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Aydemir N, Sakman ÖK, Delil Ş, Özkara Ç. Determinants of felt-stigma in adolescents with epilepsy: Is it the same story? Seizure 2023; 113:34-40. [PMID: 37952261 DOI: 10.1016/j.seizure.2023.11.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Revised: 10/30/2023] [Accepted: 11/01/2023] [Indexed: 11/14/2023] Open
Abstract
PURPOSE The present study aimed to investigate previously researched variables in adult people with epilepsy (PWE), which include felt stigma, perceived overprotection, concealment of epilepsy, and epilepsy-related concerns for adolescents with epilepsy (AWE). Another goal was to determine the reported levels of these variables and explore the relationships among them, as well as their associations with demographic and clinical factors. Additionally, we also investigated whether clinical and demographic variables create significant changes in these variables. Lastly, we aimed to determine the variables that predict felt-stigma in AWE. METHODS On hundred and nineteen AWE aged between 10 and 18 were included in the study by using convenience sampling. Participants received the scales and demographic information form either in face to face meeting or via a Zoom session. RESULTS Nearly half of the participants stated high level of felt stigma, perceived overprotection and concealment of epilepsy, while more than half reported concerns about their future/occupational prospects. Also, felt stigma had significant relations with concealment of epilepsy and concerns related to epilepsy. Early adolescents were under more risk for perceived overprotection, while late adolescents had higher concerns related to future/occupation. Females reported more felt stigma. Finally, felt stigma was predicted by concealment, concerns related to future/occupation, and concerns related to social life. CONCLUSION The variables that explain the felt-stigma in AWE appear to be quite similar to those in adult PWE.
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Affiliation(s)
- Nuran Aydemir
- Faculty of Letters, Department of Psychology, Istanbul University, Istanbul, Turkiye.
| | | | - Şakir Delil
- Faculty of Medicine, Department of Neurology, Istanbul Cerrahpaşa University, Istanbul, Turkiye
| | - Çiğdem Özkara
- Faculty of Medicine, Department of Neurology, Istanbul Cerrahpaşa University, Istanbul, Turkiye
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Concealment behaviors in Korean adults with epilepsy: Their relationships to social anxiety and seizure severity independent of felt stigma. Epilepsy Behav 2022; 129:108647. [PMID: 35299089 DOI: 10.1016/j.yebeh.2022.108647] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Revised: 02/23/2022] [Accepted: 02/24/2022] [Indexed: 11/20/2022]
Abstract
PURPOSE This study assessed whether seizure severity and social anxiety were related to self-disclosure or concealment behaviors independent of felt stigma in Korean adults with epilepsy. METHODS This multicenter, cross-sectional study used the Disclosure Management Scale (DMS), the short forms of the Social Phobia Scale (SPS-6) and Social Interaction Anxiety Scale (SIAS-6), and the Stigma Scale-Revised to evaluate Korean adults with epilepsy. Seizure severity was measured as a composite variable, and multivariate linear regression analyses were performed to assess whether seizure severity and social anxiety were related to concealment behaviors. RESULTS The 315 subjects included 132 (41.9%) women and 183 (58.1%) men. Of these subjects, 212 (67.3%) reported rarely or never talking to others about their epilepsy, whereas only 98 (31.1%) stated that they rarely or never kept their epilepsy secret from others. Linear regression analyses showed that concealment behaviors were positively correlated with degree of social anxiety (on separate models using the SIAS-6 and SPS-6) and felt stigma, and negatively associated with level of seizure severity. Both models accounted for about 14% of the variance in DMS scores. CONCLUSIONS The majority of Korean adults with epilepsy choose concealment and selective disclosure strategies. Social anxiety and seizure severity along with felt stigma play significant roles in deciding whether to disclose or conceal a diagnosis of epilepsy. The explanatory power of these models was weak.
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Kwon CS, Jacoby A, Ali A, Austin J, Birbeck GL, Braga P, Cross JH, de Boer H, Dua T, Fernandes PT, Fiest KM, Goldstein J, Haut S, Lorenzetti D, Mifsud J, Moshe S, Parko KL, Tripathi M, Wiebe S, Jette N. 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. Epilepsia 2022; 63:573-597. [PMID: 34985782 DOI: 10.1111/epi.17135] [Citation(s) in RCA: 28] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Revised: 11/09/2021] [Accepted: 11/10/2021] [Indexed: 11/25/2022]
Abstract
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.
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Affiliation(s)
- Churl-Su Kwon
- Departments of Neurosurgery, Neurology and Population Health Sciences & Policy, Icahn School of Medicine, New York, New York, USA
| | - Ann Jacoby
- Department of Public Health and Policy, University of Liverpool, Liverpool, UK
| | - Amza Ali
- Kingston Public Hospital and University of the West Indies, Kingston, Jamaica
| | - Joan Austin
- Indiana University School of Nursing, Indianapolis, Indiana, USA
| | - Gretchen L Birbeck
- Epilepsy Division, University of Rochester, Rochester, New York, USA
- Epilepsy Care Team, Chikankata Hospital, Mazabuka, Zambia
| | - Patricia Braga
- Facultad de Medicina, Institute of Neurology, Universidad de la República, Montevideo, Uruguay
| | - J Helen Cross
- Developmental Neurosciences Programme, UCL-NIHR BRC Great Ormond Street Institute of Child Health, London, UK
| | - Hanneke de Boer
- SEIN - Epilepsy Institute in the Netherlands Foundation, Heemstede, The Netherlands
| | - Tarun Dua
- Department of Mental Health and Substance Abuse, World Health Organization, Geneva, Switzerland
| | - Paula T Fernandes
- Department of Sport Science, Faculty of Physical Education, UNICAMP, Campinas, Brazil
| | - Kirsten M Fiest
- Department of Critical Care Medicine and Department of Community Health Sciences, Hotchkiss Brain Institute, O'Brien Institute for Public Health, University of Calgary, Calgary, Alberta, Canada
| | - Jonathan Goldstein
- Departments of Neurology and Population Health Sciences & Policy, Icahn School of Medicine, New York, New York, USA
| | - Sheryl Haut
- Saul R. Korey Department of Neurology, Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, New York, USA
| | - Diane Lorenzetti
- Department of Community Health Sciences, University of Calgary and Health Sciences Library, University of Calgary, Calgary, Alberta, Canada
| | - Janet Mifsud
- Department of Clinical Pharmacology and Therapeutics, Faculty of Medicine and Surgery, University of Malta, Msida, Malta
| | - Solomon Moshe
- Saul R. Korey Department of Neurology, Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, New York, USA
- Department of Pediatrics and Dominick P. Purpura Department of Neuroscience, Albert Einstein College of Medicine, Bronx, New York, USA
| | - Karen L Parko
- Department of Neurology, University of California at San Francisco, San Francisco, California, USA
- Epilepsy Center, San Francisco VA Medical Center, San Francisco, California, USA
| | - Manjari Tripathi
- Department of Neurology, All India Institute of Medical Sciences, New Delhi, India
| | - Samuel Wiebe
- Department of Clinical Neurosciences and Department of Community Health Sciences, Hotchkiss Brain Institute, O'Brien Institute for Public Health, University of Calgary, Calgary, Alberta, Canada
| | - Nathalie Jette
- Departments of Neurology and Population Health Sciences & Policy, Icahn School of Medicine, New York, New York, USA
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Validity and reliability of the Turkish version of Public Attitudes Toward Epilepsy scale. Epilepsy Behav 2020; 111:107245. [PMID: 32693372 DOI: 10.1016/j.yebeh.2020.107245] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2020] [Accepted: 06/06/2020] [Indexed: 02/06/2023]
Abstract
OBJECTIVE This study was conducted to test the validity and reliability of the Turkish version of the Public Attitudes Toward Epilepsy (PATE) scale, which aims to understand public perceptions of seizures and epilepsy. METHODS The scale was translated following the standard procedures. For psychometric validation, the Turkish version of the PATE scale was administered to 201 native Turkish speakers above the age of 18 who had no history of seizures or epilepsy. It was found that the respondents were able to fill out the scale quickly and without difficulty in understanding the translated items on the scale. RESULTS Cronbach's alpha coefficient was found to be 0.843 for the overall scale and above 0.7 for each individual item. Cronbach's alpha was 0.78 for the general domain and 0.792 for the personal domain. Exploratory and confirmatory factor analyses were carried out and showed that the scale had a structure similar to that of the original scale, with the 14 items grouped under two dimensions, similar to the original scale. CONCLUSION The Turkish version of the PATE scale was a valid and reliable tool to measure the attitudes toward epilepsy in Turkish society.
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Overprotection and determinants of overprotection in adults with epilepsy. Seizure 2020; 79:14-19. [PMID: 32408105 DOI: 10.1016/j.seizure.2020.04.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2020] [Revised: 04/07/2020] [Accepted: 04/15/2020] [Indexed: 11/21/2022] Open
Abstract
PURPOSE To examine the perceived overprotection of adult people with epilepsy (PWE) by using a specifically developed novel scale. The study also investigated whether perceived overprotection is associated with particular demographic or clinical variables. METHODS This cross-sectional study is based on responses from 200 adult PWE. The participants completed a clinical-demographic questionnaire, the perceived overprotection scale, felt-stigma scale, concealment of epilepsy scale and epilepsy concern scale. RESULTS One-way ANOVA results show that perceived overprotection was significantly greater among participants with lower income and levels of education. The highest number of affirmative responses in the perceived overprotection scale were related to going out alone and being given fewer family responsibilities due to epilepsy. Hierarchical regression results show that concerns related to social life and to future and occupation were significant predictors of high perceived overprotection. CONCLUSION Psycho-social factors, specifically concerns, seem to be more important than epilepsy-related variables in explaining perceived overprotection in adult PWE.
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Elliott N, Pembroke S, Quirke M, Pender N, Higgins A. Disclosure strategies in adults with epilepsy when telling, "I have epilepsy": The How2tell study. Epilepsia 2019; 60:2048-2059. [PMID: 31544237 DOI: 10.1111/epi.16338] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2019] [Revised: 08/22/2019] [Accepted: 08/22/2019] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To generate evidence-based knowledge about the strategies that adult people with epilepsy (PWEs) use in the process of telling others about their epilepsy. METHODS In-depth, one-to-one interviews explored PWEs' first-hand experiences of self-disclosure (or not), and grounded theory methods of inductive-deductive analysis were used to identify strategies used in disclosing. Interviews were audio-recorded, transcribed, coded, and independently recoded by two researchers using a coding framework specifically developed in this study. To account for maximum variation, PWEs (aged 18+ years) with different life experiences and situations relating to (1) gender, (2) age, (3) employment status, (4) personal relationships, (5) family relationship, (6) support group involvement, and (7) seizure frequency were included. Given the many variables and psychosocial issues associated with epilepsy, demographic details and validated measures including Quality of Life in Epilepsy-10-P, Coping Inventory of Stressful Situations-Adult, and Patient Health Questionnaire-9 were used to describe the characteristics of participants and to contextualize the results. RESULTS Forty-nine adults with epilepsy participated. Data analysis revealed six interrelated categories (with subcategories) of the strategies that PWEs reported using in the process of disclosure: (1) concerns about disclosing; (2) weighing up who and when to tell; (3) opportunities for telling; (4) moment of disclosure-how to construct the message; (5) tailoring the message to audience needs-altering the message when telling family members, partner, friends, children, or employer and workplace colleagues; and (6) managing reactions by making it ordinary. SIGNIFICANCE People with epilepsy use a range of different strategies during the process of disclosing their epilepsy. These strategies were used to inform the development of the How2tell multimedia self-management resource for PWEs on self-disclosure in everyday social and life situations. How2tell is designed to benefit PWEs by empowering them with practical information about the process of telling another person, "I have epilepsy."
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Affiliation(s)
- Naomi Elliott
- School of Nursing & Midwifery, Trinity College Dublin, Dublin, Ireland
| | - Sinead Pembroke
- School of Nursing & Midwifery, Trinity College Dublin, Dublin, Ireland
| | - Mary Quirke
- School of Nursing & Midwifery, Trinity College Dublin, Dublin, Ireland
| | - Niall Pender
- Department of Psychology, Beaumont Hospital, Dublin, Ireland
| | - Agnes Higgins
- School of Nursing & Midwifery, Trinity College Dublin, Dublin, Ireland
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Mutiso VN, Pike KM, Musyimi CW, Gitonga I, Tele A, Rebello TJ, Thornicroft G, Ndetei DM. Feasibility and effectiveness of nurses and clinical officers in implementing the WHO mhGAP intervention guide: Pilot study in Makueni County, Kenya. Gen Hosp Psychiatry 2019; 59:20-29. [PMID: 31096165 DOI: 10.1016/j.genhosppsych.2019.04.005] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2018] [Revised: 04/01/2019] [Accepted: 04/02/2019] [Indexed: 01/12/2023]
Abstract
OBJECTIVES (1) To determine the feasibility and effectiveness of nurses and clinical officers in using the mental health Global Action Programme Intervention Guide (mhGAP-IG) as an intervention tool in reducing disability, improving quality of life in the clinical outcomes in patients with the mhGAP-IG priority mental disorders in a Kenyan rural setting. (2) To identify any gaps that can be contributed towards future research. METHODS This study was conducted in 20 healthcare facilities across Makueni County in the South East of Kenya. This county had a population of approximately one million people, with no psychiatrist or clinical psychologist. We recruited 2306 participants from the healthcare facilities in the catchment areas that had previously been exposed to the community mental health awareness campaigns, while being subjected to screening for the mhGAP-IG disorders. We used the Mini-International Neuropsychiatric Interview for adults (MINI-Plus) for DSM-IV confirmatory diagnosis on those who screened positive on the mhGAP-IG. We measured disability using WHO-Disability Assessment Schedule II (DAS II), Quality of Life (QoL) using the WHO QoL-BREF, depression using Patient Health Questionnaire (PHQ-9), suicidality using The Beck Suicide Scale (BSS), psychosis using the Washington Early Recognition Center Affectivity and Psychosis (WERCAP), epilepsy using a seizure questionnaire and alcohol and substance abuse using The Alcohol, Smoking and Substance Involvement Screening Test (ASSIST). These measurements were at the baseline, followed by the training for the health professionals on using the WHO mhGAP-IG as an interventional tool. The measurements were repeated at 3 and 6 months post-intervention. RESULTS Of the 2306 participants enrolled in the study, we followed 1718 at 3 months and 1371 at 6 months a follow-up rate of 74.5% and 59.4% respectively. All participants received psycho-education and most depending on condition also received medication. Overall, there was significant decline in disabilities, improvement in seizure control and improvement in clinical outcomes on the identified mental disorders. CONCLUSIONS Trained, supervised and supported nurses and clinical officers can produce good outcomes using the mhGAP-IG for mental health.
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Affiliation(s)
- V N Mutiso
- Africa Mental Health Research and Training Foundation, Nairobi, Kenya.
| | - K M Pike
- Columbia University, Global Mental Health Program, New York, USA.
| | - C W Musyimi
- Africa Mental Health Research and Training Foundation, Nairobi, Kenya.
| | - I Gitonga
- Africa Mental Health Research and Training Foundation, Nairobi, Kenya.
| | - A Tele
- Africa Mental Health Research and Training Foundation, Nairobi, Kenya.
| | - T J Rebello
- Columbia University, Global Mental Health Program, New York, USA.
| | | | - D M Ndetei
- Africa Mental Health Research and Training Foundation, Nairobi, Kenya; Department of Psychiatry, University of Nairobi, Nairobi, Kenya.
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Nguyen DV, Vidal C, Chu HC, van Nunen S. Developing pharmacogenetic screening methods for an emergent country: Vietnam. World Allergy Organ J 2019; 12:100037. [PMID: 31198488 PMCID: PMC6558218 DOI: 10.1016/j.waojou.2019.100037] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2018] [Revised: 03/24/2019] [Accepted: 05/01/2019] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND The finding of strong associations between certain human leukocyte antigen (HLA) genotypes and the development of severe cutaneous adverse drug reactions (SCARs), [for example, HLA-B*57:01 and abacavir (ABC), HLA-B*15:02 and carbamazepine (CBZ) and HLA-B*58:01 and allopurinol], has led to HLA screening being used to prevent SCARs. Screening has been shown to be of great benefit in a number of studies. Clinical translation from bench to bedside, however, depends upon the development of simple, rapid and cost-effective assays to detect these risk alleles. In highly populated developing countries such as Vietnam, where there is a high prevalence of HLA-B*15:02 and HLA-B*58:01 correlating with a high incidence of CBZ- and allopurinol-induced SCARs, the crucial factor in the implementation of comprehensive screening programs to detect these major risk HLA alleles is the availability of suitable assays. BODY We have summarized the role and economic benefits of HLA screening, reviewed published HLA screening methods used currently in pharmacogenetic screening and examined the advantages and disadvantages of assays developed specifically for use in screening for risk alleles in the prevention of HLA-associated SCARs in Vietnam. CONCLUSION The optimal approach we propose may serve as a template for the development of screening programs in other emergent countries.
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Affiliation(s)
- Dinh Van Nguyen
- Respiratory, Allergy and Clinical Immunology, Vinmec International Hospital, Times City and Vin University, Hanoi, Viet Nam
- Northern Clinical School, The University of Sydney, Sydney, Australia
- Department of Allergy and Clinical Immunology, Hanoi Medical University, Hanoi, Viet Nam
| | - Christopher Vidal
- Northern Clinical School, The University of Sydney, Sydney, Australia
| | - Hieu Chi Chu
- Center of Allergology and Clinical Immunology, Bach Mai Hospital, Hanoi, Viet Nam
| | - Sheryl van Nunen
- Northern Clinical School, The University of Sydney, Sydney, Australia
- Department of Clinical Immunology and Allergy, Royal North Shore Hospital, Sydney, Australia
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Singh G, K Ganguly K, Banerji M, Addlakha R, Shah U, Tripathi M, Saxena V, Vohra H, Wakankar Y, Sharma M, Radhakrishnan K. Marriage in people with epilepsy: A compelling theme for psycho-behavioral research. Seizure 2018; 62:127-130. [PMID: 30122424 DOI: 10.1016/j.seizure.2018.08.005] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2018] [Revised: 08/04/2018] [Accepted: 08/07/2018] [Indexed: 10/28/2022] Open
Abstract
People with epilepsy frequently experience problems in marriage including reduced marital prospects, poor marital outcomes and diminished quality of married life. Conversely, marriage might impact epilepsy self-management and quality of life in people with epilepsy. There is little in published literature on marriage and epilepsy, so there is a need for psycho-behavioral research. Here, we focus on arranged marriages which, although now rare in western cultures, are widely prevalent in South Asian communities. Arranged marriages, in which families rather than individuals choose marital partners, are particularly problematic because epilepsy is frequently hidden during marital negotiations as well as later. From the psycho-behavioral perspective, marital prospects, outcomes and satisfaction should be examined in relation to the type of marriage (arranged vs. love) and whether or not epilepsy is hidden. Additionally, culturally-relevant tools to appraise marital quality and epilepsy self-management within marriage should be developed. The main objective should be to develop a multi-sectorial action plan with interventions at several different levels involving different stakeholders to mitigate stigma associated with epilepsy in matrimony.
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Affiliation(s)
- Gagandeep Singh
- Department of Neurology, Dayanand Medical College, Ludhiana, India; Department of Clinical & Experimental Epilepsy, UCL-Institute of Neurology, Queen Square, London, UK
| | - Kalyan K Ganguly
- Socio-Behavioral Research Unit, Indian Council of Medical Research, New Delhi, India
| | - Manjistha Banerji
- School of Educational Studies, Ambedkar University, New Delhi, India
| | - Renu Addlakha
- Centre for Women's Development Studies, New Delhi, India
| | - Urvashi Shah
- Department of Neurology, KEM Hospital, Mumbai, India
| | - Manjari Tripathi
- Department of Neurology, Neurosciences Centre, All India Institute of Medical Sciences, New Delhi, India
| | | | - Hitant Vohra
- Department of Anatomy, Dayanand Medical College, Ludhiana, India
| | | | - Meenakshi Sharma
- Non-communicable Research Division, Indian Council of Medical Research, New Delhi, India
| | - Kurupath Radhakrishnan
- Department of Neurology, Amrita Institute of Medical Sciences, Cochin, 682041, Kerala, India.
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Singh G, Selai C, Islam S, Chaudhary P, Sander JW. Marriage in epilepsy: The impact of the question in knowledge, attitude, and practice surveys. Epilepsy Behav 2018; 85:164-172. [PMID: 29957343 DOI: 10.1016/j.yebeh.2018.06.005] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2018] [Revised: 05/30/2018] [Accepted: 06/01/2018] [Indexed: 12/21/2022]
Abstract
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; I2res = 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; I2res: 99.8%; adjusted R2: 11.4%) and subject population type (P = 0.02; tau2: 0.07; I2res: 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.
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Affiliation(s)
- Gagandeep Singh
- Department of Neurology, Dayanand Medical College, Ludhiana, India; NIHR University College London Hospitals Biomedical Research Centre, UCL Institute of Neurology, Queen Square, London WC1N 3BG, UK
| | - Caroline Selai
- Education Unit, NIHR University College London Hospitals Biomedical Research Centre, UCL Institute of Neurology, Queen Square, London WC1N 3BG, UK
| | - Saiful Islam
- Education Unit, NIHR University College London Hospitals Biomedical Research Centre, UCL Institute of Neurology, Queen Square, London WC1N 3BG, UK
| | | | - Josemir W Sander
- NIHR University College London Hospitals Biomedical Research Centre, UCL Institute of Neurology, Queen Square, London WC1N 3BG, UK; Chalfont Centre for Epilepsy, Chalfont St Peter, Bucks SL9 0RJ, UK; Stichting Epilepsie Instellingen Nederland (SEIN), Achterweg 5, Heemstede 2103SW, Netherlands.
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Tanywe A, Matchawe C, Fernandez R. The experiences of people living with epilepsy in developing countries: a systematic review of qualitative evidence. ACTA ACUST UNITED AC 2018; 14:136-92. [PMID: 27532470 DOI: 10.11124/jbisrir-2016-002182] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
BACKGROUND Epilepsy is a global public health problem affecting people of all ages, sex, races, nations and social class. The majority of the 50 million people with epilepsy live in developing countries, with a prevalence rate of five to 10 people per 1000. The disease poses an enormous psychological, social and economic burden on patients. An estimated 90% of people with epilepsy in developing countries do not receive treatment due to sociocultural, economic and political factors. Current treatment interventions are limited to the clinical management of the disease and are largely driven by the healthcare provider's perspective, ignoring the experiences of people living with epilepsy (PLWE). OBJECTIVE The aim of this review was to identify, critically appraise, extract, synthesize and present the best and most current available evidence on the experiences of PLWE in developing countries. REVIEW QUESTIONS • What are the experiences of PLWE regarding the causes of their condition?• What are the experiences of PLWE regarding treatment of epilepsy?• How has epilepsy shaped the social relationships of the affected persons? INCLUSION CRITERIA People living with epilepsy in developing countries (Africa, Asia, Eastern Europe and Latin America).The experiences of PLWE in developing countries with particular attention on the causes, treatment and its impact on their social relationships.Primary research studies with a qualitative design not limited to phenomenology, ethnography, grounded theory, ethnomethodology, phenomenography, critical theory, interpretative or feminist analysis, case study, narrative studies and action research. CONTEXT Qualitative studies conducted in hospitals and community settings in developing countries. SEARCH STRATEGY A three-step search strategy was used to identify published and unpublished studies in the English language from the 1990s to the present. METHODOLOGICAL QUALITY Identified studies that met the inclusion criteria were retrieved and critically appraised by two independent reviewers prior to their inclusion using the Joanna Briggs Institute Qualitative Assessment and Review Instrument (JBI-QARI). DATA EXTRACTION Data were extracted from included papers using the recommended data extraction form embedded in the JBI-QARI. DATA SYNTHESIS Findings, where possible, were pooled using the JBI-QARI. It involved the meta-aggregation of findings to generate a set of statements that represented that aggregation, through assembling the findings rated according to their quality, and categorizing these findings on the basis of similarity in meaning. RESULTS From the 13 studies included in the review, 113 findings were extracted to create categories. Eight categories were created from which three synthesized findings were produced. The synthesized findings were: SYNTHESIZED FINDING 1: People living with epilepsy believed that the disease was caused by factors such as fever, demonic power, beatings, witchcraft, curses and God. Patients also had differing views as to whether the disease was contagious or hereditary. They indicated that the disease manifested as seizures, triggered by fever, stress, depression and anger. SYNTHESIZED FINDING 2: People living with epilepsy used biomedical and traditional methods to treat epilepsy and also developed strategies for coping with the disease beyond seeking treatment. SYNTHESIZED FINDING 3: People living with epilepsy had negative and positive experiences in their social relationships. The negative experiences were linked to the social, psychological and economic burden of the disease on patients, whereas the social support they got from friends, peers, family and community members were the positive aspects. CONCLUSION People living with epilepsy attribute the cause of the disease to agents like fever, demonic power and witchcraft. Patients use biomedical and traditional methods to treat the disease and have also developed various coping strategies (like prayers and concealment) alongside treatment. Epilepsy has negative effects on the social relationships of patients and is a social, psychological and economic burden for patients. However, there are some positive effects like the social support they receive from family members, friends and the community.
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Affiliation(s)
- Asahngwa Tanywe
- 1Cameroon Center for Evidence Based Healthcare: an Affiliate Centre of The Joanna Briggs Institute 2Centre for Behavioral and Social Research 3Institute of Medical Research and Medicinal Plant Studies (IMPM), Yaounde, Cameroon, Africa 4Centre for Evidence Based Initiatives in Health Care, University of Wollongong, Wollongong, NSW, Australia 5St George Hospital, NSW, Australia
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Aydemir N, Kaya B, Yıldız G. Development of the perceived stigma scale and the concealment of epilepsy scale for the Turkish population. Epilepsy Behav 2018; 80:1-4. [PMID: 29396355 DOI: 10.1016/j.yebeh.2017.11.032] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2017] [Revised: 11/23/2017] [Accepted: 11/26/2017] [Indexed: 11/18/2022]
Abstract
The aim of this study was to develop two culture-specific scales to measure the level of felt stigma, and level of concealment of Turkish adult people with epilepsy (PWE). For this purpose, a 10-item felt-stigma scale and a 17-item disclosure of epilepsy scale were developed and then applied to 200 adult PWE. After item and factor analyses of the stigma scale, the 10 items with a one-factor solution explained 45.6% of the variance with a 0.86 internal consistency value. Higher scores represent higher felt stigma. The concealment of epilepsy scale has 17 items loaded on one factor, which explained 45.1% of the variance. Cronbach's alpha coefficient was found to be 0.92. The higher the score, the higher the concealment of illness by the participant. For convergent validity, the relationship between stigma and disclosure scales was examined, and a positive significant relation (r=0.64, p<0.000) was found.
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Affiliation(s)
- Nuran Aydemir
- Izmir Katip Çelebi University, Faculty of Humanities and Social Sciences, Department of Psychology, Izmir, Turkey.
| | | | - Gözde Yıldız
- Izmir Katip Çelebi University, Graduate School of Social Sciences, Department of Psychology, Izmir, Turkey
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Mahendran M, Speechley KN, Widjaja E. Systematic review of unmet healthcare needs in patients with epilepsy. Epilepsy Behav 2017; 75:102-109. [PMID: 28843210 DOI: 10.1016/j.yebeh.2017.02.034] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2016] [Revised: 02/06/2017] [Accepted: 02/13/2017] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Patients with epilepsy (PWE) are more likely to have unmet healthcare needs than the general population. This systematic review assessed the reasons for unmet needs in PWE. METHODS Medline, Embase, PsycINFO, Cochrane, and Web of Science databases were searched using keywords relating to unmet healthcare needs, treatment barriers, and access to care. The search included all countries, adult and pediatric populations, survey and qualitative studies, but excluded non-English articles and articles published before 2001. Reasons for unmet needs were extracted. RESULTS Nineteen survey and 22 qualitative studies were included. Three survey and five qualitative studies excluded patients with comorbidities. There were twice as many studies on unmet mental healthcare needs than unmet physical care needs in PWE. Poor availability of health services, accessibility issues, and lack of health information contributed to unmet needs in both Western and developing countries. Lack of health services, long wait lists, uncoordinated care, and difficulty getting needed health information were prevalent in the United States (US) as well as countries with a universal healthcare system. However, unmet needs due to costs of care were reported more commonly in studies from the US. SIGNIFICANCE This systematic review identified reasons for unmet needs in PWE across different countries, which will inform specific interventions required to address these unmet needs. Unmet needs may have been underestimated due to exclusion of PWE with comorbidities in some studies. Additional studies are needed to understand the contribution of comorbidities on unmet needs and their interaction with caregiver and family factors.
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Affiliation(s)
- Mayuri Mahendran
- Department of Epidemiology & Biostatistics, Schulich School of Medicine and Dentistry, Western University, Kresge Building, Room K201, London, Ontario N6A 5C1, Canada
| | - Kathy N Speechley
- Department of Epidemiology & Biostatistics, Schulich School of Medicine and Dentistry, Western University, Kresge Building, Room K201, London, Ontario N6A 5C1, Canada; Department of Paediatrics, Western University, London, Ontario, Canada; Children's Hospital, 800 Commissioners Road East, Rm B1-437, London, Ontario N6A 5W9, Canada
| | - Elysa Widjaja
- Division of Neurology, Hospital for Sick Children, 555 University Avenue, Toronto, Ontario M5G 1X8, Canada; Diagnostic Imaging, Hospital for Sick Children, 555 University Avenue, Toronto, Ontario M5G 1X8, Canada.
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Lee SA, No SK, Park H, Kim OJ, Kwon JH, Ryu JY, Lee SM, Jo KD. Predictors of disclosure management behavior at the end of 1-year follow-up in Korean adults with newly diagnosed epilepsy. Epilepsy Behav 2017; 74:94-98. [PMID: 28732261 DOI: 10.1016/j.yebeh.2017.06.020] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2017] [Revised: 06/16/2017] [Accepted: 06/16/2017] [Indexed: 11/30/2022]
Abstract
PURPOSE Epilepsy is a concealable stigmatizing condition. We investigated the factors predicting disclosure management behavior in Korean adults with newly diagnosed epilepsy. METHODS This longitudinal multicenter study included Korean adults with newly diagnosed epilepsy. Using statistical analyses, we determined at the end of a 1-year follow-up whether Disclosure Management Scale (DMS) scores were predicted by demographic, clinical, and psychosocial variables, including felt stigma, stress coping style, personality traits, social support, and experienced discrimination from society. RESULTS Of a total of 121 participants, 69% reported that they often or sometimes kept their diagnosis a secret from others and rarely or never talked to others about their epilepsy. The average DMS score was 5.8 (SD=2.9, range 0-11). In univariate analyses, DMS scores were significantly associated with an emotion-focused coping style (r=0.320, p<0.001), social support (r=-0.185, p<0.05), and experienced discrimination (p<0.05). Emotion-focused coping was the only independent predictor of a higher DMS score. Felt stigma, personality traits, and seizure freedom were not related to the DMS score. CONCLUSIONS Two-thirds of Korean adults with newly diagnosed epilepsy often or sometimes keep their epilepsy a secret. Emotion-focused coping is the most important predictor of concealment of epilepsy diagnosis at the end of a 1-year follow-up, although social support and episodes of experienced discrimination are also associated with disclosure management strategies.
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Affiliation(s)
- Sang-Ahm Lee
- Department of Neurology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.
| | - Soon-Kee No
- Department of Neurology, Bong-Seng Memorial Hospital, Pusan, Republic of Korea
| | - Hyungkook Park
- Department of Neurology, SoonChunHyang University College of Medicine, Cheonan, Republic of Korea
| | - Ok-Joon Kim
- Department of Neurology, CHA University, Seongnam, Republic of Korea
| | - Jee-Hyun Kwon
- Department of Neurology, Ulsan College Hospital, University of Ulsan College of Medicine, Ulsan, Republic of Korea
| | - Ji-Yeon Ryu
- Department of Neurology, Kepco Medical Center, Seoul, Republic of Korea
| | - Sang-Moo Lee
- Department of Neurology, Hallym University College of Medicine, Chuncheon, Republic of Korea
| | - Kwang-Deog Jo
- Department of Neurology, Gangneung Asan Hospital, University of Ulsan College of Medicine, Gangneung, Republic of Korea
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Lee SA, Lee BI. Disclosure management behaviors in Korean adults with well-controlled epilepsy: Their relation to perception of stigma. Epilepsy Behav 2017; 67:28-32. [PMID: 28088048 DOI: 10.1016/j.yebeh.2016.11.034] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2016] [Revised: 11/22/2016] [Accepted: 11/22/2016] [Indexed: 10/20/2022]
Abstract
PURPOSE In spite of the fact that epilepsy is a concealable stigmatized identity, there is little evidence pertaining to disclosure management in adults living with epilepsy. We determined the factors contributing to disclosure management strategies in adults living with well-controlled epilepsy. METHODS This was a cross-sectional multicenter study. Korean adults whose seizures had remitted for at least one year participated in this study. Using statistical analyses, we determined whether disclosure management behaviors measured using the Disclosure Management Scale (DMS) were related to demographic, clinical, and psychosocial variables. The Stigma Scale and Hospital Anxiety Depression Scale (HADS) were used. RESULTS Of a total of 225 participants, 76% stated that they often or sometimes kept their epilepsy a secret, while 24% reported that they never or rarely kept their diagnosis hidden. The mean DMS score was 6.1 (SD=2.4). In univariate analyses, the DMS scores were significantly related to the HADS depression scores (r=0.187, p=0.005) and the presence of perceived stigma (p=0.001). In linear regression analyses, perceived stigma was identified only as an independent factor associated with DMS scores (p=0.031), while HADS depression lost significance (p=0.057). The presence of perceived stigma explained only 4.6% of the variance in DMS scores. CONCLUSIONS Our study shows that over 70% of Korean adults with well-controlled epilepsy often or sometimes keep their epilepsy a secret. Although perceived stigma is associated with concealment behaviors, it accounts for only a small proportion of the variance in disclosure management.
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Affiliation(s)
- Sang-Ahm Lee
- Department of Neurology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.
| | - Byung-In Lee
- Department of Neurology, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
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Factors affecting the employability in people with epilepsy. Epilepsy Res 2016; 128:6-11. [PMID: 27792885 DOI: 10.1016/j.eplepsyres.2016.10.003] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2016] [Revised: 09/29/2016] [Accepted: 10/22/2016] [Indexed: 11/23/2022]
Abstract
PURPOSE People with epilepsy (PWE) are negatively prejudiced in their ability to work. This study aimed to examine demographic, clinical and psychological factors associated with employability in PWE. METHODS This study recruited epilepsy patients from a neurology clinic in Malaysia. Employability was measured using employment ratio, with a ratio ≥90% (ER90) classified as high employability. Basic demographic data such as age, gender, marital status, religion, education level and household income was collected. Clinical measures consisted of age of seizure onset, seizure frequency, type of epilepsy, aura, polytherapy, nocturnal seizures and seizure control. Psychological measures included Work Self-Determination Index (WSDI), Rosenberg Self-Esteem Scale (SES), and Multidimensional Scale of Perceived Social Support (MSPSS). RESULTS Of 146 PWE, 64.4% had high employability. The participants were predominantly female (52%), Chinese (50.7%), single (50%), having tertiary education (55.5%) and focal epilepsy (72.6%). Clinically, only type of epilepsy was significantly correlated to employability of PWE. Employability of PWE was associated with ability to work (indicated by education level, work performance affected by seizures, ability to travel independently and ability to cope with stress at work) and family overprotection. The high employability group was found to have lower self-perceived stigma (ESS), higher self-determined motivation (WSDI), self-esteem (SES) and perceived social support (MSPSS), than the low employability group. Logistic regression analysis showed that tertiary education level (AOR 3.42, CI: 1.46-8.00), higher self-determination (WSDI, AOR 1.09, CI: 1.012-1.17), lower family overprotection (AOR 0.76, CI: 0.61-0.95), and generalised epilepsy (AOR 4.17, CI: 1.37-12.70) were significant predictors for higher employability in PWE. CONCLUSION Ability to work (education level), clinical factor (type of epilepsy) and psychological factor (self-determined motivation and family overprotection) were important factors affecting employability in PWE.
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Chong L, Jamieson NJ, Gill D, Singh-Grewal D, Craig JC, Ju A, Hanson CS, Tong A. Children's Experiences of Epilepsy: A Systematic Review of Qualitative Studies. Pediatrics 2016; 138:peds.2016-0658. [PMID: 27511947 DOI: 10.1542/peds.2016-0658] [Citation(s) in RCA: 42] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/06/2016] [Indexed: 11/24/2022] Open
Abstract
CONTEXT Epilepsy is a common and severe neurologic disease associated with increased mortality, seizure-related injury, and adverse psychological and quality-of-life outcomes. OBJECTIVE To describe the perspectives of children and adolescents with epilepsy. DATA SOURCES Medline, Embase, PsycINFO, and CINAHL from inception to August 2015. STUDY SELECTION Qualitative studies on children's experiences of epilepsy. DATA EXTRACTION Results from primary studies. We used thematic synthesis to analyze the findings. RESULTS Forty-three articles involving 951 participants aged 3 to 21 years across 21 countries were included. We identified 6 themes: loss of bodily control (being overtaken, susceptibility to physical harm, fragility of the brain, alertness to mortality, incapacitating fatigue), loss of privacy (declarative disease, humiliating involuntary function, unwanted special attention, social embarrassment of medicine-taking), inescapable inferiority and discrimination (vulnerability to prejudice, inability to achieve academically, consciousness of abnormality, parental shame, limiting social freedom), therapeutic burden and futility (unattainable closure, financial burden, overwhelming life disruption, exhaustion from trialing therapies, insurmountable side effects, awaiting a fabled remission), navigating health care (empowerment through information, valuing empathetic and responsive care, unexpected necessity of transition, fragmented and inconsistent care), and recontextualizing to regain normality (distinguishing disease from identity, taking ownership, gaining perspective and maturity, social and spiritual connectedness). LIMITATIONS Non-English articles were excluded. CONCLUSIONS Children with epilepsy experience vulnerability, disempowerment, and discrimination. Repeated treatment failure can raise doubt about the attainment of remission. Addressing stigma, future independence, and fear of death may improve the overall well-being of children with epilepsy.
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Affiliation(s)
- Lauren Chong
- Sydney School of Public Health and Kids Research Institute
| | | | | | - Davinder Singh-Grewal
- Discipline of Paediatrics and Child Health, University of Sydney, Sydney, New South Wales, Australia; Department of General Medicine, The Children's Hospital at Westmead, Sydney, New South Wales, Australia; and School of Maternal and Child Health, University of New South Wales, Sydney, New South Wales, Australia
| | | | - Angela Ju
- Sydney School of Public Health and Kids Research Institute
| | | | - Allison Tong
- Sydney School of Public Health and Kids Research Institute,
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Kartal A, Akyıldız A. Public awareness, knowledge, and practice relating to epilepsy among adults in Konya. Epilepsy Behav 2016; 59:137-41. [PMID: 27149554 DOI: 10.1016/j.yebeh.2016.02.006] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2015] [Revised: 02/04/2016] [Accepted: 02/05/2016] [Indexed: 10/21/2022]
Abstract
INTRODUCTION This study aimed to determine the familiarity with, knowledge of, misunderstandings, and attitudes toward epilepsy among a group of Turkish adults living in Konya, an urban city in central Turkey. METHODS By using an established familiarity-knowledge-attitudes practice questionnaire, 500 randomly selected adult residents of Konya were interviewed face-to-face. Demographic and sociocultural factors that predicted negative attitudes were determined. RESULTS More than half of all participants (68.4%) reported hearing or reading about epilepsy, 44% knew someone with epilepsy, and 42.2% had witnessed a seizure. The primary source of knowledge was via relatives and friends; Negative attitudes were about marriage and inability to live alone with epilepsy (63.2% objected to marriage and 84% objected to living alone). A preconception of epilepsy being a dangerous and lifelong disease was the primary reason for negative attitudes. Predictors of negative attitudes were female gender, lower educational status, and living in a rural area. CONCLUSION Negative attitudes regarding the marital status of patients with epilepsy still exist. These may stem from misconceptions about the cause and treatability of epilepsy.
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Affiliation(s)
- Ayşe Kartal
- Department of Child Neurology, Selçuk University Faculty of Medicine, Turkey.
| | - Abdülbaki Akyıldız
- Department of Child & Adolescent Psychiatry, Süleyman Demirel University Faculty of Medicine, Turkey
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Aydemir N, Kaya B, Yıldız G, Öztura I, Baklan B. Determinants of felt stigma in epilepsy. Epilepsy Behav 2016; 58:76-80. [PMID: 27061043 DOI: 10.1016/j.yebeh.2016.03.008] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2016] [Accepted: 03/05/2016] [Indexed: 10/22/2022]
Abstract
The present study aimed to determine the level of felt stigma, overprotection, concealment, and concerns related to epilepsy in different life domains by using culturally-specific scales for Turkish individuals with epilepsy. Also, it aimed to detect relations among the study variables and to determine the variables which predict felt stigma. For this purpose, felt stigma scale, overprotection scale, concealment of epilepsy scale, and concerns of epilepsy scale were administered to two hundred adult persons with epilepsy (PWE). The results showed that almost half of the participants reported felt stigma, overprotection, concealment of epilepsy, concerns related to future occupation, and concerns related to social life. Almost all the study variables show correlations with each other. Concealment of epilepsy, concerns related to social life, and concerns related to future occupation were found as the predictors of felt stigma.
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Affiliation(s)
- N Aydemir
- Izmir University of Economics, Department of Psychology, Izmir 35330, Turkey.
| | - B Kaya
- Izmir University of Economics, Department of Psychology, Izmir 35330, Turkey
| | - G Yıldız
- Izmir University of Economics, Department of Psychology, Izmir 35330, Turkey
| | - I Öztura
- Dokuz Eylül University, School of Medicine, Department of Neurology, Izmir, Turkey
| | - B Baklan
- Dokuz Eylül University, School of Medicine, Department of Neurology, Izmir, Turkey
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Benson A, O'Toole S, Lambert V, Gallagher P, Shahwan A, Austin JK. To tell or not to tell: A systematic review of the disclosure practices of children living with epilepsy and their parents. Epilepsy Behav 2015; 51:73-95. [PMID: 26262936 DOI: 10.1016/j.yebeh.2015.07.013] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2015] [Revised: 07/04/2015] [Accepted: 07/06/2015] [Indexed: 11/18/2022]
Abstract
Disclosing an epilepsy diagnosis to others is complex due to the condition's largely invisible nature and associated stigma. Despite this, little has been documented in terms of what this process involves for children living with epilepsy (CWE) and their parents. A systematic review was conducted to examine and synthesize evidence pertaining to: (i) the disclosure practices of CWE and their parents, (ii) enablers and barriers for disclosure, (iii) the impact of disclosure practices, and (iv) the relationship between disclosure management and other variables. The electronic databases PsycINFO, PubMed, MEDLINE, CINAHL, Scopus, and Web of Science were searched systematically. Any empirical, peer-reviewed journal articles with findings reported regarding the self- or proxy-reported disclosure practices of children aged 0-18years with any type of epilepsy and/or their parents were deemed eligible for inclusion. Two review authors completed all stages of screening, data extraction, and quality assessment independently with two additional review authors resolving any discrepancies. A total of 32 articles were included in the review. Only one dated study examined disclosure as a primary focus; in the remaining studies, disclosure was a subfocus of larger studies or pertinent qualitative themes/subthemes incidentally emerged. The limited evidence suggests that: 1) CWE and parents adopt varying disclosure management strategies - from concealment to voluntary disclosure; 2) disclosure decisions are challenging for CWE and parents; 3) many barriers to disclosure exist (e.g., fear of stigmatization and rejection); 4) only a limited number of factors that enable disclosure are known (e.g., openness by others to engage with and learn about epilepsy); 5) disclosure management is significantly related to a number of variables (e.g., child/maternal perceived stigma and seizure control); and 6) there are varying outcomes for CWE and/or their parents in accordance with the adoption of specific disclosure management strategies (e.g., disclosure resulting in greater acceptance and the receipt of support or evoking anxiety/fear in others; and concealment resulting in misunderstandings, embarrassment, and stigma-coaching), but the evidence remains inconclusive in terms of which disclosure management strategy is optimal. While some preliminary work has been conducted, disclosure of epilepsy is a topic that has been largely neglected to date. This is despite the fact that disclosure is a significant source of concern for CWE and parent populations. Future studies should focus on elucidating the unique contextual factors that inform disclosure decisions in order to develop a theoretical framework that can explain the epilepsy disclosure decision-making process.
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Affiliation(s)
- A Benson
- School of Nursing and Human Sciences, Faculty of Science and Health, Dublin City University, Dublin 9, Ireland
| | - S O'Toole
- School of Nursing and Human Sciences, Faculty of Science and Health, Dublin City University, Dublin 9, Ireland
| | - V Lambert
- School of Nursing and Human Sciences, Faculty of Science and Health, Dublin City University, Dublin 9, Ireland.
| | - P Gallagher
- School of Nursing and Human Sciences, Faculty of Science and Health, Dublin City University, Dublin 9, Ireland
| | - A Shahwan
- Neurology Department, Temple Street Children's University Hospital, Temple Street, Dublin 1, Ireland
| | - J K Austin
- Indiana University School of Nursing, Indiana University-Purdue University Indianapolis, Indianapolis, IN 46202, USA
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Employability in people with epilepsy: A systematic review. Epilepsy Res 2015; 116:67-78. [DOI: 10.1016/j.eplepsyres.2015.06.016] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2015] [Revised: 06/12/2015] [Accepted: 06/23/2015] [Indexed: 11/20/2022]
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Keikelame MJ, Swartz L. 'A thing full of stories': Traditional healers' explanations of epilepsy and perspectives on collaboration with biomedical health care in Cape Town. Transcult Psychiatry 2015; 52:659-80. [PMID: 25680366 PMCID: PMC4552613 DOI: 10.1177/1363461515571626] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The experience of epilepsy is profoundly culturally mediated and the meanings attributed to the condition can have a great impact on its social course. This qualitative study used Kleinman's Explanatory Model framework to explore traditional healers' perspectives on epilepsy in an urban township in Cape Town, South Africa. The healers who participated in the study were Xhosa-speaking, had experience caring for patients with epilepsy, and had not received any training on epilepsy. Six individual in-depth interviews and one focus group with nine traditional healers were conducted using a semi-structured interview guide. Traditional healers identified several different names referring to epilepsy. They explained epilepsy as a thing inside the body which is recognized by the way it presents itself during an epileptic seizure. According to these healers, epilepsy is difficult to understand because it is not easily detectable. Their biomedical explanations of the cause of epilepsy included, among others, lack of immunizations, child asphyxia, heredity, traumatic birth injuries and dehydration. These healers believed that epilepsy could be caused by amafufunyana (evil spirits) and that biomedical doctors could not treat the supernatural causes of epilepsy. However, the healers believed that western medicines, as well as traditional medicines, could be effective in treating the epileptic seizures. Traditional healers were supportive of collaboration with western-trained practitioners and highlighted that the strategy must have formal agreements in view of protection of intellectual property, accountability and respect of their indigenous knowledge. The findings suggest a need for interventions that promote cultural literacy among mental health practitioners. Research is urgently needed to assess the impact of such collaborations between biomedical services and traditional healers on epilepsy treatment and care.
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Diet, exercise, sleep, sexual activity, and perceived stress in people with epilepsy in NE Thailand. Epilepsy Behav 2015; 45:39-43. [PMID: 25801753 DOI: 10.1016/j.yebeh.2015.02.014] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2014] [Revised: 02/07/2015] [Accepted: 02/09/2015] [Indexed: 11/21/2022]
Abstract
The aim of this study was to find out how people with epilepsy in NE Thailand feel about their levels of stress, sleep, diet, exercise habits, and sex lives using a cross-sectional design. Two hundred and three people with epilepsy (PWE) were randomly recruited from a university epilepsy clinic in Khon Kaen and then completed an interview and a questionnaire. A total of 27.6% of the patients believed that diet had an influence on their epilepsy (of those who reported changes, 41.1% stopped consuming alcohol, while 32.1% stopped drinking caffeinated beverages). A total of 47.2% of the patients exercised at least three times per week, while 52.8% exercised two times or less a week. Daytime sleeping was prevalent, with 43.3% saying that they slept during the day frequently or every day. There were 44.3% of the patients who believed that their sex lives changed after the onset of epilepsy, with decreased sexual arousal being most commonly mentioned. A total of 76.4% of the patients said that they had medium or high levels of stress, and epilepsy was listed as the most common reason for their stress (50.2%). Focusing on the problem was the most common method to reduce stress (80.3%). The findings illuminate the need to increase attention towards improving and promoting self-management of epilepsy. As a whole, diet, exercise, sleep, stress reduction, and sex therapy can be valuable tools to improve the quality of life of people with epilepsy.
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Wo MCM, Lim KS, Choo WY, Tan CT. Employability among people with uncontrolled seizures: An interpretative phenomenological approach. Epilepsy Behav 2015; 45:21-30. [PMID: 25794681 DOI: 10.1016/j.yebeh.2015.02.016] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2014] [Revised: 02/11/2015] [Accepted: 02/13/2015] [Indexed: 11/25/2022]
Abstract
PURPOSE This study aimed to explore positive and negative factors affecting the employability in patients with uncontrolled seizures. METHOD Semistructured interviews with 21 patients with uncontrolled seizures were analyzed using interpretative phenomenological analysis. RESULT Eleven (52.4%) of the participants interviewed were employed; 7 were holding full-time position with more than 4years of working experience. The mean age was 34.6years, 71.4% were female, 38% were married, 71.4% had at least 11years of education, 38% had a driving license, 19% received government monetary aid, 66.7% had seizure onset before reaching 17years of age, 66.7% experienced monthly seizures, and 76% were on polytherapy. A total of 6 main themes were found to be affecting the employability among people with uncontrolled seizures: (a) ability to work; (b) intention to work; (c) support and stigma at workplace; (d) family support, overdependence, and protection; (e) life event; and (f) government and welfare support. Subthemes under the main theme ability to work included education, cognitive and physical functions, ability to continue working after seizures, ability to travel to work, self-perceived ability to work, and ability to cope with stress. Many shared the same idea that employment is important, but their intention to work varied. The employed group tended to work for a future goal and self-satisfaction, and the unemployed group tended to have no or lack intention to work. Positive factors were noted in the following themes: ability to work; intention to work; support and stigma at workplace; and family support, overdependence, and protection. CONCLUSION There were internal and external factors affecting the employability among people with uncontrolled seizures both positively and negatively. Positive internal factors such as ability and intention to work require further exploration.
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Affiliation(s)
- Monica Chen Mun Wo
- Division of Neurology, Department of Medicine, Faculty of Medicine, University of Malaya, Malaysia
| | - Kheng Seang Lim
- Division of Neurology, Department of Medicine, Faculty of Medicine, University of Malaya, Malaysia.
| | - Wan Yuen Choo
- Department of Social Preventive Medicine, Faculty of Medicine, University of Malaya, Malaysia
| | - Chong Tin Tan
- Division of Neurology, Department of Medicine, Faculty of Medicine, University of Malaya, Malaysia
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Jacoby A. Thirty years of psychosocial research in epilepsy: personal reflections of a social scientist. Epilepsy Behav 2015; 44:245-9. [PMID: 25576126 DOI: 10.1016/j.yebeh.2014.12.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2014] [Accepted: 12/05/2014] [Indexed: 11/26/2022]
Affiliation(s)
- Ann Jacoby
- Department of Public Health and Policy, University of Liverpool, UK.
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Nabukenya AM, Matovu JKB, Wabwire-Mangen F, Wanyenze RK, Makumbi F. Health-related quality of life in epilepsy patients receiving anti-epileptic drugs at National Referral Hospitals in Uganda: a cross-sectional study. Health Qual Life Outcomes 2014; 12:49. [PMID: 24725904 PMCID: PMC3999846 DOI: 10.1186/1477-7525-12-49] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2013] [Accepted: 04/08/2014] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Epilepsy is a devastating disorder that impacts on patients' quality of life, irrespective of use of anti epileptic drugs (AEDs). This study estimates the health-related quality of life (HRQOL) and its associated predictors among epilepsy patients receiving AEDs. METHODS A total of 175 epilepsy patients already receiving AED for at least 3 months were randomly selected and interviewed from mental clinics at Mulago and Butabika national referral hospitals in Uganda between May - July 2011. A HRQOL index, the primary outcome, was constructed using items from Quality Of Life in Epilepsy Inventory (QOLIE-31) and the Hospital Anxiety and Depression Scale (HADS) questionnaires. The internal consistency and adequacy of these items was also computed using Cronbach's alpha and Kaiser-Meyer-Olkin tests. Partial correlations were used to evaluate the contribution of the health dimensions (mental, psychological, social, physical functioning and emotional well being) and, multiple linear regressions to determine factors independently associated with HRQOL. RESULTS Just about half of the respondents (54%) were males, and nearly two thirds (62%) had received AEDs for at least 12 months. The average age was 26.6 years (SD = 11.1). The overall HRQOL mean score was 58 (SD = 13) on a scale of 0-100. The average scores of different dimensions or subscales ranged from 41 (physical) to 65 (psychological). At least three quarters (75%) of all subscales had good internal consistency and adequacy. The largest variations in the overall HRQOL were explained by social and mental functioning; each accounting for about 30% of the difference in the HRQOL but seizure control features explained a little (6%) variation. Factors negatively associated with HRQOL were poly-therapy (-1.16, p = 0.01) and frequency of seizures (-2.29, p = 0.00). Other factors associated with overall HRQOL included drug side effects, sex, marital status and education. Duration on AEDs was not a significant predictor of HRQOL. CONCLUSION The HRQOL for epilepsy patients on AEDs is very low. The predictors of low HRQOL were socio factors (marital status, education) and drug side effects, frequency of seizure, and type of therapy.
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Affiliation(s)
- Anne M Nabukenya
- MakSPH-CDC Fellowship Program, Makerere University School of Public Health, P,O, Box 7072, Kampala, Uganda.
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Seizure-related vehicular crashes and falls with injuries for people with epilepsy (PWE) in northeastern Thailand. Epilepsy Behav 2014; 32:49-54. [PMID: 24480154 DOI: 10.1016/j.yebeh.2013.12.021] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2013] [Revised: 12/16/2013] [Accepted: 12/21/2013] [Indexed: 11/23/2022]
Abstract
This cross-sectional study aimed to determine the number and types of falls and vehicular crashes with injuries , as well as some specific behavioral associations in people with epilepsy (PWE) in northeastern Thailand. Two hundred and three patients with epilepsy were randomly recruited from the university epilepsy clinic in Khon Kaen, who then completed an interview and a questionnaire. It was found that 84.5% of the patients were operating a vehicle on a regular basis (more than 3days a week), and 21.6% of those had been in a vehicle crash. Additionally, 25.6% of the patients had been involved in falls with injuries. Forty-three percent of the respondents had been involved in either a vehicular crash or a fall with an injury, with 39.7% of the accidents resulting in moderate to severe injuries. Medication compliance was estimated at 66%, while 59.1% said that they had little or no control over their seizures, and more than half the patients did not feel confident about their ability to take care of themselves or to take their antiepileptic drugs (AEDs) properly. In a multivariate model, the following factors significantly increased the risk of being in either a vehicular crash or a fall with an injury: being single, attaining a secondary or higher education, exercising at least three times a week, napping every day or more frequently, and having poor seizure control. The results of this study suggest that patients' poor medication adherence and lack of confidence in managing their seizures may contribute to accidents. Patients with epilepsy should be counseled to seek less risky behaviors and try to attend classes that provide education on AED management.
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Hosseini N, Sharif F, Ahmadi F, Zare M. Patients' perception of epilepsy and threat to self-identity: a qualitative approach. Epilepsy Behav 2013; 29:228-33. [PMID: 23995695 DOI: 10.1016/j.yebeh.2013.06.003] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2013] [Accepted: 06/03/2013] [Indexed: 10/26/2022]
Abstract
INTRODUCTION A clinical diagnosis of epilepsy often carries a silent social stigma and is associated with metaphysical forces. This qualitative study aimed to explore the Iranian patients' perception of epilepsy where clinical aspects are more benign than the social implications with long-term psychological consequences. Historically, epilepsy has been known as a form of insanity, madness, sorcery, and possession by evil spirits. METHOD Thirty participants consisting of 21 patients with epilepsy, 5 family members, and 4 medical staff were selected from urban and rural medical and health care centers, hospitals, physician offices, outpatient clinics, and the Iranian Epilepsy Association. Unstructured and semistructured interviews were applied to obtain data. Transcribed interviews and field notes were analyzed using qualitative content analysis method. FINDINGS Categories and subcategories emerged from the participants' perceptions of epilepsy and its disruptive effects on their self-identity. The main categories derived from data were 1) a different perspective about epilepsy, 2) self-debasement, and 3) being a burden. The major theme found in this study was "identity loss". CONCLUSION Our study results highlight the importance of public awareness among community members and healthcare professionals on how patients with epilepsy experience their disease with psychosocial implications. Understanding patients' perspectives can be essential to developing a comprehensive and holistic care plan for patients with epilepsy and addressing their multidimensional needs.
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Affiliation(s)
- Nazafarin Hosseini
- Social Determinants of Health Research Center, Faculty of Nursing, Yasuj University of Medical Sciences, Yasuj, Iran
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Saengsuwan J, Laohasiriwong W, Boonyaleepan S, Sawanyawisuth K, Tiamkao S. Knowledge, attitudes, and care techniques of caregivers of PWE in northeastern Thailand. Epilepsy Behav 2013; 27:257-63. [PMID: 23453636 DOI: 10.1016/j.yebeh.2013.01.014] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2012] [Revised: 01/08/2013] [Accepted: 01/12/2013] [Indexed: 10/27/2022]
Abstract
Caregivers of persons with epilepsy (PWEs) in developing countries do not always have access to correct information related to the affliction of the patients they are entrusted to care for. Epilepsy can be difficult to manage for all those involved, whether it is a family member, the PWEs themselves, or the caregiver. Misconceptions are common about epilepsy, especially in undeveloped countries where a majority of the population have lower educational levels. This study aims to acquire baseline data about caregivers of PWEs related to their knowledge, attitudes, and methods of giving care to PWEs. A cross-sectional survey was administered to 83 PWE caregivers at a university epilepsy clinic in northeastern Thailand. The caregivers believed that knowledge about epilepsy was paramount; however, they felt that their own knowledge of the condition was insufficient. Educational level, relationship to the PWEs, and sex were correlated to various aspects related to epilepsy knowledge and attitudes in caregivers. A slight negative correlation was found between caregiver knowledge and attitudes toward epilepsy with Pearson's correlation coefficient (r=-0.38, P-value 0.001). Education and improved epilepsy information need to be provided to the caregivers of PWEs in northeastern Thailand.
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Toli T, Sourtzi P, Tsoumakas K, Kalokerinou-Anagnostopoulou A. Association between knowledge and attitudes of educators towards epilepsy and the risk of accidents in Greek schools. Epilepsy Behav 2013; 27:200-3. [PMID: 23474533 DOI: 10.1016/j.yebeh.2013.01.010] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2012] [Revised: 01/08/2013] [Accepted: 01/10/2013] [Indexed: 11/16/2022]
Abstract
Accidents in children with epilepsy are an actual concern of teachers and parents in Greece and internationally. The aim of this study was to investigate the relationship between the knowledge and attitudes of teachers and the frequency of accidents caused by epilepsy in Greece. The study surveyed 1404 public elementary school teachers from all prefectures of the country by an anonymous questionnaire. Results showed that teachers cannot always recognize the manifestations of an epileptic seizure or an injury caused by it, making it difficult for them to report such incidents, and, sometimes, they use wrong or even dangerous manipulations during seizures. Furthermore, the knowledge and attitudes of teachers were associated with the occurrence of accidents. It is, therefore, of major importance that the responsible authorities provide teachers with appropriate guidelines to respond to such incidents, especially in schools where a school nurse is not present.
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Affiliation(s)
- Theodora Toli
- Department of Public Health, Faculty of Nursing, University of Athens, Greece.
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Saengsuwan J, Boonyaleepan S, Srijakkot J, Sawanyawisuth K, Tiamkao S. Factors associated with knowledge and attitudes in persons with epilepsy. Epilepsy Behav 2012; 24:23-9. [PMID: 22503426 DOI: 10.1016/j.yebeh.2012.03.006] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2012] [Revised: 03/05/2012] [Accepted: 03/06/2012] [Indexed: 11/28/2022]
Abstract
Treating persons with epilepsy (PWE) in developing countries may be different from elsewhere. Knowledge and attitudes of PWE are known to be associated with seizure control. This study aims to evaluate factors related with the knowledge and attitudes of PWE in northeastern Thailand. A cross-sectional survey using questionnaires and interviews was undertaken at the Khon Kaen University epilepsy clinic. The questionnaire comprised 22 questions (14 knowledge questions and 8 attitude questions). Two hundred three PWE participated in the study with a mean age of 36.5 years. Four factors were significantly associated with the knowledge about epilepsy, which included education level, age, epilepsy duration, and a history of experiencing antiepileptic medication side effects. In addition, there were four factors significantly associated with the attitudes about epilepsy, which included seizure control, education level, epilepsy duration, and marital status. There is a need to provide more education, preferably community based, to help PWE obtain more accurate information.
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Thomas SV, Nair A. Confronting the stigma of epilepsy. Ann Indian Acad Neurol 2011; 14:158-63. [PMID: 22028525 PMCID: PMC3200035 DOI: 10.4103/0972-2327.85873] [Citation(s) in RCA: 54] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2011] [Revised: 05/17/2011] [Accepted: 09/08/2011] [Indexed: 11/04/2022] Open
Abstract
Stigma and resultant psychosocial issues are major hurdles that people with epilepsy confront in their daily life. People with epilepsy, particularly women, living in economically weak countries are often ill equipped to handle the stigma that they experience at multiple levels. This paper offers a systematic review of the research on stigma from sociology and social psychology and details how stigma linked to epilepsy or similar conditions can result in stereotyping, prejudice and discrimination. We also briefly discuss the strategies that are most commonly utilized to mitigate stigma. Neurologists and other health care providers, social workers, support groups and policy makers working with epilepsy need to have a deep understanding of the social and cultural perceptions of epilepsy and the related stigma. It is necessary that societies establish unique determinants of stigma and set up appropriate strategies to mitigate stigma and facilitate the complete inclusion of people with epilepsy as well as mitigating any existing discrimination.
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Affiliation(s)
- Sanjeev V Thomas
- Department of Neurology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, India
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Aydemir N, Özkara Ç, Ünsal P, Canbeyli R. A comparative study of health related quality of life, psychological well-being, impact of illness and stigma in epilepsy and migraine. Seizure 2011; 20:679-85. [DOI: 10.1016/j.seizure.2011.06.017] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2011] [Revised: 06/23/2011] [Accepted: 06/25/2011] [Indexed: 10/17/2022] Open
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Yang R, Wang W, Snape D, Chen G, Zhang L, Wu J, Baker GA, Zheng X, Jacoby A. Stigma of people with epilepsy in China: views of health professionals, teachers, employers, and community leaders. Epilepsy Behav 2011; 21:261-6. [PMID: 21606005 PMCID: PMC3127044 DOI: 10.1016/j.yebeh.2011.04.001] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2011] [Revised: 03/30/2011] [Accepted: 04/01/2011] [Indexed: 11/24/2022]
Abstract
To identify possible sources of stigma of epilepsy in key informant groups, "mini-ethnographic" studies were conducted in rural and urban locations in China. Data collected from 45 semistructured interviews and 8 focus group discussions (6 persons each) were analyzed to investigate the world experienced by people with epilepsy. Underpinned by a social constructionist approach to data analysis, emerging themes were identified with the use of computer-assisted data analysis (NVivo 8). A hierarchical model was then constructed, to include practical level issues (attitudes toward risk, attitudes toward costs of epilepsy) and cultural level issues (contrast between rurality and tradition and urbanization and modernity in the Chinese context). The analysis enriches current research on factors and sources of stigma of epilepsy and highlights issues for future practice.
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Affiliation(s)
- Rongrong Yang
- Institute of Population Research, Peking University, China
| | - Wenzhi Wang
- Department of Neuroepidemiology, Beijing Neurosurgical Institute, Beijing, China
| | - Dee Snape
- Institute of Psychology, Health and Society, University of Liverpool, UK
| | - Gong Chen
- Institute of Population Research, Peking University, China
| | - Lei Zhang
- Institute of Population Research, Peking University, China
| | | | - Gus A Baker
- Division of Neurosciences, University of Liverpool, UK
| | - Xiaoying Zheng
- Institute of Population Research, Peking University, China,Corresponding Authors, Xiaoying Zheng, PhD, MD, Institute of Population Research/WHO Collaborating Centre, Peking University, Beijing 100871, China, , Telephone: 0086 10 62759185, Facsimile: 0086 10 62751974, Ann Jacoby, PhD, Department of Health Inequalities and the Social Determinants of Health, Institute of Psychology, Health and Society, Whelan Building, The Quadrangle, Brownlow Hill, Liverpool, UK, L69 3GB, , Telephone: 0044 151 794 5602/5943, Facsimile: 0044 151 794 5588
| | - Ann Jacoby
- Institute of Psychology, Health and Society, University of Liverpool, UK,Corresponding Authors, Xiaoying Zheng, PhD, MD, Institute of Population Research/WHO Collaborating Centre, Peking University, Beijing 100871, China, , Telephone: 0086 10 62759185, Facsimile: 0086 10 62751974, Ann Jacoby, PhD, Department of Health Inequalities and the Social Determinants of Health, Institute of Psychology, Health and Society, Whelan Building, The Quadrangle, Brownlow Hill, Liverpool, UK, L69 3GB, , Telephone: 0044 151 794 5602/5943, Facsimile: 0044 151 794 5588
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Aydemir N. Familiarity with, knowledge of, and attitudes toward epilepsy in Turkey. Epilepsy Behav 2011; 20:286-90. [PMID: 21277263 DOI: 10.1016/j.yebeh.2010.09.030] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/20/2010] [Accepted: 09/23/2010] [Indexed: 10/18/2022]
Abstract
The aims of the study described here were to investigate familiarity with, knowledge of, and attitudes toward epilepsy and to assess indicators of positive attitudes toward epilepsy. Questionnaires previously developed for the Turkish population were used to assess knowledge and attitudes. Data were collected from 1354 randomly selected adults. Three-quarters of the sample had heard something about epilepsy, and almost half of the sample personally knew someone with epilepsy. The sample had a moderate level of knowledge of and favorable attitudes toward epilepsy in general. Variables that predicted positive attitudes were young age, male gender, and high level of knowledge of epilepsy. The results for both knowledge and attitudes indicate that the findings of the study are largely in line with previous studies, but where there is wide variability among previous findings, the findings for the Turkish population lie, just as Turkey does geographically, between those of the East and West.
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Affiliation(s)
- Nuran Aydemir
- Department of Psychology, Izmir University of Economics, Izmir, Turkey.
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