Knowledge, attitude and traditional practices towards epilepsy among relatives of PWE (patients with epilepsy) in Marrakesh, Morocco

The experiences of caregivers of children with epilepsy: A meta-synthesis of qualitative research studies

Objective

Epilepsy is one of the most common chronic neurological disorders in children. The caregivers of these children bear heavy burden of care in the process of taking care of them. The objective of this metasynthesis was to explore the experiences and needs of caregivers of children with epilepsy.

Methods and data sources

Eight databases (PubMed, CINAHL, EMBASE, Web of Science, CNKI, Wanfang Data, VIP database, and CBM) were searched for qualitative studies from each database's inception to 31 June 2021. Studies were critically appraised using the Joanna Briggs Institute (JBI) Critical Appraisal Checklist for Qualitative Research. Qualitative data were extracted, summarized, and meta-synthesized.

Results

13 studies were included, covering the data of 316 participants. 36 research results were extracted from these studies, which were combined into 11 categories, and finally formed 4 themes: (a) heavy burden of care; (b) emotional experience; (c) coping strategies; (d) care needs.

Conclusion

Caregivers beared a heavy burden of care and psychological burden. Despite the adoption of different coping strategies, their emotional distress was still very serious. Caregivers had unmet care needs. In order to improve caregivers' care capacity, the society and healthcare workers need to provide them with information support, psychological support, and take measures to create a friendly medical and living environment for them.

Impact

Understanding the experiences of caregivers of children with epilepsy will inform future research and practice. Healthcare workers could develop interventions to reduce caregiver burden and improve the level of caregivers' mental health. On the other hand, effective programs should be designed to improve caregivers' knowledge of the disease and enhance their ability to care. Society needs to take steps to improve the medical environment and the social stigma that is not friendly to 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.

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

INTRODUCTION

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

METHODS

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

RESULTS

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

CONCLUSION

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

Epilepsy Websites in Africa: State of the Art

Purpose

Epilepsy is one of the main brain disorders in the world and should be considered a priority for healthcare in Africa. Internet is a growing source of health information for healthcare and patients with epilepsy (PWEs). In this short communication, we tried to describe the status of websites on epilepsy in Africa in terms of availability and pertinence, and to suggest ideas on how to make them more effective.

Methods

The existence of epilepsy websites and their distribution in Africa were acquired using a questionnaire sent to different neurologists in the African continent.

Results

Based on the survey answers and the web search, our results show that out of 54 African countries, only 16 countries (≈30%) have an active epilepsy website.

Conclusion

The need for reliable, clearly written, and easily comprehended information about epilepsy is considered as an important element to enhance the quality of care, for this all African countries should create and improve their epilepsy websites in order to promote education and awareness.