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Children's Experiences of Epilepsy: A Systematic Review of Qualitative Studies
Lauren Chong1, Nathan J Jamieson1, Deepak Gill2
1Sydney School of Public Health and Kids Research Institute.
Insights
Children with epilepsy face vulnerability and discrimination, impacting their well-being. Addressing stigma and improving healthcare navigation are crucial for their overall health outcomes.
Area of Science:
- Neurology
- Pediatric Neurology
- Psychology
Background:
- Epilepsy is a severe neurological disorder with significant mortality and morbidity.
- It profoundly affects psychological well-being and quality of life in affected individuals.
Purpose of the Study:
- To explore and synthesize the lived experiences of children and adolescents diagnosed with epilepsy.
- To understand their perspectives on living with the condition.
Main Methods:
- Systematic review of qualitative studies focusing on children's epilepsy experiences.
- Thematic synthesis was employed to analyze data from 43 articles.
- Included 951 participants aged 3-21 years from 21 countries.
Main Results:
- Identified six key themes: loss of bodily control, loss of privacy, inferiority and discrimination, therapeutic burden, navigating healthcare, and regaining normality.
- Participants reported feelings of vulnerability, disempowerment, and social stigma.
- Challenges included treatment futility, side effects, and fragmented healthcare.
Conclusions:
- Children with epilepsy experience significant vulnerability, disempowerment, and discrimination.
- Concerns about treatment failure, stigma, independence, and mortality impact well-being.
- Interventions should address stigma and support future independence.
Context:
Epilepsy is a common and severe neurologic disease associated with increased mortality, seizure-related injury, and adverse psychological and quality-of-life outcomes.
Objective:
To describe the perspectives of children and adolescents with epilepsy.
Data Sources:
Medline, Embase, PsycINFO, and CINAHL from inception to August 2015.
Study Selection:
Qualitative studies on children's experiences of epilepsy.
Data Extraction:
Results from primary studies. We used thematic synthesis to analyze the findings.
Results:
Forty-three articles involving 951 participants aged 3 to 21 years across 21 countries were included. We identified 6 themes: loss of bodily control (being overtaken, susceptibility to physical harm, fragility of the brain, alertness to mortality, incapacitating fatigue), loss of privacy (declarative disease, humiliating involuntary function, unwanted special attention, social embarrassment of medicine-taking), inescapable inferiority and discrimination (vulnerability to prejudice, inability to achieve academically, consciousness of abnormality, parental shame, limiting social freedom), therapeutic burden and futility (unattainable closure, financial burden, overwhelming life disruption, exhaustion from trialing therapies, insurmountable side effects, awaiting a fabled remission), navigating health care (empowerment through information, valuing empathetic and responsive care, unexpected necessity of transition, fragmented and inconsistent care), and recontextualizing to regain normality (distinguishing disease from identity, taking ownership, gaining perspective and maturity, social and spiritual connectedness).
Limitations:
Non-English articles were excluded.
Conclusions:
Children with epilepsy experience vulnerability, disempowerment, and discrimination. Repeated treatment failure can raise doubt about the attainment of remission. Addressing stigma, future independence, and fear of death may improve the overall well-being of children with epilepsy.
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