Qualidade de vida e desempenho ocupacional de pacientes submetidos à cirurgia de epilepsia

Epilepsy surgery in low- and middle-income countries: A scoping review

BACKGROUND

Epilepsy surgery is an important treatment option for people with drug-resistant epilepsy. Surgical procedures for epilepsy are underutilized worldwide, but it is far worse in low- and middle-income countries (LMIC), and it is less clear as to what extent people with drug-resistant epilepsy receive such treatment at all. Here, we review the existing evidence for the availability and outcome of epilepsy surgery in LMIC and discuss some challenges and priority.

METHODS

We used an accepted six-stage methodological framework for scoping reviews as a guide. We searched PubMed, Embase, Global Health Archives, Index Medicus for South East Asia Region (IMSEAR), Index Medicus for Eastern Mediterranean Region (IMEMR), Latin American & Caribbean Health Sciences Literature (LILACS), African Journal Online (AJOL), and African Index Medicus (AIM) to identify the relevant literature.

RESULTS

We retrieved 148 articles on epilepsy surgery from 31 countries representing 22% of the 143 LMIC. Epilepsy surgery appears established in some of these centers in Asia and Latin America while some are in their embryonic stage reporting procedures in a small cohort performed mostly by motivated neurosurgeons. The commonest surgical procedure reported was temporal lobectomies. The postoperative seizure-free rates and quality of life (QOL) are comparable with those in the high-income countries (HIC). Some models have shown that epilepsy surgery can be performed within a resource-limited setting through collaboration with international partners and through the use of information and communications technology (ICT). The cost of surgery is a fraction of what is available in HIC.

CONCLUSION

This review has demonstrated the availability of epilepsy surgery in a few LMIC. The information available is inadequate to make any reasonable conclusion of its existence as routine practice. Collaborations with international partners can provide an opportunity to bring high-quality academic training and technological transfer directly to surgeons working in these regions and should be encouraged.

Cuidados de enfermagem ao paciente no perioperatório de cortico-amigdalohipocampectomía

Este artigo teve como objetivo construir e apresentar um plano de cuidados pré e pós-operatórios para pacientes submetidos à cirurgia de cortico-amígdalo-hipocampectomia<br />(ahc) para ser implementado em uma unidade de internação cirúrgica de um Hospital Universitário do Sul do Brasil. Trata-se de um relato de experiência desenvolvida durante o Estágio Supervisionado de Enfermagem por graduandos de enfermagem. Construiu-se um plano com 26 cuidados de enfermagem para pacientes submetidos à cirurgia de ahc, que foi validado por profissionais experts da área. Realizaram-se encontros expositivos e dialogados com a equipe de enfermagem para esclarecer e desmistificar a epilepsia, suas diferentes apresentações de crises e possibilidades de tratamento, bem como apresentar o plano de cuidados elaborado. Essa experiência contribuiu com a formação profissional dos estudantes, assim como forneceu<br />subsídios para a implementação da sistematização da assistência de enfermagem a este paciente específico, considerando o cuidado sistematizado uma ferramenta fundamental no trabalho do enfermeiro.

Quality of life issues and occupational performance of persons with epilepsy

Epilepsy causes restrictions in the performance of various daily activities. The aiming of this study was to investigate whether these restrictions affect the perceived quality of life. The assessments Quality of Life in Epilepsy-31 (QOLIE-31) and Canadian Occupational Performance Measure (COPM) were applied in a sample that consisted of a single group of 34 subjects with at least two years of uncontrolled seizures. The results indicated that the most affected domains of QOLIE-31 were seizure worry, 29.77 (±21.72), and effects of drugs, 49.75 (±28.58), and for the COPM, the average of performance and satisfaction were respectively 3.10 (±3.07) and 4.45 (±3.29), and performance limitations most frequently cited were maintain employment (18), left home alone (15) and courses (15). The application of the Spearman correlation coefficient showed that the three main performance limitations posed by the COPM, especially regarding the level of satisfaction, influence the perception of quality of life. Thus, occupational performance proves to be an important area of intervention with subjects with epilepsy.