Utility of the Frontal Lobe Epilepsy Parasomnia Scale in Evaluation of Children With Nocturnal Events.

ABSTRACT: BACKGROUND: Sleep-related hypermotor epilepsy (SHE) and nocturnal non-rapid eye movement parasomnias are difficult to differentiate. Neurologists and sleep medicine clinicians largely rely on clinical history when evaluating nocturnal spells. When the diagnosis is in question, referral for video electroencephalogram monitoring is the standard. However, there are no guidelines as to when this evaluation is needed. The Frontal Lobe Epilepsy Parasomnia (FLEP) scale was developed to assist clinicians in differentiating the two among adults. The aim of this study was to provide a preliminary evaluation of the FLEP for use with children. METHODS: This was a retrospective pilot instrument validation study with a convenience sample of 17 children seen in neurology or sleep medicine clinics. To determine concurrent validity, FLEP scores were compared with clinical diagnoses by neurology providers confirmed by electroencephalography. RESULTS: With a cutoff score of 2, the modified FLEP distinguished between children with and without SHE. The FLEP tool had a specificity of 0.58, implying that 7 of the 12 children without SHE would have been accurately recommended to follow up for parasomnia management rather than more urgent evaluation of potential frontal lobe epilepsy. CONCLUSIONS: With some minor adaptations for children, the FLEP satisfactorily distinguished between SHE and non-SHE patients.

Compassion fatigue and burnout in nurses who work with children with chronic conditions and their families.

INTRODUCTION: With the current and ever-growing shortage of nurses in the United States, it is imperative that nurses find ways to prevent burnout and effectively manage compassion fatigue that can result from working with traumatized populations. The aim of this study is to identify the triggers and coping strategies that nurses who work with children with chronic conditions use to manage compassion fatigue and prevent burnout. METHOD: In this descriptive qualitative pilot project, 20 experienced nurses who work with children with chronic conditions were interviewed about their experiences with compassion fatigue and burnout. RESULTS: Findings indicate that compassion fatigue is commonly and episodically experienced by nurses working with children with chronic conditions and their families. Participants reported that insight and experience helped them develop short- and long-term coping strategies to minimize and manage compassion fatigue episodes and prevent burnout. DISCUSSION: Nurses need to be able to identify signs of compassion fatigue and develop a range of coping strategies and a support system to revitalize their compassion and minimize the risk of burnout.