Pathways to care among persons with dementia: Study from a tertiary care center.

The prevalence of dementia is increasing rapidly, specifically in low and middle income countries (LAMIC) due to demographic aging. Help seeking is delayed and usually sought at an advanced stage of illness and many are yet to receive a formal diagnosis. We interviewed 35 caregivers of persons with Dementia (as per ICD-10) using a semi-structured questionnaire, the Short Explanatory Model Interview (SEMI). We explored the pathways taken by caregivers of people with dementia en route to a tertiary care centre and the interactions they had with different health care providers. Qualitative data analysis was done using ATLAS.ti. We identified three major pathways: I) The Neuropsychiatric pathway II) The General Practitioner pathway and III) The Non-cohesive pathway. In general, the caregivers were poorly informed about the illness details such as diagnosis, course and outcome. Neurologists communicated the diagnosis of 'Dementia' more frequently. When information was made available, the caregivers were satisfied with proper information about illness and with at least, partial improvement of symptoms. There is a need for increasing the awareness of dementia in community at large. Health services and systems that address this important public health problem need strengthening. Sensitization and training of primary care physician and staff to identify dementia at an early stage are the need of the hour.

Outcome of a school-based health education program for epilepsy awareness among schoolchildren.

BACKGROUND: A diagnosis of epilepsy has a major effect on children; especially among schoolchildren. Studies have shown that a significant proportion of teachers and students have negative attitude and misunderstanding towards epilepsy making it difficult for a child with epilepsy. At the same time, there is a dearth is dearth of literature regarding interventions to bring about a change in the attitudes of children. METHODOLOGY: The aim of the present study was to study the outcome of a school-based health education program for epilepsy awareness among schoolchildren. The objectives were to assess the level of knowledge, attitude, and practices about epilepsy and relationship among these variables. A total of 70 children, from 8th-10th grades were selected randomly for the study. For the study purpose, knowledge, attitude, and practices of epilepsy instrument were developed and face validated by experts. RESULTS: Results show that the mean, median, and mode age of the respondents in the study were 14.55 (±1.33), 15, and 14 years, respectively. The gender distribution of the respondents was 54.9% boys and 45.1% girls. With regard to knowledge, attitude, and practices in epilepsy, knowledge strongly and positively correlated with attitude (p=0.001, r=.423) and practice domains (p=0.001, r=.486). Postattitude and (p=0.001, r=.338) practice were positively correlated, which shows that positive attitude brings positive practice. Hence, it is concluded that a training program brings desirable change in the knowledge, attitude, and practice domains among children. CONCLUSION: Health education programs for schoolchildren are very important to bring changes in their attitude, behavior, and practices.