Department of Psychiatry and Behavioral Neurosciences, McMaster University/St Joseph's Healthcare Hamilton, Hamilton, ON, Canada; Department of Psychiatry, University of Lagos, Mushin, Lagos State, Nigeria; Discipline of Psychiatry, The University of Adelaide, Adelaide, SA, Australia.
Federal Medical Centre, Birnin Kebbi, Kebbi State, Nigeria.
Epilepsy Behav. 2021 Jul;120:107992. doi: 10.1016/j.yebeh.2021.107992. Epub 2021 May 4.
Parent caregivers often play vital roles in the care of adolescents with epilepsy (AWE) in resource-restricted settings; however, little is known about the burden borne by these parents. This study investigated the burden perceived by parents of AWE and described the explanatory factors.
An equal number (n = 121) of age- and gender-matched parent caregivers of AWE (cases) and parents of adolescents with sickle cell disease (comparison group) were interviewed with the Parent Illness Intrusiveness Rating Scale to assess disruptions in their relationships and lifestyle. Parents of AWE were assessed for psychological distress with the 12-item General Health Questionnaire, and AWE were interviewed with the Hospital Depression-Anxiety Scale.
The majority of the cases and the comparison group were mothers (76%), with mean (SD) ages of 44.11 (SD = 6.92) versus 43.59 (SD = 6.39) years, respectively. The prevalence rate of psychological distress in cases was 38%, and depressive-anxiety symptom was prevalent in 39.7% of AWE. The level of perceived burden was significant in all parent caregivers, albeit higher in cases relative to the comparison group across multiple domains, including relationship/personal development, intimacy, instrumental and global. A high level of burden in parents of AWE was predicted by a poor family financial and material support to the adolescents, increased contact hours with adolescents, psychological distress in the parent caregivers, and anxiety-depressive symptoms in AWE after controlling for cofounders.
The study findings underscore the need for psychosocial support to bolster resilience and adaptive coping styles in parents of AWE, particularly in resource-restricted settings. A culturally sensitive interdisciplinary blueprint of locally viable actions model for psychosocial support for parent caregivers of AWE is strongly suggested. Future studies are indicated to shed more light on the modifiable risks of perceived burden, and the effectiveness of psychosocial interventions in parents of AWE.
在资源有限的环境中,青少年癫痫(AWE)患者的父母通常在照顾患者方面发挥着至关重要的作用;然而,人们对这些父母所承受的负担知之甚少。本研究旨在调查 AWE 患者父母所感受到的负担,并描述其解释因素。
采用病例对照研究,以 1:1 的比例,对 AWE 患者的父母(病例组)和镰状细胞病青少年的父母(对照组)进行访谈,采用父母疾病侵扰量表评估其人际关系和生活方式的中断情况。使用 12 项一般健康问卷评估 AWE 患者父母的心理困扰,采用医院焦虑抑郁量表评估 AWE。
病例组和对照组的大多数父母均为母亲(76%),年龄分别为 44.11(SD=6.92)岁和 43.59(SD=6.39)岁。病例组中,心理困扰的患病率为 38%,AWE 中抑郁焦虑症状的患病率为 39.7%。所有父母都感受到了明显的负担,但病例组的负担水平相对对照组更高,在多个领域均存在差异,包括人际关系/个人发展、亲密关系、工具性和整体方面。在控制了混杂因素后,AWE 患者父母的高负担水平可由青少年家庭经济和物质支持较差、与青少年的接触时间增加、父母的心理困扰以及 AWE 的焦虑抑郁症状来预测。
研究结果强调需要为 AWE 患者的父母提供社会心理支持,以增强其适应力和应对方式,特别是在资源有限的环境中。强烈建议制定一种具有文化敏感性的跨学科蓝图,为 AWE 患者的父母提供可行的社会心理支持方案。需要进一步的研究来阐明可改变的负担感知风险,以及社会心理干预对 AWE 患者父母的有效性。