Kroner Barbara L, Wright Cyndi, Friedman Daniel, Macher Kim, Preiss Liliana, Misajon Jade, Devinsky Orrin
RTI International, Rockville, Maryland, U.S.A.
Epilepsia. 2014 Oct;55(10):1486-94. doi: 10.1111/epi.12799. Epub 2014 Oct 16.
Describe the characteristics of persons with epilepsy (PWEs) and caregivers that have or have not heard of sudden unexpected death in epilepsy (SUDEP) prior to completing a survey through the Internet or in the clinical setting.
An online survey for adult PWEs and caregivers was solicited by e-mail and newsletter to Epilepsy Therapy Project members. A similar survey was implemented in a clinic setting of a community hospital. The survey asked about seizure characteristics, epilepsy management, fear of death, and familiarity with the term SUDEP. Respondents that never heard of SUDEP read a definition and responded to questions about their initial reactions.
Surveys from 1,392 PWEs and 611 caregivers recruited through an epilepsy Website and a clinic demonstrated that Internet respondents were much more likely to have heard about SUDEP than the clinic population (71.1% vs. 38.8%; p < 0.001), and caregivers of PWEs were more likely to have heard about SUDEP than PWEs (76.2% vs. 65.2%; p < 0.001). Prior awareness was related to an increased level of education, more severe and longer duration of epilepsy, and having an epileptologist as the primary care provider. Although most PWEs and caregivers reported feelings of fear, anxiety, and sadness after first hearing of SUDEP, they wanted to discuss it with their doctor. Persons with epilepsy, and especially their caregivers, often worry that the PWEs may die of epilepsy or seizures. This worry escalated with knowledge of SUDEP and increased epilepsy severity. Approximately half of PWEs and caregivers believed that knowledge about SUDEP would influence their epilepsy management.
Our results may help epilepsy care providers determine when to facilitate a discussion about epilepsy-related mortality and SUDEP among patients and caregivers, and to educate those at high risk about the importance of seizure control as well as reduce fears about death in patients with well-controlled and nonconvulsive epilepsies.
描述癫痫患者(PWEs)及其照料者在通过互联网或临床环境完成一项调查之前,是否听说过癫痫性猝死(SUDEP)的特征。
通过电子邮件和时事通讯向癫痫治疗项目成员征集针对成年癫痫患者及其照料者的在线调查。在一家社区医院的诊所环境中进行了类似的调查。该调查询问了癫痫发作特征、癫痫管理、对死亡的恐惧以及对SUDEP一词的熟悉程度。从未听说过SUDEP的受访者阅读了一个定义,并回答了关于他们最初反应的问题。
通过一个癫痫网站和一家诊所招募的1392名癫痫患者和611名照料者的调查显示,互联网受访者比诊所人群更有可能听说过SUDEP(71.1%对38.8%;p<0.001),癫痫患者的照料者比癫痫患者更有可能听说过SUDEP(76.2%对65.2%;p<0.001)。先前的知晓与教育程度提高、癫痫病情更严重和病程更长以及以癫痫专科医生作为主要护理提供者有关。尽管大多数癫痫患者及其照料者在首次听说SUDEP后报告有恐惧、焦虑和悲伤情绪,但他们希望与医生讨论此事。癫痫患者,尤其是他们的照料者,常常担心癫痫患者可能死于癫痫或癫痫发作。随着对SUDEP的了解和癫痫病情严重程度的增加,这种担忧加剧。大约一半的癫痫患者及其照料者认为,关于SUDEP的知识会影响他们对癫痫的管理。
我们的结果可能有助于癫痫护理提供者确定何时促进患者及其照料者之间关于癫痫相关死亡率和SUDEP的讨论,并向高危人群宣传癫痫控制的重要性,同时减少对病情得到良好控制且无惊厥性癫痫患者的死亡恐惧。