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“我们尽力了。但我们的生活并不正常”:家庭经历的结节性硬化症和癫痫管理。

'We've made the best of it. But we do not have a normal life': families' experiences of tuberous sclerosis complex and seizure management.

机构信息

Guys and St Thomas' NHS Foundation Trust (Kings Health Partners), Evelina London Children's Hospital, London, UK.

Institute of Neuroscience, Newcastle University, Newcastle upon Tyne, UK.

出版信息

J Intellect Disabil Res. 2019 Aug;63(8):947-956. doi: 10.1111/jir.12609. Epub 2019 Feb 18.

Abstract

BACKGROUND

Tuberous sclerosis complex (TSC) is a complex multisystem genetic disorder. Approximately 84% of people with TSC have epilepsy. However, there is little literature available regarding families' experiences with TSC and seizure management. Therefore, the aim of the current study was to explore families' positive and negative experiences, and attitudes towards TSC, epilepsy and medical management of seizures.

METHODS

Framework analysis informed an open exploration of families' experiences with TSC, epilepsy and medical management of seizures. Using structured interviews, 11 parents of people with TSC and 2 people with TSC were interviewed, providing the data set for transcription and thematic analysis.

RESULTS

'TSC rules our life' overarched three subordinate themes: 'Our normal', 'Burnout' and 'Seizure management has given us our life back'. Families had to adapt to the normality of needing to constantly supervise their child even as they become an adult. They express a feeling of fear particularly of seizures, and this has impact throughout the family. There are frequent expressions of exhaustion and struggling to fight for access and support. There are some positives and cautious hope with the gaining of control from seizures as being able to predict or plan improves activity and participation. These interviews provided a rich insight into the lives of those with TSC and their families.

CONCLUSION

There are exciting developments with respect to scientific understanding of the pathophysiology of TSC, which opens opportunity for new treatments. Holistic family centred health care and practical support (e.g. opportunities for parental respite) is as important as medical intervention. As TSC is such a complex condition, there is a need for specialist clinics and TSC-specific research.

摘要

背景

结节性硬化症(TSC)是一种复杂的多系统遗传疾病。大约 84%的 TSC 患者患有癫痫。然而,关于家庭在 TSC 及其癫痫管理方面的经验,相关文献却很少。因此,本研究旨在探讨家庭在 TSC、癫痫和癫痫医疗管理方面的积极和消极体验以及态度。

方法

框架分析深入探讨了家庭在 TSC、癫痫和癫痫医疗管理方面的经验。通过结构式访谈,对 11 名 TSC 患者的父母和 2 名 TSC 患者进行了访谈,为转录和主题分析提供了数据集。

结果

“TSC 主宰着我们的生活”涵盖了三个子主题:“我们的常态”、“疲惫不堪”和“癫痫管理让我们的生活恢复正常”。家庭必须适应需要不断监督孩子的常态,即使孩子已经成年。他们特别害怕癫痫发作,并因此感到恐惧,这种恐惧会影响整个家庭。他们经常感到筋疲力尽,努力争取获得支持和帮助。在控制癫痫方面,也存在一些积极的方面和谨慎的希望,因为能够预测或计划可以改善活动和参与度。这些访谈深入了解了 TSC 患者及其家庭的生活。

结论

随着对 TSC 病理生理学的科学理解的不断发展,为新的治疗方法开辟了机会。以家庭为中心的整体医疗保健和实际支持(例如为父母提供喘息机会)与医疗干预同样重要。由于 TSC 是一种复杂的疾病,因此需要专业的诊所和 TSC 特定的研究。

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