepsy Centre, Centre for Clinical Brain Sciences; 20 Sylvan Place Edinburgh Scotland UK EH9 1UW
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10
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Myers L, Lancman M, Laban-Grant O, Lancman M, Jones J. Socialization characteristics in persons with epilepsy. Epilepsy Behav 2017; 72:99-107. [PMID: 28575775 DOI: 10.1016/j.yebeh.2017.04.036] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2016] [Revised: 03/16/2017] [Accepted: 04/22/2017] [Indexed: 10/19/2022]
Abstract
OBJECTIVE The purpose of this report was to describe social behaviors and preferences in adults with epilepsy, including self-reported use of various socialization media (face-to-face and indirect communication) as well as perceived social barriers. METHODS 1320 consecutive persons with epilepsy (PWEs) confirmed through inpatient video-EEG monitoring were administered a questionnaire on the day of their first appointment. The questionnaire was designed to assess preferences in socialization practices, frequency of interpersonal contact, use of social media, and perceived barriers to socialization. The survey was developed to gain a better understanding of the socialization behaviors and preferences of our patients for the future development of customized activities in our wellness program. RESULTS Our sample revealed higher rates of unemployment and single status as compared to the US Census of 2012. With regard socialization however, many were quite social (86% reported daily/weekly communication with friends and family via telephone, 71% saw relatives in person weekly, 68% saw friends weekly, and 65% reported using the computer daily/weekly to socialize). Facebook® was the preferred on-line social media. Indoor/solitary activities were most common with 63% stating they watch TV/read/use the computer followed by physical exercise and spending time outdoors (36%). The frequency of socialization with friends, relatives, and coworkers decreased with the respondents' age and the longer the respondent had carried the diagnosis of epilepsy. Respondents who were taking a greater number of AEDs or were considered refractory were less likely to consider participating in socialization-enhancing activities. The primary barriers to socialization that respondents endorsed were driving prohibition and medication side-effects. Respondents expressed the greatest interest in online support groups or educational programs (31%), office-based support groups (25%), and volunteering (19%). CONCLUSION Although the respondents indicate that they do face barriers to socialization, a majority report frequent communication with relatives and friends via phone, in-person and social media. When designing wellness interventions with this group of patients in the future, online, as well as face to face options for support appear to be desired by a number of PWEs.
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Affiliation(s)
- Lorna Myers
- Northeast Regional Epilepsy Group, United States.
| | | | | | | | - Jace Jones
- Northeast Regional Epilepsy Group, United States
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