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癫痫患儿父母的压力和感知耻辱感。

Stress and perceived stigma among parents of children with epilepsy.

机构信息

Department of Psychiatric Social Work, National Institute of Mental Health and Neurosciences, Govindswamy Building (2nd Floor), Hosur Road, Near Bangalore Milk Dairy, Landmark: SBI NIMHANS Branch, Bangalore, 560 029, India.

出版信息

Neurol Sci. 2019 Jul;40(7):1363-1370. doi: 10.1007/s10072-019-03822-6. Epub 2019 Mar 22.

Abstract

PURPOSE

The present study aimed at understanding the stress and perceived stigma among parents of children with epilepsy seeking treatment at a tertiary referral center for neurology in South India.

MATERIALS AND METHODS

Parents of sixty children suffering from epilepsy in the age group of 4-15 years were interviewed to explore parental stress and perceived stigma. They were recruited consecutively over a period of 6 months in 2015. Tools administered were Childhood-Illness related Parenting Stress Inventory (Manford in J Neurol 264(8):1811-24, 2017) and the Parent Stigma Scale (Baca et al. in Value Health 13(6):778-786, 2010).

RESULTS

The mean age of parents was 37.2 years, and the majority of parents who used to bring their child to the hospital were male (71.7%) and educated up to the secondary/intermediate level (36%) and were from lower socio-economic status. The mean age of children with epilepsy was 8.4 years with the majority of them being male (66.7%), affected with chronic seizures (58.3%) with most commonly occurring seizure type being generalized seizures (50%), with a co-morbid diagnosis of cerebral palsy (26.7%). A significant number of parents reported difficulty in communicating with medical team (58.3%) and significant others (51.7%) about their child's seizures and difficulty in making decisions related to their child's medical care (43.3%) which strained their financial resources and created difficulty in adequate role functioning. Findings indicated that most of the parents of children with chronic seizures perceived reactions of others to be negative (53.3%) and would limit family social interaction which resulted into emotional reaction in the form of anger, guilt, fear, anxiety, and depression.

CONCLUSION

Parents are important figures in the process by which children with epilepsy came to acknowledge themselves being different from other children. Parents often feared divulging their child's epilepsy to their friends and relatives because they experienced a sense of shame, self-blame, and rejection which also increased their stress.

摘要

目的

本研究旨在了解在印度南部一家神经病学三级转诊中心接受治疗的癫痫患儿的父母所承受的压力和感知到的耻辱感。

材料和方法

2015 年期间,我们连续招募了年龄在 4-15 岁之间的 60 名癫痫患儿的父母,对其进行访谈以探讨父母的压力和感知到的耻辱感。使用的工具是儿童疾病相关父母压力量表(Manford 在 J Neurol 264(8):1811-24, 2017)和父母耻辱量表(Baca 等人在 Value Health 13(6):778-786, 2010)。

结果

父母的平均年龄为 37.2 岁,大多数带孩子去医院的父母是男性(71.7%),受教育程度为中学/中级(36%),社会经济地位较低。癫痫患儿的平均年龄为 8.4 岁,其中大多数为男性(66.7%),患有慢性癫痫发作(58.3%),最常见的发作类型为全身性发作(50%),伴有脑瘫合并症诊断(26.7%)。相当数量的父母报告在与医疗团队(58.3%)和其他重要人员(51.7%)交流孩子的癫痫发作方面存在困难,并且在做出与孩子的医疗保健相关的决策方面存在困难(43.3%),这给他们的财务资源带来了压力,并导致他们难以充分发挥作用。研究结果表明,大多数患有慢性癫痫发作的儿童的父母认为他人的反应是负面的(53.3%),并限制了家庭的社会互动,这导致了他们的情绪反应,表现为愤怒、内疚、恐惧、焦虑和抑郁。

结论

父母是癫痫患儿认识到自己与其他孩子不同的过程中的重要人物。父母往往害怕向朋友和亲戚透露他们孩子的癫痫,因为他们感到羞耻、自责和被拒绝,这也增加了他们的压力。

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