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Liu Y, Wang Y, Li X, Wu X. Efficacy and safety of levetiracetam vs. oxcarbazepine in the treatment of children with epilepsy: a systematic review and meta-analysis. Front Pediatr 2024; 12:1336744. [PMID: 38711491 PMCID: PMC11072191 DOI: 10.3389/fped.2024.1336744] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2023] [Accepted: 04/04/2024] [Indexed: 05/08/2024] Open
Abstract
Background Levetiracetam (LEV) and oxcarbazepine (OXC) are new antiseizure medications (ASMs). In recent years, OXC monotherapy is widely used in children with epilepsy; however, no consensus exists on applying LEV monotherapy among children with epilepsy. Objective The present work focused on comparing the efficacy and safety of LEV and OXC monotherapy in treating children with epilepsy. Methods We conducted a comprehensive search across multiple databases including PubMed, Cochrane Library, Embase, Web of Science, CNKI, Wanfang Database, VIP, and China Biology Medicine disc, covering studies from inception to August 26, 2023. We included randomized controlled trials (RCTs) and cohort studies evaluating the efficacy and safety of LEV and OXC monotherapy for treating epilepsy in children. We utilized Cochrane Risk of Bias Tool in RevMan 5.3 software for assessing included RCTs quality. In addition, included cohort studies quality was determined using Newcastle-Ottawa Scale (NOS). A random-effects model was utilized to summarize the results. Results This meta-analysis included altogether 14 studies, including 893 children with epilepsy. LEV and OXC monotherapy was not statistical different among children with epilepsy in seizure-free rate (relative risk [RR] = 1.010, 95% confidence interval [CI] [0.822, 1.242], P > 0.05) and seizure frequency decrease of ≥50% compared with baseline [RR = 0.938, 95% CI (0.676, 1.301), P > 0.05]. Differences in total adverse reaction rate [RR = 1.113, 95% CI (0.710, 1.744), P > 0.05] and failure rate because of serious adverse reaction [RR = 1.001, 95% CI (0.349, 2.871), P > 0.05] were not statistical different between LEV and OXC treatments among children with epilepsy. However, the effects of OXC monotherapy on thyroid among children with epilepsy was statistically correlated than that of LEV (thyroid stimulating hormone: standardized mean difference [SMD] = -0.144, 95% CI [-0.613, 0.325], P > 0.05; free thyroxine: SMD = 1.663, 95% CI [0.179, 3.147], P < 0.05). Conclusion The efficacy of LEV and OXC monotherapy in treating children with epilepsy is similar. However, OXC having a more significant effect on the thyroid than that of LEV. Therefore, LEV may be safer for children with epilepsy who are predisposed to thyroid disease than OXC. Systematic Review Registration https://www.crd.york.ac.uk/, PROSPERO (CRD42024514016).
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Affiliation(s)
- Yuanyuan Liu
- School of Public Health, Jiamusi University, Jiamusi, China
| | - Yanxu Wang
- Department of Food Hygiene Monitoring, Jiamusi City Center for Disease Control and Prevention, Jiamusi, China
| | - Xingzhou Li
- School of Public Health, Jiamusi University, Jiamusi, China
| | - Xiaomin Wu
- Director, Jiamusi City Center for Disease Control and Prevention, Jiamusi, China
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Wei W, Dong L, Ye J, Xiao Z. Current status and influencing factors of family resilience in families of children with epilepsy: a cross-sectional study. Front Psychiatry 2024; 15:1354380. [PMID: 38516257 PMCID: PMC10954834 DOI: 10.3389/fpsyt.2024.1354380] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2023] [Accepted: 02/21/2024] [Indexed: 03/23/2024] Open
Abstract
Purpose The study was designed to describe the level of family resilience and identify the protective factors and vulnerability factors of family resilience in families of children with epilepsy. So as to provide theoretical guidance for implementing intervention programs to promote family resilience. Methods From November 2020 to July 2021, 258 parents of children with epilepsy were investigated using a convenience sampling method. The questionnaire included demographic data, Chinese-Family Resilience Assessment Scale, Social Support Rating Scale, and the Beck Depression Inventory. SPSS25.0 was used for descriptive statistical analysis, univariate analysis, and multivariate linear regression analysis. Results In this study, two hundred and fifty-eight primary caregivers completed the paper questionnaires. The total score of family resilience was (134.97 ± 16.57), which was above the medium level. Multiple linear regression analysis revealed that subjective support (β=0.327, P<0.001), comorbidity (β=0.181, P<0.05), objective support (β=0.117, P<0.05), and parental depression (β=-0.158, P<0.05) were significantly related to family resilience. These variables contribute 31.7% of the variance in family resilience (F=18.07, P< 0.001). Conclusion The families of children with epilepsy presented appropriate resilience after the children were diagnosed with epilepsy. Family resilience was correlated with multiple factors, subjective and objective support could be protective factors, comorbidity and parental depression could be vulnerability factors of family resilience. Therefore, future psychosocial interventions could focus on enhancing subjective support and objective support, reducing parental depression, and screening for epilepsy comorbidity to promote the family resilience of children with epilepsy.
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Affiliation(s)
- Wenjing Wei
- Nursing Department, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Lianlian Dong
- Nursing Department, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Jinghua Ye
- Department of Neurology, China Medical University Shenzhen Children’s Hospital, Shenzhen, China
| | - Zhitian Xiao
- Department of Neurology, China Medical University Shenzhen Children’s Hospital, Shenzhen, China
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Cui C, Li S, Chen W, Zhou H, Zheng X. Chinese families' knowledge, attitudes, and practices regarding seizure management for children with epilepsy: a mixed-methods study. Front Public Health 2023; 11:1081720. [PMID: 37255754 PMCID: PMC10225546 DOI: 10.3389/fpubh.2023.1081720] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2022] [Accepted: 04/17/2023] [Indexed: 06/01/2023] Open
Abstract
Objective This study aimed to examine Chinese families' knowledge, attitudes, and practices regarding the management of acute seizures (AS) that occur outside the hospital in children with epilepsy (CWE) and factors that influence AS. Design A mixed-methods sequential explanatory study was conducted, which was integrated at the design and methods levels. In phase 1, a questionnaire was developed for this study, and a family functioning assessment was administered from Nov 2021 to Apr 2022. Multivariate logistic regression was used to analyze the knowledge, attitudes, and practices (KAP) and factors that influence AS. In phase 2, family caregivers (FCGs) were recruited from Jul to Aug 2022 to participate in a qualitative exploration, using semi-structured interviews and a combination of inductive and deductive methods. Setting The setting was five children's specialty hospitals in different regions of China. Participants The participants were FCGs of CWE. A total of 645 participants were included in the quantitative phase, and 15 FCGs (eight parents, five grandparents, and two others) were recruited for the qualitative phase. Results The FCGs' average total KAP score for AS management was 66.23 ± 15.12, with 45.42% of FCGs having a low level. Univariate and multivariate regression analyses showed that demographic factors, disease characteristics, and family function significantly predicted family management of AS. The three most salient themes and eight sub-themes from phase 2 were explored. The quantitative and qualitative databases were analyzed separately and combined through integration, and a conceptual model was constructed based on the individual and family self-management theory (IFSMT); the model consisted of context, knowledge, self-regulation, and promotion factors. Conclusion Chinese families have a positive attitude toward the management of out-of-hospital AS in CWE, but lack practice and related knowledge. AS management for CWE families was associated with the demographic characteristics of FCGs, epilepsy, and family characteristics. The research findings expand the existing application requirements of an Acute Seizure Action Plan and patient safety. Our results also indicate a pressing need for localized development of AS emergency medicine in family medicine, the establishment of auxiliary information systems, the utilization of caregivers' positive psychological resources, and improvements in family function for intergenerational care.
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Affiliation(s)
- Cui Cui
- National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Department of Nursing Children's Hospital of Chongqing Medical University, Chongqing, China
| | - Shuangzi Li
- National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Neurology Department of Children's Hospital of Chongqing Medical University, Chongqing, China
| | - Wenjin Chen
- National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Neurology Department of Children's Hospital of Chongqing Medical University, Chongqing, China
| | - Hengyu Zhou
- School of Nursing, Chongqing Medical University, Chongqing, China
| | - Xianlan Zheng
- National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Department of Nursing Children's Hospital of Chongqing Medical University, Chongqing, China
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Koliouli F, Andrianakou M, Issari P. Corrigendum: COVID-19 and parents of children with epilepsy: experiences and positive changes. Front Public Health 2023; 11:1209062. [PMID: 37234756 PMCID: PMC10206331 DOI: 10.3389/fpubh.2023.1209062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Accepted: 04/21/2023] [Indexed: 05/28/2023] Open
Abstract
[This corrects the article DOI: 10.3389/fpubh.2023.1079518.].
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Affiliation(s)
- Flora Koliouli
- Psychology Department, National and Kapodistrian University of Athens, Athens, Greece
- School of Early Childhood Education, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Marianna Andrianakou
- Psychology Department, National and Kapodistrian University of Athens, Athens, Greece
| | - Philia Issari
- Psychology Department, National and Kapodistrian University of Athens, Athens, Greece
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Koliouli F, Andrianakou M. COVID-19 and parents of children with epilepsy: Experiences and positive changes. Front Public Health 2023; 11:1079518. [PMID: 36844820 PMCID: PMC9947290 DOI: 10.3389/fpubh.2023.1079518] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Accepted: 01/16/2023] [Indexed: 02/11/2023] Open
Abstract
Introduction The aim of this study is to explore the ways that parents with children or adolescents with epilepsy (CAWE) experienced the restrictive measures, as well as the stressors and challenges that they had to face. Methods We employed an experiential approach and fifteen Greek-speaking parents answered to an in-depth semi-structured interview, during the second lockdown period. Data were analyzed through the Thematic Analysis (TA). Results The emerging themes were the challenges encountered in terms of medical monitoring, the "stay-home" impact on their everyday lives as a family, their psycho-emotional responses. More specifically, parents identified the irregular doctor appointments and their struggle to access the hospital services as the most important challenges. Moreover, parents reported that the "stay-home" impact has disrupted their children's daily routines among others. Finally, parents highlighted their emotional strain and worries experienced during the lockdown along with the positive changes that occurred.
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Affiliation(s)
- Flora Koliouli
- Psychology Department, National and Kapodistrian University of Athens, Athens, Greece,School of Early Childhood Education, Aristotle University of Thessaloniki, Thessaloniki, Greece,*Correspondence: Flora Koliouli ✉
| | - Marianna Andrianakou
- Psychology Department, National and Kapodistrian University of Athens, Athens, Greece
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Sawant NS, Singh SS, Mahajan S, Ravat SH. A Retrospective Analysis of Psychiatric Presurgical Evaluation of Children and Adolescents Evaluated for Epilepsy Surgery in a Comprehensive Epilepsy Care Unit of Mumbai. J Neurosci Rural Pract 2022; 13:95-100. [PMID: 35110926 PMCID: PMC8803523 DOI: 10.1055/s-0041-1742159] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
Abstract
Background Epilepsy being one of the most prevalent neurological diseases in children is associated with psychopathology and academic concerns. Epilepsy surgery is considered for refractory epilepsy at some centers in India and hence this study was undertaken to find out prevalence and type of psychopathology in children and adolescents with refractory epilepsy before epilepsy surgery. Methods All data were analyzed from the records of patients undergoing preepilepsy surgery protocol workup in comprehensive center of epilepsy care at a general municipal hospital in Mumbai. A record of 150 children and adolescents in the age group of 3 to 18 years over a period of 10 years was taken and all details of demographics, epilepsy, and psychopathology were recorded. Results The mean age for our sample was 11.4 ± 3.4 years and a male preponderance was seen. Majority (80%) of the children were pursuing education. The duration of seizure disorder was approximately 4.41 + 2.36 years and complex partial seizures were seen commonly in 50% of the children. Both magnetic resonance imaging (MRI) and video electroencephalography (VEEG) findings revealed right sided lateralization followed by left in majority of the patients. Psychopathology was seen in 70 (46%) patients with mental retardation, hyperkinetic disorders affecting attention and activity and oppositional defiant disorder, and unspecified mental disorder due to underlying brain damage being the type of International Classification of Disease-10th Revision (ICD-10) disorders seen. Patients with psychopathology showed a left-sided predominance on their MRI and VEEG findings for laterality of the epileptogenic focus as compared with right side. Conclusion Refractory seizures and associated psychopathology impact family life, friendships, and academics and worsen prognosis and quality of life. Screening for psychopathology in children with epilepsy would therefore lead to better outcomes especially prior to epilepsy surgery.
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Affiliation(s)
- Neena S Sawant
- Department of Psychiatry, Seth Gordhandas Sunderdas Medical College and King Edward Memorial Hospital, Mumbai, Maharashtra, India
| | - Suraj S Singh
- Department of Psychiatry, Seth Gordhandas Sunderdas Medical College and King Edward Memorial Hospital, Mumbai, Maharashtra, India
| | - Sachin Mahajan
- Department of Psychiatry, Lokmanya Tilak Municipal Medical College and Lokmanya Tilak Municipal General Hospital, Mumbai, Maharashtra, India
| | - Sangeeta H Ravat
- Department of Neurology, Seth Gordhandas Sunderdas Medical College and King Edward Memorial Hospital, Mumbai, Maharashtra, India
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Wei W, Yang R, Zhang J, Chen H, Ye J, Su Q, Liao J, Xiao Z. The Mediating Roles of Family Resilience and Social Support in the Relationship Between Illness Severity and Depressive Symptoms Among Primary Caregivers of Children With Epilepsy in China. Front Neurol 2022; 13:831899. [PMID: 35265030 PMCID: PMC8899194 DOI: 10.3389/fneur.2022.831899] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Accepted: 01/31/2022] [Indexed: 02/05/2023] Open
Abstract
PURPOSE This study was designed to assess the effects of epilepsy severity, family resilience, and social support on depression in primary caregivers of children with epilepsy (CWE), and to test the mediating roles of family resilience and social support in this relationship. METHOD Two hundred fifty-two caregivers of children with epilepsy were recruited from October 2020 to May 2021. The questionnaire contained sociodemographic characteristics, Epilepsy Severity, Chinese-Family Resilience Assessment Scale (C-FRAS), Social Support Rating Scale (SSRS), Beck Depression Inventory (BDI). Structural equation models were used to evaluate whether family resilience and social support as mediators between epilepsy severity and depression. RESULTS In this study, the prevalence of depressive symptoms among primary caregivers of CWE in China was 69.84%. Epilepsy severity was positively associated with depression. Family resilience and social support were negatively correlated with depressive symptoms (both p < 0.01). Furthermore, the fitness indices of structural models were satisfactory. The direct effect of epilepsy severity on depression was 0.266 (95% CI 0.064-0.458), this pathway explained 62.88% variance of depression. The indirect effect of family resilience and then social support was 0.069 (95% CI 0.025-0.176), indicating that the serial multiple mediation was significant. The serial mediation pathway explained 16.31% variance of depression. CONCLUSIONS The high incidence of depression among primary carers of CWE deserves more attention. They should be screened routinely, especially those parents of children with severe epilepsy. Family resilience and social support could be protective factors for caregivers' mental adjustment. Therefore, future psychosocial interventions for enhancing family resilience and social support should be implemented, in order to reduce their depression.
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Affiliation(s)
- Wenjing Wei
- China Medical University, Shenzhen Children's Hospital, Shenzhen, China
| | - Rongrong Yang
- China Medical University, Shenzhen Children's Hospital, Shenzhen, China
| | - Jie Zhang
- China Medical University, Shenzhen Children's Hospital, Shenzhen, China
| | - Haili Chen
- China Medical University, Shenzhen Children's Hospital, Shenzhen, China
| | - Jinghua Ye
- Department of Neurology, Shenzhen Children's Hospital, China Medical University, Shenzhen, China
| | - Qiru Su
- Department of Clinical Research, Shenzhen Children's Hospital, China Medical University, Shenzhen, China
| | - Jianxiang Liao
- Department of Neurology, Shenzhen Children's Hospital, China Medical University, Shenzhen, China
- *Correspondence: Jianxiang Liao
| | - Zhitian Xiao
- Department of Neurology, Shenzhen Children's Hospital, China Medical University, Shenzhen, China
- Zhitian Xiao
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Lu J, Xia H, Li W, Shen X, Guo H, Zhang J, Fan X. Genetic Polymorphism of GABRG2 rs211037 is Associated with Drug Response and Adverse Drug Reactions to Valproic Acid in Chinese Southern Children with Epilepsy. Pharmgenomics Pers Med 2021; 14:1141-1150. [PMID: 34552348 PMCID: PMC8450188 DOI: 10.2147/pgpm.s329594] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Accepted: 09/02/2021] [Indexed: 12/25/2022]
Abstract
Background Valproic acid (VPA) is recommended as a first-line treatment for children with epilepsy. GABRG2 polymorphism is found to be associated with epilepsy susceptibility and therapeutic response of anti-seizure medications (ASM); however, the role of GABRG2 in VPA treatment still remains unknown. Objective The purpose of this study was to explore the association of GABRG2 gene polymorphism with the drug response and adverse drug reactions (ADRs) related to VPA. Methods A retrospective study including 96 Chinese children with epilepsy treated by VPA was carried out. The ADRs were collected during VPA therapy and GABRG2 rs211037 in enrolled patients was genotyped using Sequenom MassArray system. A network pharmacological analysis involved protein–protein interaction and enrichment analysis was constructed to investigate the potential targets and pathways of GABRG2 on VPA-related ADRs. Results Among 96 patients, 41 individuals were defined as seizure together with 49 patients with seizure-free and 6 patients unclassified. Carriers of homozygote GABRG2 rs211037 CC genotype exhibited seizure-free to VPA (P = 0.042), whereas those with CT genotype showed seizure. Furthermore, CC genotype had predisposition to digestive ADRs (P = 0.037) but was a protective factor for VPA-associated weight gain (P = 0.013). Ten key genes related to digestive ADRs and weight gain induced by VPA were identified by network pharmacological analysis and mainly involved in “GABAergic synaptic signaling”, “GABA receptor signaling”, and “taste transduction” pathways/processes through enrichment analysis. Conclusion This study revealed that GABRG2 variation exerted a predictable role in the efficacy and safety of VPA treatment for Chinese children with epilepsy.
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Affiliation(s)
- Jieluan Lu
- Department of Clinical Pharmacology, College of Pharmacy, Jinan University, Guangzhou, 510632, People's Republic of China
| | - Hanbing Xia
- Department of Pharmacy, Baoan Women's and Children's Hospital, Jinan University, Shenzhen, 518102, People's Republic of China
| | - Wenzhou Li
- Department of Pharmacy, Baoan Women's and Children's Hospital, Jinan University, Shenzhen, 518102, People's Republic of China
| | - Xianhuan Shen
- Department of Clinical Pharmacology, College of Pharmacy, Jinan University, Guangzhou, 510632, People's Republic of China
| | - Huijuan Guo
- Department of Pharmacy, Baoan Women's and Children's Hospital, Jinan University, Shenzhen, 518102, People's Republic of China
| | - Jianping Zhang
- Department of Clinical Pharmacology, College of Pharmacy, Jinan University, Guangzhou, 510632, People's Republic of China
| | - Xiaomei Fan
- Department of Pharmacy, Baoan Women's and Children's Hospital, Jinan University, Shenzhen, 518102, People's Republic of China
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Lin YY, Lee WT, Yang HL, Weng WC, Tsai SY. [Associations Between Daytime Physical Activity and Sleep Patterns in Children With Epilepsy]. Hu Li Za Zhi 2021; 68:53-63. [PMID: 34337703 DOI: 10.6224/jn.202108_68(4).07] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
BACKGROUND Epilepsy is one of the most common chronic neurological diseases in children. Sleep disorders tend to increase the risk of seizures, and research has found that moderate physical activity may improve the quantity and quality of sleep in adults. However, the link between physical activity level and sleep patterns in toddlers and preschool-age children with epilepsy remains unclear. PURPOSE To explore the association between level of physical activity and sleep patterns in toddlers and preschool-age children with epilepsy. METHODS A cross-sectional, descriptive, correlational study was conducted. Ninety-eight children with epilepsy (1.5-6 years old) wore an actigraph for seven days. Additional data were collected using a health information datasheet, Children's Sleep Habits Questionnaire (CSHQ), and sleep diary, all of which were completed by the parents of each child. RESULTS The results showed that the mean amount of time spent in moderate-to-vigorous physical activity per day was 36.00 ± 49.20 minutes and that only 23 children (23.5%) had a nighttime sleep efficiency greater than 85%. The overall CSHQ score (56.00 ± 5.69) indicated the presence of moderate to severe sleep disturbances. Multiple regression analysis showed the hours and percentage of moderate-to-vigorous physical activity to be positively associated with night sleep efficiency (β = .54, p < .01; β = .51, p < .01) and negatively associated with nighttime sleep hours (β = -.55, p < .01; β = -.52, p < .01), even after controlling for potential confounders. CONCLUSIONS / IMPLICATIONS FOR PRACTICE Based on the findings, the sleep patterns and physical activity of children with epilepsy should be regularly assessed. Furthermore, appropriately increasing the duration of moderate-to-vigorous physical activity may improve sleep efficiency and prevent reductions in the duration of night sleep.
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Affiliation(s)
- Ying-Ying Lin
- MSN, RN, School of Nursing, National Taiwan University, Taiwan, ROC
| | - Wang-Tso Lee
- PhD, MD, Director, Department of Pediatric Neurology, National Taiwan University Hospital, and Professor, School of Medicine, National Taiwan University, Taiwan, ROC
| | - Hsiao-Ling Yang
- PhD, RN, Associate Professor, School of Nursing, College of Medicine, National Taiwan University, and Adjunct Supervisor, Department of Nursing, National Taiwan University Hospital, Taiwan, ROC
| | - Wen-Chin Weng
- PhD, MD, Attending Physician, Department of Pediatric Neurology, National Taiwan University Hospital, Taiwan, ROC
| | - Shao-Yu Tsai
- PhD, RN, Professor, School of Nursing, College of Medicine, National Taiwan University, and Adjunct Supervisor, Department of Nursing, National Taiwan University Hospital, Taiwan, ROC.
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Yang H, Chi Y, Zhu Z, Huang K, Xiang L, Xiao B, Tang W, Feng L. Attitudes Toward Epilepsy Among Parents of Children With Epilepsy in Southern China. Front Neurol 2021; 11:602000. [PMID: 33633657 PMCID: PMC7901895 DOI: 10.3389/fneur.2020.602000] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2020] [Accepted: 12/23/2020] [Indexed: 11/29/2022] Open
Abstract
Purpose: To evaluate the attitudes toward epilepsy among parents of children with epilepsy (CWE) in China and identify some related factors for future interventions for parents to offer more social support for CWE. Method: The Chinese Public Attitudes Toward Epilepsy (CPATE) scale was administered to 234 parents of CWE and 203 parents of normal children in Xiangya hospital during 2019–2020. Results: The cumulative score of the parents of CWE (26.427 ± 6.688) was significantly lower than that of the normal children group (32.330 ± 7.234, p < 0.001). Subanalysis showed more positive attitudes among parents of CWE than the control group (p < 0.001) toward education (4.765 ± 1.985 vs. 6.621 ± 2.419), social life (6.556 ± 2.456 vs. 8.010 ± 2.683), marriage (9.586 ± 2.675 vs. 11.025 ± 2.900), and employment (3.876 ± 1.364 vs. 4.5123 ± 1.283). The attitudes toward epilepsy among parents of CWE with seizures in public (27.16 ± 6.66) or during sleep (27.10 ± 6.38) were more negative than those without (25.35 ± 6.62 and 25.08 ± 7.10, respectively) (p < 0.05). In addition, female and low income were negatively related to parents' attitudes toward epilepsy. Conclusions: More active policy guidance and adequate social support should be given to parents of children with seizures in public or during sleep to instruct their children to form a positive perception about epilepsy, which is expected to have a positive impact on their social abilities in the future.
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Affiliation(s)
- Haojun Yang
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, China
| | | | - Ziqing Zhu
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, China
| | - Kailing Huang
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, China
| | - Lan Xiang
- Department of Neurology, Hunan Provincial People's Hospital, Hunan Normal University, Changsha, China
| | - Bo Xiao
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, China
| | - Weiting Tang
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, China
| | - Li Feng
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, China
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Zhang M, Zhang H, Hu S, Zhang M, Fang Y, Hu J, Liao J. Investigation of Anxiety, Depression, Sleep, and Family Function in Caregivers of Children With Epilepsy. Front Neurol 2021; 12:744017. [PMID: 34764930 PMCID: PMC8575681 DOI: 10.3389/fneur.2021.744017] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Accepted: 09/06/2021] [Indexed: 02/05/2023] Open
Abstract
Objective: Epilepsy is a chronic disease that places a heavy burden on caregivers. Previous studies have shown that caregivers of epilepsy patients often experience anxiety and depression; however, few comprehensive studies have assessed their sleep quality and family function. Based on the current understanding of the anxiety and depression state of caregivers in children with epilepsy, we further explored the caregivers' sleep and family function and evaluated the predictors of the depression state of caregivers. Methods: In this cross-sectional online anonymous survey, we sent an online questionnaire to the caregivers of children with epilepsy who visited our hospital. The QR code of the questionnaire was scanned at the follow-up course to conduct an online survey. The questionnaire contained questions about sociodemographic and clinical information, the Self-rating Anxiety Scale, Self-rating Depression Scale, Pittsburgh Sleep Quality Index, and the Family Assessment Device. Results: A total of 308 caregivers of children with epilepsy aged 0-12 years were included in this study. The mean age of children with epilepsy was 4.8 ± 3.18 years, and the average illness duration was 34.2 ± 29.18 months. Further, 47.1% of the children took three or more anti-seizure medications, and 43.2% were on ketogenic diet therapy. We found that in 77.9% of the cases, the subjects were the mothers, in 89% there was more than one co-caregiver, and in 51.9%, financial help was required. Further, 63.6% of the caregivers thought they could not get enough access to disease knowledge education, and 83.7% perceived epilepsy was a terrible disease. Our results also showed that 65.6% of the caregivers were in depression status, 41.9% were in anxiety status, and 49.0% had poor sleep quality. The proportion of unhealthy family functioning in each subscale was 45.1-96.1%, and the unhealthy behavior control function accounted for 96.1%. Binary logistic regression analysis of the data showed that without co-caregivers [odds ratio (OR), 5.193], free of anxiety status (OR, 0.063), good sleep quality (OR, 0.446), healthy family role dimension (OR, 0.344), and healthy family general functional dimension (OR, 0.259) were predictors of depression status in caregivers of children with epilepsy. Conclusion: Anxiety and depression status are common in caregivers of children with epilepsy, with depression status being more prominent. Moreover, a considerable proportion of caregivers had poor sleep quality and unhealthy family function. The caregivers' anxiety status, sleep quality, family role dimension, family general function dimension, and the number of co-caregivers were predictors of depression status in caregivers. In clinical practice, caregivers' anxiety and depression status, poor sleep quality, and unhealthy family functioning should be addressed along with the treatment of children with epilepsy.
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Affiliation(s)
- Meiyan Zhang
- Center of Child Healthcare and Mental Health, Shenzhen Children's Hospital, Shenzhen, China
| | - Huiting Zhang
- China Medical University, Shenzhen Children's Hospital, Shenzhen, China
| | - Shuxian Hu
- Department of Neurology, Shenzhen Children's Hospital, Shenzhen, China
| | - Man Zhang
- Department of Neurology, Shenzhen Children's Hospital, Shenzhen, China
| | - Yu Fang
- China Medical University, Shenzhen Children's Hospital, Shenzhen, China
| | - Junjie Hu
- Shenzhen Children's Hospital Affiliated to Medical College of Shantou University, Shenzhen, China
| | - Jianxiang Liao
- Department of Neurology, Shenzhen Children's Hospital, Shenzhen, China
- *Correspondence: Jianxiang Liao
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Widjaja E, Guttmann A, Tomlinson G, Snead OC, Sander B. Economic burden of epilepsy in children: A population-based matched cohort study in Canada. Epilepsia 2020; 62:152-162. [PMID: 33258123 DOI: 10.1111/epi.16775] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2020] [Revised: 11/06/2020] [Accepted: 11/08/2020] [Indexed: 11/27/2022]
Abstract
OBJECTIVE The economic burden of childhood epilepsy to the health care system remains poorly understood. This study aimed to determine phase-specific and cumulative long-term health care costs in children with epilepsy (CWE) from the health care payer perspective. METHODS This cohort study utilized linked health administrative databases in Ontario, Canada. Incident childhood epilepsy cases were identified from January 1, 2003 to June 30, 2017. CWE were matched to children without epilepsy (CWOE) on age, sex, rurality, socioeconomic status, and comorbidities, and assigned prediagnosis, initial, ongoing, and final care phase based on clinical trajectory. Phase-specific, 1-year and 5-year cumulative health care costs, attributable costs of epilepsy, and distribution of costs across different ages were evaluated. RESULTS A total of 24 411 CWE were matched to CWOE. The costs were higher for prediagnosis and initial care than ongoing care in CWE. Hospitalization was the main cost component. The costs of prediagnosis, initial, and ongoing care were higher in CWE than CWOE, with the attributable costs at $490 (95% confidence interval [CI] = $352-$616), $1322 (95% CI = $1247-$1402), and $305 (95% CI = $276-$333) per 30 patient-days, respectively. Final care costs were lower in CWE than CWOE, with attributable costs at -$2515 (95% CI = -$6288 to $961) per 30 patient-days. One-year and 5-year cumulative costs were higher in CWE ($14 776 [95% CI = $13 994-$15 546] and $39 261 [95% CI = $37 132-$41 293], respectively) than CWOE ($6152 [95% CI = $5587-$6768] and $15 598 [95% CI = $14 291-$17 006], respectively). The total health care costs were highest in the first year of life in CWE for prediagnosis, initial, and ongoing care. SIGNIFICANCE Health care costs varied along the continuum of epilepsy care, and were mainly driven by hospitalization costs. The findings identified avenues for remediation, such as enhancing care around the time of epilepsy diagnosis and better care coordination for epilepsy and comorbidities, to reduce hospitalization costs and the economic burden of epilepsy care.
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Affiliation(s)
- Elysa Widjaja
- Institute of Health Policy, Management, and Evaluation, University of Toronto, Toronto, ON, Canada.,Diagnostic Imaging, Hospital for Sick Children, Toronto, ON, Canada.,Division of Neurology, Hospital for Sick Children, Toronto, ON, Canada.,ICES, Toronto, ON, Canada
| | - Astrid Guttmann
- Institute of Health Policy, Management, and Evaluation, University of Toronto, Toronto, ON, Canada.,ICES, Toronto, ON, Canada.,Department of Pediatrics, Hospital for Sick Children, Toronto, ON, Canada.,Leong Centre for Healthy Children, University of Toronto, ON, Canada
| | - George Tomlinson
- Institute of Health Policy, Management, and Evaluation, University of Toronto, Toronto, ON, Canada.,Toronto Health Economics and Technology Assessment Collaborative, University Health Network, Toronto, ON, Canada
| | - O Carter Snead
- Division of Neurology, Hospital for Sick Children, Toronto, ON, Canada
| | - Beate Sander
- Institute of Health Policy, Management, and Evaluation, University of Toronto, Toronto, ON, Canada.,ICES, Toronto, ON, Canada.,Toronto Health Economics and Technology Assessment Collaborative, University Health Network, Toronto, ON, Canada.,Public Health Ontario, Toronto, ON, Canada
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Wang MY, Lai YC, Chen CL, Lin YY, Chiou YG. [Improving the Storage Integrity of Electroencephalography (EEG) Recordings in the Pediatric Ward]. Hu Li Za Zhi 2018; 65:102-108. [PMID: 30066328 DOI: 10.6224/jn.201808_65(4).13] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
BACKGROUND & PROBLEMS A total of 20 cases of children with epilepsy implemented electroencephalography (EEG) recording examinations in our ward between January 1st and March 10th, 2016. Fifteen (75%) of the recordings were incompletely stored, indicating that the EEG recordings storage integrity in our unit was 25%. Incomplete storage of these recordings results in prolonged hospital stays and negatively affects the ability of doctors to provide accurate diagnoses. PURPOSE This project was developed to increase the EEG recording storage integrity for epileptic children to 100%. RESOLUTIONS Improvement plans included reinforcing related promotions, formulating a standard flowchart for EEG recording education, making "warm bear signs", designing simple cartoon health-education flashcards, and providing in-service education. RESULTS The EEG recording storage integrity for epileptic children in our ward rose to 100% after implementation of the resolution measures, which achieved our purpose. CONCLUSIONS We want to share this experience to improve the storage integrity of EEG recordings at other hospitals and clinics. The greatest benefit of this project was that the family members of children with epilepsy perceived more strongly the effort and care of the nursing staffs during examinations, which reduces the costs of healthcare.
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Affiliation(s)
- Mei-Ying Wang
- BSN, RN, Assistant Head Nurse, Department of Nursing, Kaohsiung Chang Gung Memorial Hospital, Taiwan, ROC.
| | - Yu-Chen Lai
- BSN, RN, Department of Nursing, Kaohsiung Chang Gung Memorial Hospital, Taiwan, ROC
| | - Chi-Ling Chen
- ADN, RN, Department of Nursing, Kaohsiung Chang Gung Memorial Hospital, Taiwan, ROC
| | - Yi-Yu Lin
- BSN, RN, Head Nurse, Department of Nursing, Kaohsiung Chang Gung Memorial Hospital, Taiwan, ROC
| | - Yen-Gan Chiou
- MSN, RN, Supervisor, Department of Nursing, Kaohsiung Chang Gung Memorial Hospital, and Doctoral Student, Graduate Institute of Clinical Medical Sciences, Chang Gung University, Taiwan, ROC
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Carmassi C, Corsi M, Bertelloni CA, Carpita B, Gesi C, Pedrinelli V, Massimetti G, Peroni DG, Bonuccelli A, Orsini A, Dell'Osso L. Mothers and fathers of children with epilepsy: gender differences in post-traumatic stress symptoms and correlations with mood spectrum symptoms. Neuropsychiatr Dis Treat 2018; 14:1371-1379. [PMID: 29872304 PMCID: PMC5973431 DOI: 10.2147/ndt.s158249] [Citation(s) in RCA: 41] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND Post-traumatic stress disorder (PTSD) and post-traumatic stress spectrum have been recently applied to understand the impact of life-threatening disease or injury in one's child; nevertheless, scant data are available on a particular chronic illness such as epilepsy whose phenotypic expression is seizures, which are acute, sudden, and unpredictable manifestations. Subjects with bipolar disorders or with mood spectrum symptoms demonstrated to be more vulnerable to develop PTSD in the aftermath of a trauma. OBJECTIVES The main aim of this study was to evaluate post-traumatic symptoms among 134 parents of children with a diagnosis of epilepsy, followed at the outpatient neurologic unit of Department of Pediatrics in Santa Chiara Hospital in Pisa, as well as gender differences. The second aim of this study was to estimate the impact of lifetime mood spectrum on post-traumatic stress symptoms in the same study sample after fulfillment of the Trauma and Loss Spectrum-Self Report (TALS-SR) and the Mood Spectrum-Self Report (MOODS-SR) lifetime version. RESULTS Results showed 10.4% and 37.3% of PTSD full and partial, respectively. Demographic characteristics and clinical features of the study sample did not show any impact on stress symptomatology. Mothers presented higher rates at all Diagnostic and Statistical Manual of Mental Disorders (DSM)-5 PTSD symptoms' clusters except avoidance. Nevertheless, noteworthy correlations between post-traumatic symptomatology and mood spectrum symptoms detected with the self-report tools, emerged only in the subgroup of the fathers. CONCLUSION These findings corroborate the need to provide assistance to caregivers of pediatric patients and confirm the hypothesis that lifetime mood spectrum may have an impact on reaction to traumas.
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Affiliation(s)
| | | | | | | | | | | | | | - Diego Giampietro Peroni
- Pediatric Clinic, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Alice Bonuccelli
- Pediatric Clinic, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Alessandro Orsini
- Pediatric Clinic, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
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