Camp experiences and attitudes toward epilepsy: a pilot study.

Most healthcare providers report anecdotally that a camping experience helps children and adolescents with chronic health conditions to develop more positive attitudes toward their condition. However, children's and adolescents' perceptions have rarely been studied systematically. This pilot study of 20 campers with epilepsy who were 8-16 years of age was undertaken to examine the effect of a camp experience on their attitudes toward epilepsy. Attitudes, measured by the 13-item Child Attitude Toward Illness Scale (CATIS), were assessed before and after the camp experience. No pretest or posttest difference in attitude toward epilepsy was found in the total group. However, when attitudes were examined by seizure frequency, there was a trend for those with more frequent seizures to report a more positive attitude after the camp experience. Issues in evaluating camp experiences for youth with chronic conditions are reviewed, and recommendations are made for a comprehensive camp evaluation. Nurses are encouraged to assist families whose child is challenged by more frequent seizures to consider a camp experience.

Epilepsy surgery for partial seizures.

Epilepsy, a common neurological condition most often diagnosed in childhood, has physical, psychologic, and psychosocial effects on individuals. Of people diagnosed with complex partial seizures, about 10%-20% will not be able to achieve control of their seizures with medical management. The impact of continued seizures can be devastating on developing children and their families. Surgery for removal of the epileptic focus can offer the hope of an ordinary life; over 70% of patients achieve either complete seizure control or are greatly improved (Ventureyra & Higgins, 1993). Surgery requires a careful evaluation, services of a multidisciplinary team, and education and support for children and families. Pediatric nurses can identify potential candidates, act as advocates to encourage families to seek this option, and work collaboratively with their colleagues in specialty centers to facilitate referrals.

Using a health promotion model to enhance medication compliance.

Noncompliance with antiepileptic medication regimens is a leading cause of treatment failure. As a behavior, its causes are multifactorial and the degree to which it is exhibited varies from patient to patient. Interventions to encourage positive behavioral change need to be based on an understanding of the psychological, physiological and psychosocial aspects which explain noncompliance. Pender's Health Promotion Model provides a framework that can be used by the nurse to identify factors which interfere with the patient's ability to practice compliance and develop a treatment plan.

Epilepsy, pregnancy and parenting--an American perspective.

Pregnancy for a woman with epilepsy is considered a high risk obstetric condition. However, 90% of women with epilepsy can have safe pregnancies and healthy babies. To achieve this goal several steps must be taken. The pregnancy should be planned and take place at a time when her seizures are well controlled with medications least harmful to the baby. Care during the pregnancy requires a collaborative effort between the neurologist managing her epilepsy and the obstetrician managing the pregnancy. Attention must be given to the effects of pregnancy on seizure control and the effects of the women's seizures and their treatment on the pregnancy. Education and support assist the woman and other significant people through this process. After the baby arrives, the woman needs to continue to maintain the best possible seizure control and to plan for the safety of herself and her child if seizures occur. This is a family effort. Attention must also be given to the needs of a child growing up in a home where a parent has seizures.

Epilepsy in the elderly.

Other than children under the age of 5 years, the highest incidence of new onset epilepsy occurs in the population over 65 years of age. Risk factors in this age group include stroke, head trauma, dementia, infection, alcoholism and aging. Clinically, seizure behavior may be confused with other neurological impairments, thus delaying accurate diagnosis. Concomitant drug therapy affects the choice of antiepileptic drugs. Neuroscience nurses need to identify high-risk patients, recognize and document seizure activity and adverse drug reactions and interactions, and modify traditional seizure first aid for the frail elderly. An understanding of the psychosocial impact of epilepsy is necessary when offering education and support to the patient and family.

Preparing for epilepsy surgery.

Preparation for epilepsy surgery should assure that both patient and supporters understand the diagnostic and surgical procedures undertaken. Also essential is consideration of psychosocial concerns. This can be done by integrating discussions of psychosocial issues with evaluations of emotional readiness for surgery as part of a pre-surgical education programme. A programme developed by an epilepsy nurse specialist at a Comprehensive Epilepsy Program addresses these issues. It is a staged process and parallels the patient/supporter's progress through the steps necessary before a surgical option is offered. At each stage while information is presented an evaluation of emotional state and expressed/implied concerns is carried out. The goal is to assure that both patient and supporter understand the procedures and are comfortable in their decision to accept the elective procedure offered. This article will identify these expressed/implied concerns and describe the support programme which addresses them. In addition it will attempt to assist people contemplating epilepsy surgery in their preparation for the process.

Meeting the needs of children whose parents have epilepsy.

Improved treatment, changes in societal attitudes and repeal of restrictive laws have resulted in more people with epilepsy being able to pursue ordinary lives, including marriage and parenthood. When a parent continues to experience seizures, significant impact on the child may result. Changing family roles, fears and anxieties can disrupt the family's equilibrium. A family program at the Oregon Comprehensive Epilepsy Program has been developed to address the needs of children whose parents have seizures.

Assessing seizure activity in mentally disabled adults.

Epilepsy occurs in about 30% of mentally disabled adults. With the closure of long-term care institutions and the move of patient care into the community, there is greater opportunity for nurses to provide care for disabled people in hospitals, clinics and other community settings. The ability to accurately assess seizure activity in these people is essential in order to provide the best possible treatment. This article discusses factors which complicate assessment: lack of verbal skills, attendant neurological deficits, polypharmacy, misdiagnoses and presumed noncompliance with diagnostic procedures. Practical nursing interventions and strategies to address this clinical problem are offered.