Chew Judith, Carpenter John, Haase Anne M
Medical Social Work Department, KK Women's and Children's Hospital, Singapore.
Social Work and Applied Social Science, School for Policy Studies, University of Bristol, Bristol, UK.
Child Care Health Dev. 2019 Mar;45(2):241-250. doi: 10.1111/cch.12648.
Systematic reviews of quantitative research on the effects of childhood epilepsy have established its association with higher levels of psychiatric diagnosis, externalizing and internalizing problems, lower health-related quality of life, social competence, and poorer academic achievements, compared with their peers. However, much less is known about young people's experiences of living with epilepsy and its impact on their development from their own perspectives.
Semistructured interviews were conducted with 15 young people aged between 13 and 16 years. Participants were recruited as part of a larger mixed methods study examining individual and family influences on outcomes for young people with epilepsy. These young people attended an epilepsy clinic in KK Women's and Children's Hospital, Singapore. The framework approach to data management and analyses involved both inductive and deductive generation of themes.
Findings from young people's interviews provided in-depth descriptions of stressful circumstances encountered. Interconnectedness between severity of the impairment and its impact on key developmental tasks, such as independence, autonomy, and social development, were emphasized. Seizures and illness-related demands disrupted their day-to-day functioning and challenged their abilities to meet these tasks. In addition to these impairment effects, young people's experiences of social exclusion were also affected by social and environmental factors, which act as systemic barriers to participation. In turn, this has an effect on their self-esteem. Nevertheless, young people reported positive experiences, such as support from both family and friends, which served as protective factors against the stress of living with a chronic medical condition.
The demands of epilepsy affect various domains of young people's lives. In order to obtain a holistic understanding of young people's inclusion or exclusion to participation, it is necessary to consider impairment effects, barriers to doing, and barriers to being.
关于儿童癫痫影响的定量研究的系统评价表明,与同龄人相比,癫痫与更高水平的精神疾病诊断、外化和内化问题、较低的健康相关生活质量、社交能力以及较差的学业成绩有关。然而,从年轻人自身的角度来看,对于他们患有癫痫的经历及其对自身发展的影响,我们知之甚少。
对15名年龄在13至16岁之间的年轻人进行了半结构化访谈。作为一项更大规模的混合方法研究的一部分,招募了这些参与者,该研究考察了个体和家庭对癫痫青少年结局的影响。这些年轻人在新加坡KK妇女儿童医院的癫痫诊所就诊。数据管理和分析的框架方法涉及主题的归纳和演绎生成。
年轻人访谈的结果深入描述了他们所遇到的压力环境。强调了损伤严重程度与其对关键发展任务(如独立性、自主性和社会发展)的影响之间的相互联系。癫痫发作和与疾病相关的需求扰乱了他们的日常功能,并挑战了他们完成这些任务的能力。除了这些损伤影响外,年轻人的社会排斥经历也受到社会和环境因素的影响,这些因素成为参与的系统性障碍。反过来,这又对他们的自尊产生影响。尽管如此,年轻人报告了一些积极的经历,比如来自家人和朋友的支持,这些是抵御患有慢性疾病压力的保护因素。
癫痫的需求影响着年轻人生活的各个领域。为了全面了解年轻人参与或被排除参与的情况,有必要考虑损伤影响、行为障碍和存在障碍。