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学龄儿童癫痫发作的管理:面向学校工作人员的教育项目

Management of epileptic seizures in school-age children: Educational project dedicated to school staff.

作者信息

Renzetti Tommaso, Calabrese Costanza, Pietrafusa Nicola, Pannacci Ilaria, Rainò Raffaella, Giuffrida Andrea, Specchio Nicola, Vigevano Federico

机构信息

Department of Neurosciences and Neurorehabilitation, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy.

Rare and Complex Epilepsy Unit, Department of Neurosciences and Neurorehabilitation, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy.

出版信息

Epilepsy Behav. 2020 Apr;105:106951. doi: 10.1016/j.yebeh.2020.106951. Epub 2020 Feb 18.

DOI:10.1016/j.yebeh.2020.106951
PMID:32086151
Abstract

OBJECTIVE

The objective of this study was to educate the school staff for a correct management of epileptic seizures in order to increase the safety of young people at school and promoting the administration of rescue drugs and in order to improve care and reduce improper calls to the health emergency number.

METHODS

This project started in January 2016, and it is still ongoing at the Department of Neuroscience of Bambino Gesù Children's Hospital in Rome, Italy. There has been a data cut-off evaluation in November 2018. Two-hour training meetings with the school staff have been organized. The major topics of the training activities were as follows: report what epilepsy is, how to manage students with epileptic seizures, and how to administer rescue medications. During the meetings, the following two questionnaires were administered: one pretest in order to collect personal information and information on awareness of epilepsy, willingness to administer rescue medications, and anxiety in facing a seizure; and one posttest in order to check the knowledge acquired after the training sessions. Statistical analysis was performed using R version 3.2.3 (R Foundation for Statistical Computing, http://www.R-project.org/). Demographics (sex and age) and teaching experience were summarized with descriptive statistics for each variable. Demographics, teaching experience, awareness of disability, and knowledge of epilepsy were correlated to the management of seizures occurring in the classroom before the course; results are reported as odds ratios [OR] and 95% confidence interval (95 CI).

RESULTS

Nine hundred school staff members (95% school staff and 5% social workers) entered in the project between January 2016 and November 2018. Seven hundred and forty (82%) returned the questionnaires fulfilled, and not all of them were completely filled. Ninety-eight percent of school staff (676/691) were aware about epilepsy; however, only in 16% (110) the awareness of epilepsy came from medical staff, scientific brochures, or participation in conventions. Thirty-five percent of school staff (248/707) believed that epilepsy reduces learning abilities, and 58% (409/703) believed that children with epilepsy need school support. After the training, 68% of school staff (496/734) correctly filled in the questionnaire related to the management of acute seizures versus 8% of them (57/718) in the prequestionnaire. After the training, 89% of school staff (601/675) were ready to administer rescue medications versus 54% (384/712) before the training. The majority of participants reported that the level of anxiety related to the management of seizures after the training significantly reduced.

CONCLUSIONS

Results of this project documented an increase in knowledge of epilepsy, a better knowledge on management of acute seizures in the school settings, a reduction in anxiety, and an increase in willingness to administer rescue medications. Further studies should be planned in order to document the changes in the real-world management of seizures, to evaluate if a reduction in hospital admittances might be reached, and to extend the project by assessing, through a questionnaire, the stigma and prejudices against the children affected by epilepsy by their classmates.

摘要

目的

本研究的目的是培训学校工作人员正确管理癫痫发作,以提高在校青少年的安全性,促进急救药物的使用,并改善护理情况,减少对健康急救号码的不当呼叫。

方法

该项目于2016年1月启动,目前仍在意大利罗马的 Bambino Gesù 儿童医院神经科学部进行。2018年11月进行了数据截止评估。已组织了与学校工作人员的两小时培训会议。培训活动的主要主题如下:介绍什么是癫痫、如何管理癫痫发作的学生以及如何使用急救药物。在会议期间,发放了以下两份问卷:一份预测试问卷,用于收集个人信息以及关于癫痫认知、使用急救药物的意愿和面对发作时的焦虑情况的信息;一份后测试问卷,用于检查培训课程后获得的知识。使用R 3.2.3版本(R统计计算基金会,http://www.R-project.org/)进行统计分析。对每个变量的人口统计学特征(性别和年龄)和教学经验进行描述性统计汇总。人口统计学特征、教学经验、残疾认知和癫痫知识与课程前课堂上癫痫发作的管理相关;结果以比值比[OR]和95%置信区间(95 CI)报告。

结果

2016年1月至2018年11月期间,900名学校工作人员(95%为学校工作人员,5%为社会工作者)参与了该项目。740人(82%)返回了填写完整的问卷,但并非所有人都完全填写。98%的学校工作人员(676/691)了解癫痫;然而,只有16%(110人)对癫痫的了解来自医务人员、科学手册或参加会议。35%的学校工作人员(248/707)认为癫痫会降低学习能力,58%(409/703)认为癫痫儿童需要学校支持。培训后,68%的学校工作人员(496/734)正确填写了与急性发作管理相关的问卷,而在预问卷中这一比例为8%(57/718)。培训后,89%的学校工作人员(601/675)准备好使用急救药物,而培训前这一比例为54%(384/712)。大多数参与者报告称,培训后与发作管理相关的焦虑水平显著降低。

结论

该项目的结果表明,对癫痫的了解有所增加,对学校环境中急性发作管理的认识有所提高,焦虑有所减少,使用急救药物的意愿有所增加。应规划进一步的研究,以记录癫痫发作实际管理中的变化,评估是否可能减少住院人数,并通过问卷评估同学对受癫痫影响儿童的耻辱感和偏见,从而扩展该项目。

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