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等待癫痫发作缓解的经历以及对支持治疗决策的机器学习技术的认知:一项针对近期发病的成年癫痫患者的定性研究

Experience of waiting for seizure freedom and perception of machine learning technologies to support treatment decision: A qualitative study in adults with recent onset epilepsy.

作者信息

Reeder Sandra, Foster Emma, Vishwanath Swarna, Kwan Patrick

机构信息

School of Public Health and Preventive Medicine, Monash University, 553 St Kilda Road, Melbourne 3004, Australia; Department of Neurosciences, Monash University, Central Clinical School, 99 Commercial Road, Melbourne 3004, Australia.

Department of Neurosciences, Monash University, Central Clinical School, 99 Commercial Road, Melbourne 3004, Australia; Department of Neurology, The Alfred, 55 Commercial Road, Melbourne 3004, Australia.

出版信息

Epilepsy Res. 2023 Feb;190:107096. doi: 10.1016/j.eplepsyres.2023.107096. Epub 2023 Jan 24.

Abstract

PURPOSE

With no reliable surrogate biomarkers for treatment response, people with epilepsy currently await the passage of time to determine whether prescribed treatments are effective. Few studies have examined the issues faced by people with epilepsy during this waiting period. We aim to explore the experiences of people with recently diagnosed epilepsy as they wait to achieve seizure freedom.

METHODS

We purposively sampled adults of working age who had been diagnosed and treated for epilepsy for less than four years. Semi-structured interviews were undertaken between July and September 2021. A thematic analysis using a framework approach was performed.

RESULTS

We recruited 15 patients. Results revealed four main themes: 1) Impact on mental health, as people with newly diagnosed epilepsy described waiting for seizure freedom as a time of vulnerability, uncertainty, and confusion. 2) Participants described their life as "on hold", prior to achieving effective seizure control 3) Difficulty navigating health systems to find and understand information about epilepsy, tests, and medications, and to find the 'right' health professional to address their needs. 4) Technology systems that support clinician decision making with selecting effective medications early after diagnosis were cautiously welcomed by participants.

CONCLUSION

Interventions are needed to reduce the negative impacts experienced by people who are newly diagnosed with epilepsy while waiting for effective seizure control. Technology systems that support clinician decision making were acceptable, as people with epilepsy sought accessible and effective solutions to restore a sense of control in their lives.

摘要

目的

由于缺乏可靠的治疗反应替代生物标志物,癫痫患者目前只能等待时间来确定所开的治疗方法是否有效。很少有研究探讨癫痫患者在这段等待期所面临的问题。我们旨在探索近期被诊断为癫痫的患者在等待实现无癫痫发作过程中的经历。

方法

我们有目的地抽取了工作年龄、被诊断和治疗癫痫不到四年的成年人。在2021年7月至9月期间进行了半结构化访谈。采用框架法进行了主题分析。

结果

我们招募了15名患者。结果揭示了四个主要主题:1)对心理健康的影响,因为新诊断为癫痫的患者将等待无癫痫发作描述为一个脆弱、不确定和困惑的时期。2)参与者将他们的生活描述为在实现有效的癫痫发作控制之前“暂停”。3)在医疗系统中难以找到并理解有关癫痫、检查和药物的信息,以及找到能满足其需求的“合适”医疗专业人员。4)支持临床医生在诊断后早期选择有效药物进行决策的技术系统受到参与者的谨慎欢迎。

结论

需要采取干预措施,以减少新诊断为癫痫的患者在等待有效癫痫发作控制期间所经历的负面影响。支持临床医生决策的技术系统是可以接受的,因为癫痫患者寻求可获取且有效的解决方案,以恢复对生活的控制感。

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