Knowledge of and attitudes expressed toward epilepsy by carers of people with epilepsy: a UK perspective

A knowledge-based simple education program for patients with epilepsy in Japan: Effects sustained after the program implementation

PURPOSE

To investigate the effects of an original education program on patients with epilepsy (PWE). The effects on knowledge about epilepsy, attitude to epilepsy, depression scales, and quality of life were investigated.

METHOD

Thirty-five PWE participated in a lecture-style educational program using an original knowledge-oriented textbook. All patients were administered a total of four rating scales: the Knowledge about Epilepsy Scale (KES), the Attitude toward Epilepsy Scale (AES), and the Japanese version of the Quality of Life in Epilepsy Inventory (QOLIE-31-P), the Beck Depression Inventory (BDI). The KES and AES of patients (pKES and pAES) were compared to those of medical students (St) and residents (Rd).

RESULTS

After education, pKES improved and showed significant differences among pre-and post-education and six months later. Before education, pKES was inferior to St and Rd. However, after education, pKES changed and became superior to St and Rd. Six months later, the advantage was lost, but not significantly. PAES also improved after education, with significant differences before, after, and six months later after education. PAES was statistically inferior to St and Rd before education, but the difference disappeared after education, and the effect persisted after six months. The non-depressed (BDI < 20) and depressed groups (BDI ≧ 20) improved in the KES after education. About the AES, the non-depressive group has a statistical tendency, but not the depressive group. At six months, the depressed group's AES is significantly lower than the non-depressed group.

CONCLUSION

While correct knowledge about epilepsy can improve attitudes and perceptions of epilepsy in PWE, special measures are needed for PWE with depression.

An evaluation of the knowledge, attitudes, and behaviors of parents regarding epilepsy

BACKGROUND AND AIMS

Knowledge about epilepsy and attitudes toward people with epilepsy can influence measures taken to manage epilepsy and seizures. The support and understanding of parents of children with epilepsy are invaluable in helping develop ordinary living skills. To determine the educational needs of parents of children with epilepsy, their knowledge, attitudes, and behaviors should be evaluated. Therefore, we interviewed parents who had a child with epilepsy who was treated at the pediatric neurology clinic of a university hospital. We aimed to evaluate parents' knowledge, attitudes, and behaviors toward children with epilepsy to determine their educational needs.

METHODS

This descriptive study included 221 parents of children with epilepsy who applied to Hatay Mustafa Kemal University Medical Faculty Hospital. A questionnaire was used to collect data. Pearson and exact chi-square tests were used for analysis.

RESULTS

In the present study, 221 parents were interviewed. A total of 66.5% of the participants were at the primary education level. The rate of participants who preferred healthcare professionals as a source of information about epilepsy was 78.9%. Forty-eight percent of the parents did not see consanguineous marriage as a reason. While some parents stated that epilepsy was supernatural, others had no idea whether it was contagious or not, and 46.2% of the participants stated that epilepsy is not a hereditary disease. The rate of those who tried nonphysician treatment was 16.3%. The rate of participants who thought that drinking alcohol would not trigger seizures was 86.9%. It was determined that 30.8% of the participants pulled the patient's tongue out during seizures. 16.7% of participants thought that patients with epilepsy were disabled. 50.7% of the participants stated that their children with epilepsy could do any profession.

CONCLUSIONS

Our study documented parents' lack of knowledge about epilepsy. Many parents have significant misunderstandings, negative attitudes, and parenting practices, and their knowledge and understanding of epilepsy needs to be improved.

Systematic review of frequency of felt and enacted stigma in epilepsy and determining factors and attitudes toward persons living with epilepsy-Report from the International League Against Epilepsy Task Force on Stigma in Epilepsy

OBJECTIVE

To review the evidence of felt and enacted stigma and attitudes toward persons living with epilepsy, and their determining factors.

METHODS

Thirteen databases were searched (1985-2019). Abstracts were reviewed in duplicate and data were independently extracted using a standardized form. Studies were characterized using descriptive analysis by whether they addressed "felt" or "enacted" stigma and "attitudes" toward persons living with epilepsy.

RESULTS

Of 4234 abstracts, 132 met eligibility criteria and addressed either felt or enacted stigma and 210 attitudes toward epilepsy. Stigma frequency ranged broadly between regions. Factors associated with enacted stigma included low level of knowledge about epilepsy, lower educational level, lower socioeconomic status, rural areas living, and religious grouping. Negative stereotypes were often internalized by persons with epilepsy, who saw themselves as having an "undesirable difference" and so anticipated being treated differently. Felt stigma was associated with increased risk of psychological difficulties and impaired quality of life. Felt stigma was linked to higher seizure frequency, recency of seizures, younger age at epilepsy onset or longer duration, lower educational level, poorer knowledge about epilepsy, and younger age. An important finding was the potential contribution of epilepsy terminology to the production of stigma. Negative attitudes toward those with epilepsy were described in 100% of included studies, and originated in any population group (students, teachers, healthcare professionals, general public, and those living with epilepsy). Better attitudes were generally noted in those of younger age or higher educational status.

SIGNIFICANCE

Whatever the specific beliefs about epilepsy, implications for felt and enacted stigma show considerable commonality worldwide. Although some studies show improvement in attitudes toward those living with epilepsy over time, much work remains to be done to improve attitudes and understand the true occurrence of discrimination against persons with epilepsy.

Knowledge gap exists among caregivers of adults compared to caregivers of children with epilepsy: a comparative analysis from a low resource setting

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We compared knowledge, attitude, behavior, belief and seizure recognition among CG-A and CG-C.

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Overall performance of caregivers of adults and children in tested domains was good.

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Knowledge-behavior, knowledge-faith and knowledge-seizure recognition gaps existed in CG-A.

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Lack of formal education in CG-A lead to inadequate factual knowledge and the knowledge gaps.

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CG-A need focused education to improve seizure recognition and response and dispel epilepsy myths.

Caregivers of adults (CG-A) and caregivers of children (CG-C) may differ in their knowledge, attitude and behavior and hence their education requirements during epilepsy counseling could vary. This study compares the current knowledge, attitudes, behavior during a seizure, presence of myths surrounding epilepsy and ability to recognize seizures among a sample of CG-A and CG-C. Caregivers of children and adult patients with minimum 6 months history of epilepsy were enrolled. Information was collected using a questionnaire about clinical and demographic details and five domains (KAP-plus); knowledge, attitude, behavior, presence of myths and a video data for identification of focal impaired awareness seizures (FIAS) and generalized tonic-clonic seizures (GTCS). There were 132 CG-A and 127 CG-C. CG-C were younger and better educated compared to CG-A (formal education of 64.6% vs 44.7% p = 0.001). CG-A and CG-C were comparable in the knowledge and attitude domains. CG-A scored less than CG-C in the domains of behavior (15.5 vs 16.8 p = <0.001), myths (15.4 vs 16.2 p = 0.002), video recognition of FIAS and GTCS (0.7 vs 0.94 p = 0.001) and KAP-plus score (22.9 vs 24.6 p = 0.017). The knowledge-behavior or knowing-doing gap, knowledge-faith gap and knowledge-recognition gaps existed more among CG-A compared to CG-C. Focused education strategies are required to bridge the gap among CG-A.

Knowledge and attitude towards epilepsy among rural residents in southern Ethiopia: a cross-sectional study

BACKGROUND

Although epilepsy is one of the most prevalent neurological problems, it is highly surrounded by stigma and prejudice, which results in negative attitude towards the illness. Due to numerous misconceptions and beliefs attributed towards epilepsy, most people in rural communities have poor understanding and perception about epilepsy. Studying knowledge and attitude of this major neurologic problem among rural residents is crucial to add knowledge and show area of interventions. Therefore, the aim of this study was to assess the knowledge and attitude towards Epilepsy among rural residents in Ethiopia.

METHODS

This was a community based cross-sectional study conducted in rural parts of Gedeo zone, Southern Ethiopia. A total of 732 randomly selected adult residents were interviewed using a pre-tested questionnaire. The collected data were entered to Epi-data version 3.1 and analyzed using SPSS version 20. Descriptive statistics and logistic regressions were performed. Multivariable binary logistic regression analysis was conducted to determine the presence of a statistically significant association between explanatory variables and outcome variables at corresponding 95% CI.

RESULTS

The magnitude of poor knowledge and unfavorable attitude towards epilepsy were 27.0 and 51.6%, respectively. Participants who can't read and write, having stigma related to epilepsy, participants who did not live with epileptic patients; unfavorable attitude and age were factors associated with poor knowledge towards epilepsy. On the other hand, Stigma related to epilepsy, poor knowledge, age and perceiving epilepsy as a God punishment for sinful activities were variables significantly associated with unfavorable attitude of epilepsy.

CONCLUSIONS

There is a gap regarding the knowledge and attitude towards epilepsy among community residents in southern Ethiopia. This demonstrates a need for community educational program regarding epilepsy which can increase community awareness particularly in rural areas to decrease stigma and negative beliefs towards epilepsy.

Evaluation of sleep quality in spouses of people with epilepsy

OBJECTIVE

The objective of this study was to evaluate the spouses of people with epilepsy with and without a history of seizures during sleep in terms of depression, anxiety, and sleep quality.

METHODS AND MATERIALS

This prospective, cross-sectional study was conducted in three groups of 18-55 year olds, who were at least primary school graduates. The 1st group consisted of healthy spouses of 30 healthy volunteers with age and sex matched with the other groups. The 2nd group comprised spouses of 30 people with epilepsy who had been married for at least one year and had no history of seizures during sleep. The 3rd group consisted of spouses of 30 people with epilepsy who had been married for at least one year and had a history of at least one seizure during sleep in the course of the previous year. The questionnaire including demographic data, Pittsburgh Sleep Quality Index (PSQI), Beck Depression Inventory (BDI), and the Beck Anxiety Inventory (BAI) was applied to all participants.

RESULTS

The mean age of the 1st group was 35.07 ± 8.33 years, that of the 2nd group was 36.47 ± 7.63 years, and that of the 3rd group was 35.33 ± 6.05 years. There was no significant age difference between the groups (p = 0.740). The depression scores of the 2nd and the 3rd groups were significantly higher than that of the 1st group (p < 0.001, for both). The anxiety scores of the 3rd group were significantly higher than those of the 1st and the 2nd groups (p < 0.001 and p = 0.001, respectively). Thirty percent (n = 9) of the 1st group, 40% (n = 12) of the 2nd group, and 70% (n = 21) of the 3rd group had poor sleep quality. The sleep disorder rate in the 3rd group was significantly higher than in the 1st and the 2nd groups (p = 0.002 and p = 0.020, respectively). When the PSQI subscales were examined, the sleep quality, sleep latency, usual sleep efficiency, daytime dysfunction, and the total sleep total score were significantly higher in the 3rd group than the 1st and the 2nd groups. The patients in the third group had significantly higher scores of sleep duration, sleep disturbance, and sleep medication use than those in the 1st group.

CONCLUSION

We found out that the PSQI score, which reflected the sleep quality, was poor in the spouses of people with epilepsy, who had seizures during sleep. To the best of our knowledge, these findings are the first in the literature on this subject.

A qualitative study of the communication and information needs of people with learning disabilities and epilepsy with physicians, nurses and carers

Background

Living with a chronic condition such as epilepsy can have a debilitating effect on the individual and their carers. Managing epilepsy among people with learning disabilities may present a challenge because of limited communication and may require a multidisciplinary approach. The study investigated the communication and information needs of people with learning disabilities with epilepsy and their physicians, nurses and carers.

Methods

Qualitative designed was adopted to collect data from 15 community-based people with mild learning disabilities with epilepsy and 13 carers. Recorded data were transcribed verbatim and analysed thematically.

Results

A range of findings emerged related to patient communication and information needs. These included: Knowledge regarding epilepsy; involvement; honesty and openness when giving information and consistency in provision of information.

Conclusion

People with learning disabilities with epilepsy and their carers would like to know more about epilepsy, to be more involved decision makings through communication in the management of epilepsy to enable them feedback information regarding their health.

The neurology-psychiatry interface in epilepsy

Epilepsy and mental illness have a bidirectional association. Psychiatrists are likely to encounter epilepsy as comorbidity. Seizures may present as mental illness. Equally, the management of psychiatric conditions has the potential to destabilise epilepsy. There is a need for structured epilepsy awareness and training amongst psychiatrists. This paper outlines key considerations around diagnosis, treatment and risk while suggesting practical recommendations.

Marriage in epilepsy: The impact of the question in knowledge, attitude, and practice surveys

BACKGROUND

Knowledge, attitudes, and practice (KAP) questionnaire-based surveys have captured negative attitudes towards marriage involving people with epilepsy (PWE). The attitudes may vary according to the nature of the question posed, whether personal or generic, in addition to many other covariates.

METHODS

We carried out meta-proportion and -regression analyses of epilepsy-related KAP surveys published between 1970 and 2016 in the medical literature analysis retrieval system online (MEDLINE) database.

RESULTS

The pooled estimate of the proportion of those responding positively to the marriage question was 0.45 (95% confidence interval (_95%CI): 0.35 to 0.54; I²_res = 99.89%). The pooled proportion of positive responders to a personal question (0.40; _95%CI: 0.35 to 0.46) was significantly lower than those responding positively to a generic question (0.64; _95%CI: 0.57 to 0.70) (P = 0.001). When modeled individually in regression analyses, only the continent of origin of the survey (P = 0.001; tau²: 0.06; I²_res: 99.8%; adjusted R²: 11.4%) and subject population type (P = 0.02; tau²: 0.07; I²_res: 99.9%; adjusted R²: 4.2%) were associated with the pooled estimate of positive responders to the question on marriage.

CONCLUSIONS

Personal questions probing the possibility of marriage of self or family members to someone with epilepsy bring about negative attitudes more often than generic questions inquiring the marriage-worthiness of PWE.

Investigating the awareness, behavior, and attitude toward epilepsy among university students in Benghazi, Libya

OBJECTIVE

The aim of this study was to explore the level of knowledge regarding epilepsy and attitudes prevalent toward people with epilepsy (PWE) among Libyan university students in comparison with international data.

METHODS

A self-administrated questionnaire on awareness regarding epilepsy and behaviors toward PWE was distributed among undergraduate students enrolled in the University of Benghazi. The collected data were analyzed against responses from an Italian survey that utilized a similar questionnaire to explore epilepsy-related knowledge and attitudes among Italian university students in Rome (Mecarelli et al., 2007).

RESULTS

Out of the 500 interviewed students, 96% successfully completed the survey. Further, 96.6% asserted that they possessed some knowledge regarding epilepsy, gained mainly from their families (76.6%). A total of 57.5% considered epilepsy to be a psychiatric disorder while 11.6% recommended psychological tests for the diagnosis of epilepsy. Moreover, 37.5% believed in ancient superstitions, such as possession by evil forces, as the underlying cause of the condition, and 31.8% recommended traditional remedies to cure it. Further, 66.6% deemed epilepsy as a barrier for career prospects, 41% indicated that it presents an impediment in participation in sports, and 35% considered it as an obstacle in marriage. Additionally, epilepsy was perceived as a severe illness by 53.3% of the respondents and considered to be a moderately severe condition by 43.7%. The responses were found to be statistically significant (P<0.05) against the responses from the Italian study.

CONCLUSION

There is a reasonable level of awareness regarding epilepsy among Libyan students, though a lack of accuracy in the acquired knowledge exists. The ancient misconceptions regarding the nature of epilepsy and negative attitudes toward PWE appear to be rather common among the Libyan students. Consequently, the discrepancies in the views between the two surveys concerning the ways in which epilepsy is perceived and PWE are treated were extremely evident, thus reflecting the already established view that epilepsy faces greater stigma as a health condition in developing countries in comparison with Western nations.

Parental knowledge and attitudes towards epilepsy -A study from Jordan

PURPOSE

To explore the knowledge, attitudes and behaviors of parents whose children were diagnosed with epilepsy.

METHODS

Cross-sectional questionnaire based study of parents who accompanied their children with epilepsy to the child neurology clinics at three university hospitals in Jordan.

RESULTS

Most parents (427, 90.3%) knew that epilepsy is not related to a psychiatric disease. Approximately half of the parents (245, 51.8%) used the internet as their source of knowledge, and most used Arabic websites. Searching the word epilepsy was rarely used (51, 10.8%). Most of the parents (428,90.5%) were not restricting their children from watching TV or from using the computer (358,75.5%).However, many parents (280,59.2%) were restricting them from participating in sports. Parents had negative attitudes towards epilepsy; 189 (40.0%)thought that epileptic children can have normal intelligence, and 292 (61.7%) thought that they can continue into higher education. Greater parental knowledge of epilepsy was found to be correlated with the parental education level (p<0.05).Positive attitudes and behaviors towards epilepsy were found to be correlated with a higher parental education level, control of epilepsy,an absence of associated co morbidities, a higher income and internet use (p<0.05).

CONCLUSION

This study sheds an important light on the current knowledge status and attitudes of parents of children with epilepsy, and is an invaluable tool for tailoring the delivery of information and support resources for families in our region.

An evaluation of knowledge and attitudes toward epilepsy in Eastern Turkey

PURPOSE

This study was designed to determine the knowledge and attitudes regarding epilepsy among individuals in eastern Turkey.

METHOD

This descriptive study involved 530 healthy individuals who came to the Research and Application Hospital of Ataturk University in Erzurum, Turkey. A questionnaire and the epilepsy knowledge and attitude scale were administered to collect data. Mann-Whitney U, Kruskal-Wallis, and Spearman's correlation tests were used to analyze the data.

RESULTS

The participants' epilepsy knowledge mean score was 6.34 (SD=3.71), and their attitude mean score was 50.22 (SD=11.17). There was a positive (r=0.404) correlation between the knowledge and the attitude scores (p<0.001), and negative correlations between age and the knowledge (p=0.036) and the attitude scores (p<0.001). The mean knowledge and attitude scores were higher for the participants who were high school and university graduates, had expenses equal to income, and lived in nuclear families and in the city center (p<0.001). Civil servants and housewives had significantly higher mean knowledge scores, and students had significantly higher mean attitude scores (p<0.001). Significantly higher knowledge and attitude mean scores were also found for those who knew patients with epilepsy, had witnessed epileptic seizures, obtained information from healthcare personnel, and did not believe that epilepsy was associated with religion (p<0.001).

CONCLUSIONS

The study participants had low knowledge about epilepsy but displayed positive attitudes toward it. Higher knowledge positively affected attitude, and younger individuals had greater knowledge and, thus, more positive attitudes. Women, civil servants, and housewives had higher knowledge, whereas singles and students had better attitudes. The participants who had high educational levels and expenses equal to income and lived in nuclear families and the city center had more knowledge and displayed more positive attitudes. Greater knowledge and more positive attitudes were also found among the participants who knew patients with epilepsy, had witnessed epileptic seizures, obtained the information from healthcare personnel, and did not believe that epilepsy was associated with religion.

Worsening of attitudes toward epilepsy following less influential media coverage of epilepsy-related car accidents: An infodemiological approach

To evaluate changes in the attitudes of nonmedical university students toward epilepsy in 2015, the present study compared the results of questionnaire surveys from four different time periods: before media coverage of epilepsy-related car accidents (2008-2010), during a period of abundant media coverage (2011-2012), after media coverage (2013-2014), and after novel media coverage (2015). The nonmedical students that completed the questionnaire were divided into four groups: 2008-2010, 2011-2012, 2013-2014, and 2015. The rates of students that had read or heard about epilepsy decreased significantly in 2015 compared with those in 2013-2014. Attitudes toward epilepsy had also worsened in 2015. The rates of students that would not oppose their children playing with or attending school alongside children with epilepsy and those who thought that people with epilepsy should be hired in the same way as other people had decreased significantly in 2015 compared with those in 2011-2012 and 2013-2014. Analyses of information-seeking behavior on the Internet showed that the increase in Google search volume and Wikipedia page views was much less in 2015 than in 2011 and 2012. These findings suggest that familiarity with epilepsy had worsened even after media coverage of novel epilepsy-related car accidents. This suggests that media coverage in 2015 was less influential than that in 2011 and 2012.

Knowledge and Attitude toward Epilepsy of Close Family Members of People with Epilepsy in North of Iran

Background. Knowledge and attitudes are required for relatives of people with epilepsy to allow them to better understand and cope with this condition. This study evaluated the knowledge and attitudes of family members of people with epilepsy about the disease. Methods. This cross-sectional survey was conducted using a self-administered questionnaire completed by close family members of people with epilepsy at the outpatient clinic of a medical university. The questionnaire included 25 items that determined the demographics and information on the level of knowledge and attitudes about epilepsy. Results. The 124 participants had an average age of 36.88 ± 10.68 years. The mean knowledge score was 10.32 ± 2.25 (range: 4 to 15). 87.1% of respondents answered that epilepsy is a brain disorder, 39 (31.5%) said epilepsy is inherited. As a whole, 62 (50%) had good knowledge about the disease. The mean score of attitude was 7.25 ± 1.54 (range: 2 to 10). 83.9% of respondents believed that a person with epilepsy can get married and get pregnant (76.6%). Overall, 15 (12.1%) had negative attitudes and 109 (87.9%) had positive attitudes. Conclusion. The main findings of this study indicated good knowledge and a positive attitude about epilepsy among family members of people with epilepsy.

Informal caregivers of clients with neurological conditions: profiles, patterns and risk factors for distress from a home care prevalence study

Background

Individuals living in the community with neurological conditions receive the majority of their care from informal caregivers. The purpose of this project was to provide a profile of caregivers of home care clients with neurological conditions. The study also examined prevalence of caregiver distress and the association between neurological conditions and other client and caregiver characteristics with distress.

Methods

The study population included Canadian home care clients in the Winnipeg Regional Health Authority in Manitoba and in the province of Ontario. Clients with RAI-Home Care (RAI-HC) assessment data from 2003 to 2010 were examined. Neurological conditions of interest included Alzheimer’s disease and related dementias, multiple sclerosis, amyotrophic lateral sclerosis, Parkinson’s disease, Huntington disease, epilepsy, muscular dystrophy, cerebral palsy, traumatic brain injury, spinal cord injury, and stroke. Descriptive statistics were analyzed to describe home care client characteristics and caregiver characteristics for each neurological condition. Logistic regression analysis was used to identify risk factors associated with caregiver distress.

Results

A substantial proportion of home care clients were found to have one or more of the neurological conditions (38.8 % to 41.9 %). Caregiver distress was twice as prevalent among caregivers of clients with neurological conditions (28.0 %). The largest associations with caregiver distress were the amount of informal care hours provided in a week and the MAPLe algorithm, an indicator of a client’s level of priority for care. After adjustment for client characteristics, Huntington disease was the neurological condition most strongly associated with caregiver distress. However, clients’ clinical characteristics and informal care hours had a stronger association with caregiver distress than the presence of a neurological condition. Provision of formal home care services provided a protective effect from caregiver distress.

Conclusions

Neurological conditions are common among home care clients and a significant proportion of informal caregivers providing care to these clients experience distress. The complexity of clients with neurological conditions suggests the need for multicomponent support strategies for informal caregivers.

Sustained improvement of attitudes about epilepsy following a reduction in media coverage of car accidents involving persons with epilepsy

To evaluate changes in the attitudes of nonmedical students about epilepsy, the present study compared the results of a questionnaire that was completed in three different time periods: before media coverage of car accidents associated with epilepsy, during a period of abundant media coverage about epilepsy-related accidents, and after media coverage of epilepsy-related accidents. The nonmedical students who completed the questionnaire were divided into three groups: Years 08-10 (preaccident era), Years 11-12 (media coverage era), and Years 13-14 (postmedia coverage era). The rates of students who had read or heard about epilepsy and of students who did not think that epilepsy was a mental disorder increased annually throughout the study period. There was an improvement in attitudes about epilepsy after the media coverage era, and this change was not altered even after a decrease in the media coverage of epilepsy-related car accidents. Additionally, the rate of positive answers did not differ between Years 11-12 and Years 13-14. These findings demonstrate that the familiarity with and improved attitudes about epilepsy were sustained even after the media coverage of car accidents involving persons with epilepsy had decreased.

Is attitude toward epilepsy and driving affected by media coverage?

BACKGROUND

The media have recently reported on car accidents related to persons with epilepsy in Japan. We were concerned that sensational media coverage may worsen the attitude toward epilepsy among non-medical persons. We carried out a questionnaire survey among non-medical students in order to evaluate the effects of media on the attitude toward epilepsy and the holding of a driving license in persons with epilepsy.

METHODS

The survey was performed using a structured questionnaire. The students were divided into two groups according to knowledge on the recent serious car accidents related to persons with epilepsy. In order to clarify the effects of media coverage, we compared the attitude toward epilepsy and driving in persons with epilepsy between those who knew about the accidents and those who did not.

RESULTS

The proportion of students who were familiar with epilepsy was higher in those who knew about the accidents, whereas no significant difference was observed in attitude toward epilepsy. The proportion of students who opposed the idea of persons with epilepsy holding a driving license was not different according to knowledge of the car accidents, whereas that of students who opposed severe punishment of epilepsy patients in the case of a car accident was lower in those who knew about the accidents.

CONCLUSIONS

Media coverage did not affect the attitude of the participants toward restriction of driving license in persons with epilepsy, whereas the proportion of participants who object to severe punishment for car accidents in persons with epilepsy was decreased.

Attitude toward epilepsy after media coverage of car accidents related to persons with epilepsy in Japan

We compared the familiarity with and attitude toward epilepsy among nonmedical students before and after media coverage on car accidents related to persons with epilepsy in Japan. We have annually conducted a questionnaire survey on attitude toward epilepsy since 2008. We divided students into two groups: pre-accident era (years 2008-2010) and post-accident era (years 2011-2012). The rate of students who have read or heard about epilepsy was significantly higher in the post-accident era. Students in the post-accident era answered more frequently that they do not oppose the idea of their kids playing or attending school with children with epilepsy, they think that people with epilepsy should be hired in the same way as other people, and they do not oppose the idea of their children one day marrying a person with epilepsy. The results of our study show that media coverage of car accidents related to persons with epilepsy positively affected familiarity with and attitude toward epilepsy.

Development and validation of a public attitudes toward epilepsy (PATE) scale

INTRODUCTION

A quantitative scale of public attitudes toward epilepsy is essential to determine the magnitude of social stigma against epilepsy. This study aims to develop and validate a cross-culturally applicable scale of public attitudes toward epilepsy.

METHODS

A set of questions was selected from questionnaires identified from a literature review, following which a panel review determined the final version, consisting of 18 items. A 1-5 Likert scale was used for scoring. Additional questions, related to perception of the productivity of people with epilepsy and of a modified epilepsy stigma scale, were added as part of construct validation. One hundred and thirty heterogeneous respondents were collected, consisting of various age groups, ethnicity and occupation status levels.

RESULTS

After item and factor analyses, the final version consisted of 14 items. Psychometric properties of the scale were first determined using factor analysis, which revealed a general and a personal domain, with good internal consistency (Cronbach's coefficient 0.868 and 0.633, respectively). Construct validation was demonstrated. The mean score for the personal domain was higher than that for the general domain (2.72±0.56 and 2.09±0.59, respectively). The mean scores of those with tertiary education were significantly lower for the general domain, but not for the personal domain. Age was positively correlated with the mean scores in the personal domain, but not in the general domain.

CONCLUSION

This scale is a reliable and valid scale to assess public attitudes toward epilepsy, in both the general and personal domains.

Patients' perceptions of living with epilepsy: a phenomenographic study

AIM

The study aimed to describe how patients with epilepsy perceive living with epilepsy.

BACKGROUND

Epilepsy signifies a medical diagnosis as well as a social label. Persons living with epilepsy have more psychosocial problems compared with the general population, and stigma is often experienced. Few studies address patients' life situations as a whole, and there are no studies on how patients perceive living with epilepsy.

DESIGN

This was a qualitative interview study where 19 outpatients were purposively chosen and interviewed.

METHOD

A phenomenographic approach was used for interviewing and for analysing the interviews.

RESULTS

Living with epilepsy was perceived in two different ways depending on the person's feelings towards the condition. A positive feeling signified 'Living with epilepsy means living a normal life - gaining and maintaining control' with the descriptive categories: 'Accepting the person with epilepsy', 'Taking responsibility' and 'Appreciating the good things'. A negative feeling signified 'Living with epilepsy means living with focus on the condition - conflict and avoidance or resigning to fate' with the descriptive categories: 'Struggling with feelings of stigma, prejudices and loss of control' and 'Giving up hope of recovery, accepting loss of control'.

CONCLUSION

The findings indicate that patients' perceptions of living with epilepsy are closely related to their feelings towards the condition. There is a need for further exploration of the relationship between perceptions of epilepsy as a phenomenon, perceptions of living with epilepsy and feelings related to the condition. Relevance to clinical practice.  The findings demonstrated how important feelings and perceptions are to how patients with epilepsy regard themselves. This knowledge is essential for nurses when helping patients to better understand underlying reasons for their reactions to various situations. Forming interventions to help patients with epilepsy to find coping strategies that enhance self-esteem and self-value is another area of relevance.

Familiarity with, understanding of, and attitudes toward epilepsy among people with epilepsy and healthy controls in South Korea

This study identifies differences between people with epilepsy (PWE) and healthy controls in South Korea with respect to their familiarity with, understanding of, and attitudes toward epilepsy. PWE and controls older than 18 years of age were recruited from outpatient clinics and health promotion centers, respectively, associated with five university hospitals located throughout the country. Structured questionnaires consisting of 18 items were administered in face-to-face interviews. The sample consisted of 1924 participants (PWE: 384, controls: 1540). The groups did not differ with respect to age, sex, and place of residence. However, the groups did differ significantly in educational, marital, and occupational status (P=0.000). Familiarity with seizures and epilepsy (two items) did not differ significantly between the groups. Questions pertaining to understanding seizures and epilepsy (seven items) showed that controls had significantly greater misunderstanding of the etiology and long-term prognosis of epilepsy compared with PWE. Attitudes expressed toward PWE were significantly different in response to six of seven questions. Control subjects expressed more negative attitudes toward PWE than did PWE themselves, particularly concerning potential relationships with their children (e.g., friendships, marriage). In conclusion, we found significant differences between PWE and controls, particularly with respect to understanding of and attitudes toward epilepsy. We recommend the development of different strategies for PWE and controls to improve understanding of and attitudes toward epilepsy and to reduce the knowledge gap between these groups. Nationwide educational programs conducted by associated organizations and the government may provide the solution to this problem.

Patient, caregiver, and health care practitioner knowledge of, beliefs about, and attitudes toward epilepsy

The medical literature related to knowledge of, beliefs about, and attitudes toward epilepsy was reviewed from the perspective of patients, caregivers, and health care providers. The literature points to a desire for enhanced epilepsy education by patients and caregivers; however, these needs have not been met by primary or specialty care. Surveys of general practitioners (GPs) point to limitations in knowledge and negative attitudes. GPs view their role in epilepsy care as primarily educational and tend to acknowledge their limitations by referring difficult cases. Ongoing education for GPs is important, as is an improved partnership in defining roles for care and education. Health care professionals specialized in epilepsy care acknowledge their own set of barriers to optimal care. Epilepsy education programs have been able to improve knowledge; however, long-term improvements in behavioral outcomes or quality of life are less documented. Suggestions for improvements are provided.