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Lang J, Jeschke S, Müller RM, Herziger B, Bertsche T, Neininger MP, Bertsche A. Knowledge and attitudes towards epilepsy: A survey of people with epilepsy. Epilepsy Res 2022; 184:106964. [PMID: 35691219 DOI: 10.1016/j.eplepsyres.2022.106964] [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: 03/27/2022] [Revised: 05/18/2022] [Accepted: 06/02/2022] [Indexed: 11/19/2022]
Abstract
PROBLEM Many studies focus on knowledge and attitudes of unaffected people towards epilepsy and people with epilepsy (PWE). The perspective of PWE themselves is much less explored. METHODS We invited PWE in Germany to answer a questionnaire on their knowledge and attitudes towards epilepsy and PWE. RESULTS The questionnaire was completed by 230 PWE (median age: 40 years; min./max.: 19/83; 66 % female). Of PWE, 22 % thought that PWE are more helpful, and 10 % thought that PWE are friendlier than other people. Nevertheless, reservations about relationships and friendships with other PWE existed: of the participants, only 74 % would definitely go on a date with another PWE, and 90 % would definitely include another PWE they liked into their circle of friends. Swimming was judged as more dangerous for PWE than for healthy people by 71 % of PWE. Of PWE, 86 % correctly assumed it was not useful to hold a person having a seizure to the ground. Putting a solid object in the mouth was considered not useful by 85 % of PWE. Of PWE, 20 % would definitely administer an available emergency medication if another PWE had a seizure. For 67 % of PWE, certain preconditions should have to be fulfilled such as an available document with instructions. Of PWE, 11 % stated they would not administer an available emergency medication if another PWE had a seizure. CONCLUSION Although positive attitudes of PWE towards other PWE exist, we also found some reservations calling for psychosocial support. Most PWE had sufficient knowledge about risks of certain activities and about measures to be taken during a seizure. Nevertheless, a small group of PWE showed knowledge gaps. Thus, educational support still seems essential.
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Affiliation(s)
- J Lang
- Neuropaediatrics, University Hospital for Children and Adolescents, Ernst-Heydemann-Straße 8, Rostock 18057, Germany.
| | - S Jeschke
- Neuropaediatrics, University Hospital for Children and Adolescents, Ernst-Heydemann-Straße 8, Rostock 18057, Germany.
| | - R M Müller
- Neuropaediatrics, University Hospital for Children and Adolescents, Ernst-Heydemann-Straße 8, Rostock 18057, Germany.
| | - B Herziger
- Neuropaediatrics, University Hospital for Children and Adolescents, Ernst-Heydemann-Straße 8, Rostock 18057, Germany.
| | - T Bertsche
- Clinical Pharmacy, Institute of Pharmacy, Medical Faculty, Leipzig University, and Drug Safety Center, Leipzig University and Leipzig University Hospital, Bruederstrasse 32, Leipzig 04103, Germany.
| | - M P Neininger
- Clinical Pharmacy, Institute of Pharmacy, Medical Faculty, Leipzig University, and Drug Safety Center, Leipzig University and Leipzig University Hospital, Bruederstrasse 32, Leipzig 04103, Germany.
| | - A Bertsche
- Neuropaediatrics, University Hospital for Children and Adolescents, Ernst-Heydemann-Straße 8, Rostock 18057, Germany.
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Zhang Q, Li W, Li E, Yang X, Hao N, Yan B, Zhou D, Hao X. Disease awareness and dietary habits of patients with epilepsy in western China: a cross-sectional study. ACTA EPILEPTOLOGICA 2021. [DOI: 10.1186/s42494-021-00065-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
The optimal management of epilepsy includes engaging patients through education on knowledge of the disease, its treatment and diet control.
Methods
This was a cross-sectional survey-based cohort study, aimed to investigate the awareness of epilepsy in Chinese patients and to understand their dietary habits. Participants were consecutively enrolled from epileptic patients treated in a single epilepsy center from October 1, 2019 to February 29, 2020. A self-reported questionnaire (Cronbach’s α = 0.758) consisting of 3 parts was sent to 407 patients with epilepsy. The questionnaire included items on demographic information, epilepsy features, awareness of epilepsy treatment and dietary habits.
Results
About half of the patients (53.8%, 219/407) thought epilepsy was curable and only 80% knew that the first choice of treatment is medication. While 58.6% of the patients with low educational level preferred the use of antiepileptic drugs (p = 0.014), 52.7% believed that the medication should not be stopped immediately after seizure control (p = 0.026), especially after surgery (40.5%, p = 0.011). Patients with lower household monthly incomes had less awareness of the use of antiepileptic drugs than patients with higher incomes: only 39.2 and 49.8% of patients with lower incomes thought that the drugs could be stopped after epilepsy surgery or seizure control, respectively, compared to 51.6 and 66.1% with higher incomes. Alcohol (86.2%), caffeine (56.8%) and strong tea (49.1%) were top three foods considered by the patients to be avoided to prevent seizures. Approximately 30.2% of patients identified at least one food that made them susceptible to seizures.
Conclusions
Patient education on epilepsy, antiepileptic drugs and diet for management of seizures should be provided especially to patients with less education, lower income or inaccurate beliefs of epilepsy in Western China.
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Schwab C, Wadle NE, Knake S, von Podewils F, Siebenbrodt K, Kohlhase K, Schulz J, Menzler K, Mann C, Rosenow F, Seifart C, Strzelczyk A. Patients' knowledge about epilepsy-related risks, morbidity, and mortality: A multicenter cohort study from Germany. Epilepsy Behav 2021; 124:108343. [PMID: 34619541 DOI: 10.1016/j.yebeh.2021.108343] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2021] [Revised: 09/10/2021] [Accepted: 09/13/2021] [Indexed: 11/21/2022]
Abstract
INTRODUCTION Patient education is a central component of quality care. Enhancing patient knowledge can improve patients' quality of life and facilitate successful self-management. We sought to identify patients' knowledge levels and knowledge gaps regarding epilepsy-related risks, morbidity, and mortality. METHODS Adult patients with epilepsy presenting to the university hospitals in Frankfurt, Greifswald, and Marburg between February 2018 and May 2020 were asked to participate in this questionnaire-based study. RESULTS A total of 238 patients (52% women), with a mean age of 39.2 years (range: 18-77 years), participated in this study. Spontaneously, the majority of patients (51.3%) named driving a car, and other traffic-related accidents as possible causes of morbidity and mortality, and 23.9% of patients reported various causes of premature death, such as suffocation, drowning, and respiratory or cardiac arrest due to seizures. Falls due to epilepsy (19.7%) and injuries in general (17.6%) were named as further causes of morbidity and mortality. The vast majority were aware that alcohol (87.4%), sleep deprivation (86.6%), and risky activities in daily life (80.3%) increased the risk of seizure occurrence or increased morbidity and mortality. Regarding overall mortality, 52.1% thought that people with epilepsy were at greater risk of premature death, whereas 46.2% denied this fact to be true. Only 29.4% were aware of status epilepticus, and 27.3% were aware of sudden unexpected death in epilepsy (SUDEP). Driving ability, working ability, and seizure risk were named as major or moderate concerns among patients, but the risk of premature mortality was not a major concern. One-quarter of all patients (26.9%) indicated that they were not counseled about any risk factors or causes of morbidity or mortality by their physicians. CONCLUSIONS A lack of knowledge concerning premature mortality, SUDEP, and status epilepticus exists among adult patients with epilepsy. A substantial number of patients indicated that these issues were not discussed adequately by their physicians.
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Affiliation(s)
- Christina Schwab
- Epilepsy Center Frankfurt Rhine-Main, Department of Neurology, Goethe-University Frankfurt, Frankfurt am Main, Germany
| | - Nora-Elena Wadle
- Epilepsy Center Frankfurt Rhine-Main, Department of Neurology, Goethe-University Frankfurt, Frankfurt am Main, Germany
| | - Susanne Knake
- Epilepsy Center Hessen and Department of Neurology, Philipps-University Marburg, Marburg (Lahn), Germany
| | - Felix von Podewils
- Epilepsy Center and Department of Neurology, University of Greifswald, Greifswald, Germany
| | - Kai Siebenbrodt
- Epilepsy Center Frankfurt Rhine-Main, Department of Neurology, Goethe-University Frankfurt, Frankfurt am Main, Germany
| | - Konstantin Kohlhase
- Epilepsy Center Frankfurt Rhine-Main, Department of Neurology, Goethe-University Frankfurt, Frankfurt am Main, Germany
| | - Juliane Schulz
- Epilepsy Center and Department of Neurology, University of Greifswald, Greifswald, Germany
| | - Katja Menzler
- Epilepsy Center Hessen and Department of Neurology, Philipps-University Marburg, Marburg (Lahn), Germany
| | - Catrin Mann
- Epilepsy Center Frankfurt Rhine-Main, Department of Neurology, Goethe-University Frankfurt, Frankfurt am Main, Germany
| | - Felix Rosenow
- Epilepsy Center Frankfurt Rhine-Main, Department of Neurology, Goethe-University Frankfurt, Frankfurt am Main, Germany
| | - Carola Seifart
- Institutional Review Board, Medical Faculty, Philipps-University Marburg, Marburg (Lahn), Germany
| | - Adam Strzelczyk
- Epilepsy Center Frankfurt Rhine-Main, Department of Neurology, Goethe-University Frankfurt, Frankfurt am Main, Germany; Epilepsy Center Hessen and Department of Neurology, Philipps-University Marburg, Marburg (Lahn), Germany.
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Choi SA, Lim K, Baek H, Yoo S, Cho A, Kim H, Hwang H, Kim KJ. Impact of mobile health application on data collection and self-management of epilepsy. Epilepsy Behav 2021; 119:107982. [PMID: 33946011 DOI: 10.1016/j.yebeh.2021.107982] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Revised: 02/12/2021] [Accepted: 04/05/2021] [Indexed: 12/22/2022]
Abstract
Recent advances in mobile health have enabled health data collection, which includes seizure and medication tracking and epilepsy self-management. We developed a mobile epilepsy management application, integrated with a hospital electronic health record (EHR). In this prospective clinical trial, we assessed whether the mobile application provides quality healthcare data compared to conventional clinic visits, and enhances epilepsy self-management for patients with epilepsy. The study population includes patients with epilepsy (ages 15 years and older) and caregivers for children with epilepsy. Participants were provided access to the application for 90 days. We compared healthcare data collected from the mobile application with data obtained from clinic visits. The healthcare data included seizure records, seizure triggering factors, medication adherence rate, profiles of adverse events resulting from anti-seizure medication (ASM), and comorbidity screenings. In addition, we conducted baseline and follow-up questionnaires after the 90-day period to evaluate how this mobile application improved epilepsy knowledge and self-efficacy in seizure management. Data of 99 participants (18 patients with epilepsy and 81 caregivers) were analyzed. Among 24 individuals who had seizures, we obtained detailed seizure records from 13 individuals through clinic visits and for 18 from the application. Aside from the 6 individuals who reported their medication adherence during clinic visitation, half of the study participants had adherence rates of over 70%, as monitored through the application. However, the adherence rates were not reliable due to high variability. Twenty-three individuals reported 59 adverse reactions on the application, whereas 21 individuals reported 24 adverse reactions during clinic visits. We collected comorbidity data from 4 individuals during clinic visits. In comparison, 64 participants underwent comorbidity self-screening on the application, and 2 of them were referred to neuropsychiatric services. Compared to rare/non-users, app users demonstrated significant improvement in epilepsy knowledge score (p < 0.001) and self-efficacy score (p = 0.038). In conclusion, mobile health technology would help patients and caregivers to record their healthcare data and aid in self-management. Mobile health technology would provide an influential clinical validity in epilepsy care when users engage and actively maintain records on the application.
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Affiliation(s)
- Sun Ah Choi
- Department of Pediatrics, Ewha Womans University Medical Center, Ewha Womans University College of Medicine, Seoul, South Korea
| | - Kahyun Lim
- Office of eHealth Research and Business, Seoul National University Bundang Hospital, Seongnam, South Korea
| | - Hyunyoung Baek
- Office of eHealth Research and Business, Seoul National University Bundang Hospital, Seongnam, South Korea
| | - Sooyoung Yoo
- Office of eHealth Research and Business, Seoul National University Bundang Hospital, Seongnam, South Korea
| | - Anna Cho
- Department of Pediatrics, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, South Korea
| | - Hunmin Kim
- Department of Pediatrics, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, South Korea.
| | - Hee Hwang
- Department of Pediatrics, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, South Korea
| | - Ki Joong Kim
- Department of Pediatrics, Seoul National University Children's Hospital, Seoul National University College of Medicine, Seoul, South Korea
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Almohammed OA, Almutiri NM, Almozaai SS, Alquraishi NH, Alotaibie MM, Al Yami MS. Patients' knowledge about epilepsy in a tertiary medical center: A cross-sectional study from Riyadh, Saudi Arabia. Epilepsy Behav 2021; 116:107395. [PMID: 33640295 DOI: 10.1016/j.yebeh.2020.107395] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2020] [Revised: 08/05/2020] [Accepted: 08/09/2020] [Indexed: 10/22/2022]
Abstract
OBJECTIVE Epilepsy is a noncommunicable disease that affects approximately 65 million people worldwide. Its management depends greatly on the self-management capacity of the individual. Patients with epilepsy (PWE) who have a good level of knowledge about their disease tend to have better coping mechanisms, as well as better compliance in taking their antiepileptic drugs (AEDs), which improves overall control of symptoms. This study aimed to evaluate the current patients' knowledge about epilepsy and identify factors associated with knowledge of different aspects of epilepsy and its management in a tertiary medical center in Riyadh, Saudi Arabia. METHODS A cross-sectional study was carried out at a tertiary medical center in Riyadh, Saudi Arabia. Participants were included if they had a documented diagnosis of epilepsy and excluded if they were non-Saudi or had nonepileptic seizures. The Arabic version of the Epilepsy Patient Knowledge Questionnaire (EPKQ) was used to assess patient's knowledge of epilepsy definition and etiology, safety concerns, medication compliance, social activities, and legal issues of employment and driving. Fisher's exact and Chi-Square tests were used to investigate differences in knowledge of epilepsy among different segments of participants. Data management and statistical analyses were carried on using the IBM SPSS Statistics for Windows, version 25. RESULTS A total of 126 PWE were enrolled in the study. About two-thirds of them were females, and about 68% of them were at least high-school graduates. About one-half of PWE had good knowledge of their condition (>75%), and females had better knowledge than males (p = 0.004). The majority (75.4%) of PWE were knowledgeable about the etiology of epilepsy, about 70% knew that putting a foreign object in a seizing patients' mouth was inappropriate, and only 38% of them did not have adequate knowledge of situations that increase the risk of seizure. About 40% of PWE thought pregnant women should discontinue their AEDs, 53.2% of participants knew what to do when they experience side effects from AEDs, but most of them recognized that they should not automatically stop taking their medications when they stop having seizures. Patients older than 50 years or younger than 21 years of age were less likely to recognize that it was safe for PWE to engage in different social activities (p = 0.042). About 30% of respondents believed that PWE cannot engage in most types of jobs, and more than 50% of participants did not know under which situation PWE can drive. CONCLUSION This study revealed that about half of PWE had inadequate knowledge about their disorder. Patients with epilepsy had better knowledge about the causes of their condition compared with safety concerns and the treatment of epilepsy, whereas the majority of participants knew the types of jobs and activities that they could engage in. Hence, educational interventions are needed to promote patients' knowledge, especially in terms of safety and the legalities of employment and driving.
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Affiliation(s)
- Omar A Almohammed
- Department of Clinical Pharmacy, College of Pharmacy, King Saud University, P.O. Box 2457, Riyadh 11451, Saudi Arabia.
| | - Nouf M Almutiri
- Department of Pharmacy Practice, College of Pharmacy, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
| | - Shahad S Almozaai
- Department of Pharmacy Practice, College of Pharmacy, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
| | - Norah H Alquraishi
- Department of Pharmacy Practice, College of Pharmacy, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
| | - May M Alotaibie
- College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
| | - Majed S Al Yami
- Department of Pharmacy Practice, College of Pharmacy, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
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Koltai DC, Smith CE, Cai GY, Ratliff O, Kakooza-Mwesige A, Najjuma JN, Muhindo R, Rukundo GZ, Teuwen DE, Kayanja A, Kalubi P, Haglund MM, Fuller AT. Healthcare provider perspectives regarding epilepsy care in Uganda. Epilepsy Behav 2021; 114:107294. [PMID: 32763023 DOI: 10.1016/j.yebeh.2020.107294] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2020] [Revised: 06/23/2020] [Accepted: 06/28/2020] [Indexed: 01/29/2023]
Abstract
OBJECTIVE Epilepsy is the most common chronic neurological disorder in the world and imposes a large economic burden on global healthcare systems, especially in low-income settings and rural areas as is found in sub-Saharan Africa (SSA). Despite the high epilepsy prevalence, there are no systematic descriptions of healthcare provider (HCP) perceptions and needs in managing people with epilepsy (PWE) in Uganda. Identifying these perceptions and needs is crucial for understanding community priorities, thereby enhancing the development of culturally sensitive communications, interventions, and research approaches. METHODS In this qualitative study, we used semistructured interview guides to conduct focus group discussions that explored the perspectives of 32 providers of epilepsy care from health facilities around Mbarara, Uganda. Our sample included nonspecialized general physicians (n = 3), medical residents (n = 8), medical clinical officers (n = 3), psychiatric clinical nurses (n = 6), medical nurses and nursing assistants (n = 9), and other providers (n = 3), who were loosely grouped into discussion groups based on level or type of training. Self-assessed proficiency ratings were also administered to gain a better understanding of participants' confidence in their training, preparedness, and capabilities regarding epilepsy care. Thematic analysis of the focus group transcripts was conducted to ascertain commonly occurring themes about perceptions and challenges in epilepsy care. RESULTS Our analyses identified nine major themes that dominated the perspectives of the study participants: care management, medications, diagnostics, HCP training, human resources, location, patient education, social support, and community knowledge and beliefs. Proficiency ratings prioritized areas of confidence as knowledge related to referrals, psychosocial impacts, and seizure neurophysiology. Areas of need were revealed as knowledge of diagnostic tools and antiepileptic drug (AED) regimens. CONCLUSIONS Our findings delineate the perspectives of providers caring for PWE, with consistent recognition of challenges centering around resource augmentation, infrastructure strengthening, and education. Participants emphasized the urgent need to augment these resources to address limitations in medication types and access, trained human resources, and diagnostic tools. They overwhelmingly recognized the need for infrastructure strengthening to address human, diagnostic, medicinal, and capital resource limitations that place undue burden on patients with epilepsy and physicians. Providers indicated a clear desire to learn more about different diagnostic tools and medical management practices, potentially through continuing education, specialized training, or more intentional in-school diagnostic preparation. They also advocated for the powerful influence of patient and family education and clearly articulated the need for community sensitization and support. This article is part of the Special Issue "The Intersection of Culture, Resources, and Disease: Epilepsy Care in Uganda".
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Affiliation(s)
- Deborah C Koltai
- Duke Division of Global Neurosurgery and Neurology, Department of Neurosurgery, Box 3807 Duke University Medical Center, Durham, NC 27705, USA; Duke University School of Medicine, Department of Neurology, Durham, NC, USA; Duke University School of Medicine, Department of Psychiatry and Behavioral Sciences, DUMC, Box 3119, Trent Drive, Durham, NC, USA.
| | - Caleigh E Smith
- Duke University Trinity College of Arts & Sciences, Durham, NC 27708, USA
| | - Grace Y Cai
- Duke University Trinity College of Arts & Sciences, Durham, NC 27708, USA
| | - Olivia Ratliff
- Duke University Trinity College of Arts & Sciences, Durham, NC 27708, USA
| | - Angelina Kakooza-Mwesige
- Department of Paediatrics and Child Health, Makerere University College of Health Sciences, Mulago Hill Road, P.O. Box 7072, Kampala, Uganda; Department of Paediatrics and Child Health, Mulago National Referral Hospital, Pediatric Neurology Unit, Kampala, Uganda
| | - Josephine N Najjuma
- Mbarara University of Science and Technology Department of Nursing, Plot 8 - 18 Kabale Road, PO Box 1410, Mbarara, Uganda; Mbarara Regional Referral Hospital, Mbarara, Uganda
| | - Rose Muhindo
- Mbarara Regional Referral Hospital, Mbarara, Uganda; Mbarara University of Science and Technology, Department of Medicine, Plot 8 - 18 Kabale Road, PO Box 1410, Mbarara, Uganda
| | - Godfrey Z Rukundo
- Mbarara University of Science and Technology, Department of Psychiatry, Faculty of Medicine, Plot 8 - 18 Kabale Road, PO Box 1410, Mbarara, Uganda
| | - Dirk E Teuwen
- UCB, Allée de la recherche 60, 1070 Brussels, Belgium
| | - Adrian Kayanja
- Mbarara Regional Referral Hospital, Mbarara, Uganda; Mbarara University of Science and Technology, Department of Medicine, Plot 8 - 18 Kabale Road, PO Box 1410, Mbarara, Uganda
| | - Peter Kalubi
- Mbarara University of Science and Technology, Department of Paediatrics and Child Health, Plot 8 - 18 Kabale Road, P. O Box 1410, Mbarara, Uganda
| | - Michael M Haglund
- Duke Division of Global Neurosurgery and Neurology, Department of Neurosurgery, Box 3807 Duke University Medical Center, Durham, NC 27705, USA; Duke Global Health Institute, 310 Trent Dr, Durham, NC 27710, USA; Duke University, School of Medicine, Durham, NC, USA
| | - Anthony T Fuller
- Duke Division of Global Neurosurgery and Neurology, Department of Neurosurgery, Box 3807 Duke University Medical Center, Durham, NC 27705, USA; Duke Global Health Institute, 310 Trent Dr, Durham, NC 27710, USA; Duke University, School of Medicine, Durham, NC, USA
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Franke GH, Nentzl J, Jagla-Franke M, Prell T. Medication Adherence and Coping with Disease in Patients from a Neurological Clinic: An Observational Study. Patient Prefer Adherence 2021; 15:1439-1449. [PMID: 34234417 PMCID: PMC8253891 DOI: 10.2147/ppa.s311946] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Accepted: 05/05/2021] [Indexed: 01/17/2023] Open
Abstract
PURPOSE Medication non-adherence is a huge concern for the medical community. For chronic, especially neurological diseases, taking medication is a central pillar of treatment. To improve adherence to these oftentimes complex medication regimens, the construct needs to be understood in more depth. The aim of this study was to investigate associations between adherence with sociodemographics, clinical variables, and coping in neurological patients. PATIENTS AND METHODS The sample consisted of 545 patients from a German neurological clinic. Adherence was assessed with the Stendal Adherence to Medication Score (SAMS). Patients were grouped as completely adherent (SAMS = 0), non-adherent (upper 25% of the sample), and moderately adherent. Associations with coping were assessed using the Essen Coping Questionnaire. RESULTS Medication adherence was low compared to other non-neurological patient samples. Differences between adherence groups were found regarding gender and facets of coping, namely "trivialisation, wishful thinking and defence" and "finding of inner stability". CONCLUSION Interventions to improve medication adherence should focus on facets of coping with disease, increasing acceptance of disease, willpower, and confidence in treatment.
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Affiliation(s)
- Gabriele Helga Franke
- Department of Applied Human Sciences, Magdeburg-Stendal University of Applied Sciences, Stendal, Germany
| | - Julia Nentzl
- Department of Applied Human Sciences, Magdeburg-Stendal University of Applied Sciences, Stendal, Germany
| | - Melanie Jagla-Franke
- Department of Applied Human Sciences, Magdeburg-Stendal University of Applied Sciences, Stendal, Germany
| | - Tino Prell
- Department of Neurology, Jena University Hospital, Jena, Germany
- Center for Healthy Ageing, Jena University Hospital, Jena, Germany
- Correspondence: Tino Prell Department of Neurology, Jena University Hospital, Jena, Germany Email
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Syvertsen M, Vasantharajan S, Moth T, Enger U, Koht J. Predictors of high school dropout, anxiety, and depression in genetic generalized epilepsy. Epilepsia Open 2020; 5:611-615. [PMID: 33336132 PMCID: PMC7733661 DOI: 10.1002/epi4.12434] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2020] [Revised: 08/18/2020] [Accepted: 09/02/2020] [Indexed: 11/11/2022] Open
Abstract
Affective disorders are overrepresented in epilepsy, and people with epilepsy may be at risk of dropping out from school. The aim of the present study was to assess factors influencing high school dropout, anxiety, and depression in genetic generalized epilepsy (GGE). One hundred and ten people with GGE aged 19-40 years underwent a clinical interview, including the Hospital Anxiety and Depression Scale (HADS) questionnaire. Potential predictors of high school dropout were analyzed with logistic regression, and factors influencing total HADS score were analyzed with linear regression. Having felt excluded because of epilepsy was significantly associated with high school dropout (odds ratio 7.80, P = .009), as was total HADS score (odds ratio 1.22, P = .005). If a participant was currently employed or undergoing education, previous high school dropout was less likely (odds ratio 0.07, P = .005). High school dropout was associated with increased current anxiety and depression (β = 0.32, P = .005). Epilepsy severity (current drug resistance, current polytherapy, and active generalized tonic-clonic seizures) was not associated with high school dropout, nor with total HADS score. The issue of stigma in epilepsy must be thoroughly addressed in comprehensive care and may be as important as seizure control when it comes to education and quality of life.
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Affiliation(s)
- Marte Syvertsen
- Department of NeurologyDrammen HospitalVestre Viken Hospital TrustDrammenNorway
| | | | - Thea Moth
- Institute of Clinical MedicineUniversity of OsloOsloNorway
| | - Ulla Enger
- Department of NeurologyDrammen HospitalVestre Viken Hospital TrustDrammenNorway
| | - Jeanette Koht
- Department of NeurologyDrammen HospitalVestre Viken Hospital TrustDrammenNorway
- Institute of Clinical MedicineUniversity of OsloOsloNorway
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Recognizing and refuting the myth of tongue swallowing during a seizure. Seizure 2020; 83:32-37. [DOI: 10.1016/j.seizure.2020.09.023] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2020] [Revised: 09/28/2020] [Accepted: 09/29/2020] [Indexed: 11/23/2022] Open
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Kuramochi I, Oga K, Iwayama T, Miyawaki Y, Ishihara T, Kobayashi S, Yoshimasu H. Pilot trial of "Epi-school" group psychosocial education program for patients with epilepsy and their relatives in Japan. Epilepsy Behav 2020; 113:107545. [PMID: 33238235 DOI: 10.1016/j.yebeh.2020.107545] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/05/2020] [Revised: 10/11/2020] [Accepted: 10/11/2020] [Indexed: 11/25/2022]
Abstract
INTRODUCTION In epilepsy treatment, it is important for patients with epilepsy (PWE) to have accurate knowledge of epilepsy and to actively engage in treatment. In Japan, there are a few facilities for implementing learning programs for PWE, and their long-term usefulness has not been established. We conducted a pilot group psychosocial education program for PWE and their relatives in Japan. METHODS Participants were PWE and their relatives who were 18 years old or older, were able to consent to participate in the study, and who were visiting the outpatient clinic of Saitama Medical Center from September 2019 to March 2020. As an intervention, we created a psychosocial educational program called "Epi-school" for PWE and their relatives, consisting of three sessions. Outcomes included patients' quality of life (QOL) measured with the epilepsy-31-P (QOLIE-31P), Rosenberg self-esteem scale (RSES), Stigma scale for chronic neurological disease (SSCI-8), and Epilepsy knowledge scale, before and after Epi-school. In addition, in a free-form questionnaire, we collected the impressions of patients and their relatives regarding the experience of participating in a group psychosocial education program. RESULTS We examined 11 patients (two males, nine females) and 12 relatives (four males, eight females) who participated in Epi-school during the target period. The analyses revealed that only the scales measuring knowledge about epilepsy in the effect index showed significant increases in both patients and relatives after the program compared with before the program (patients: F [1,5.30] = 13.65, P < .05; relatives: F [1,4] = 17.50, P < .05). Moreover, a large effect size (d = 0.85) was obtained in patients, and a large effect size (d = 1.03) was obtained in relatives. In the open-ended questionnaire after participating in Epi-school, respondents reported changes in the psychological state of patients in the "learning epilepsy knowledge and coping methods", including changes in "acquired knowledge of illness" and "acquisition of coping with psychological aspects". Furthermore, it reports of "discovery/surprise", "thanks to medical staff", "interaction with other patients/relatives", and "new anxiety". In addition, "positive thoughts on treatment", "hopes for the future", "expectations for interaction with medical staff", "expectations for interaction with colleagues with the same disease", and "coming out of epilepsy" were reported. Regarding the psychological state of relatives after participating in Epi-school, it revealed "thanks to medical staff", "interactions with other patients/relatives", and "awareness of and remarks about other patients' statements". The results also revealed responses including "positive thoughts about treatment", "expectations of medical care", and "expectations of the community". DISCUSSION The results confirmed that Epi-school led to improved knowledge, and psychological changes, including improved QOL and positive acceptance of epilepsy. Participants' awareness about epilepsy appeared to improve through encounters with other participants' attitudes toward epilepsy, possibly changing via the ways participants interacted. It is important to promote understanding of epilepsy, enhance the effects of treatment, and reduce psychosocial restrictions. CONCLUSIONS Epi-school may be useful as part of epilepsy treatment to improve the QOL of PWE by making it easier for patients and their relatives to develop acceptance of living with epilepsy. The main limitation in the current study was the small sample size and the lack of a control group. In future studies, we plan to further investigate the usefulness of psychosocial education programs in Japan, including Epi-school, by increasing the sample size, including a control comparison, and collecting more comprehensive data. We hope that the current findings will encourage the provision of appropriate medical insurance funding for patient learning programs in Japan.
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Affiliation(s)
- Izumi Kuramochi
- Department of Psychiatry, Saitama Medical Center, Saitama Medical University, Saitama, Japan.
| | - Koko Oga
- Department of Nursing, Saitama Medical Center, Saitama Medical University, Saitama, Japan
| | - Takayuki Iwayama
- Department of Psychiatry, Saitama Medical Center, Saitama Medical University, Saitama, Japan; Department of Psychology, Showa Women's University, Tokyo, Japan
| | - Yuko Miyawaki
- Department of Psychiatry, Saitama Medical Center, Saitama Medical University, Saitama, Japan
| | - Tomoki Ishihara
- Department of Pharmacy, Saitama Medical Center, Saitama Medical University, Saitama, Japan
| | - Sayaka Kobayashi
- Department of Psychiatry, Saitama Medical Center, Saitama Medical University, Saitama, Japan
| | - Haruo Yoshimasu
- Department of Psychiatry, Saitama Medical Center, Saitama Medical University, Saitama, Japan
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Impact of clinical pharmacist managed patient counselling on the knowledge and adherence to antiepileptic drug therapy. CLINICAL EPIDEMIOLOGY AND GLOBAL HEALTH 2020. [DOI: 10.1016/j.cegh.2020.04.021] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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Raman S, Wai Chang C, Ee Heng J, Wan Wong S. Impact of an Epilepsy Educational Programme on Coping Mechanism, Attitude, Knowledge and Awareness: A Rural Sabah Experience. MALAYSIAN JOURNAL OF PHARMACEUTICAL SCIENCES 2020. [DOI: 10.21315/mjps2020.18.2.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
Abstract
Epilepsy is a disabling disease which has not been adequately emphasised as a public
health concern. Patients are often left in the dark about their disease, affecting their ability to cope and live a normal life. This study aimed to explore and evaluate the effects of a structured epilepsy education programme (EEP) on awareness, knowledge and attitude (AKA) and coping mechanism of patients. Recruited participants were required to complete the modified Malay AKA epilepsy questionnaire and Malay brief coping orientation to problem experienced (Brief COPE)-27. Upon completion, they received a structured EEP conducted by trained personnel using validated materials. Participants were then followed up for a period of 6 months and reassessed at 1, 3 and 6 months to measure any changes in their AKA and coping mechanisms. Twenty-two participants were successfully recruited. Total AKA score of participants showed a significant increase (mean score difference = 16.3, p = 0.021, 95% CI: 3.0, 28.1) at 6 months post-EEP. This improvement was mostly contributed by the increase in both knowledge and attitude scores. Religion was the most preferred coping mechanism (82.5%), followed by instrumental support, emotional support, active coping and acceptance at 75.0%, respectively. Only three domains showed significant differences after the educational programme: planning: 62.5% versus 77.5%, p = 0.026; denial: 57.5% versus 37.5%, p = 0.004; venting: 62.5% versus 52.5%, p = 0.004. The EEP was effective in improving attitude and knowledge while bringing about changes in coping skills of patients over a period of time. Educational programmes should be part of epilepsy standard of care, especially as they are inexpensive and brief yet impactful
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Affiliation(s)
- Sivaraj Raman
- Pharmacy Department, Hospital Keningau, Keningau, Sabah, Malaysia
| | - Chun Wai Chang
- Pharmacy Department, Hospital Keningau, Keningau, Sabah, Malaysia
| | - Jin Ee Heng
- Pharmacy Department, Hospital Keningau, Keningau, Sabah, Malaysia
| | - See Wan Wong
- Pharmacy Department, Hospital Tenom, Tenom, Sabah, Malaysia
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Noble A, Nevitt S, Holmes E, Ridsdale L, Morgan M, Tudur-Smith C, Hughes D, Goodacre S, Marson T, Snape D. Seizure first aid training for people with epilepsy attending emergency departments and their significant others: the SAFE intervention and feasibility RCT. HEALTH SERVICES AND DELIVERY RESEARCH 2020. [DOI: 10.3310/hsdr08390] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Background
No seizure first aid training intervention exists for people with epilepsy who regularly attend emergency departments and their significant others, despite such an intervention’s potential to reduce clinically unnecessary and costly visits.
Objectives
The objectives were to (1) develop Seizure first Aid training For Epilepsy (SAFE) by adapting a broader intervention and (2) determine the feasibility and optimal design of a definitive randomised controlled trial to test SAFE’s efficacy.
Design
The study involved (1) the development of an intervention informed by a co-design approach with qualitative feedback and (2) a pilot randomised controlled trial with follow-ups at 3, 6 and 12 months and assessments of treatment fidelity and the cost of SAFE’s delivery.
Setting
The setting was (1) third-sector patient support groups and professional health-care organisations and (2) three NHS emergency departments in England.
Participants
Participants were (1) people with epilepsy who had visited emergency departments in the prior 2 years, their significant others and emergency department, paramedic, general practice, commissioning, neurology and nursing representatives and (2) people with epilepsy aged ≥ 16 years who had been diagnosed for ≥ 1 year and who had made two or more emergency department visits in the prior 12 months, and one of their significant others. Emergency departments identified ostensibly eligible people with epilepsy from attendance records and patients confirmed their eligibility.
Interventions
Participants in the pilot randomised controlled trial were randomly allocated 1 : 1 to SAFE plus treatment as usual or to treatment as usual only.
Main outcome measures
Consent rate and availability of routine data on emergency department use at 12 months were the main outcome measures. Other measures of interest included eligibility rate, ease with which people with epilepsy could be identified and routine data secured, availability of self-reported emergency department data, self-reported emergency department data’s comparability with routine data, SAFE’s effect on emergency department use, and emergency department use in the treatment as usual arm, which could be used in sample size calculations.
Results
(1) Nine health-care professionals and 23 service users provided feedback that generated an intervention considered to be NHS feasible and well positioned to achieve its purpose. (2) The consent rate was 12.5%, with 53 people with epilepsy and 38 significant others recruited. The eligibility rate was 10.6%. Identifying people with epilepsy from attendance records was resource intensive for emergency department staff. Those recruited felt more stigmatised because of epilepsy than the wider epilepsy population. Routine data on emergency department use at 12 months were secured for 94.1% of people with epilepsy, but the application process took 8.5 months. Self-reported emergency department data were available for 66.7% of people with epilepsy, and people with epilepsy self-reported more emergency department visits than were captured in routine data. Most participants (76.9%) randomised to SAFE received the intervention. The intervention was delivered with high fidelity. No related serious adverse events occurred. Emergency department use at 12 months was lower in the SAFE plus treatment as usual arm than in the treatment as usual only arm, but not significantly so. Calculations indicated that a definitive trial would need ≈ 674 people with epilepsy and ≈ 39 emergency department sites.
Limitations
Contrary to patient statements on recruitment, routine data secured at the pilot trial’s end indicated that ≈ 40% may not have satisfied the inclusion criterion of two or more emergency department visits.
Conclusions
An intervention was successfully developed, a pilot randomised controlled trial conducted and outcome data secured for most participants. The consent rate did not satisfy a predetermined ‘stop/go’ level of ≥ 20%. The time that emergency department staff needed to identify eligible people with epilepsy is unlikely to be replicable. A definitive trial is currently not feasible.
Future work
Research to more easily identify and recruit people from the target population is required.
Trial registration
Current Controlled Trials ISRCTN13871327.
Funding
This project was funded by the National Institute for Health Research (NIHR) Health Services and Delivery Research programme and will be published in full in Health Services and Delivery Research; Vol. 8, No. 39. See the NIHR Journals Library website for further project information.
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Affiliation(s)
- Adam Noble
- Department of Health Services Research, University of Liverpool, Liverpool, UK
| | - Sarah Nevitt
- Department of Biostatistics, University of Liverpool, Liverpool, UK
| | - Emily Holmes
- Centre for Health Economics and Medicine Evaluation, Bangor University, Bangor, UK
| | - Leone Ridsdale
- Department of Basic and Clinical Neuroscience, King’s College London, London, UK
| | - Myfanwy Morgan
- Institute of Pharmaceutical Science, King’s College London, London, UK
| | | | - Dyfrig Hughes
- Centre for Health Economics and Medicine Evaluation, Bangor University, Bangor, UK
| | - Steve Goodacre
- School of Health and Related Research, University of Sheffield, Sheffield, UK
| | - Tony Marson
- Department of Molecular and Clinical Pharmacology, University of Liverpool, Liverpool, UK
| | - Darlene Snape
- Department of Health Services Research, University of Liverpool, Liverpool, UK
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Pandey DK, Dasgupta R, Levy J, Wang H, Serafini A, Habibi M, Song W, Shafer PO, Loeb JA. Enhancing epilepsy self-management and quality of life for adults with epilepsy with varying social and educational backgrounds using PAUSE to Learn Your Epilepsy. Epilepsy Behav 2020; 111:107228. [PMID: 32599431 PMCID: PMC7319931 DOI: 10.1016/j.yebeh.2020.107228] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2020] [Revised: 06/04/2020] [Accepted: 06/04/2020] [Indexed: 02/05/2023]
Abstract
PURPOSE People with epilepsy (PWE) come from a wide variety of social backgrounds and educational skillsets, making self-management (SM) education for improving their condition challenging. Here, we evaluated whether a mobile technology-based personalized epilepsy SM education intervention, PAUSE to Learn Your Epilepsy (PAUSE), improves SM measures such as self-efficacy, epilepsy SM behaviors, epilepsy outcome expectations, quality of life (QOL), and personal impact of epilepsy in adults with epilepsy. METHODS Recruitment for the PAUSE study occurred from October 2015 to March 2019. Ninety-one PWE were educated using an Internet-enabled computer tablet application that downloads custom, patient-specific educational programs from Epilepsy.com. Validated self-reported questionnaires were used for outcome measures. Participants were assessed at baseline (T0), the first follow-up at completion of the PWE-paced 8-12-week SM education intervention (T1), and the second follow-up at least 3 months after the first follow-up (T2). Multiple linear regression was used to assess within-subject significant changes in outcome measures between these time points. RESULTS The study population was diverse and included individuals with a wide variety of SM educational needs and abilities. The median time for the first follow-up assessment (T1) was approximately 4 months following the baseline (T0) and 8 months following baseline for the second follow-up assessment (T2). Participants showed significant improvement in all SM behaviors, self-efficacy, outcome expectancy, QOL, and personal impact of epilepsy measures from T0 to T1. Participants who scored lower at baseline tended to show greater improvement at T1. Similarly, results showed that participant improvement was sustained in the majority of SM measures from T1 to T2. CONCLUSION This study demonstrated that a mobile technology-based personalized SM intervention is feasible to implement. The results provide evidence that epilepsy SM behavior and practices, QOL, outcome expectation for epilepsy treatment and management, self-efficacy, and outcome expectation and impact of epilepsy significantly improve following a personalized SM education intervention. This underscores a greater need for a pragmatic trial to test the effectiveness of personalized SM education, such as PAUSE to Learn Your Epilepsy, in broader settings specifically for the unique needs of the hard-to-reach and hard-to-treat population of PWE.
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Affiliation(s)
- Dilip K. Pandey
- Neurology and Rehabilitation, University of Illinois College of Medicine, University of Illinois Chicago, 912 S. Wood St, Chicago, IL 60612, USA,Corresponding author at: 174N NPI (MC 796), 912 S Wood St, Chicago, IL 60612, USA
| | - Raktima Dasgupta
- Health Policy and Administration, School of Public Health, University of Illinois Chicago, 1603 W. Taylor St., Chicago, IL 60612, USA
| | - Jessica Levy
- Neurology and Rehabilitation, University of Illinois College of Medicine, University of Illinois Chicago, 912 S. Wood St, Chicago, IL 60612, USA
| | - Heng Wang
- Epidemiology and Biostatistics, School of Public Health, University of Illinois Chicago, 1603 W. Taylor St., Chicago, IL 60612, USA
| | - Anna Serafini
- Neurology and Rehabilitation, University of Illinois College of Medicine, University of Illinois Chicago, 912 S. Wood St, Chicago, IL 60612, USA
| | - Mitra Habibi
- Pharmacy Practice, College of Pharmacy, University of Illinois Chicago, 833 S. Wood St., Chicago, IL 60612, USA
| | - Woojin Song
- Neurology and Rehabilitation, University of Illinois College of Medicine, University of Illinois Chicago, 912 S. Wood St, Chicago, IL 60612, USA
| | - Patricia O. Shafer
- Epilepsy Foundation, 8301 Professional Place West, Landover, MD 20785, USA
| | - Jeffrey A. Loeb
- Neurology and Rehabilitation, University of Illinois College of Medicine, University of Illinois Chicago, 912 S. Wood St, Chicago, IL 60612, USA
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Jones FJS, Smith JR, Ayub N, Herman ST, Buchhalter JR, Fureman BE, Cash SS, Hoch DB, Moura LMVR. Implementing standardized provider documentation in a tertiary epilepsy clinic. Neurology 2020; 95:e213-e223. [PMID: 32546650 PMCID: PMC7455323 DOI: 10.1212/wnl.0000000000009778] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2019] [Accepted: 12/17/2019] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE To incorporate standardized documentation into an epilepsy clinic and to use these standardized data to compare patients' perception of epilepsy diagnosis to provider documentation. METHODS Using quality improvement methodology, we implemented interventions to increase documentation of epilepsy diagnosis, seizure frequency, and type from 49.8% to 70% of adult nonemployee patients seen by 6 providers over 5 months of routine clinical care. The main intervention consisted of an interactive SmartPhrase that mirrored a documentation template developed by the Epilepsy Learning Healthcare System. We assessed the weekly proportion of complete SmartPhrases among eligible patient encounters with a statistical process control chart. We used a subset of patients with established epilepsy care linked to existing patient-reported survey data to examine the proportion of patient-to-provider agreement on epilepsy diagnosis (yes vs no/unsure). We also examined sociodemographic and clinical characteristics of patients who disagreed vs agreed with provider's documentation of epilepsy diagnosis. RESULTS The median SmartPhrase weekly completion rate was 78%. Established patients disagreed with providers with respect to epilepsy diagnosis in 18.5% of encounters (κ = 0.13), indicating that they did not have or were unsure if they had epilepsy despite having a provider-documented epilepsy diagnosis. Patients who disagreed with providers were similar to those who agreed with respect to age, sex, ethnicity, marital status, seizure frequency, type, and other quality-of-life measures. CONCLUSION This project supports the feasibility of implementing standardized documentation of data relevant to epilepsy care in a tertiary epilepsy clinic and highlights an opportunity for improvement in patient-provider communication.
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Affiliation(s)
- Felipe J S Jones
- From the Department of Neurology (F.J.S.J., J.R.S., N.A., S.S.C., D.B.H., L.M.V.R.M.), Massachusetts General Hospital, Harvard Medical School; Department of Neurology (S.T.H.), Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA; Department of Pediatrics (J.R.B.), Cumming School of Medicine, University of Calgary, Alberta, Canada; and Research and New Therapies (B.E.F.), Epilepsy Foundation, Landover, MD.
| | - Jason R Smith
- From the Department of Neurology (F.J.S.J., J.R.S., N.A., S.S.C., D.B.H., L.M.V.R.M.), Massachusetts General Hospital, Harvard Medical School; Department of Neurology (S.T.H.), Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA; Department of Pediatrics (J.R.B.), Cumming School of Medicine, University of Calgary, Alberta, Canada; and Research and New Therapies (B.E.F.), Epilepsy Foundation, Landover, MD
| | - Neishay Ayub
- From the Department of Neurology (F.J.S.J., J.R.S., N.A., S.S.C., D.B.H., L.M.V.R.M.), Massachusetts General Hospital, Harvard Medical School; Department of Neurology (S.T.H.), Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA; Department of Pediatrics (J.R.B.), Cumming School of Medicine, University of Calgary, Alberta, Canada; and Research and New Therapies (B.E.F.), Epilepsy Foundation, Landover, MD
| | - Susan T Herman
- From the Department of Neurology (F.J.S.J., J.R.S., N.A., S.S.C., D.B.H., L.M.V.R.M.), Massachusetts General Hospital, Harvard Medical School; Department of Neurology (S.T.H.), Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA; Department of Pediatrics (J.R.B.), Cumming School of Medicine, University of Calgary, Alberta, Canada; and Research and New Therapies (B.E.F.), Epilepsy Foundation, Landover, MD
| | - Jeffrey R Buchhalter
- From the Department of Neurology (F.J.S.J., J.R.S., N.A., S.S.C., D.B.H., L.M.V.R.M.), Massachusetts General Hospital, Harvard Medical School; Department of Neurology (S.T.H.), Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA; Department of Pediatrics (J.R.B.), Cumming School of Medicine, University of Calgary, Alberta, Canada; and Research and New Therapies (B.E.F.), Epilepsy Foundation, Landover, MD
| | - Brandy E Fureman
- From the Department of Neurology (F.J.S.J., J.R.S., N.A., S.S.C., D.B.H., L.M.V.R.M.), Massachusetts General Hospital, Harvard Medical School; Department of Neurology (S.T.H.), Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA; Department of Pediatrics (J.R.B.), Cumming School of Medicine, University of Calgary, Alberta, Canada; and Research and New Therapies (B.E.F.), Epilepsy Foundation, Landover, MD
| | - Sydney S Cash
- From the Department of Neurology (F.J.S.J., J.R.S., N.A., S.S.C., D.B.H., L.M.V.R.M.), Massachusetts General Hospital, Harvard Medical School; Department of Neurology (S.T.H.), Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA; Department of Pediatrics (J.R.B.), Cumming School of Medicine, University of Calgary, Alberta, Canada; and Research and New Therapies (B.E.F.), Epilepsy Foundation, Landover, MD
| | - Daniel B Hoch
- From the Department of Neurology (F.J.S.J., J.R.S., N.A., S.S.C., D.B.H., L.M.V.R.M.), Massachusetts General Hospital, Harvard Medical School; Department of Neurology (S.T.H.), Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA; Department of Pediatrics (J.R.B.), Cumming School of Medicine, University of Calgary, Alberta, Canada; and Research and New Therapies (B.E.F.), Epilepsy Foundation, Landover, MD
| | - Lidia M V R Moura
- From the Department of Neurology (F.J.S.J., J.R.S., N.A., S.S.C., D.B.H., L.M.V.R.M.), Massachusetts General Hospital, Harvard Medical School; Department of Neurology (S.T.H.), Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA; Department of Pediatrics (J.R.B.), Cumming School of Medicine, University of Calgary, Alberta, Canada; and Research and New Therapies (B.E.F.), Epilepsy Foundation, Landover, MD
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Bahou Y, Alzghoul L, Alajloni EM, Albliwi MA, Alsabatin NO, Toubah YK. Knowledge and awareness among patients with epilepsy observed at Jordan University Hospital. Epilepsy Behav 2020; 102:106697. [PMID: 31812903 DOI: 10.1016/j.yebeh.2019.106697] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/21/2019] [Revised: 11/06/2019] [Accepted: 11/08/2019] [Indexed: 10/25/2022]
Abstract
The objective of this study was to assess the level of knowledge and awareness about epilepsy among patients with epilepsy (PWE) and to determine the correlation with sociodemographic and disease-related factors. A prospective cross-sectional study was set, and it included PWE attending the adult neurology clinic at Jordan University Hospital (JUH), Amman, Jordan. A structured questionnaire was utilized, which consisted of 3 parts: sociodemographic factors, disease characteristics, and an epilepsy knowledge scale - the Epilepsy Knowledge Profile-General (E.K.P-G) scale. There was a total of 108 patients, 43 males and 65 females with an age range from 16 to 63 years. The average score of the subjects in the E.K.P-G scale was 16.4/34 (48%). Twenty out of the 34 questions were answered correctly by less than 50% of the respondents. There was an overall poor understanding of the etiology of epilepsy. A higher E.K.P-G score was significantly correlated with higher levels of education, higher household income, controlled seizures for more than 2 years, and living in urban areas. On the other hand, there was no significant correlation between the level of knowledge and age, gender, marital status, occupational status, type of seizure, duration of epilepsy, source of information, number of antiepileptic drugs (AEDs), and family history of epilepsy. In conclusion, the study showed a significant lack of knowledge about epilepsy among PWE at JUH. A public educational program is necessary in Jordan to educate PWE about their disorder.
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Affiliation(s)
- Yacoub Bahou
- Neurology Section, Internal Medicine Department, Jordan University Hospital, Amman, Jordan.
| | - Loai Alzghoul
- Department of Physiology and Biochemistry, School of Medicine, The University of Jordan, Amman, Jordan
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Gutiérrez-Viedma Á, Sanz-Graciani I, Romeral-Jiménez M, Parejo-Carbonell B, Serrano-García I, Cuadrado ML, Aledo-Serrano Á, Gil-Nagel A, Toledano R, García-Morales I. Patients' knowledge on epilepsy and SUDEP improves after a semi-structured health interview. Epilepsy Behav 2019; 99:106467. [PMID: 31421520 DOI: 10.1016/j.yebeh.2019.106467] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2019] [Revised: 07/25/2019] [Accepted: 07/29/2019] [Indexed: 11/30/2022]
Abstract
BACKGROUND Patients' education is the most relevant contributor to patient self-management of epilepsy. We aimed to assess the acquisition of knowledge after a semi-structured interview. METHODS We performed a quasi-experimental prospective study with a cohort of patients with epilepsy admitted for prolonged video electroencephalogram (VEEG). We measured patients' baseline knowledge with a 10-item true-false test (test A). Then, a qualified nurse carried out a semi-structured interview. We measured acquired knowledge with another 10-item true-false exam (test B), prior to VEEG discharge and after a 3- to 5-month follow-up, and we compared the difference between the scores in test A and test B. Finally, we conducted a satisfaction and suitability survey on the interview at follow-up. RESULTS Thirty-two patients participated, half were women. Their median age was 39.5, and the median length of schooling was 14 years. The median time since epilepsy onset was 13 years, 75% had suffered tonic-clonic seizures. The median score on test A was 7, while the median score on test B was 8.5 (p < 0.001) both at VEEG discharge and after follow-up. After the interview, 84.4% of participants reported that they were very satisfied with the information received; 87.5% stated that they had not previously heard about SUDEP (sudden unexpected dead in epilepsy); and 93.8% considered it important to receive detailed information about SUDEP. CONCLUSIONS Patient education through a semi-structured comprehensive interview improves knowledge of patients with epilepsy about their disease. The calm atmosphere and the qualified nursing working at VEEG units make them an appropriate setting for talking about epilepsy and its risks, including SUDEP.
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Affiliation(s)
- Álvaro Gutiérrez-Viedma
- Unidad de Epilepsia, Servicio de Neurología, Hospital Clínico San Carlos, Calle Profesor Martín Lagos s/n, 28040 Madrid, Spain; Departamento de Medicina, Facultad de Medicina, Universidad Complutense de Madrid, Plaza de Ramón y Cajal s/n, 28040 Madrid, Spain; Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Calle Profesor Martín Lagos s/n, 28040 Madrid, Spain.
| | - Isabel Sanz-Graciani
- Unidad de Epilepsia, Servicio de Neurología, Hospital Clínico San Carlos, Calle Profesor Martín Lagos s/n, 28040 Madrid, Spain; Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Calle Profesor Martín Lagos s/n, 28040 Madrid, Spain
| | - María Romeral-Jiménez
- Unidad de Epilepsia, Servicio de Neurología, Hospital Clínico San Carlos, Calle Profesor Martín Lagos s/n, 28040 Madrid, Spain; Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Calle Profesor Martín Lagos s/n, 28040 Madrid, Spain
| | - Beatriz Parejo-Carbonell
- Unidad de Epilepsia, Servicio de Neurología, Hospital Clínico San Carlos, Calle Profesor Martín Lagos s/n, 28040 Madrid, Spain; Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Calle Profesor Martín Lagos s/n, 28040 Madrid, Spain
| | - Irene Serrano-García
- Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Calle Profesor Martín Lagos s/n, 28040 Madrid, Spain; Unidad de Metodología de Investigación y Epidemiología Clínica, Servicio de Medicina Preventiva, Hospital Clínico San Carlos, Calle Profesor Martín Lagos s/n, 28040 Madrid, Spain
| | - María-Luz Cuadrado
- Unidad de Epilepsia, Servicio de Neurología, Hospital Clínico San Carlos, Calle Profesor Martín Lagos s/n, 28040 Madrid, Spain; Departamento de Medicina, Facultad de Medicina, Universidad Complutense de Madrid, Plaza de Ramón y Cajal s/n, 28040 Madrid, Spain; Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Calle Profesor Martín Lagos s/n, 28040 Madrid, Spain
| | - Ángel Aledo-Serrano
- Unidad de Epilepsia, Servicio de Neurología, Hospital Ruber Internacional, Calle La Masó 38, 28034 Madrid, Spain
| | - Antonio Gil-Nagel
- Unidad de Epilepsia, Servicio de Neurología, Hospital Ruber Internacional, Calle La Masó 38, 28034 Madrid, Spain
| | - Rafael Toledano
- Unidad de Epilepsia, Servicio de Neurología, Hospital Ruber Internacional, Calle La Masó 38, 28034 Madrid, Spain; Unidad de Epilepsia, Servicio de Neurología, Hospital Ramón y Cajal, Carretera de Colmenar Viejo 100, 28034 Madrid, Spain
| | - Irene García-Morales
- Unidad de Epilepsia, Servicio de Neurología, Hospital Clínico San Carlos, Calle Profesor Martín Lagos s/n, 28040 Madrid, Spain; Departamento de Medicina, Facultad de Medicina, Universidad Complutense de Madrid, Plaza de Ramón y Cajal s/n, 28040 Madrid, Spain; Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Calle Profesor Martín Lagos s/n, 28040 Madrid, Spain; Unidad de Epilepsia, Servicio de Neurología, Hospital Ruber Internacional, Calle La Masó 38, 28034 Madrid, Spain
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A call for better information about epilepsy: The patients’ perspective—An online survey. Seizure 2019; 69:173-179. [DOI: 10.1016/j.seizure.2019.04.015] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2019] [Revised: 04/15/2019] [Accepted: 04/18/2019] [Indexed: 11/23/2022] Open
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Miller WR. The Projected Care Trajectory for Persons with Epilepsy. Nurs Clin North Am 2019; 54:425-435. [PMID: 31331628 DOI: 10.1016/j.cnur.2019.04.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Epilepsy is a complex neurologic disease that requires both medical management and self-management. People with epilepsy and their families complete many transitions throughout the health care system in managing this disease. This article reviews key transitions for people with epilepsy and discusses strategies for improving these transitions.
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Affiliation(s)
- Wendy R Miller
- Department of Community Health Systems, Indiana University School of Nursing, 600 Barnhill Drive, Indianapolis, IN 46202, USA.
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Eshiet U, Okonta J, Ukwe C. The efficacy of a pharmacist implemented educational treatment programme for people with epilepsy: A report of a randomised controlled trial. Seizure 2019; 69:147-153. [PMID: 31048271 DOI: 10.1016/j.seizure.2019.04.011] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2019] [Revised: 03/15/2019] [Accepted: 04/13/2019] [Indexed: 11/18/2022] Open
Abstract
PURPOSE To evaluate the efficacy of a pharmacist implemented educational treatment programme in improving knowledge and perception of epilepsy among people with the condition. METHOD A randomized controlled study was conducted on patients with epilepsy recruited from the medical and neurology out-patient clinics of two tertiary hospitals. Patients in the intervention group were offered an educational treatment programme implemented by a clinical pharmacist. The impact of the educational intervention was evaluated by using an epilepsy knowledge scale and the brief illness perception questionnaire. RESULTS There was a statistical significant difference between the control and intervention group over time on the knowledge of epilepsy, as the knowledge of epilepsy among patients in the intervention group significantly increased; F (2154) = 150.15, p = 0.000, Partial η2 = 0.661. Also, there was a statistical significant difference between the control and intervention group over time on the perception of epilepsy, as the perception of epilepsy among patients in the intervention group significantly improved; F (2, 154) = 12.386, p = 0.000, Partial η2 = 0.138. CONCLUSION The Pharmacist implemented educational intervention improved patients' knowledge and perception of epilepsy. This finding has revealed the potential positive impact of pharmacists' involvement in the management of epilepsy.
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Affiliation(s)
- Unyime Eshiet
- Department of Clinical Pharmacy and Biopharmacy, University of Uyo, Nigeria
| | - Jegbefume Okonta
- Department of Clinical Pharmacy and Pharmacy Management, University of Nigeria, Nsukka, Nigeria
| | - Chinwe Ukwe
- Department of Clinical Pharmacy and Pharmacy Management, University of Nigeria, Nsukka, Nigeria.
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Saengow VE, Chancharoenchai P, Saartying W, Pimpa W, Chotichanon N, Lewsirirat T, Srisantisuk P. Epilepsy video animation: Impact on knowledge and drug adherence in pediatric epilepsy patients and caregivers. Clin Neurol Neurosurg 2018; 172:59-61. [DOI: 10.1016/j.clineuro.2018.06.031] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2018] [Revised: 06/28/2018] [Accepted: 06/29/2018] [Indexed: 10/28/2022]
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Parfenova EV, Rider FK, Gersamia AG. Sociocultural aspects and different types of stigmatization in epilepsy. NEUROLOGY, NEUROPSYCHIATRY, PSYCHOSOMATICS 2018. [DOI: 10.14412/2074-2711-2018-1s-89-95] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
This literature review deals with knowledge and beliefs about epilepsy and with the attitude of patients, relatives, and society as a whole towards epilepsy. It discusses the stigma that is associated with the disease and has a strong impact on patients with epilepsy and their families. The problems of stigma or related concepts in different countries are analyzed.
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Michaelis R, Tang V, Goldstein LH, Reuber M, LaFrance WC, Lundgren T, Modi AC, Wagner JL. Psychological treatments for adults and children with epilepsy: Evidence-based recommendations by the International League Against Epilepsy Psychology Task Force. Epilepsia 2018; 59:1282-1302. [PMID: 29917225 DOI: 10.1111/epi.14444] [Citation(s) in RCA: 72] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/13/2018] [Indexed: 12/12/2022]
Abstract
Given the significant impact that psychosocial factors and epilepsy treatments can have on the health-related quality of life (HRQOL) of individuals with epilepsy and their families, there is great clinical interest in the role of psychological evaluation and treatments to improve HRQOL and comorbidities. Therefore, the International League Against Epilepsy (ILAE) charged the Psychology Task Force with the development of recommendations for clinical care based on evaluation of the evidence from their recent Cochrane review of psychological treatments in individuals with epilepsy. The literature search for a recent Cochrane review of randomized controlled trials investigating psychological treatments for individuals with epilepsy constitutes the key source of evidence for this article. To provide practical guidance to service providers, we provide ratings on study research designs based on (1) the American Academy of Neurology's Level of Evidence system and (2) the Grading of Recommendations, Assessment, Development, and Evaluation system. This paper is the culmination of an international collaboration process involving pediatric and adult psychologists, neurologists, psychiatrists, and neuropsychiatrists. The process and conclusions were reviewed and approved by the ILAE Executive Committee. The strongest evidence for psychological interventions was identified for the most common mental health problems, including depression, neurocognitive disturbances, and medication adherence. Psychological interventions targeting the enhancement of HRQOL and adherence and a decrease in comorbidity symptoms (anxiety, depression) should be incorporated into comprehensive epilepsy care. There is a range of psychological strategies (ie, cognitive behavioral therapy and mindfulness-based therapies) that show promise for improving the lives of persons with epilepsy, and clinical recommendations are provided to assist epilepsy health care providers in treating the comorbidities and challenges associated with epilepsy and its treatments.
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Affiliation(s)
- Rosa Michaelis
- Department of Neurology, Herdecke Community Hospital, University of Witten/Herdecke, Herdecke, Germany.,Integrated Curriculum for Anthroposophical Medicine (ICURAM), Witten/Herdecke University, Herdecke, Germany.,Department of Neurology, Center for Cognitive Neuroscience, Paracelsus Medical University, Salzburg, Austria
| | - Venus Tang
- Division of Neurosurgery, Department of Surgery, Faculty of Medicine, Chinese University of Hong Kong, Shatin, Hong Kong.,Department of Clinical Psychology, Prince of Wales Hospital, Shatin, Hong Kong
| | - Laura H Goldstein
- Department of Psychology, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, UK
| | - Markus Reuber
- Academic Neurology Unit, Royal Hallamshire Hospital, University of Sheffield, Sheffield, UK
| | - William Curt LaFrance
- Departments of Psychiatry and Neurology, Rhode Island Hospital, Brown University, Providence, RI, USA
| | - Tobias Lundgren
- Department of Clinical Neuroscience, Center for Psychiatry Research, Karolinska Institute, Stockholm, Sweden
| | - Avani C Modi
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Janelle L Wagner
- College of Nursing and Department of Pediatrics, Medical University of South Carolina, Charleston, SC, USA
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Knowledge, attitude and practice of parents regarding pediatric antiepileptic drug therapy. ACTA ACUST UNITED AC 2018. [DOI: 10.1016/j.ijep.2014.11.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Abstract
Objectives To evaluate the parental knowledge, attitude and practice (KAP) regarding the antiepileptic medication therapy in childhood.
Methods This study was carried out over a period of 10 months in the division of Pediatric Neurology of Amrita Institute of Medical Sciences. The cohort of patients was selected randomly meeting the inclusion and exclusion criteria. Parents' KAP regarding epilepsy and antiepileptic drug therapy was assessed using a questionnaire prepared by the authors and patient adherence towards antiepileptic drug therapy by using Pediatric Epilepsy Self-Management Questionnaire (PEMSQ).
Results A total of 123 patients were selected and enrolled in the study. Seventy eight percent of the respondents knew that epilepsy is a brain disorder, while only 6% of them were aware about all the treatment options. The scoring in the domain of “Disease and Treatment Knowledge & Expectations of parents” was found to be significantly low (69.07%) when compared to other domains in the PEMSQ. Although socioeconomic status did not correlate with knowledge score of the parents (p = 0.216), it was significantly related to adherence (p = 0.042).
Conclusion In this cohort, even though the parents had a fair knowledge about the nature of epilepsy, they were found to be less aware about its characteristics, causes and prognosis. The awareness about the nature and duration of treatment, its objectives, use of drugs, their side effects and importance of adherence to drug regimen was found to be significantly low with a potential for affecting the therapeutic outcome. Special awareness programs for parents of children with epilepsy may be needed to reduce the knowledge gaps in the management of epilepsy and to ensure compliance and optimal therapeutic outcomes.
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Martino T, Lalla A, Carapelle E, Di Claudio MT, Avolio C, d'Orsi G. First-aid management of tonic-clonic seizures among healthcare personnel: A survey by the Apulian section of the Italian League Against Epilepsy. Epilepsy Behav 2018; 80:321-325. [PMID: 29402633 DOI: 10.1016/j.yebeh.2017.11.017] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/15/2017] [Revised: 11/15/2017] [Accepted: 11/19/2017] [Indexed: 02/07/2023]
Abstract
INTRODUCTION To evaluate the knowledge of healthcare workers about first-aid measures to be performed during and after a tonic-clonic seizure. METHODS One hundred and fifty-four healthcare workers (86 physicians) working at 8 tertiary hospitals in the Apulia region, Italy, responded to a questionnaire comprising of 28 questions based on available Italian and international recommendations about what to do during a tonic-clonic seizure. RESULTS One hundred and fifty-four healthcare workers completed and returned surveys with a response rate of 96.25%. There were 55 nurses (35.7%), 86 physicians (55.8%), and 13 healthcare workers with different roles (Electroencephalograph technicians, psychologists, social workers). Among physicians, there were 7 cardiologists, 3 surgeons, 12 infectious-disease specialists, 11 internal medicine specialists, 2 psychiatrists, 2 gynecologists, 27 specialists working in the emergency department, and 22 physicians with different specializations. Nearly 90% of the respondents identified head protection as important first aid, while 100% responded to not keep the legs elevated. To avoid tongue bite, both physicians and other healthcare workers would put something in the mouth (54.0%), like a Guedel cannula (71.0%) fingers (29.5%). Grabbing arms and legs, trying to stop the seizure, would be potentially performed by 11.6% of our sample. Physicians would administer a benzodiazepine during the seizure (65.7%) and during the postictal phase (29.2%), even if the patient is known to have epilepsy (23.7%), and in this case, 11.3% of respondents would administer the usual antiepileptic medications. More than half of respondents would call the emergency telephone number, because of necessary hospitalization in case of tonic-clonic seizure, even if it is experienced by a patient known to have epilepsy. CONCLUSION Our survey suggests the need for epilepsy educational programs on first-aid management of seizures among healthcare workers.
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Affiliation(s)
- Tommaso Martino
- Epilepsy Centre - Clinic of Nervous System Diseases, Riuniti Hospital, Foggia, Italy
| | - Alessandra Lalla
- Epilepsy Centre - Clinic of Nervous System Diseases, Riuniti Hospital, Foggia, Italy
| | - Elena Carapelle
- Epilepsy Centre - Clinic of Nervous System Diseases, Riuniti Hospital, Foggia, Italy
| | | | - Carlo Avolio
- Epilepsy Centre - Clinic of Nervous System Diseases, Riuniti Hospital, Foggia, Italy
| | - Giuseppe d'Orsi
- Epilepsy Centre - Clinic of Nervous System Diseases, Riuniti Hospital, Foggia, Italy.
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- Epilepsy Centre - Clinic of Nervous System Diseases, Riuniti Hospital, Foggia, Italy
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Alkhateeb JM, Alhadidi MS. Information about epilepsy on the internet: An exploratory study of Arabic websites. Epilepsy Behav 2018; 78:288-290. [PMID: 29153965 DOI: 10.1016/j.yebeh.2017.07.012] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2017] [Revised: 07/09/2017] [Accepted: 07/09/2017] [Indexed: 10/18/2022]
Abstract
The aim of this study was to explore information about epilepsy found on Arabic websites. The researchers collected information from the internet between November 2016 and January 2017. Information was obtained using Google and Yahoo search engines. Keywords used were the Arabic equivalent of the following two keywords: epilepsy (Al-saraa) and convulsion (Tashanoj). A total of 144 web pages addressing epilepsy in Arabic were reviewed. The majority of web pages were websites of medical institutions and general health websites, followed by informational and educational websites, others, blogs and websites of individuals, and news and media sites. Topics most commonly addressed were medical treatments for epilepsy (50% of all pages) followed by epilepsy definition (41%) and epilepsy etiology (34.7%). The results also revealed that the vast majority of web pages did not mention the source of information. Many web pages also did not provide author information. Only a small proportion of the web pages provided adequate information. Relatively few web pages provided inaccurate information or made sweeping generalizations. As a result, it is concluded that the findings of the present study suggest that development of more credible Arabic websites on epilepsy is needed. These websites need to go beyond basic information, offering more evidence-based and updated information about epilepsy.
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Nagan M, Caffarelli M, Donatelli S, Rosman NP. Epilepsy or a Seizure Disorder? Parental Knowledge and Misconceptions About Terminology. J Pediatr 2017; 191:197-203.e5. [PMID: 29173305 DOI: 10.1016/j.jpeds.2017.08.068] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2017] [Revised: 07/03/2017] [Accepted: 08/03/2017] [Indexed: 10/18/2022]
Abstract
OBJECTIVE To assess primary caregiver understanding of the term epilepsy. STUDY DESIGN A cross-sectional telephone survey evaluated understanding of the term epilepsy among primary caregivers of children diagnosed with epilepsy at an urban referral center during a 24-month period. Three measures of primary caregiver understanding were used: (1) identifying if their child had a seizure disorder, epilepsy, or both; (2) providing an open-ended definition of epilepsy; and (3) selecting from a multiple-choice definition of epilepsy. Caregivers with 3 correct answers were assigned the greatest knowledge score. Associations with possible predictor variables were analyzed. RESULTS Caregivers for 75 of 116 eligible patients were contacted successfully. Of those, 55 of 75 met eligibility criteria; 45 of the eligible caregivers completed the survey. Twenty-six of 45 caregivers (58%) identified that their child had both a seizure disorder and epilepsy, 5 of 45 (11%) provided a correct open-ended definition of epilepsy, and 16 of 45 (36%) selected the correct multiple-choice definition. Fifteen caregivers (33%) had no correct answers. Seventeen (38%) answered 1, 9 (20%) answered 2, and 4 (9%) answered all 3 measures correctly. Caregivers with greater self-rated understanding had greater epilepsy knowledge scores (P = .008). Having a child neurologist as the first person to discuss the diagnosis with the caregiver also predicted a greater epilepsy knowledge score (P = .04). CONCLUSIONS Most primary caregivers of children with epilepsy have a poor understanding of the term epilepsy. Changes are needed in how we educate caregivers about the meaning of this term.
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Affiliation(s)
- Margot Nagan
- Department of Pediatrics and Neurology, Division of Pediatric Neurology, Children's Hospital of Colorado, Aurora, CO; Department of Pediatrics and Neurology, Division of Pediatric Neurology, University of Colorado Denver, Denver, CO
| | - Mauro Caffarelli
- Department of Pediatrics and Neurology, Division of Pediatric Neurology, Benioff Children's Hospital, San Francisco, CA; Department of Pediatrics and Neurology, Division of Pediatric Neurology, University of California San Francisco School of Medicine, San Francisco, CA
| | - Stephanie Donatelli
- Department of Pediatrics and Neurology, Division of Pediatric Neurology, Boston Children's Hospital, Boston, MA; Department of Pediatrics and Neurology, Division of Pediatric Neurology, Harvard Medical School, Boston, MA; Department of Pediatrics and Neurology, Division of Pediatric Neurology, Boston Medical Center, Boston, MA; Department of Pediatrics and Neurology, Division of Pediatric Neurology, Boston University School of Medicine, Boston, MA
| | - N Paul Rosman
- Department of Pediatrics and Neurology, Division of Pediatric Neurology, Boston Medical Center, Boston, MA; Department of Pediatrics and Neurology, Division of Pediatric Neurology, Boston University School of Medicine, Boston, MA.
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AlAjmi R, Al-Aqeel S, Baz S. The impact of a pharmacist-led educational interview on medication adherence of Saudi patients with epilepsy. Patient Prefer Adherence 2017; 11:959-964. [PMID: 28572723 PMCID: PMC5441662 DOI: 10.2147/ppa.s124028] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
PURPOSE To evaluate the effectiveness of a pharmacist-led educational interview in terms of adherence to antiepileptic drug administration among adult patients with epilepsy. METHOD Sixty adult patients with epilepsy who fulfilled the inclusion criteria were recruited. A pharmacist-led educational interview was conducted with the intervention group (n=30). Patients in the control group (n=30) were interviewed and contacted 6 weeks after the initial visit without receiving any intervention. Antiepileptic drug adherence was measured during clinic visits, and 6 weeks afterwards using the 8-item Morisky Medication Adherence Scale. This prospective interventional study was conducted between September and December 2013. RESULTS Only 29 control patients and 27 intervention patients completed the 6 weeks post-intervention adherence measurement. The adherence score average in the intervention group was 5.26±0.98 at baseline and improved to 6.7±0.823 (P<0.0001) after intervention. In the control group, the adherence score average was 5.76±1.806 at baseline and 5.83±1.627 at 6 weeks (P=0.792). While there was no statistically significant difference in adherence score between intervention and control groups at baseline, the post-intervention difference was significant (P=0.024). CONCLUSION Our study suggests that pharmacist-led educational interviews had a positive impact on medication adherence in patients with epilepsy.
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Affiliation(s)
- Refah AlAjmi
- Clinical Pharmacy Department, College of Pharmacy, King Saud University, Riyadh, Kingdom of Saudi Arabia
| | - Sinaa Al-Aqeel
- Clinical Pharmacy Department, College of Pharmacy, King Saud University, Riyadh, Kingdom of Saudi Arabia
| | - Salah Baz
- Department of Neurosciences, King Faisal Specialist Hospital and Research Center, Riyadh, Kingdom of Saudi Arabia
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Milošević M, Friedrich L, Tomasović S, Bielen I. Online epilepsy counseling in Croatia: What do users want to know? Seizure 2016; 41:116-9. [PMID: 27525581 DOI: 10.1016/j.seizure.2016.07.020] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2016] [Revised: 07/29/2016] [Accepted: 07/31/2016] [Indexed: 10/21/2022] Open
Abstract
PURPOSE The purpose of this study is to better understand which specific epilepsy-related issues are cause for seeking out professional advice online. METHOD An online epilepsy counseling service introduced by the Croatian Epilepsy Association allows users to anonymously submit questions related to epilepsy via e-mail or online contact form, which are later answered by an epilepsy professional. The questions were classified both by inquirers and by content. Inquirers were classified as patients, patient's parents, family members, partners, and friends of patients with epilepsy. In terms of content, questions were divided into three groups: medical, socially-oriented, and unclassifiable questions. RESULTS In sum, 355 e-mails, which included 513 questions, were analyzed. The vast majority of inquirers were patients themselves (48%) and parents of patients (28%). While 76% of questions concerned the medical aspects of epilepsy, there was as well significant interest in administrative and practical issues associated with the diagnosis of epilepsy. Among medical questions, the most popular concerned prognosis (15%) and second opinions (14%); among socially-oriented questions, inquirers were primarily interested in matters associated with their profession (28%). As well, the parents of patients were more likely to question an epilepsy diagnosis than the patients themselves (p<0.001). CONCLUSION According to the results of this study, it is clear that epilepsy professionals should invest more time in discussing with patients the topics which interest them the most, as well as refer them to other professionals that can help them with non-medical epilepsy-related issues, and advise them on reliable Internet sources.
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Affiliation(s)
- Marina Milošević
- Department of Neurology, Sveti Duh University Hospital, Sveti Duh 64, Zagreb, Croatia.
| | - Latica Friedrich
- Department of Neurology, Sveti Duh University Hospital, Sveti Duh 64, Zagreb, Croatia
| | - Sanja Tomasović
- Department of Neurology, Sveti Duh University Hospital, Sveti Duh 64, Zagreb, Croatia; School of Medicine Josip Juraj Strossmayer, University of Osijek, Osijek, Croatia
| | - Ivan Bielen
- Department of Neurology, Sveti Duh University Hospital, Sveti Duh 64, Zagreb, Croatia; School of Medicine Josip Juraj Strossmayer, University of Osijek, Osijek, Croatia
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Atakli D, Dogan Ak P, Guveli BT, Yuksel B. Knowledge of epilepsy among persons with epilepsy in Turkey. Epilepsy Behav 2016; 57:41-45. [PMID: 26921597 DOI: 10.1016/j.yebeh.2016.01.030] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2015] [Revised: 01/24/2016] [Accepted: 01/25/2016] [Indexed: 01/28/2023]
Abstract
PURPOSE It has been shown in studies that there are knowledge gaps about epilepsy in both developing and developed countries all around the world. Lack of knowledge exists even among people with epilepsy (PWE), and this may affect their lives negatively. This study aimed to evaluate what PWE in Turkey know about their disease. METHOD A self-completed questionnaire consisting of demographic details, an item about perceived stigmatization, and 24 items about general knowledge of medical and social aspects of epilepsy was developed. Applicants were asked to answer 'true', 'false', or 'do not know' to each statement. The scores of the questionnaire were defined as low (< 15 point), medium (≥ 15-20), and high (≥ 20). RESULTS The mean score on the questionnaire was 15.17 ± 3.74 (range, 4-24). One hundred twenty-five PWE (37.9%) scored low, 170 PWE (51.5%) scored medium, and 35 PWE (10.6%) scored high. The education level and household income were highly correlated with the knowledge level. Higher education level (r: 0.31) and high income (r: 0.25) were correlated with higher mean scores (p < 0.01). Lack of information was present particularly in terms of etiology, management of seizures, and medication during pregnancy. CONCLUSION We documented the knowledge deficit of PWE about their disease, a situation that may lead to suboptimal management and negative attitudes. We concluded that study programs should be organized and more education should be provided to PWE in order to overcome these issues.
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Affiliation(s)
- Dilek Atakli
- Bakirkoy Education and Research Hospital for Psychiatry, Neurology and Neurosurgery, Neurology Department, Istanbul, Turkey; Fatih Sultan Mehmet Education and Research Hospital, Neurology Department, Istanbul, Turkey; Antalya Education and Research Hospital, Neurology Department, Antalya, Turkey
| | - Pelin Dogan Ak
- Bakirkoy Education and Research Hospital for Psychiatry, Neurology and Neurosurgery, Neurology Department, Istanbul, Turkey; Fatih Sultan Mehmet Education and Research Hospital, Neurology Department, Istanbul, Turkey; Antalya Education and Research Hospital, Neurology Department, Antalya, Turkey.
| | - Betul Tekin Guveli
- Bakirkoy Education and Research Hospital for Psychiatry, Neurology and Neurosurgery, Neurology Department, Istanbul, Turkey; Fatih Sultan Mehmet Education and Research Hospital, Neurology Department, Istanbul, Turkey; Antalya Education and Research Hospital, Neurology Department, Antalya, Turkey
| | - Burcu Yuksel
- Bakirkoy Education and Research Hospital for Psychiatry, Neurology and Neurosurgery, Neurology Department, Istanbul, Turkey; Fatih Sultan Mehmet Education and Research Hospital, Neurology Department, Istanbul, Turkey; Antalya Education and Research Hospital, Neurology Department, Antalya, Turkey
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Facteurs d’insertion professionnelle des personnes souffrant d’épilepsie : revue de la littérature. ARCH MAL PROF ENVIRO 2016. [DOI: 10.1016/j.admp.2015.10.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Lee SA, Lee BI. Association of knowledge about epilepsy with mood and self-efficacy in Korean people with epilepsy. Epilepsy Behav 2015; 52:149-53. [PMID: 26414345 DOI: 10.1016/j.yebeh.2015.08.027] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2015] [Revised: 08/18/2015] [Accepted: 08/18/2015] [Indexed: 11/26/2022]
Abstract
PURPOSE We determined the level of knowledge about epilepsy in Korean people with epilepsy (PWE) and evaluated whether this is associated with self-efficacy, perceived stigma, anxiety, and depressive mood in these patients. METHODS This was a cross-sectional multicenter study. A total of 530 PWE participated from 31 secondary or tertiary hospitals in Korea. Knowledge about epilepsy was assessed using 34 medical items (EKP-M) of the Epilepsy Knowledge Profile-General. Additional questionnaires included the Epilepsy Self-Efficacy Scale (ESES), Stigma Scale, and Hospital Anxiety and Depression Scale (HADS). Multiple linear regression analyses were used. RESULTS The mean EKP-M score was 22.2 (SD: 4.1). By univariate analyses, the EKP-M was related to ESES (r=0.220, p<0.001) and HADS-D (r=-0.154, p<0.001) scores but not to the Stigma Scale or HADS-A. By linear regression analyses, after adjusting for the confounding variables, the higher EKP-M scores were independently related to both higher ESES (p<0.001) and lower HADS-D scores (p<0.05). CONCLUSION Korean PWE have a relatively low level of knowledge about their condition. Knowledge about epilepsy is associated with a high level of self-efficacy and less depressive symptoms in affected individuals.
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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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Verma M, Arora A, Malviya S, Nehra A, Sagar R, Tripathi M. Do expressed emotions result in stigma? A potentially modifiable factor in persons with epilepsy in India. Epilepsy Behav 2015; 52:205-11. [PMID: 26453891 DOI: 10.1016/j.yebeh.2015.08.008] [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: 04/21/2015] [Revised: 06/23/2015] [Accepted: 08/05/2015] [Indexed: 12/18/2022]
Abstract
OBJECTIVE Feeling stigmatized or having comorbid depression in a PWE may significantly influence epilepsy care and treatment. An important contributory factor to this can be the expressed emotions (EEs) from family, friends, or society. The present study aimed at understanding the influence of EEs, as exhibited by close relatives, on the perception of stigma and comorbid depression experienced by PWEs. METHOD Eighty PWEs aged 18 years and above, both genders, visiting neurology OPD in AIIMS Hospital, were recruited. Using the PHQ-09, we subdivided them into Group I (PWEs with comorbid depression) and Group II (PWEs without comorbid depression), followed by administration of Levels of Expressed Emotions Scale and Stigma Scale for Epilepsy, respectively. RESULTS The comparative analysis, using independent t-test (for categorical data), Pearson's correlation (for continuous data), and multivariate regression analysis, reflected significant influence of EEs on depression and stigma, with more than 20% of the participants reporting comorbid depression, out of which more than 50% further expressed feelings of inferiority or disgrace due to the ways in which family or society discriminated them from healthy persons, thereby highlighting a greater associations of high EEs as opposed to low EEs from key individuals on patients' perception of stigma or feeling of depression. CONCLUSION The result suggested that EEs from a relative might go unnoticed but may significantly overwhelm the patient, thereby making him succumb to depression or feeling stigmatized. The analysis of such a clinical profile and relationship between EEs and perceived stigma/depression may help us understand the pattern of attribution styles adopted by PWEs, thereby utilizing it further for enhancing the efficacy of cognitive-behavioral therapy for facilitating sustained recovery and improved quality of life for PWEs.
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Affiliation(s)
- Mansi Verma
- Department of Neurology, All India Institute of Medical Sciences (AIIMS), New Delhi, India.
| | - Amit Arora
- Department of Neurology, AIIMS, Delhi, India.
| | | | - Ashima Nehra
- Department of Neuropsychology, AIIMS, Delhi, India.
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Al-Eryani B, Saied KG, Sharaf Alddin R, Al-Sobaihi S, Lutf W, Al-Taiar A. Knowledge of, attitudes toward, and perceptions of epilepsy among university students in Yemen. Epilepsy Behav 2015; 52:102-7. [PMID: 26409137 DOI: 10.1016/j.yebeh.2015.08.011] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2015] [Revised: 08/08/2015] [Accepted: 08/08/2015] [Indexed: 10/23/2022]
Abstract
This cross-sectional study aimed to describe the knowledge and perceptions about epilepsy and the attitudes toward people with epilepsy (PWEs) among university students in Yemen. A self-administered questionnaire was completed by 1155 students. Approximately 23% thought that epilepsy is a form of insanity, and 18% thought that it is a form of mental retardation. About 22% and 10% believed that evil spirits and an evil eye cause epilepsy, respectively. Similarly, 12% believed that children with epilepsy (CWEs) should be isolated from other children, while 12% and 14% thought that PWEs should not get married and should not have children, respectively. Approximately 23% of the students would not allow their child to play with CWEs, and 37% would not employ PWEs in a clerical job. Furthermore, 64% of the students would not agree to marry PWEs. Some misconceptions were strongly linked to attitudes toward PWEs. In conclusion, the negative attitudes toward PWEs among university students in Yemen were slightly more common compared with other settings in the Middle East and showed significant differences between genders which may warrant consideration when designing educational campaigns.
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Affiliation(s)
- Bilguis Al-Eryani
- Department of Paediatrics, Faculty of Medicine and Health Sciences, Sana'a University, Yemen
| | - Khaled Ghilan Saied
- Department of Community Medicine, Faculty of Medicine and Health Sciences, Sana'a University, Yemen
| | - Reem Sharaf Alddin
- Department of Community Medicine, Faculty of Medicine and Health Sciences, Sana'a University, Yemen
| | - Saber Al-Sobaihi
- Department of Global Health Promotion, Division of Public Health, Tokyo Medical and Dental University, Tokyo, Japan
| | | | - Abdullah Al-Taiar
- Department of Community Medicine and Behavioural Sciences, Faculty of Medicine, Kuwait University, Kuwait.
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Yadegary MA, Maemodan FG, Nayeri ND, Ghanjekhanlo A. The effect of self-management training on health-related quality of life in patients with epilepsy. Epilepsy Behav 2015; 50:108-12. [PMID: 26232570 DOI: 10.1016/j.yebeh.2015.04.051] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2014] [Revised: 02/24/2015] [Accepted: 04/21/2015] [Indexed: 11/17/2022]
Abstract
PURPOSE Epilepsy is the most common chronic neurological disease after headache. Health-related quality of life in patients with epilepsy is disturbed by psychosocial factors, seizures, and treatment side effects. This study was conducted to determine the effect of a self-management training program on quality of life in patients with epilepsy. METHODS In this controlled clinical trial, 60 patients with epilepsy going to Zanjan Neurology Clinic were examined. The samples were selected using convenience sampling and divided randomly into the case group (30 people) and control group (30 people) using the table of random numbers. Four training sessions on the nature of epilepsy and self-managementwere run for the case group. All the patients completed an inventory for quality of life twice: before and one month after the intervention. The data were analyzed using the chi-square test, independent t-test, and paired t-test. RESULTS There was no statistically significant difference between the two groups before the intervention in terms of personal specifications and scores and dimensions of the quality of life. One month after the intervention, a statistically significant difference was observed between the two groups in terms of the scores and dimensions of quality of life that indicated improved quality of life in the case group (P<0.001). CONCLUSION The self-management training program improved the quality of life in patients with epilepsy. The present findings highlight that psychosocial variables can have incremental significance over biomedical variables in the health-related quality of life of patients with epilepsy.
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Affiliation(s)
- Mohammad Ali Yadegary
- School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran.
| | | | - Nahid Dehghan Nayeri
- Tehran University of Medical Sciences, Nursing Management Department, Nursing and Midwifery Care Research Center, Tehran, Iran.
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Hixson JD, Barnes D, Parko K, Durgin T, Van Bebber S, Graham A, Wicks P. Patients optimizing epilepsy management via an online community: the POEM Study. Neurology 2015; 85:129-36. [PMID: 26085605 PMCID: PMC4515038 DOI: 10.1212/wnl.0000000000001728] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2014] [Accepted: 03/18/2015] [Indexed: 01/17/2023] Open
Abstract
Objective: The study objective was to test whether engaging in an online patient community improves self-management and self-efficacy in veterans with epilepsy. Methods: The study primary outcomes were validated questionnaires for self-management (Epilepsy Self-Management Scale [ESMS]) and self-efficacy (Epilepsy Self-Efficacy Scale [ESES]). Results were based on within-subject comparisons of pre- and postintervention survey responses of veterans with epilepsy engaging with the PatientsLikeMe platform for a period of at least 6 weeks. Analyses were based on both completer and intention-to-treat scenarios. Results: Of 249 eligible participants enrolled, 92 individuals completed both surveys. Over 6 weeks, completers improved their epilepsy self-management (ESMS total score from 139.7 to 142.7, p = 0.02) and epilepsy self-efficacy (ESES total score from 244.2 to 254.4, p = 0.02) scores, with greatest impact on an information management subscale (ESMS–information management total score from 20.3 to 22.4, p < 0.001). Results were similar in intention-to-treat analyses. Median number of logins, postings to forums, leaving profile comments, and sending private messages were more common in completers than noncompleters. Conclusions: An internet-based psychosocial intervention was feasible to implement in the US veteran population and increased epilepsy self-management and self-efficacy scores. The greatest improvement was noted for information management behaviors. Patients with chronic conditions are increasingly encouraged to self-manage their condition, and digital communities have potential advantages, such as convenience, scalability to large populations, and building a community support network. Classification of evidence: This study provides Class IV evidence that for patients with epilepsy, engaging in an online patient community improves self-management and self-efficacy.
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Affiliation(s)
- John D Hixson
- From the Departments of Neurology (J.D.H., K.P.), Psychiatry (D.B.), and Epidemiology & Biostatistics (D.B.), University of California San Francisco and the SF VA Medical Center; US Medical Affairs (T.D.), UCB, Inc.; Northern California Institute for Research and Education and the SF VA Medical Center (S.V.B.); and PatientsLikeMe (A.G., P.W.).
| | - Deborah Barnes
- From the Departments of Neurology (J.D.H., K.P.), Psychiatry (D.B.), and Epidemiology & Biostatistics (D.B.), University of California San Francisco and the SF VA Medical Center; US Medical Affairs (T.D.), UCB, Inc.; Northern California Institute for Research and Education and the SF VA Medical Center (S.V.B.); and PatientsLikeMe (A.G., P.W.)
| | - Karen Parko
- From the Departments of Neurology (J.D.H., K.P.), Psychiatry (D.B.), and Epidemiology & Biostatistics (D.B.), University of California San Francisco and the SF VA Medical Center; US Medical Affairs (T.D.), UCB, Inc.; Northern California Institute for Research and Education and the SF VA Medical Center (S.V.B.); and PatientsLikeMe (A.G., P.W.)
| | - Tracy Durgin
- From the Departments of Neurology (J.D.H., K.P.), Psychiatry (D.B.), and Epidemiology & Biostatistics (D.B.), University of California San Francisco and the SF VA Medical Center; US Medical Affairs (T.D.), UCB, Inc.; Northern California Institute for Research and Education and the SF VA Medical Center (S.V.B.); and PatientsLikeMe (A.G., P.W.)
| | - Stephanie Van Bebber
- From the Departments of Neurology (J.D.H., K.P.), Psychiatry (D.B.), and Epidemiology & Biostatistics (D.B.), University of California San Francisco and the SF VA Medical Center; US Medical Affairs (T.D.), UCB, Inc.; Northern California Institute for Research and Education and the SF VA Medical Center (S.V.B.); and PatientsLikeMe (A.G., P.W.)
| | - Arianne Graham
- From the Departments of Neurology (J.D.H., K.P.), Psychiatry (D.B.), and Epidemiology & Biostatistics (D.B.), University of California San Francisco and the SF VA Medical Center; US Medical Affairs (T.D.), UCB, Inc.; Northern California Institute for Research and Education and the SF VA Medical Center (S.V.B.); and PatientsLikeMe (A.G., P.W.)
| | - Paul Wicks
- From the Departments of Neurology (J.D.H., K.P.), Psychiatry (D.B.), and Epidemiology & Biostatistics (D.B.), University of California San Francisco and the SF VA Medical Center; US Medical Affairs (T.D.), UCB, Inc.; Northern California Institute for Research and Education and the SF VA Medical Center (S.V.B.); and PatientsLikeMe (A.G., P.W.)
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Fountain NB, Van Ness PC, Bennett A, Absher J, Patel AD, Sheth KN, Gloss DS, Morita DA, Stecker M. Quality improvement in neurology: Epilepsy Update Quality Measurement Set. Neurology 2015; 84:1483-7. [PMID: 25846995 DOI: 10.1212/wnl.0000000000001448] [Citation(s) in RCA: 73] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Affiliation(s)
- Nathan B Fountain
- From the Neurology Department (N.B.F.), Comprehensive Epilepsy Program, University of Virginia, Charlottesville; the Department of Neurology and Neurotherapeutics (P.C.V.N.), University of Texas Southwestern Medical Center, Dallas; the American Academy of Neurology (A.B.), Minneapolis, MN; Absher Neurology (J.A.), Greenville, SC; the Division of Neurology and Pediatrics (A.D.P.), Nationwide Children's Hospital and The Ohio State University College of Medicine, Columbus; the Division of Neurocritical Care & Emergency Neurology, Department of Neurology (K.N.S.), Yale University School of Medicine, New Haven, CT; the Department of Neurology (D.S.G.), Geisinger Health System, Danville, PA; the Department of Pediatrics, Division of Neurology (D.A.M.), Cincinnati Children's Hospital Medical Center, OH; and the Department of Patient Safety, Quality and Innovation (M.S.), Winthrop University Hospital, Mineola, NY
| | - Paul C Van Ness
- From the Neurology Department (N.B.F.), Comprehensive Epilepsy Program, University of Virginia, Charlottesville; the Department of Neurology and Neurotherapeutics (P.C.V.N.), University of Texas Southwestern Medical Center, Dallas; the American Academy of Neurology (A.B.), Minneapolis, MN; Absher Neurology (J.A.), Greenville, SC; the Division of Neurology and Pediatrics (A.D.P.), Nationwide Children's Hospital and The Ohio State University College of Medicine, Columbus; the Division of Neurocritical Care & Emergency Neurology, Department of Neurology (K.N.S.), Yale University School of Medicine, New Haven, CT; the Department of Neurology (D.S.G.), Geisinger Health System, Danville, PA; the Department of Pediatrics, Division of Neurology (D.A.M.), Cincinnati Children's Hospital Medical Center, OH; and the Department of Patient Safety, Quality and Innovation (M.S.), Winthrop University Hospital, Mineola, NY
| | - Amy Bennett
- From the Neurology Department (N.B.F.), Comprehensive Epilepsy Program, University of Virginia, Charlottesville; the Department of Neurology and Neurotherapeutics (P.C.V.N.), University of Texas Southwestern Medical Center, Dallas; the American Academy of Neurology (A.B.), Minneapolis, MN; Absher Neurology (J.A.), Greenville, SC; the Division of Neurology and Pediatrics (A.D.P.), Nationwide Children's Hospital and The Ohio State University College of Medicine, Columbus; the Division of Neurocritical Care & Emergency Neurology, Department of Neurology (K.N.S.), Yale University School of Medicine, New Haven, CT; the Department of Neurology (D.S.G.), Geisinger Health System, Danville, PA; the Department of Pediatrics, Division of Neurology (D.A.M.), Cincinnati Children's Hospital Medical Center, OH; and the Department of Patient Safety, Quality and Innovation (M.S.), Winthrop University Hospital, Mineola, NY
| | - John Absher
- From the Neurology Department (N.B.F.), Comprehensive Epilepsy Program, University of Virginia, Charlottesville; the Department of Neurology and Neurotherapeutics (P.C.V.N.), University of Texas Southwestern Medical Center, Dallas; the American Academy of Neurology (A.B.), Minneapolis, MN; Absher Neurology (J.A.), Greenville, SC; the Division of Neurology and Pediatrics (A.D.P.), Nationwide Children's Hospital and The Ohio State University College of Medicine, Columbus; the Division of Neurocritical Care & Emergency Neurology, Department of Neurology (K.N.S.), Yale University School of Medicine, New Haven, CT; the Department of Neurology (D.S.G.), Geisinger Health System, Danville, PA; the Department of Pediatrics, Division of Neurology (D.A.M.), Cincinnati Children's Hospital Medical Center, OH; and the Department of Patient Safety, Quality and Innovation (M.S.), Winthrop University Hospital, Mineola, NY
| | - Anup D Patel
- From the Neurology Department (N.B.F.), Comprehensive Epilepsy Program, University of Virginia, Charlottesville; the Department of Neurology and Neurotherapeutics (P.C.V.N.), University of Texas Southwestern Medical Center, Dallas; the American Academy of Neurology (A.B.), Minneapolis, MN; Absher Neurology (J.A.), Greenville, SC; the Division of Neurology and Pediatrics (A.D.P.), Nationwide Children's Hospital and The Ohio State University College of Medicine, Columbus; the Division of Neurocritical Care & Emergency Neurology, Department of Neurology (K.N.S.), Yale University School of Medicine, New Haven, CT; the Department of Neurology (D.S.G.), Geisinger Health System, Danville, PA; the Department of Pediatrics, Division of Neurology (D.A.M.), Cincinnati Children's Hospital Medical Center, OH; and the Department of Patient Safety, Quality and Innovation (M.S.), Winthrop University Hospital, Mineola, NY
| | - Kevin N Sheth
- From the Neurology Department (N.B.F.), Comprehensive Epilepsy Program, University of Virginia, Charlottesville; the Department of Neurology and Neurotherapeutics (P.C.V.N.), University of Texas Southwestern Medical Center, Dallas; the American Academy of Neurology (A.B.), Minneapolis, MN; Absher Neurology (J.A.), Greenville, SC; the Division of Neurology and Pediatrics (A.D.P.), Nationwide Children's Hospital and The Ohio State University College of Medicine, Columbus; the Division of Neurocritical Care & Emergency Neurology, Department of Neurology (K.N.S.), Yale University School of Medicine, New Haven, CT; the Department of Neurology (D.S.G.), Geisinger Health System, Danville, PA; the Department of Pediatrics, Division of Neurology (D.A.M.), Cincinnati Children's Hospital Medical Center, OH; and the Department of Patient Safety, Quality and Innovation (M.S.), Winthrop University Hospital, Mineola, NY
| | - David S Gloss
- From the Neurology Department (N.B.F.), Comprehensive Epilepsy Program, University of Virginia, Charlottesville; the Department of Neurology and Neurotherapeutics (P.C.V.N.), University of Texas Southwestern Medical Center, Dallas; the American Academy of Neurology (A.B.), Minneapolis, MN; Absher Neurology (J.A.), Greenville, SC; the Division of Neurology and Pediatrics (A.D.P.), Nationwide Children's Hospital and The Ohio State University College of Medicine, Columbus; the Division of Neurocritical Care & Emergency Neurology, Department of Neurology (K.N.S.), Yale University School of Medicine, New Haven, CT; the Department of Neurology (D.S.G.), Geisinger Health System, Danville, PA; the Department of Pediatrics, Division of Neurology (D.A.M.), Cincinnati Children's Hospital Medical Center, OH; and the Department of Patient Safety, Quality and Innovation (M.S.), Winthrop University Hospital, Mineola, NY
| | - Diego A Morita
- From the Neurology Department (N.B.F.), Comprehensive Epilepsy Program, University of Virginia, Charlottesville; the Department of Neurology and Neurotherapeutics (P.C.V.N.), University of Texas Southwestern Medical Center, Dallas; the American Academy of Neurology (A.B.), Minneapolis, MN; Absher Neurology (J.A.), Greenville, SC; the Division of Neurology and Pediatrics (A.D.P.), Nationwide Children's Hospital and The Ohio State University College of Medicine, Columbus; the Division of Neurocritical Care & Emergency Neurology, Department of Neurology (K.N.S.), Yale University School of Medicine, New Haven, CT; the Department of Neurology (D.S.G.), Geisinger Health System, Danville, PA; the Department of Pediatrics, Division of Neurology (D.A.M.), Cincinnati Children's Hospital Medical Center, OH; and the Department of Patient Safety, Quality and Innovation (M.S.), Winthrop University Hospital, Mineola, NY
| | - Mona Stecker
- From the Neurology Department (N.B.F.), Comprehensive Epilepsy Program, University of Virginia, Charlottesville; the Department of Neurology and Neurotherapeutics (P.C.V.N.), University of Texas Southwestern Medical Center, Dallas; the American Academy of Neurology (A.B.), Minneapolis, MN; Absher Neurology (J.A.), Greenville, SC; the Division of Neurology and Pediatrics (A.D.P.), Nationwide Children's Hospital and The Ohio State University College of Medicine, Columbus; the Division of Neurocritical Care & Emergency Neurology, Department of Neurology (K.N.S.), Yale University School of Medicine, New Haven, CT; the Department of Neurology (D.S.G.), Geisinger Health System, Danville, PA; the Department of Pediatrics, Division of Neurology (D.A.M.), Cincinnati Children's Hospital Medical Center, OH; and the Department of Patient Safety, Quality and Innovation (M.S.), Winthrop University Hospital, Mineola, NY
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Mameniskiene R, Sakalauskaite-Juodeikiene E, Budrys V. People with epilepsy lack knowledge about their disease. Epilepsy Behav 2015; 46:192-7. [PMID: 25847428 DOI: 10.1016/j.yebeh.2015.03.002] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2015] [Revised: 02/28/2015] [Accepted: 03/02/2015] [Indexed: 12/01/2022]
Abstract
For people with epilepsy, knowledge of their disease is an important factor in optimizing the control of their seizures. Better-informed patients can more easily participate in the treatment process, reducing disease-related anxiety and coping better with stigma. This study was developed in a Lithuanian tertiary epilepsy center to assess knowledge of disease among people with epilepsy, to estimate differences in disease knowledge between patient groups, and to evaluate how epilepsy influences patients' daily lives. We asked patients to complete a questionnaire and collected information from outpatient cards on epilepsy etiology, type of seizures, findings of diagnostic tests, and information about patients' antiepileptic drugs. Our results showed that people with epilepsy have poor knowledge about their disease: almost half of the patients did not identify the cause of their illness or their type of seizures; most did not know the results of their EEG and neuroimaging studies. Patients also lacked general knowledge about their disease and implications for lifestyle. However, cognitive deficits were not assessed in this study, and this may have affected the answers where patients were required to recall and name their drugs or the dosage of medication. Almost half of them believed that epilepsy had changed their lives significantly and reported anxiety and constant fear of seizures. Patients were also afraid to have because of the possibility they would also have epilepsy. There is clearly a great need for improved educational intervention for people with epilepsy.
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Affiliation(s)
- R Mameniskiene
- Clinic of Neurology and Neurosurgery Faculty of Medicine, Vilnius University, Vilnius, Lithuania; Department of Neurology, Vilnius University Hospital "Santariskiu klinikos", Vilnius, Lithuania.
| | - E Sakalauskaite-Juodeikiene
- Clinic of Neurology and Neurosurgery Faculty of Medicine, Vilnius University, Vilnius, Lithuania; Department of Neurology, Vilnius University Hospital "Santariskiu klinikos", Vilnius, Lithuania
| | - V Budrys
- Clinic of Neurology and Neurosurgery Faculty of Medicine, Vilnius University, Vilnius, Lithuania; Department of Neurology, Vilnius University Hospital "Santariskiu klinikos", Vilnius, Lithuania
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Freitas-Lima P, Monteiro EA, Macedo LRH, Funayama SS, Ferreira FIS, Matias Júnior I, Angelis G, Nogueira AMA, Alexandre V, Velasco TR, Pinheiro-Martins AP, Sakamoto AC. The social context and the need of information from patients with epilepsy: evaluating a tertiary referral service. ARQUIVOS DE NEURO-PSIQUIATRIA 2015; 73:298-303. [DOI: 10.1590/0004-282x20150007] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/13/2014] [Accepted: 12/02/2014] [Indexed: 11/21/2022]
Abstract
Objective Characterize the social profile and the need of information from patients with refractory epilepsy. Method A semi-structured questionnaire was applied to 103 patients to investigate sociodemographic aspects, pharmacotherapy and any doubts about epilepsy. Results Patients were highly dependent on having a free and accessible supply of antiepileptic drugs. Sixty-eight percent of the population was unemployed, and 26% confirmed receiving social security benefits due to epilepsy. Twenty-nine percent of the population reached high school. Eighty-five percent of the patients had at least one doubt about epilepsy; treatment and epilepsy aspects in general were the main topics. Conclusion : As observed in developed countries, patients with refractory epilepsy from a developing country also have high rates of unemployment and low educational levels. The results raise a concern about the need of information about epilepsy by patients and their families, urging the necessity to invest in strategies to solve this deficiency in knowledge.
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Affiliation(s)
| | | | | | | | | | | | - Geisa Angelis
- Universidade de São Paulo, Brazil; Hospital das Clínicas, Brazil
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Ryu HU, Lee SA, Eom S, Kim HD. Perceived stigma in Korean adolescents with epilepsy: Effects of knowledge about epilepsy and maternal perception of stigma. Seizure 2015; 24:38-43. [DOI: 10.1016/j.seizure.2014.11.010] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2014] [Revised: 10/26/2014] [Accepted: 11/25/2014] [Indexed: 11/24/2022] Open
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Perceptions and experiences of epilepsy among patients from black ethnic groups in South London. Prim Health Care Res Dev 2014; 16:450-60. [DOI: 10.1017/s1463423614000437] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
ObjectiveThe National Institute of Clinical Excellence suggested black ethnic minorities with epilepsy have different cultural, communicative and health-care needs. However, little is known about these despite increasing migration of black African and Caribbean people to Europe. This study aims to explore perceptions and experiences of epilepsy among black African and Caribbean people in South London.MethodsSemi-structured interviews were undertaken with 11 participants, to examine their beliefs and perceptions of living with epilepsy. Interviews were recorded, transcribed, codes generated and thematic analysis undertaken.ResultsAfrican participants described supernatural causes for epilepsy and experienced considerable stigma whereas Caribbean participants described epilepsy as a ‘normal illness’. However, both African and Caribbean participants experienced social restrictions arising from their epilepsy.ConclusionsThe findings of higher levels of perceived stigma and social restriction seen in African participants may be a continuation of beliefs reported in participants’ country of origin. There is also evidence that views regarding epilepsy transition through generations vary depending on place of birth.Practical ImplicationsHealth-care professionals need to be aware of and engage with the particular beliefs and concerns of black African and Caribbean people to achieve equity in health outcomes.
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Szaflarski M. Social determinants of health in epilepsy. Epilepsy Behav 2014; 41:283-9. [PMID: 24998313 DOI: 10.1016/j.yebeh.2014.06.013] [Citation(s) in RCA: 68] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2014] [Revised: 06/05/2014] [Accepted: 06/07/2014] [Indexed: 10/25/2022]
Abstract
Social factors have been identified as key drivers of epilepsy care, outcomes, and disparities, but there is a limited understanding of what these factors are and how they translate into disparities. This targeted review provides an overview of the social determinants of health framework and applies this perspective to the literature about social and psychosocial factors in epilepsy; a social determinants of health--epilepsy model is proposed. The key social determinants of health in epilepsy include socioeconomic status, race/ethnicity, age, and gender. For example, low socioeconomic status and minority status have been associated with a higher risk of epilepsy, more hospitalizations and emergency room visits (versus neurology services), antiepileptic drug nonadherence, and a lower rate of epilepsy surgery. Such differences in care/treatment and outcomes translate into health disparities, many of which are considered unjust (inequitable) and modifiable through social action. Other social determinants of health include structural and sociocultural contextual conditions (e.g., health economy, policy, and social stigma/discrimination) and mediating mechanisms including material (e.g., housing), behavioral/biological (e.g., adherence), psychosocial (e.g., perceived stigma), and health system (e.g., access) factors. There are complex relationships among social determinants of health in epilepsy, which remain poorly understood and hamper efforts to address and eliminate disparities in epilepsy care and outcomes. Further empirical work grounded in sound theory and robust methodologies is needed to identify points of intervention and design effective and socially acceptable solutions to any pervasive disparities in epilepsy.
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Affiliation(s)
- Magdalena Szaflarski
- Department of Sociology, University of Alabama at Birmingham, HHB 460H, 1720 2nd Ave South, Birmingham, AL 35294-1152, USA.
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Agarwal R, Patel R, Set K, Zidan M, Sivaswamy L. Safety, Awareness, and Familiarity regarding Epilepsy in Teenage Years (SAFETY): understanding the adolescents' perspective about their disease. Epilepsy Behav 2014; 41:114-8. [PMID: 25461200 DOI: 10.1016/j.yebeh.2014.09.056] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/23/2014] [Revised: 09/11/2014] [Accepted: 09/20/2014] [Indexed: 10/24/2022]
Abstract
OBJECTIVE The objective of this study was to evaluate the understanding of adolescent patients regarding epilepsy. METHODS The SAFETY (Safety, Awareness, and Familiarity regarding Epilepsy in Teenage Years) questionnaire (content validity index: 0.96, Flesch readability score: 66.6) was administered to 165 cognitively normal adolescents with epilepsy (85 females, mean age: 15.2 ± 1.6 years, range: 13-18 years). The first part of the questionnaire was devised to evaluate knowledge about epilepsy and antiepileptic medications (SAFETY-K: 7 questions). The second part queried lifestyle modifications and safety (SAFETY-S: 10 questions). Female participants answered 5 additional questions related to reproductive health (RH questionnaire). RESULTS The correct response rate for the composite SAFETY questionnaire was 51.5%. The average rates of correct responses for the SAFETY-K and SAFETY-S questions were 47.9% and 53.9%, respectively. On univariate logistic regression analysis, factors which were significant predictors of correct responses included age (odds ratio: 1.8, C.I. = 1.3-2.4), race (Caucasian vs. African-American; odds ratio: 3.9, C.I. = 1.4-10.4), and employment of at least one parent in a professional occupation (odds ratio: 3.3, C.I. = 1.1-10.3). The correct response rate did not correlate with the duration of epilepsy, extent of seizure control, number of antiepileptic medications, parental educational, or (un)employment status. The mean rate of correct responses for the RH questions amongst teenage girls was 17.4%. CONCLUSIONS There is lack of awareness about epilepsy and its associated lifestyle modifications in adolescents with epilepsy seen at our institution. This is especially true in young adolescents, African-American patients, and those whose parents are not employed in professional occupations. Teenage girls with epilepsy appear to have limited knowledge with respect to contraception and childbearing.
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Affiliation(s)
- Rajkumar Agarwal
- Division of Neurology, Carman and Ann Adams Department of Pediatrics, Children's Hospital of Michigan, Wayne State University School of Medicine, 3901 Beaubien Blvd., Detroit, MI 48201, USA.
| | - Riddhiben Patel
- Division of Neurology, Carman and Ann Adams Department of Pediatrics, Children's Hospital of Michigan, Wayne State University School of Medicine, 3901 Beaubien Blvd., Detroit, MI 48201, USA.
| | - Kallol Set
- Division of Neurology, Carman and Ann Adams Department of Pediatrics, Children's Hospital of Michigan, Wayne State University School of Medicine, 3901 Beaubien Blvd., Detroit, MI 48201, USA.
| | - Marwan Zidan
- Department of Biostatistics, Children's Hospital of Michigan, Wayne State University School of Medicine, 3901 Beaubien Blvd., Detroit, MI 48201, USA.
| | - Lalitha Sivaswamy
- Division of Neurology, Carman and Ann Adams Department of Pediatrics, Children's Hospital of Michigan, Wayne State University School of Medicine, 3901 Beaubien Blvd., Detroit, MI 48201, USA.
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Kassie GM, Kebede TM, Duguma BK. Knowledge, attitude, and practice of epileptic patients towards their illness and treatment in jimma university specialized hospital, southwest ethiopia. NORTH AMERICAN JOURNAL OF MEDICAL SCIENCES 2014; 6:383-90. [PMID: 25210671 PMCID: PMC4158646 DOI: 10.4103/1947-2714.139288] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BACKGROUND Epilepsy is a major public health problem and specially in developing countries where its incidence is found to be higher. In countries like Ethiopia, epilepsy is thought as a supernatural happening and patients usually suffer from social discrimination and prejudice. AIMS The objective of this study was to assess the knowledge, attitude, and practice of people with epilepsy regarding their illness and its treatment at Jimma University Specialized Hospital (JUSH). MATERIALS AND METHODS A cross-sectional hospital-based study was conducted among patients with epilepsy on follow-up at epilepsy clinic. The study was done between June and July 2013 and data was analyzed by using SPSS version 16.0. RESULTS A total of 180 epileptic patients, on follow-up clinic, were interviewed out. A total of 25.5% and 60% of the respondents have knowledge about the cause and treatment of epilepsy, respectively. And, 70% of the respondents have positive attitude towards their treatment. About 53.3% of the respondents suggested correct positioning of the patients during seizure to prevent aspiration. CONCLUSION The study has showed that the majority of the respondents have medium knowledge and better attitude towards epilepsy and its treatments. They also have medium knowledge about the first aid measures to be taken for seizing patients.
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Affiliation(s)
- Gizat Molla Kassie
- Department of Pharmacy, College Public Health and Medical Sciences, Jimma University, Jimma, Ethiopia
| | - Tsegaye Melaku Kebede
- Department of Pharmacy, College Public Health and Medical Sciences, Jimma University, Jimma, Ethiopia
| | - Bogale Kebede Duguma
- Department of Pharmacy, College Public Health and Medical Sciences, Jimma University, Jimma, Ethiopia
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Ogunrin OA, Obiabo OY, Obehigie E. Risk factors for epilepsy in Nigerians - a cross-sectional case-control study. Acta Neurol Scand 2014; 129:109-13. [PMID: 24127647 DOI: 10.1111/ane.12192] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/11/2013] [Indexed: 11/26/2022]
Abstract
OBJECTIVE The identification of risk factors that predispose to development of epilepsy is crucial to its primary prevention. This study evaluated the risks conferred by some predisposing factors. PATIENTS AND METHODS This cross-sectional analytical study assessed the relative contributions of various risk factors to development of epilepsy in 244 adult Nigerians with epilepsy compared with equal number of age- and sex-matched controls. Odds ratio and Fisher exact test were used to express significant association. RESULTS Birth asphyxia (OR 6.87), recurrent childhood febrile convulsions (OR 5.74), central nervous system (CNS) infections (OR 3.38), head trauma (OR 1.82), rural dwelling without health care access (OR 2.44), and history of epilepsy in first-degree relatives (OR 3.44) were identified as significant risk factors for epilepsy. CONCLUSIONS Prompt diagnosis and appropriate treatment for febrile diseases and CNS infections, use of head helmets and car seat belts would contribute to reduced incidence.
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Affiliation(s)
- O. A. Ogunrin
- Neurology Unit; Department of Medicine; University of Benin Teaching Hospital; Benin City Nigeria
| | - O. Y. Obiabo
- Neurology Unit; Department of Medicine; University of Benin Teaching Hospital; Benin City Nigeria
| | - E. Obehigie
- Neurology Unit; Department of Medicine; University of Benin Teaching Hospital; Benin City Nigeria
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Bhalla D, Chea K, Chamroeun H, Vichea C, Huc P, Samleng C, Sebbag R, Gérard D, Dumas M, Oum S, Druet-Cabanac M, Preux PM. Comprehensive evaluation of the psychosocial parameters of epilepsy: A representative population-based study in Prey Veng (Cambodia). Epilepsia 2013; 54:1342-51. [DOI: 10.1111/epi.12218] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/08/2013] [Indexed: 11/26/2022]
Affiliation(s)
- Devender Bhalla
- INSERM UMR 1094; Tropical Neuroepidemiology; Limoges France
- School of Medicine; Institute of Neuroepidemiology and Tropical Neurology; CNRS FR 3503 GEIST; University of Limoges; Limoges France
- Centre Hospitalier Universitaire; Limoges France
- Cambodian Society of Neurology; Phnom Penh Cambodia
| | - Kimly Chea
- University of Health Sciences; Phnom Penh Cambodia
| | - Hun Chamroeun
- Cambodian Society of Neurology; Phnom Penh Cambodia
- University of Health Sciences; Phnom Penh Cambodia
- Department of Neurology; Calmette Hospital; Phnom Penh Cambodia
| | - Chan Vichea
- Department of Neurology; Calmette Hospital; Phnom Penh Cambodia
| | - Pierre Huc
- INSERM UMR 1094; Tropical Neuroepidemiology; Limoges France
- School of Medicine; Institute of Neuroepidemiology and Tropical Neurology; CNRS FR 3503 GEIST; University of Limoges; Limoges France
| | - Chan Samleng
- Cambodian Society of Neurology; Phnom Penh Cambodia
- University of Health Sciences; Phnom Penh Cambodia
- Department of Neurology; Calmette Hospital; Phnom Penh Cambodia
| | - Robert Sebbag
- Department of Access to Medicines; Sanofi; Gentilly France
| | - Daniel Gérard
- Department of Access to Medicines; Sanofi; Gentilly France
| | - Michel Dumas
- INSERM UMR 1094; Tropical Neuroepidemiology; Limoges France
- School of Medicine; Institute of Neuroepidemiology and Tropical Neurology; CNRS FR 3503 GEIST; University of Limoges; Limoges France
| | - Sophal Oum
- University of Health Sciences; Phnom Penh Cambodia
| | - Michel Druet-Cabanac
- INSERM UMR 1094; Tropical Neuroepidemiology; Limoges France
- School of Medicine; Institute of Neuroepidemiology and Tropical Neurology; CNRS FR 3503 GEIST; University of Limoges; Limoges France
- Centre Hospitalier Universitaire; Limoges France
| | - Pierre-Marie Preux
- INSERM UMR 1094; Tropical Neuroepidemiology; Limoges France
- School of Medicine; Institute of Neuroepidemiology and Tropical Neurology; CNRS FR 3503 GEIST; University of Limoges; Limoges France
- Centre Hospitalier Universitaire; Limoges France
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Health-related quality of life improvement via telemedicine for epilepsy: printed versus SMS-based education intervention. Qual Life Res 2013; 22:2123-32. [PMID: 23329469 DOI: 10.1007/s11136-013-0352-6] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/10/2013] [Indexed: 10/27/2022]
Abstract
BACKGROUND Improving health-related quality of life (HRQoL) among people with epilepsy (PWE) has become the focus of various treatment programmes and behavioural interventions which continue to be challenging to both patients and healthcare professionals. AIMS AND OBJECTIVES To investigate the impact of SMS-based epilepsy education programme on PWE's HRQoL status and to determine the predictors for good HRQoL. METHODS Eligible epilepsy out-patients from three public hospitals in East Coast Peninsular Malaysia were randomized into two groups: intervention (IG) and control (CG). Patients in the CG were supplied with only printed epilepsy educational module, while those in the IG additionally received short message service (SMS) from the Mobile Epilepsy Educational System (MEES). The Malay Quality of Life in Epilepsy Inventory-30 (MQOLIE-30) was utilized for HRQoL assessment. Descriptive statistics, paired t test, analysis of covariance and multiple logistic regression were employed for data analyses (SPSS 16). RESULTS One hundred and forty-four PWE were recruited for the study (age = 30.5 ± 11.8; unmarried = 60.4 %; education level ≤ SPM/Cambridge O' level = 76.4 %; illness duration > 5 years = 51.1 %). After controlling for possible confounders, IG exhibited positive changes in HRQoL profile compared to CG particularly in Seizure Worry, Overall Quality of Life, Emotional Well-Being, Social Functioning and Overall Score (p < 0.05). After adjusting for covariates, being employed and receiving additional SMS-based epilepsy education programme emerged as the significant predictors of good HRQoL among PWE. CONCLUSION Receiving continuous SMS-based epilepsy information from the MEES seemed to generate positive impacts on PWE's overall HRQoL. This study has provided a basis for future innovations to inspire efforts in ensuring the welfare and HRQoL of PWE and their families.
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Lua PL, Neni WS. Feasibility and acceptability of mobile epilepsy educational system (MEES) for people with epilepsy in Malaysia. Telemed J E Health 2012; 18:777-84. [PMID: 23078181 DOI: 10.1089/tmj.2012.0047] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Telemedicine innovations, including short message service (SMS), have been used to address a range of health concerns in a variety of settings. Practical, safe, and cost-effective, this simple tool can also potentially improve patients' understanding toward their own diseases via knowledge enhancement. This study was designed to develop and assess the feasibility and acceptability of an SMS-based epilepsy educational program for epilepsy patients. SUBJECTS AND METHODS This was a prospective randomized interventional study. Epilepsy outpatients from three general hospitals in East Coast Peninsular Malaysia received the SMS-based mobile epilepsy educational system (MEES) for a 3-month period. RESULTS In total, 51 patients completed the study (median age, 25.0 years; 51.0% female; 92.2% Malay; 56.9% single; education level, 70.6% ≤SPM/Cambridge O-level equivalent; 25.5% supportive workers; monthly income, 58.8% ≤MYR 500.0/USD 158.5). Approximately 86.0% of the patients owned at least a mobile phone. The total cost of SMS delivery was economically affordable (MYR 3.08/USD 0.98 per patient). Overall, 74.0% agreed that MEES was either very or quite useful. It is encouraging that the majority of patients have offered positive comments and favorable opinions specifically toward epilepsy education (94.0%), drug-taking reminder (90.0%), and clinic appointment reminder (88.0%). It was also reported that 88.2% of the participants would recommend MEES to other people with epilepsy. CONCLUSIONS The current study adds to the growing evidence suggesting that a greater investment in telemedicine programs involving SMS would be both feasible and well received by patients and could be a potentially valuable approach to increase access and effectiveness of epilepsy care.
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Affiliation(s)
- Pei Lin Lua
- Centre for Clinical and Quality of Life Studies, Faculty of Medicine and Health Sciences, Universiti Sultan Zainal Abidin, Jalan Sultan Mahmud, Kuala Terengganu, Malaysia.
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Pfäfflin M, Petermann F, Rau J, May TW. The psychoeducational program for children with epilepsy and their parents (FAMOSES): results of a controlled pilot study and a survey of parent satisfaction over a five-year period. Epilepsy Behav 2012; 25:11-6. [PMID: 22980075 DOI: 10.1016/j.yebeh.2012.06.012] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2012] [Revised: 06/05/2012] [Accepted: 06/11/2012] [Indexed: 11/24/2022]
Abstract
Feasibility of the educational program FAMOSES (modular service package epilepsy for families) was evaluated in a controlled pilot study. Parents of children with epilepsy from epilepsy centers in Germany were allocated to either educational group (treatment group, n=55) or waiting-list group (control group, n=48). Questionnaires included epilepsy-specific scales (knowledge, coping, adaptation, anxiety, rules and limitations, seizure management, impact of epilepsy). Multivariate analysis of variance with repeated measurements indicated significant improvements in the treatment group compared to the control group (time×group interaction: p<0.01). Univariate analyses (ANOVA) confirmed improvements in knowledge (p<0.001), adaptation (p<0.01), epilepsy-related anxiety (p<0.05), and seizure management (p<0.05). Surveillance as well as seizure frequency (p<0.05) of children whose parents participated in the treatment group was reduced (p<0.05). Furthermore, parents' satisfaction with the content and interactive didactic format of the program was assessed in a survey with 852 parents over a five-year period. This survey showed an improvement over the course of time (p<0.05). Feasibility and need for the educational program were confirmed.
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Affiliation(s)
- M Pfäfflin
- Epilepsy Center Bethel, Bielefeld, Germany.
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Alkhamra H, Tannous A, Hadidi M, Alkhateeb J. Knowledge and attitudes toward epilepsy among school teachers and counselors in Jordan. Epilepsy Behav 2012; 24:430-4. [PMID: 22683285 DOI: 10.1016/j.yebeh.2012.05.004] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2012] [Revised: 05/03/2012] [Accepted: 05/04/2012] [Indexed: 10/28/2022]
Abstract
This study investigated the knowledge and attitudes of Jordanian school teachers and counselors toward epilepsy. A sample of 259 teachers and counselors completed the two-part questionnaire. Validity was assessed using an informed panel of judges, and test-retest reliability was established. The results showed average knowledge of epilepsy and generally favorable attitudes toward students with epilepsy. Although participants revealed apt knowledge about the causes and symptoms of epilepsy, they demonstrated poor knowledge about methods of dealing with seizures. However, participants scored high on items relating to the equality of rights and the need for further support. Findings indicated that although participants showed favorable attitudes, more information and awareness about epilepsy should be provided to teachers and counselors within the school systems of Jordan.
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Affiliation(s)
- Hatem Alkhamra
- Department of Counseling and Special Education, Faculty of Educational Sciences, The University of Jordan, Queen Rania Alabdullah Street, Amman, Jordan.
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