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Author Spotlight: Advancing Pediatric Epilepsy Surgery in Children Through Novel Biomarkers and Enhanced Localization
Published on: September 20, 2024
Parenting stress does not normalize after child's epilepsy surgery
Olga Braams1, Joost Meekes2, Kees Braun3
1Sector of Neuropsychology for Children and Adolescents, University Medical Center Utrecht, PO Box 85090, 3508 AB Utrecht, The Netherlands; Brain Center Rudolf Magnus, University Medical Center Utrecht, PO Box 85500, 3508 GA Utrecht, The Netherlands; Department of Pediatric Psychology and Social Work, University Medical Center Utrecht, PO Box 85090, 3508 AB Utrecht, The Netherlands; Bio Research Center for Children, Wekeromseweg 8, 6816 VS Arnhem, The Netherlands.
Insights
Parenting stress in parents of children undergoing epilepsy surgery decreases post-operation but remains elevated. Counseling is recommended to address persistent stress related to epilepsy and child characteristics.
Area of Science:
- Pediatric Neurology
- Child Psychology
- Neuropsychology
Background:
- Epilepsy surgery is a significant event for children and their families.
- Parenting stress is a recognized factor impacting families with children with epilepsy.
- Understanding the trajectory of parenting stress around surgery is crucial for support.
Purpose of the Study:
- To quantify parenting stress in parents before and two years after pediatric epilepsy surgery.
- To compare parenting stress levels between parents of children with epilepsy and control groups.
- To identify factors influencing parenting stress post-surgery.
Main Methods:
- A cohort of 31 parents of children with epilepsy undergoing surgery and 31 control parents were assessed.
- The Parenting Stress Index questionnaire was administered pre-surgery and two years post-surgery.
- Neuropsychological assessments, life event evaluations, and epilepsy severity were also measured.
Main Results:
- Parents of children with epilepsy reported higher stress than controls pre-surgery.
- Total parenting stress significantly decreased two years post-surgery but remained higher than controls.
- Specific subscales related to parental role restriction and child distractibility/hyperactivity showed significant decreases.
- Lower child intelligence correlated with higher stress on specific subscales.
- Stress reduction was greater in children who became seizure-free.
Conclusions:
- Parenting stress following pediatric epilepsy surgery diminishes but does not fully normalize within two years.
- Persistent stress is linked to parental role restrictions and child-specific challenges.
- Ongoing psychological support and counseling are recommended for parents, irrespective of surgical outcomes.
Purpose:
This study aimed to investigate parenting stress expressed by parents before and two years after their children's epilepsy surgery.
Subjects:
Parents of 31 consecutively included surgery patients with epilepsy and parents of 31 healthy sex- and age-matched control children were the subjects of this study. Materials and procedure: The questionnaire 'Parenting Stress Index', which distinguishes a Parent domain (stress leading parents to feel themselves inadequate) from a Child domain (child features felt by parent to cause stress) was completed before surgery of the patients and two years thereafter. At both time points, intelligence examination of the child was part of a comprehensive neuropsychological assessment, as were evaluations of recent stress-enhancing life events and epilepsy severity.
Results:
Prior to surgery, total parenting stress was significantly higher in parents of patients than in parents of controls. Two years after surgery, total parenting stress had decreased significantly in parents of patients. The scores on parent-related subscales Role Restriction and Spouse and on the child-related subscale Distractibility/Hyperactivity, all relatively high before surgery, decreased significantly. Still, parents of patients experienced significantly more stress compared with parents of controls mainly because of persistently higher stress scores in parents of patients on the subscale Role Restriction (Parent domain) and on five of six subscales in the Child domain. Intelligence of the child was associated with parenting stress: the lower the child's intelligence, the higher the stress score on the subscale Distractibility/Hyperactivity and the lower the stress score on the subscale Mood. Stress decreased more in parents of patients who became seizure-free after surgery than in parents of patients with recurrent seizures.
Conclusions:
Parenting stress decreases but does not normalize in the first two years after epilepsy surgery. Parents should be offered counseling on epilepsy-related intricacies contributing to parenting stress, immediately after diagnosis as well as after epilepsy surgery, notwithstanding the resulting seizure status of the child.
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