Primary school female teachers' knowledge, attitude, and practice toward students with epilepsy in Riyadh, Saudi Arabia

Epilepsy first aid awareness among healthcare workers in Saudi Arabia: A cross-sectional study

Objectives

Epilepsy is a neurological disorder affecting more than 50 million human lives of all ages, its social, physical and psychological implications is of huge concern. The current study and as a continuation of epilepsy knowledge assessment projects conducted by our research team is aimed to assess the knowledge of healthcare workers regarding epilepsy first aid in Saudi Arabia.

Methods

A cross-sectional questionnaire-based study was carried out from 2020 to 2021.

Results

During the study period, 272 healthcare workers were recruited; participants were males and females from different nationalities in various Saudi Arabian cities, possess diverse qualifications, and belong to several healthcare-related professions. The question, "Did you witness an epileptic seizure"? was answered as "Yes" by 42% of participants, and in response to the question "If you know that this patient struggles during seizure attacks," 58% of respondents stated that they would not call an ambulance. Moreover, the question "Put something in his/her mouth to prevent tongue biting" was incorrectly answered as "Yes" by 42% of respondents, and the question "Try to catch him/her and stop his/her movement" in order to control the attack was answered "Yes" by 21% of respondents. Furthermore, almost 90% of healthcare participants do not know how to use the Vagus Nerve Stimulation device. The mean knowledge score among participants was 23.7; sex, as well as type of higher qualification obtained, was found to be significantly associated with the score of knowledge.

Conclusion

Knowledge toward epilepsy and epilepsy first aid among healthcare workers in Saudi Arabia was found fragile. Further research is appreciated to support the current findings.

The evaluation of the training, "the approach to epilepsy and epileptic seizure," which was given to teachers in Türkiye

INTRODUCTION

Epilepsy is the most common neurological disorder among humans after headaches. According to the World Health Organization, approximately 50-65 million individuals were diagnosed with epilepsy throughout the world, and around two million new cases of epilepsy are added to this figure every year.

METHODS

Designed as descriptive and cross-sectional research, this study was performed on 132 elementary school teachers. Training on epilepsy and epileptic seizure was given to teachers. The pretest and posttest research data were collected with the face-to-face interview method. In this process, the epilepsy knowledge scale was used as well as a survey form that had questions designed to find out about teachers' personal characteristics. The Statistical Package for Social Science 25.0 was utilized in the statistical analysis of research data. In the research, the statistical significance was identified if the p-value was below.05 (p < .05).

RESULTS

Of all teachers participating in the study, 59.1% were female, 90.2% were married, and 47.7% witnessed an epilepsy seizure before. The mean of teachers' pretest epilepsy knowledge scores was 8.43 ± 4.31 points before the training while the mean of their posttest epilepsy knowledge scores was 12.65 ± 2.48 points after the training. The difference between the means of pretest and posttest scores was statistically significant (p = .000). After the training, there was a statistically significant increase in means of scores obtained by teachers from each item of the epilepsy knowledge scale (p < .05).

CONCLUSIONS

As there was a statistically significant improvement in levels of teachers' knowledge about both epilepsy and epileptic seizure after the training, it is recommended that the training about the approach to epilepsy and epileptic seizure be given to all teachers, and additionally, including these topics in the course curricula of universities is recommended.

Chronic diseases and illness in schools: Teachers' confidence in helping students with intellectual disabilities

Background

With movement to educate students with intellectual disabilities in special and mainstream schools, a considerable number of students with intellectual disabilities have common chronic diseases such as epilepsy and diabetes. In addition, these students may also face common illnesses, which occur in all students, such as fevers and headaches. Teachers are responsible for their students and provide first aid when needed. Therefore, this study aimed to determine whether teachers are confident in their ability to provide help when symptoms related to chronic diseases and illnesses occur.

Methods

In this cross-sectional study, questionnaires were sent to 300 male and female teachers of students with intellectual disabilities in Riyadh, Saudi Arabia.

Results

The findings illustrate that, in general, teachers have little confidence in helping students with chronic diseases and illnesses. Although the teachers felt that they were less confident in dealing with some symptoms of illnesses and chronic diseases, there were some symptoms that they showed either strong or low confidence in dealing with.

Conclusion

The recommendations include increasing teachers' confidence in providing first aid.

Awareness of Seizure First Aid among the population in Jazan, Saudi Arabia: A survey Study

Background

First aid during a seizure is critical, but many people in Jazan, Saudi Arabia may not know what to do. This is because epilepsy is often stigmatized in the region and regarded as a spiritual or mental disorder. This study investigated the awareness of seizure first aid among the population living in Jazan.

Methods

An online survey was conducted. Healthcare workers and people who had never heard of epilepsy were excluded. Participants were asked to identify correct measures of seizure first aid from a list of 20 statements [9 correct and 11 incorrect]. A composite awareness score was calculated by subtracting the number of incorrect statements from the number of correct statements. Participants were classified into three groups: high, intermediate, and low awareness. Logistic regression was used to identify factors associated with high awareness.

Results

Of the 1215 participants, 80.5 % had low awareness of seizure first aid. The most common correct responses were clearing the area of dangerous objects (91.3 %), putting a pillow under the neck (69.3 %), and timing the seizure (68.5 %). However, only 32.2 % knew to tell the person what happened after the seizure. The most common misconception was that an ambulance should be called immediately, regardless of the details (88.3 %). Other common misconceptions included putting something in the person's mouth (87.5 %), holding them down (83.0 %), taking out their contact lenses (79.9 %), and giving antiseizure medications orally (73.2 %). People who previously watched an educational video on seizure first aid (OR = 4.27, 95 % CI = 1.48-12.34, p = .007) or who knew someone with epilepsy (OR = 9.01, 95 % CI = 2.82-28.83, p < .001) were more likely to have a high awareness of seizure first aid.

Conclusion

The study found that most people in Jazan, Saudi Arabia do not know how to provide first aid for seizures. The findings inform future research and highlight the need for increased education and training on seizure first aid in this region.

Self-Disclosure Patterns Among Children and Youth with Epilepsy: Impact of Perceived-Stigma

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.

Knowledge of Epilepsy and Seizure First Aid Among Teachers in Eastern Province, Saudi Arabia

BACKGROUND

Epilepsy is one of the most common neurological disorders among patients, with a high prevalence in adults and children in Saudi Arabia. It can have a negative impact on a child's health, behavior, and academic performance, as well as their mental health. As a seizure attack can happen in school and the teachers will be the first health providers, preventing complications and ensuring student performance, development of social skills, and future employment can be significantly impacted by a teacher's awareness and attitudes towards epilepsy.

METHODS

A descriptive cross-sectional study was conducted in Eastern Province, Saudi Arabia, targeting teachers in schools of all educational levels using a self-administrated validated questionnaire in Arabic. A total of 423 teachers fulfilling the inclusion criteria were included. Teachers' ages ranged from 18 to more than 50 years with mean age of 42.6 ± 9.3 years old. Exactly 261 (61.7%) teachers were females and 400 (94.6%) were Saudi.

RESULTS

We defined acceptable level of awareness as the ability to recognize seizure phenomena (if they have witnessed one before) as a medical neurological problem (as opposed to attributing it to religious and/or superstitious beliefs, etc.) with ability to respond promptly with proper first aid required when encountering a seizure (turn on one side, avoid placing items in mouth, etc). Exactly 163 (38.5%) had good overall knowledge level while 260 (61.5%) had poor knowledge regarding epilepsy.

CONCLUSION

Our research found that teachers have poor knowledge about epilepsy, wherein 38.5% had good overall knowledge level while 61.5% had poor knowledge regarding epilepsy. However, only a 9.2% had first-aid training, which suggests that knowledge and practice of epilepsy first aid needs to be improved via public awareness campaigns and first-aid training courses in schools.

Knowledge, attitude and practice of schoolteachers towards students with epilepsy in Al-Jouf, Saudi Arabia

BACKGROUND: Epilepsy is a common disorder in which brain activity becomes abnormal that causes recurrent seizures or periods of jerky movement of the whole body. Immediately after a seizure, people are often transiently confused, weak and unable to communicate. OBJECTIVE: This study assesses the knowledge, attitude, and practice (KAP) of school teachers towards an epileptic child. METHODS: This cross-sectional study was conducted among primary and secondary school teachers from different schools in Sakaka, Domat Al-Jandal, Al-Qurayyat, Tabarjal Northern region of Aljouf, Saudi Arabia. They were assessed on their KAP toward students with epilepsy using a self-administrated questionnaire. RESULTS: 306 respondents participated and completed the questionnaire. The practice was poor among the teachers. Practice scores were significantly different among the male and female teachers. Teachers would do the following to the seizing child: 159 (52%) would pull the child’s tongue out (p-value 0.012), 66 (21.6%) would put a spoon in the mouth (p-value 0.055), 43 (14.1%) would remove any tight clothes (p-value 0.009) and 244 (79.7 %) would take the child to the hospital (p-value 0.029). There were significant differences among senior teachers and those with longer years of teaching experience: 83.6% of teachers with > 20 years of teaching experience think that the student with epilepsy has no need of a special classroom (P = 0.053), 89.6% of those with > 20 years of teaching experience said that they did not move the child during seizure in comparison with less years of teaching experience (p = 0.048), in which 97% of those with experience > 20 years said that they would ensure normal breathing (p = 0.015). CONCLUSION: The majority of Aljouf schoolteachers were adequately knowledgeable about students with epilepsy, but they need more information about the correct way of practice towards the student with epilepsy.

Public awareness of first-aid management of seizures in Saudi Arabia

BACKGROUND

First aid measures in cases of epileptic seizures are crucial. Misconceptions about seizure first-aid measures are probably common. Most of the previous data focused on teachers and healthcare providers. The objective of this study was to assess the awareness of seizure first-aid measures and their associated factors in a community sample in Saudi Arabia.

METHODS

A cross-sectional study was carried out using an online questionnaire between July 2020 and February 2021. Those who had never heard of epilepsy and healthcare workers were excluded. Overall and individual scores were calculated for first-aid measures during and after the seizures as well as calling the ambulance.

RESULTS

A total of 1542 participants were included in the study. The overall awareness score of seizure first-aid measures was 57.3%. The awareness of the need to call the ambulance in special circumstances was the highest individual score (78.3%), followed by measures after the seizure (54.2%), and finally measures during the seizure (48.4%). For the latter, the awareness of injury prevention measures was the highest (74.9%), while the awareness of treatment options was the lowest (12.2%). Overall awareness score was significantly higher in older age (p = 0.015), female gender (p < 0.001), divorced status (p = 0.014), knowing someone with epilepsy (p < 0.001), attending a course or workshop about seizure first-aid (p < 0.001), watching a video on seizure first-aid on any platform (p < 0.001), and having basic life support training (p < 0.001).

CONCLUSIONS

The awareness of seizure first-aid measures is still inadequate among the public in Saudi Arabia. The current finding underscores the importance of simulation videos on social media and/or field-training campaigns to improve the public awareness of seizure first-aid measures.

Effect of health education on female primary school teachers' knowledge of seizure first aid: An interventional study

INTRODUCTION

Epilepsy is a common neurological disease. Patients with epilepsy are at risk of developing seizure at any time. The aim of this study was to assess the effects of health education on schoolteachers' first aid management of epileptic seizure.

METHODS

A self-administered questionnaire was distributed to participating primary school teachers in the city of Makkah. It included baseline demographic data, a teacher's awareness about epilepsy, as well as first aid measures. An educational lecture was later delivered to teachers and was followed by a discussion. Awareness and attitude were re-assessed using the same questionnaire.

RESULTS

A total of 259 female primary school teachers completed the study. Before intervention, 134 (51.7%) of the teachers had good awareness regarding epilepsy, which was significantly increased to 86.9% after the intervention. For seizure first aid, 45.9% of teachers correctly reported that would make sure the person is safe and ask for help in the case of witnessing a seizure attack, which was improved to 84.2% after intervention, with a percent change of 38.2% (p = 0.001). In addition, rolling a person onto their side and asking for help after the end of a seizure was known by 53.3% of the teachers before the intervention and increased to 84.6% after the intervention, showing a percent change of 31.2% (p = 0.001).

CONCLUSION

The health education program resulted in significant improvements to teachers' responses to seizure and improvements in all aspects of epilepsy awareness.

Teachers and Epilepsy in Saudi Arabia: Gaps in Knowledge and Potential Roles

In young children, epilepsy, a disorder marked by recurring seizures, is frequent. Schoolteachers play an important role in the development of young children and hence have a big impact on their psychosocial development. This study was carried out to examine the available data from Saudi Arabia in order to better understand the knowledge gap among Saudi instructors. Although schoolteachers’ knowledge in Saudi Arabia has improved over time, such that they now have significant knowledge that can affect student performance, social skill development, future endeavors, and life quality, a significant percentage still believes that epilepsy is linked to psychiatric illness. Few teachers have obtained first-aid training in the area of seizure treatment. It is consequently vital to improve instructors’ knowledge of seizure first aid. Teachers’ understanding and attitudes concerning epilepsy could be improved by health education. Schoolteachers should get focused and guided health education to improve their knowledge of epilepsy and change their attitudes.

Schoolteacher's knowledge, attitudes, and practice toward student with epilepsy in Taif, Saudi Arabia: Cross-sectional study

Background

Globally, teachers have misconceptions about epilepsy and its management. Little is known about Saudi Teachers' knowledge about epilepsy in Taif City.

Method

Descriptive questionnaire-based cross-sectional survey of a sample of schoolteachers in Taif Governate.

Results

The study included (n = 420) schoolteachers. All heard about epilepsy and (n = 116, 27.6%) knew about epilepsy from an afflicted individual, and (n = 102, 24.3%) from social media outlets. Most teachers believed that an epileptic fit constitutes seizures (n = 370, 88.1%). Some (n = 330, 78.6%) were not satisfied with their knowledge level. Attitudes were positively associated with years of experience, but, generally, were only modest with 50.2% fearful of having an epileptic child in class. The mean practice score was 6.9 (out of 15). Practice was improved by having a pupil with epilepsy in class.

Discussion and Conclusion

Schoolteachers in Taif showed excellent crude knowledge about epilepsy. However, knowledge of crucial details of the disorder were poor. This could be due to reliance on social media for information. There was high level of insight among schoolteachers regarding their sub-optimum knowledge levels. Knowledge was much better among experienced schoolteachers. Witnessing an epileptic fit improved knowledge. Teachers' attitudes toward epilepsy were negative, likely because of significant epilepsy-related stigma. Years of experience were significantly associated with increased attitude score. Schoolteachers' actual practice in handling epilepsy cases was below-expectation. There is pressing need for high-quality workshops to address knowledge and practice deficits.

Public awareness and attitudes toward epilepsy in Saudi Arabia: A systematic review and meta-analysis

INTRODUCTION

Public awareness of epilepsy and attitudes toward people with epilepsy (PWE) largely affect patients' perceived stigma and their quality of life. Educational interventions to increase public awareness of the disease need to target areas of lowest awareness levels to achieve best results. The aim of this review was to identify these areas in Saudi Arabia.

METHODS

This review was based on PRISMA guidelines. Medline, PsychInfo, Embase, Ovid Evidence-Based Medicine Reviews, and Web of Science databases were searched for relevant literature. Inclusion criteria was cross-sectional studies that are done in Saudi Arabia, assess any aspect of epilepsy awareness or attitudes toward PWE, and report outcomes in proportions. Meta-analysis was done on outcomes reported in ≥5 studies utilizing random-effects model. Quality assessment was done using AXIS tool.

RESULTS

Twenty-seven studies were included in this review. A total of 48 questions' outcomes were reported in ≥3 studies, and 26 of them were included in the meta-analysis. The meta-analysis estimated that 6.4% (CI 4.2-9.7%) of the population think epilepsy is a contagious disease; 90.7% (CI 85.5-94.1%) have heard/read about epilepsy; 53.1% (CI 47.7-58.3%) have witnessed a seizure; 38.6% (CI 24.7-54.7%) think epilepsy is a psychological disorder; 25.2% (CI 16.5-36.7%) think it is caused by spirit possession; 35.1% (CI 22.0-50.8%) were estimated to think it is caused by evil eye (envy); 37.9% (CI 21.9-57.0%) would try to put something inside a seizing patient's mouth to prevent tongue biting; 34.6% (CI 26.9-43.1%) would approve their offspring marrying someone with epilepsy.

CONCLUSION

Areas of unsatisfactory awareness levels included etiology of epilepsy and appropriate seizure responses. Attitudes were more negative regarding marriage, children, and employment. These areas need to be properly addressed in future educational interventions.

Knowledge of Epilepsy and seizure first aid among teachers in Jeddah, Saudi Arabia

PURPOSE

Epilepsy is one of the most common neurological disorders, with a national prevalence of 6.54/1000. The majority of the patients are adolescents and at risk of experiencing a seizure in school. Consequently, schoolteachers would be among the first health care providers. Thus, teachers' knowledge and practice are imperative for the students' safety and development. We aimed to assess the knowledge of epilepsy and seizure first aid among teachers at all educational levels in Jeddah, Saudi Arabia.

METHOD

A cross-sectional study using a self-administered validated questionnaire was distributed to teachers to assess their necessary demographic data and their knowledge about epilepsy and seizure first aid by using Chi-square test to find significant associations.

RESULTS

Our sample included 822 teachers, 54.1% of the respondents were male, and 45.7% female. The majority of participants had moderate knowledge of epilepsy and lacked first aid training. Most participants recognized epilepsy as a neurological disorder, and 42.2% have witnessed a seizure in school. Our study showed a significant relationship between knowledge score and qualification (P-value = 0.037) as well as knowledge score and witnessing a seizure (P-value = 0.046).

CONCLUSION

The knowledge score shows that teachers in Jeddah have moderate knowledge of epilepsy, and approximately one-tenth have taken first aid training. We recommend educational campaigns on epilepsy and first aid courses targeting students and teachers in schools.

Management of epileptic seizures in school-age children: Educational project dedicated to school staff

OBJECTIVE

The objective of this study was to educate the school staff for a correct management of epileptic seizures in order to increase the safety of young people at school and promoting the administration of rescue drugs and in order to improve care and reduce improper calls to the health emergency number.

METHODS

This project started in January 2016, and it is still ongoing at the Department of Neuroscience of Bambino Gesù Children's Hospital in Rome, Italy. There has been a data cut-off evaluation in November 2018. Two-hour training meetings with the school staff have been organized. The major topics of the training activities were as follows: report what epilepsy is, how to manage students with epileptic seizures, and how to administer rescue medications. During the meetings, the following two questionnaires were administered: one pretest in order to collect personal information and information on awareness of epilepsy, willingness to administer rescue medications, and anxiety in facing a seizure; and one posttest in order to check the knowledge acquired after the training sessions. Statistical analysis was performed using R version 3.2.3 (R Foundation for Statistical Computing, http://www.R-project.org/). Demographics (sex and age) and teaching experience were summarized with descriptive statistics for each variable. Demographics, teaching experience, awareness of disability, and knowledge of epilepsy were correlated to the management of seizures occurring in the classroom before the course; results are reported as odds ratios [OR] and 95% confidence interval (95 CI).

RESULTS

Nine hundred school staff members (95% school staff and 5% social workers) entered in the project between January 2016 and November 2018. Seven hundred and forty (82%) returned the questionnaires fulfilled, and not all of them were completely filled. Ninety-eight percent of school staff (676/691) were aware about epilepsy; however, only in 16% (110) the awareness of epilepsy came from medical staff, scientific brochures, or participation in conventions. Thirty-five percent of school staff (248/707) believed that epilepsy reduces learning abilities, and 58% (409/703) believed that children with epilepsy need school support. After the training, 68% of school staff (496/734) correctly filled in the questionnaire related to the management of acute seizures versus 8% of them (57/718) in the prequestionnaire. After the training, 89% of school staff (601/675) were ready to administer rescue medications versus 54% (384/712) before the training. The majority of participants reported that the level of anxiety related to the management of seizures after the training significantly reduced.

CONCLUSIONS

Results of this project documented an increase in knowledge of epilepsy, a better knowledge on management of acute seizures in the school settings, a reduction in anxiety, and an increase in willingness to administer rescue medications. Further studies should be planned in order to document the changes in the real-world management of seizures, to evaluate if a reduction in hospital admittances might be reached, and to extend the project by assessing, through a questionnaire, the stigma and prejudices against the children affected by epilepsy by their classmates.

Potential for Increased Epilepsy Awareness: Impact of Health Education Program in Schools for Teachers and Children

Background  Epilepsy, although a common disorder, yet is highly stigmatized. Under this condition, children with epilepsy are more vulnerable to stigmatization, social isolation, lack of support, and psychological and emotional problems. Thus, there is an immediate need of literature focusing on intervention studies to change the attitudes of school teachers and children.

Methods  The study was conducted with the objectives to evaluate knowledge, attitude, and practices (KAP) about epilepsy among school teachers and children; provide educational training program to teachers; and check the efficacy of training program imparted by teacher and trainer.

Results  Repeated measure of analysis of variance shows that knowledge ( F = 1,134.875, p < 0.001), attitude ( F = 2,429.909, p < 0.001), and practice ( F = 2,205.122, p < 0.001) are significantly different between pre- and posttests indicated by Pillai’s trace test. Similarly, from the Pillai’s test, knowledge ( F = 49.317, p < 0.001), attitude ( F = 125.304, p < 0.001), and practice ( F = 178.697, p < 0.001) are significantly different among teachers, trainer imparting training to children, and teachers imparting training to children. It is seen that KAP scores significantly differ between two time points and across the three groups. Among all the groups, teachers imparting training to children had high level of practice.

Conclusion  Inclusion of health education programs in the textbooks and health education schemes for teachers and school children are crucial ways to bring a change in their attitude, behavior, and practices toward epilepsy.

Makkah female teachers' knowledge of seizure first aid

BACKGROUND

Epilepsy is a common disorder in Saudi Arabia, with a prevalence of 6.54/1000 people. Most patients with epilepsy in the country are younger than 19 years of age, and thus, many occurrences of epileptic seizures can occur in schools. As such, teachers are often faced with the challenge of responding to the attack and providing first aid and post-event care to the child with epilepsy.

OBJECTIVES

The objective of this study was to assess the knowledge school teachers in the Makkah region possess about seizure first aid.

METHODS

A self-administered questionnaire was distributed electronically among school teachers in the Makkah region, with the aim to assess basic demographic data about the teachers as well as their knowledge about epilepsy, seizure first aid, and postseizure care.

RESULTS

Out of the teachers who responded to the questionnaire (n = 426), 89% were female teachers; 85.7% recognized epilepsy as a neurological disease. The majority (55%) stated that they would open a patient's mouth and insert an object during a seizure. Those with less teaching experience (1-10 years) correctly identified how to ensure safety in comparison with the more experienced teachers (≫10 years) (P value ≪ 0.001), and 45% of the overall participants recognized when to transfer patients to a medical facility. Both teachers with postgraduate degrees and the more experienced teachers recognized when to transfer students to hospital.

CONCLUSION

Female school teachers in the Makkah region significantly lack adequate training and knowledge of seizure first aid. A health education policy targeting teachers may improve this.