Parents of children with epilepsy: Characteristics associated with high and low levels of health literacy

Health Literacy and Self-Efficacy in Parents of Toddlers-A Cross-Sectional Study

AIM

Young children depend on their parents to develop in a positive and healthy way. For parents to promote and maintain good health for their children, parent's level of health literacy and self-efficacy is important. The aim of this study was to explore health literacy in parents of toddlers and investigated the associations between parental health literacy and self-efficacy.

DESIGN

The study utilised a quantitative cross-sectional design.

METHOD

Parents (N = 76) with children between the ages of 6 weeks and 12 months were recruited from a public health centre in Norway. Multidimensional health literacy was measured using the Health Literacy Questionnaire-Parent version while self-efficacy was measured using the General Self-Efficacy Scale. The health literacy domains are presented by descriptive analysis. The associations among health literacy domains, demographic variables and self-efficacy were analysed using bivariate correlations and non-parametric tests.

RESULTS

Health literacy scores were overall high, and self-efficacy was positively associated with all nine health literacy dimensions. The highest score of health literacy was found for the feel that healthcare providers understand and support my child's situation dimension (median 3.8 with interquartile range 3.3-4.0). The lowest scores of health literacy were found for the appraisal of health information dimension (median 3.2 with interquartile range 3.0-3.8). Self-efficacy had a score of median 3.5 with interquartile range 3.2-3.7.

CONCLUSION

The parents of toddlers in this study had high parental health literacy and self-efficacy. Self-efficacy was positively associated with all nine health literacy constructs. Future research should include multiple measure points to assess the dynamic variation on both parental health literacy, self-efficacy and demographic variables.

PATIENT OR PUBLIC CONTRIBUTION

No patient or public contribution.

Improving the health literacy of persons with epilepsy

Improving health literacy can improve health. This essay reviews the resources available to help improve epilepsy health literacy, including websites, drug inserts/labels/information leaflets, patient educators, handouts, plain language, lay summaries, and other efforts to close the gaps between research and epilepsy health literacy.

Meeting Parents' Health Literacy Needs-Designing and Feasibility Testing of a Three-Step Intervention in the Childhood Epilepsy Context

AIMS

(1) To codesign a health literacy intervention within a specialist healthcare setting to help the parents of children with epilepsy access, comprehend, use and communicate information and (2) to assess the intervention's feasibility by exploring stakeholders' perspectives on its usefulness, ease of use of trial methods and contextual factors impacting its execution.

DESIGN

A codesign participatory approach followed by a feasibility approach inspired by the OPtimising HEalth LIteracy and Access to Health Services (Ophelia) process for health literacy intervention development.

METHODS

(1) The codesign approach included workshops with (a) multidisciplinary personnel (n = 9) and (b) parents (n = 12), along with (c) an interview with one regional epilepsy specialist nurse (n = 1). The participants discussed parents' health literacy needs on the basis of vignettes and brainstormed service improvements. A three-step intervention was subsequently designed. (2) The intervention's feasibility was assessed via interviews with six parents (n = 6), a focus group interview with study nurses, a short doctors survey and a log of time spent testing the intervention.

RESULTS

(1) The parents of first-time admitted children to a specialist epilepsy hospital were targeted for the intervention. Nurse-parent consultations were central to the intervention, activating parents in codeveloping and executing a tailored education plan. (2) Feasibility: parents (n = 6) experienced consultations and education plans that were beneficial for enhancing their self-efficacy in managing the child's condition. The study nurses (n = 3) acknowledged positive outcomes in streamlining patient education but felt that their training on the intervention methods was insufficient. Both parents and nurses identified limited personnel resources as a significant barrier to executing the intervention.

CONCLUSION

The codesigned intervention engaged nurses and parents in HL development despite system barriers. The parents experience enhanced self-efficacy in managing their child's condition. However, needs refinements and further feasibility tests are needed before future implementation.

REPORTING METHOD

The Consort Statement 2010 extension for reporting non-randomised pilot and feasibility studies was used to ensure the methodological quality of the study. A Consort Statement 2010 checklist is provided as an additional file.

PATIENT OR PUBLIC CONTRIBUTION

The collaboration of parents within the target group, the providers involved and the project's steering committee was crucial in codesigning and evaluating this three-step intervention. Parents and multidisciplinary providers actively contributed through workshops, interviews and in discussion meetings. The study nurses testing the intervention played a key role in defining the documentation process for the codeveloped education plan.

IMPLICATIONS FOR PROFESSIONAL CARE

This three-step health literacy intervention can positively impact parents' self-efficacy in managing their child's condition. Enhancing nurses' communication skills is essential for improving parents' health literacy, making it crucial to allocate resources for such training. The intervention content and strategies to meet parents' health literacy needs require refinement, with more provider involvement to better adapt it to the context. Future studies should focus on further feasibility testing by considering a more flexible time frame.

TRIAL REGISTRATION

Open Science Framework: https://osf.io/fg9c7/.

Health literacy in parents of children with Hirschsprung disease: a novel study

PURPOSE

To explore health literacy (HL) among parents of children with Hirschsprung disease (HD).

METHODS

Norwegian-speaking parents of children under 16 who underwent HD surgery at a tertiary center were surveyed using the Health Literacy Questionnaire-Parent, electronic Health Literacy Scale, General Self-efficacy Scale, and a study-specific questionnaire. Demographics were collected and ethical approval was obtained.

RESULTS

Among 132 parents (77 mothers) of 91 children (median age 8 years), high HL scores appeared in the domains "understanding health information" and "active engagement", with lower scores in "provider support", "health information appraisal", and "social support". Higher HL correlated with parents aged over 40 and higher education. Lower scores were seen with non-exclusive Norwegian use at home and not living with the child's other parent. High electronic HL scores were common (mean 3.6, maximum score 5). 69% had high self-efficacy scores (score > 2, maximum score 4). Self-efficacy correlated strongly with higher HL scores.

CONCLUSION

Parents of children with HD feel healthcare providers lack understanding of their child's challenges, experience limited social support and struggle with interpreting health information. We suggest targeted HL interventions for young, lower-educated, non-cohabitating parents and those not primarily speaking the official language at home.

Health literacy and rational drug use attitudes in parents of children with epilepsy

PURPOSE

Understanding parental attitudes and health literacy is crucial for promoting safe and effective medication use, which is pivotal in managing epilepsy, a condition requiring consistent and informed treatment decisions. So, this study aimed to determine the impact of health literacy among parents of children with epilepsy on their attitudes towards rational drug use.

METHOD

This study, conducted at a university hospital's Child Neurology Outpatient Clinic in Konya, Turkey from May to December 2023, employed a descriptive research design involving 234 parents of children with epilepsy who attended routine check-ups during this period. Data collection utilized a Demographic Information Form, the Parental Attitude Scale towards Rational Drug Use, and the Health Literacy Scale, analyzed using IBM SPSS Statistics Standard Concurrent User V 25. Analytical methods included descriptive statistics (number, percentage, mean, standard deviation, median, minimum, maximum), as well as One-Way ANOVA, Independent-Sample T Test, Correlation, and Linear Regression (Enter method), with statistical significance set at p < 0.05.

RESULTS

It was determined that 67.1 % of the parents participating in the study were female, with a mean age of 35.85 ± 0.47 years, and the average age of the children was 7.93 ± 4.78 years. It was found that 66.7 % consult a doctor first about the medications they use and health concerns, 97 % do not use medication for their children without a doctor's prescription, and of those who do use non-prescription medication, 32.9 % administer antipyretics. The average total score of the Health Literacy Scale was moderate (43.17 ± 10.99), and the average total score of the Parental Attitude Scale towards Rational Drug Use was high (164.09 ± 32.09). Parental education level, occupation, and income status variables showed statistically significant differences in health literacy and attitudes towards rational drug use. Additionally, a moderately significant positive correlation was found between parents' health literacy and their attitudes towards rational drug use.

CONCLUSION

This study underscores the critical influence of health literacy on parental attitudes towards rational drug use in children with epilepsy, emphasizing responsible healthcare decision-making. It advocates for tailored interventions to enhance health literacy among parents, aiming to foster safer medication practices and improved health outcomes for children with epilepsy.

Teachers' Negative Attitudes and Limited Health Literacy Levels as Risks for Low Awareness of Epilepsy in Turkey

OBJECTIVES

For students with epilepsy, schools are a critical environment for managing the disease properly. This study examined awareness of epilepsy, attitudes toward epilepsy, and health literacy among school teachers in Turkey.

METHODS

This study was conducted in a city in Turkey with 1408 public school teachers from June 2021 to September 2021.

RESULTS

The median scores of the scales were 5, 29, and 32 for epilepsy awareness, epilepsy attitudes, and health literacy, respectively. Epilepsy awareness was higher in women, and epilepsy attitudes were more positive in women than men (p<0.05). While epilepsy awareness was higher in primary school teachers, epilepsy attitudes were more positive in secondary school teachers (p<0.05). Epilepsy awareness was lower in secondary school teachers (odds ratio [OR], 1.27; p<0.05), those who did not have an individual with epilepsy in their family/social environment (OR, 1.57; p<0.001), those who did not have a student with epilepsy in their class (OR, 1.45; p<0.05), and in those who had not witnessed an epilepsy seizure (OR,1.19; p<0.05). Compared to those with positive attitudes regarding epilepsy, epilepsy awareness was 1.36 times lower in those with negative attitudes (p<0.001). Epilepsy awareness was 1.92 times lower in those with limited health literacy than those with adequate health literacy (p<0.001).

CONCLUSIONS

In this study, low epilepsy awareness, negative epilepsy attitudes, and limited health literacy were common among teachers. The findings from this study suggest that panels, workshops, and health training on epilepsy should be organized for school teachers and included at regular intervals in certified first-aid practices.

Developing and maintaining health literacy: A continuous emotional, cognitive, and social process for parents of children with epilepsy-A qualitative study

Childhood epilepsy is often complicated by neurobehavioral comorbidities, and parents are expected to actively engage in managing the condition. Insufficient parental health literacy (HL) has been associated with reduced health outcomes for children with epilepsy. Little is known about the parents' experiences of information seeking, social support, navigating the healthcare system, and interactions with healthcare professionals and how these skills may contribute to the development of sufficient HL. This study explored parents' experiences of their caregiver responsibility and the development of their HL in relation to caring for their child with epilepsy. Ten parents of children under 12 years of age with epilepsy were purposedly sampled and interviewed individually, using semi-structured interviews. The interviews were analyzed using qualitative content analysis, in line with Graneheim & Lundman. The analyses resulted in three themes, each comprising two sub-themes. The themes were: (1) Alone with the responsibility, (2) The combat for information and support, and (3) Developing vigilance and distrust in system competence. Lack of flexibility in healthcare services, insufficient multidisciplinary collaboration, and unclear treatment provider responsibility made the parents feel alone in the caregiver's responsibility. Poor local provider competence related to childhood epilepsy was a barrier to developing sufficient HL. A trusting relationship with professionals and timely access to competent health services were facilitators for developing HL. Higher HL made the parents more critical for the healthcare services, which triggered vigilance and reduced their trust in the professionals' information. For the parents, developing and maintaining HL was a continuous emotional, cognitive, and social process. Health information and care support need to be adjusted to the severity of the child's condition, the resources are available, and the parent's HL. The results of this study may contribute to the development of future interventions for strengthening parental HL in the childhood epilepsy context.