Participation in healthcare behavior by adolescents with epilepsy and factors that influence it during the transition period: A cross-sectional study in China.

PURPOSE: Given the importance of adolescents' participation in the care of their chronic diseases during their transitional period in the healthcare system, the present study investigated the degree of participation in healthcare behavior by Chinese adolescents with chronic epilepsy and identified factors that should be addressed by health interventions. METHODS: The study used a convenience sample of 1238 adolescent patients with epilepsy, who were hospitalized in 17 tertiary A-level children or maternal and child specialty hospitals in China between January 2017 and March 2020. Several scales were used to measure their degree of participation in healthcare behavior and the factors that influence it. Data collection was conducted after uniform training of the investigators. The adolescents who met the inclusion and exclusion criteria could scan the QR code of the questionnaire via a mobile phone. RESULTS: The age of the participants ranged from 12.2 to 17.8 years (mean 14.2 years), and the sample had a male-to-female ratio of 1.25:1. The patients' average total score of participation in healthcare behavior was 125.58 (SD = 12.25), which was lower than the norm for China. Their scores on the six dimensions of participation were highest for information interaction, followed in descending order by medical decision-making, treatment and care, appeal, diagnosis and treatment decision-making, and questioning supervision. Multiple linear regression found significant associations between health-care participation and five personal and disease variables (gender, age, course of disease, number of comorbid diseases, type of family structure), self-efficacy, and coping styles (cognitive-palliative and acceptance), which explained 52.1% of the variance in patients' total scores on participating in healthcare behavior. CONCLUSIONS: The participation of young Chinese patients with epilepsy in transitional healthcare behavior needs to be improved. Participation was positively associated with being female, a longer course of disease, fewer comorbidities, and living in a nuclear family. Patients who used cognitive-palliative and acceptance coping styles and those who had higher self-efficacy also had significantly higher levels of participation in healthcare behavior. The study provides useful reference points for adolescents with chronic disease to participate in healthcare programs, in order to achieve a smooth transition from childhood to adulthood.

Health Assessment of Chinese Adolescents with Epilepsy in the Preparatory Phase of Transition Process from Pediatric to Adulthood:A Single-Center Study Using the Omaha System.

OBJECTIVE: Epilepsy is one of the most common childhood-onset neurological disorder characterized by both seizures and the related comorbidities. The preparatory phase in transition refers to a dynamic process of identifying and resolving health issues to ensure seamless continuing care from childhood to adulthood. This study identifies the health issues of the preparatory phase in transition from children to adulthood using the Omaha System. METHODS: This prospective, single-center study enrolled 86 adolescents with epilepsy in China. The Problem Classification Scheme and Problem Rating Scale for Outcomes of Omaha System were used to evaluate transition-induced health problems. RESULTS: These health problems cover all four domains of the problem classification scheme of the Omaha System, and the specific distribution is related to the type of epilepsy. The results of the four-category classification evaluation showed that the most common health problem is health-related behavioral problems (46.1%), followed by psychosocial problems (23.0%), physiological problems (20.6%), and environmental problems (10.3%). The distribution of these health problems in generalized seizures, focal seizures, and generalized-focal seizures are significantly different (P < 0.01). The results of the outcome rating scale showed that 83.4% of the children had minimal knowledge, 84.2% had inconsistently appropriate behaviors, and 86.7% had moderate symptoms. CONCLUSIONS: The health problems of patients with epilepsy during the preparatory phase of transition process from pediatric to adulthood should be emphasized. Identification of health problems though the Omaha System can improve management for adolescents with epilepsy, including prevention, nursing care, social support, and therapeutic interventions.

[Effects of different types and concentration of oral sweet solution on reducing neonatal pain during heel lance procedures].

OBJECTIVE: To compare the effect of different types and concentrations of sweet solutions on neonatal pain during heel lance procedure. METHOD: Totally 560 full term neonates (male 295, female 265) were randomized into 7 groups:placebo group (plain water), 10% glucose, 25% glucose, 50% glucose, 12% sucrose, 24% sucrose and 30% sucrose groups.In each group, 2 ml corresponding oral solutions were administered through a syringe by dripping into the neonate's mouth 2 minute before heel lance. The procedure process was recorded by videos, from which to collect heart rate, oxygen saturation and pain score 1 min before puncture, 3, 5 and 10 min after puncture. RESULT: The average heart rate increase 3, 5 and 10 min after procedure in the 25% and 50% glucose groups, 12% and 24% and 30% sucrose groups was significantly lower than those in the placebo group (P < 0.01 or 0.05). The average heart rate increase 3 min after procedure in the sucrose group was lower than that in the glucose group (P < 0.01).Neonates who received 30% sucrose has a significantly lower average heart rate increase than those who received 12% and 24% sucrose 3 min after heel lance (both P < 0.05) . The average oxygen saturation decrease 3, 5, 10 min after procedure was significantly lower than those in the placebo group (P < 0.01). The average oxygen saturation decrease 3 min after procedure in the sucrose groups was significantly lower than that in the glucose groups (P < 0.01). The average pain score 3, 5, 10 min after procedure was significantly lower than those in the placebo group (P < 0.01). The average pain score 3 min after procedure in the sucrose groups was significantly lower than that in the glucose groups (P < 0.01). CONCLUSION: Oral administration of sweet solutions is an effective way to relieve neonatal pain on procedure, and sucrose has a better pain relief action than glucose, moreover, 30% sucrose provides better effect in control of heart rate increase 3 min after heel lance, but the best concentration of sucrose for pain relief needs further study.