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使用基于计算机游戏的癫痫教育计划(Epigame)对马来西亚癫痫儿童进行癫痫教育干预的效果:一项前瞻性队列研究。

The effectiveness of epilepsy educational intervention using computer game-based epilepsy educational program (Epigame) among Malaysian children with epilepsy: A prospective cohort study.

机构信息

Division of Paediatric Neurology, Department of Paediatrics, Faculty of Medicine, University Malaya, Kuala Lumpur, Malaysia.

Division of Paediatric Neurology, Department of Paediatrics, Faculty of Medicine, University Malaya, Kuala Lumpur, Malaysia; Paediatric Department, Sabah Women and Children Hospital, Sabah, Malaysia.

出版信息

Epilepsy Behav. 2023 Dec;149:109536. doi: 10.1016/j.yebeh.2023.109536. Epub 2023 Nov 25.

Abstract

BACKGROUND

A computer game-based epilepsy educational programme (Epigame) can potentially improve the awareness, knowledge and attitude (AKA) and quality of life (QOL) of children with epilepsy (CWE). Our study among Malaysian CWE aimed to assess the: i) baseline level of epilepsy AKA and potential characteristics associated with poor levels of AKA, ii) effectiveness of Epigame in improving AKA and QOL of CWE.

METHOD

Prospective cohort study on CWE age 7-18 years old with no comorbidities. Epilepsy education was delivered using Epigame. CWE completed AKA questionnaire before (time point 1 [TP1]), immediately after (TP2), 3 months (TP3) after provision of Epigame. Child self-report Health-Related Quality of Life Measurement for Children with Epilepsy (CHEQOL-25) questionnaire was completed at TP1 and TP3.

RESULTS

Total of 106 CWE participated in this study (mean age of 13.3 years). Baseline (TP1) AKA was rated "very low to moderate" for awareness domain in 95.3 %, "very low to moderate" for knowledge domain in 67 %, "negative to indifferent" for attitude domain in 54.7 %, and "very poor to moderate' for total AKA score domain in 84 %. "Positive to very positive" for child attitude domain was significantly associated with parents with "positive to very positive" for attitude domain (OR 10.6, 95 % CI 3.23-34.66). "Good to excellent" for total child AKA domain was significantly associated with parents with "Good to excellent" for total AKA domain (OR 5.2, 95 % CI 1.16-15.02) and with < 2 antiseizure medication (OR 5.0, 95 % CI 1.34-18.98). The scores in the knowledge, attitude and total AKA score domains improved significantly after the introduction of Epigame at TP3. There were no significant improvements in the CHEQOL-25 scores over time except for the "Quest for Normality" subscale score (mean of score difference between TP1 and TP3 = 1.0, 95 % CI 0.19-1.81).

CONCLUSION

Majority of Malaysian CWE had low levels of epilepsy AKA, particularly among parents with "negative to indifferent" for attitude domain, parents with "very poor to moderate" for total AKA domain and on polytherapy. Introduction of Epigame was effective in improving scores of the knowledge, attitude and total AKA domains, and the QOL "Quest for Normality" domain of the CHEQOL-25.

摘要

背景

基于计算机游戏的癫痫教育计划(Epigame)有可能提高儿童癫痫(CWE)的意识、知识和态度(AKA)以及生活质量(QOL)。我们在马来西亚 CWE 中的研究旨在评估:i)癫痫 AKA 的基线水平以及与 AKA 水平低相关的潜在特征,ii)Epigame 对提高 CWE 的 AKA 和 QOL 的有效性。

方法

对年龄在 7-18 岁且无合并症的 CWE 进行前瞻性队列研究。使用 Epigame 提供癫痫教育。CWE 在提供 Epigame 之前(时间点 1 [TP1])、之后立即(TP2)和 3 个月(TP3)完成 AKA 问卷。儿童自我报告的癫痫儿童健康相关生活质量测量量表(CHEQOL-25)问卷在 TP1 和 TP3 时完成。

结果

共有 106 名 CWE 参加了这项研究(平均年龄为 13.3 岁)。基线(TP1)时,95.3%的意识领域 AKA 被评为“非常低至中度”,67%的知识领域 AKA 被评为“非常低至中度”,54.7%的态度领域 AKA 被评为“消极至冷漠”,84%的总 AKA 评分领域被评为“非常差至中度”。儿童态度领域的“积极到非常积极”与父母态度领域的“积极到非常积极”呈显著相关(OR 10.6,95%CI 3.23-34.66)。总儿童 AKA 领域的“良好到优秀”与父母总 AKA 领域的“良好到优秀”(OR 5.2,95%CI 1.16-15.02)和<2 种抗癫痫药物(OR 5.0,95%CI 1.34-18.98)显著相关。在引入 Epigame 后,TP3 时知识、态度和总 AKA 评分领域的评分显著提高。除了“追求常态”分量表评分(TP1 和 TP3 之间的评分差异平均值为 1.0,95%CI 0.19-1.81)外,CHEQOL-25 评分随时间无显著变化。

结论

大多数马来西亚 CWE 的癫痫 AKA 水平较低,特别是在父母态度领域为“消极至冷漠”、父母总 AKA 领域为“非常差至中度”和接受多种药物治疗的 CWE 中。引入 Epigame 有效提高了知识、态度和总 AKA 领域的评分,以及 CHEQOL-25 的“追求常态”领域的 QOL。

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