i
APPENDIX-A
ii
APPENDIX-B
INFORMED CONSENT FORM
EFFECTIVENESS OF A NURSE EXECUTED EPILEPSY EDUCATION
PROGRAM ON KNOWLEDGE, SELF-MANAGEMENT AND QUALITY OF
LIFE AMONG PATIENTS WITH EPILEPSY
Name of the principle investigator: Mrs. A. Seethalakshmi
The current study is aimed at determining the effectiveness of an epilepsy
education program. The effectiveness of this program on knowledge, selfmanagement and Quality of Life is determined by the Epilepsy Knowledge Scale,
Epilepsy Self Management Scale and the QoLIE31. Each session takes about 20
minutes. The data is to be collected once at first contact, once at 90 days (three
months) after the group instruction using the Epilepsy Information Booklet and the
2nd posttest is at the end of 180 days (six months) to determine the Knowledge, Selfmanagement, seizure frequency and Quality of Life. It involves a voluntary
participation and does not involve any invasive procedures. The data are to be
collected from patients diagnosed with epilepsy attending the neurology OPD at Sri
Ramachandra Hospital.
This study involves voluntary participation and if you are not willing to
participate there will be no disturbance to the regular care and consultation that you
are receiving.
The duration of participation in this study will be for six months. It involves
collecting information at the time of first contact regarding your condition, how you
are able to manage epilepsy, day-to- day activities, your medication intake and your
Quality of Life.
When you come for your second follow-up on the 15th day some of you will
receive group instruction (along with 3-5 others) for 25 minutes on your condition,
management, trigger factors, activities to be avoided, medications and regarding any
other doubts that you might have. You will also receive the Epilepsy Information
Booklet and a seizure dairy that you will have to maintain for the next 30 days.
The seizure diary has to be brought along with you on your subsequent
follow-up at the end of 30 days. It will take 20 minutes to give your responses to the
questions asked. The first assessment will be carried out at 90 days (the third month)
and the second assessment at 180 days (the end of the sixth month) when you will
have to give your responses to the questions asked.
iii
This study does not involve any invasive procedures or tests; it involves
collecting and giving information only. There is no risk to your physical self by
participating in this study. You will benefit from the information that is given to you
on Self-management of epilepsy. There is no cost for participation in this study.
Participation is completely voluntary and no payment will be provided.
The information that is obtained from you will be kept confidential. Your
name will not be used in reporting of information in publications or conference
presentations.
You have the right to refuse to participate in this study, the right to withdraw
from the study and the right to have your data destroyed at any point during or after
the study without penalty.
Participation in this study is completely voluntary and your consent is required
before you can participate in this study.
I have read this consent form and fully understood the contents of this
document. I voluntarily consent to participate in this study. All of my questions
concerning this study have been answered. If I have any questions in the future about
this study they will be answered by the investigator listed below. I understand that this
consent ends at the conclusion of this study.
Contact address with phone number:
Principle investigator:
Mrs. A.Seethalakshmi
Reader, Faculty of Nursing,
SRU, Porur - 116.
Phone number: 9940420846
By signing this form, I agree to participate in this study. A copy of this form has been
given to me.
Date:
Name:
Participant’s Signature/
Thumb impression:
Witness name:
Witness signature:
iv
CERTIFICATION OF INFORMED CONSENT
I certify that I have explained the nature and purpose of this study to the
above- named individual and I have discussed the potential benefits of this study
participation. The questions the individual had about this study have been answered,
and I will always be available to address future questions.
Date:
Consent:
Signature of the person obtaining:
Name:
Signature of Principal investigator:
v
APPENDIX-C
RANDOMIZATION
0001: group 2
0002: group 2
0003: group 1
0004: group 1
0005: group 1
0006: group 2
0007: group 2
0008: group 1
0009: group 2
0010: group 1
0011: group 1
0012: group 2
0013: group 2
0014: group 2
0015: group 1
0016: group 1
0017: group 2
0018: group 1
0019: group 1
0020: group 2
0021: group 1
0022: group 2
0023: group 1
0024: group 2
0025: group 2
0026: group 1
0027: group 2
0028: group 2
0029: group 1
0030: group 1
0031: group 1
0032: group 1
0033: group 1
0034: group 1
0035: group 2
0036: group 2
0037: group 2
0038: group 2
0039: group 2
0040: group 1
0041: group 2
0042: group 1
0043: group 1
0044: group 1
0045: group 2
0046: group 1
0047: group 2
0048: group 1
0049: group 2
0050: group 2
0051: group 1
0052: group 2
0053: group 2
0054: group 1
0055: group 1
0056: group 2
0057: group 2
0058: group 1
0059: group 1
0060: group 2
0061: group 1
0062: group 2
0063: group 2
0064: group 1
0065: group 1
0066: group 2
0067: group 1
0068: group 1
0069: group 2
0070: group 2
0071: group 1
0072: group 1
0073: group 1
0074: group 1
0075: group 2
0076: group 2
0077: group 2
0078: group 1
0079: group 2
0080: group 2
0081: group 2
0082: group 2
0083: group 1
0084: group 2
0085: group 2
0086: group 1
0087: group 2
0088: group 1
0089: group 1
0090: group 1
0091: group 1
0092: group 2
0093: group 1
0094: group 1
0095: group 1
0096: group 2
0097: group 1
0098: group 2
0099: group 2
0100: group 2
0101: group 1
0102: group 2
0103: group 1
0104: group 2
0105: group 2
0106: group 1
0107: group 1
0108: group 1
0109: group 2
0110: group 2
0111: group 2
0112: group 2
0113: group 1
0114: group 1
0115: group 1
0116: group 1
0117: group 2
0118: group 2
0119: group 2
0120: group 1
0121: group 1
0122: group 1
0123: group 2
0124: group 2
0125: group 2
0126: group 1
0127: group 2
0128: group 2
0129: group 1
0130: group 1
vi
0131: group 2
0132: group 1
0133: group 2
0134: group 2
0135: group 1
0136: group 1
0137: group 2
0138: group 1
0139: group 2
0140: group 1
0141: group 2
0142: group 2
0143: group 1
0144: group 2
0145: group 1
0146: group 2
0147: group 2
0148: group 1
0149: group 1
0150: group 1
0151: group 1
0152: group 1
0153: group 2
0154: group 2
0155: group 2
0156: group 1
0157: group 1
0158: group 1
0159: group 2
0160: group 2
0161: group 1
0162: group 2
0163: group 2
0164: group 1
0165: group 2
0166: group 1
0167: group 1
0168: group 1
0169: group 2
0170: group 2
0171: group 2
0172: group 2
0173: group 1
0174: group 1
0175: group 2
0176: group 2
0177: group 1
0178: group 2
0179: group 1
0180: group 1
0181: group 2
0182: group 2
0183: group 1
0184: group 1
0185: group 1
0186: group 2
0187: group 2
0188: group 1
0189: group 2
0190: group 1
0191: group 1
0192: group 2
0193: group 2
0194: group 1
0195: group 2
0196: group 2
0197: group 1
0198: group 1
0199: group 1
0200: group 2
0201: group 2
0202: group 1
0203: group 1
0204: group 1
0205: group 1
0206: group 2
0207: group 2
0208: group 2
0209: group 1
0210: group 2
0211: group 1
0212: group 2
0213: group 1
0214: group 1
0215: group 2
0216: group 2
0217: group 1
0218: group 1
0219: group 2
0220: group 2
0221: group 1
0222: group 1
0223: group 1
0224: group 2
0225: group 1
0226: group 2
0227: group 1
0228: group 2
0229: group 2
0230: group 2
0231: group 2
0232: group 1
0233: group 1
0234: group 2
0235: group 2
0236: group 2
0237: group 1
0238: group 2
0239: group 1
0240: group 1
0241: group 1
0242: group 1
0243: group 2
0244: group 2
0245: group 2
0246: group 2
0247: group 2
0248: group 1
0249: group 1
0250: group 1
0251: group 1
0252: group 1
0253: group 1
0254: group 1
0255: group 1
0256: group 2
0257: group 2
0258: group 2
0259: group 2
0260: group 2
0261: group 2
0262: group 1
0263: group 1
0264: group 1
0265: group 1
0266: group 2
0267: group 2
0268: group 2
0269: group 2
0270: group 1
vii
0271: group 2
0272: group 2
0273: group 2
0274: group 2
0275: group 1
0276: group 2
0277: group 1
0278: group 1
0279: group 1
0280: group 1
0281: group 1
0282: group 1
0283: group 2
0284: group 2
0285: group 2
0286: group 1
0287: group 2
0288: group 2
0289: group 1
0290: group 1
0291: group 2
0292: group 1
0293: group 2
0294: group 2
0295: group 1
0296: group 1
0297: group 2
0298: group 1
0299: group 2
0300: group 1
viii
APPENDIX-D
PART-I
BACKGROUND VARIABLES
A.DEMOGRAPHIC DATA
1. Age (in years)
a. 21-40
b. 41-60
2. Gender
a. Male
b. Female
3. Education
a. Non formal
b. Primary
c. Secondary
d. Graduate
4. Occupation
a. Employed
b. Self-employed
c. Unemployed
d. Daily wages
f. Housewife
g. Others
5. Family income (in Rs/month)
a. 2500
b. 2501-5000
c. 5001-7500
d. 7501
6. Place of residence
a. Urban
b. Rural
7. Marital status
a. Married
b. Unmarried
8. Type of family
a. Joint family
b. Nuclear family
Coding
1
2
1
2
1
2
3
4
1
2
3
4
5
6
1
2
3
4
1
2
1
2
1
2
ix
9. Accompanied by caregiver
a. Yes
b. No
B. Social variables
10. Caregiver relationship
a. Mother/Father
b. Sister/ Brother
c. Wife/ Husband
d. Friends/ Others
11. Dependent on
a. Independent
b. Mother/ Father
c. Sister/ Brother
d. Wife/ Husband
e. Friends/ Others
12 Medical expenses met by
a. Self
b. Others
C. CLINICAL VARIABLES
13. Age at onset of epilepsy (in yrs)
a. 5
b. 6 -15
c. 16-25
d. 26
14. Duration of epilepsy (in yrs)
a. 5
b. 6 -10
c. 11-15
d. 16
15. Type of epilepsy
a. Focal
b. Generalized
c. Unclassified
16. Time of occurrence of your seizures
a. Day
b. Night
c. Any time
1
2
1
2
3
4
1
2
3
4
5
1
2
1
2
3
4
1
2
3
4
1
2
3
1
2
3
x
APPENDIX-E
EPILEPSY KNOWLEDGE SCALE
SL.
No.
YES
NO
DO
NOT
KNOW
1
People with epilepsy should avoid strenuous work
because this can provoke seizures.
0
1
0
2
An EEG can always prove the diagnosis of epilepsy.
0
1
0
3
People with epilepsy are as capable as other people.
All the people with seizure should avoid working with
open machinery.
1
0
0
0
1
0
5
Every seizure destroys a number of nerve cells in the
brain.
0
1
0
6
People with seizures should not swim without an
accompanying person.
1
0
0
7
All people with epilepsy should avoid flashing or
strobing lights.
0
1
0
8
In most cases doctors can control epileptic seizures
with medication.
1
0
0
9
If your seizures are controlled for some months, you
can reduce the dose of antiepileptic medication.
0
1
0
10
All people with epilepsy have similar symptoms.
0
1
0
11
If a patient expects a seizure, he/she should take an
additional dose of antiepileptic medication.
0
1
0
12
On job application, a patient should always disclose
his or her epilepsy condition.
0
1
0
13
People with epilepsy can take an active part in sports.
An epileptic seizure always results in loss of
consciousness.
1
0
0
0
1
0
4
14
15
People whose seizures only happen during sleep may
hold a drivers license.
1
0
0
16
Everyone can have a seizure, given the appropriate
circumstances.
1
0
0
17
Blood samples can be used to measure the
concentration of antiepileptic medication in the body.
1
0
0
18
Epilepsy is a symptom of mental illness.
0
1
0
19
If persons with epilepsy drive, they must inform the
driving authorities about their condition.
0
1
0
xi
APPENDIX-F
Epilepsy Self-Management Scale
The Epilepsy Self-Management Scale (ESMS) is a 38 item scale that assesses
frequency of use of epilepsy self-management practices. Each item is rated on a 5point scale ranging from 1, never, to 5, always. Items for the scale were developed
from a review of the literature on epilepsy self-management and discussions with
people with epilepsy and health care professionals caring for people with epilepsy.
The 26 original items were categorized into three areas: a) medication-related, b)
safety-related, and c) general lifestyle management. Total scores are found by reverse
coding the 12 negatively worded items and summing responses to all 38 individual
items. Total possible scores range from 38-190 with higher scores indicating more
frequent use of self-management strategies.
The 26-item instrument was evaluated by a panel of experts in epilepsy
management familiar with instrument development. Content validity was assessed on
the original 26-item version using the procedures described by Waltz, Strickland, and
Lenz (1984) yielding a content validity index (CVI) of 93% indicating strong
agreement among the reviewers that the items measure self-management practices.
Internal consistency reliability reported for a 26-item scale has ranged from .81-.86
(DiIorio et al., 1992; DiIorio et al., 1994). Twelve additional items were written to
address lifestyle issues and safety measures and these items. The 38-item scale was
factor analyzed yielding 5 factors: Medication, Information, Safety, Seizure, and
Lifestyle Management (DiIorio et al., 2004).
References
DiIorio, C., Faherty, B., & Manteuffel, B. (1992). The relationship of self-efficacy
and social support in self-management of epilepsy. Western Journal of Nursing
Research, 14 (3), 292-303.
DiIorio, C., Faherty, B., & Manteuffel, B. (1994). Epilepsy self-management: Partial
replication and extension. Research in Nursing & Health, 17, 167-174.
DiIorio, C., & Henry, M. (1995). Self-management in persons with epilepsy. Journal
of Neuroscience Nursing, 27, 338-343.
DiIorio, C., Hennessy, M., & Manteuffel, B., (1996). Epilepsy self-management: A
test of a theoretical model. Nursing Research, 45, 211-217.
xii
DiIorio, C., Shafer, P., Letz, R., Henry, T., Schomer, D., Yeager, K. (2004). Project
EASE: A study to test a psychosocial model of epilepsy medication management.
Epilepsy & Behavior,5(6), 926-936.
DiIorio C. Shafer P. O., McCarty F., Letz R., Henry T., Schomer D.L., Yeager K.A.
(2006). Behavioral, social, and affective factors associated with self-efficacy for selfmanagement among people with epilepsy. Epilepsy & Behavior, 9, 158-163.
DiIorio C., Escoffery C., McCarty F., Yeager K.A., Henry T.R., Koganti A.,
Reisinger E., Wexler, B. (2008). Evaluation of WebEase: An epilepsy selfmanagement website. Health Education Research. [August
4.
doi:10.1093/her/
cyn012].
Robinson, E., DiIorio, C., DePadilla, L., McCarty, F., Yeager, K., Henry, T.,
Schomer, D., & Shafer, P. (2008). Psychosocial predictors of lifestyle management in
adults with epilepsy. Epilepsy & Behavior. June 30 [Epub ahead of print].
xiii
Epilepsy Self Management Scale
Instructions: The following statements describe what people do to manage their
epilepsy. Please circle one number for each statement to show how often you do the
following. As you answer the questions, please think about your activities in the past
year.
Never Rarely Sometimes
IM 1. I write down how often I have
seizures and when they occur.
LM 2. I do things such as relaxation,
guided imagery, and self hypnosis
to manage stress.
IM 3. I call my doctor when I think I
am having side effects from my
seizure medication.
*MM 4. When my seizure medication is
running out, I spread out the time
between doses.
IM 5. I keep a record of the types of
seizures I have.
*SM 6. I stay out late at night.
IM 7. I keep track of the side effects of
my seizure medication.
*MM 8. When my seizure medication
is running out, I take less medication at
each time.
MM 9. I take my seizure medication the
way my doctor orders it.
SeM 10. I stay out of situations that
might cause a seizure.
SeM 11. If I am going away from
home, I take my seizure medication
with me.
SeM 12. I call my doctor if I am having
more seizures than usual.
LM 13.I make sure I get enough sleep.
LM 14. I do things that I enjoy to help
manage stress.
SeM 15. I have a way to remind myself
to take my seizure medication.
Most of
the Always
Time
1
2
3
4
5
1
2
3
4
5
1
2
3
4
5
1
2
3
4
5
1
2
3
4
5
1
1
2
2
3
3
4
4
5
5
1
2
3
4
5
1
2
3
4
5
1
2
3
4
5
1
2
3
4
5
1
2
3
4
5
1
1
2
2
3
3
4
4
5
5
1
2
3
4
5
xiv
Most of
Never Rarely Sometimes the Always
Time
MM 16. I take my seizure medication at
the same time each day.
*SM 17. I would go swimming alone.
LM. 18. I do things such as relaxation,
guided imagery, and self hypnosis to
keep myself from having a seizure.
SeM 19. When the doctor orders blood
tests, I have them done.
IM 20. I wear or carry information
stating that I have epilepsy.
*MM 21. I have to put off having my
seizure medication refilled because it
costs too much money.
LM. 22. I get enough exercise.
*SM. 23. I use power tools such as
electric saws, electric hedge trimmers,
or electric knives without an automatic
shutoff.
*MM 24. I miss doctor or clinic
appointments.
*MM 25. If I had side effects from the
seizure medications, I would skip a dose
without asking my doctor.
SM 26. I take showers instead of baths.
MM 27. I plan ahead and have my
seizure medication refilled before I run
out.
M *MM 28. I miss doses of my seizure
medication because I do not remember
to take it.
SM 29. I keep the temperature of the
water in my home low enough so I do
not get burned.
*MM 30. I skip doses of seizure
medication.
SM 31. I check with my doctor before
taking other medicines.
SeM 32. I stay away from things that
make me have seizures.
LM. 33. I eat regular meals.
1
2
3
4
5
1
1
2
2
3
3
4
4
5
5
1
2
3
4
5
1
2
3
4
5
1
2
3
4
5
1
1
2
2
3
3
4
4
5
5
1
2
3
4
5
1
2
3
4
5
1
1
2
2
3
3
4
4
5
5
1
2
3
4
5
1
2
3
4
5
1
2
3
4
5
1
2
3
4
5
1
2
3
4
5
1
2
3
4
5
xv
Most of
Never Rarely Sometimes the Always
Time
*SM 34. I climb objects such as high
stools, chairs, or ladders.
IM 35. I talk with other people who
have epilepsy.
*SM 36. I drink a lot of alcoholic
beverages such as beer, wine, and
whiskey.
IM 37. I participate in a support group
for persons with epilepsy.
IM 38. I practice what to do during a
seizure with my family and friends.
Subscales:
IM
=
Information management
MM
=
Medication management
SM
=
Safety management
SeM
=
Seizure management
LM
=
Lifestyle management
* Reverse code
1
2
3
4
5
1
2
3
4
5
1
2
3
4
5
1
2
3
4
5
1
2
3
4
5
xvi
xvii
xviii
xix
xx
xxi
xxii
xxiii
xxiv
xxv
xxvi
APPENDIX-H
SEIZURE DIARY
Name:
IP NO:
Seizure Diary for the month of______________
Date
Sleep
Seizures
Yes / No
Waking
Seizures
Yes / No
Time of
Seizures
Comments
Kindly include alcohol intake ,
Mood changes, missed
medication,
Date of menstrual cycle.
1st
2nd
3rd
4th
5th
6th
7th
8th
9th
10th
11th
12th
13th
14th
15th
16th
17th
18th
19th
20th
21st
22nd
23rd
24th
25th
26th
27th
28th
29th
30th
31st
Total
Medication intake: Any days of skipped medication, no availability of medication
and other illness
xxvii
APPENDIX-I
CONTENT VALIDITY FROM EXPERTS
Prof. P.V.Ramachandran
Chairman Nursing Education,
Sri Ramachandra College of Nursing,
Sri Ramachandra University,
Porur, Chennai -600116
Prof. Dr. Rajeswari Vaidyanathan
Research Co-ordinator,
MIOT College of Nursing,
Manapakkam,
Porur, Chennai-600 116.
Dr. Ardith Doorenbos
Associate Professor,
University of Washington,
School of Nursing,
Seattle,
W.A498195.
Dr. V.Shankar, M.D, D.M.,
Professor of Neurology,
Sri Ramachandra Medical College,
Sri Ramachandra University,
Porur, Chennai-600 116.
Dr. Rebecca Samson, M.Sc., (N), Ph.D.,
Dean, College of Nursing,
Pondicherry Institute of Medical Sciences (PIMS),
Puducherry-605 014.
xxviii
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a. 21&- 40
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2.
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a. Bs
b. ö£s
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3.
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11. öÁγº ö\À¾®ö£õÊx E[PÒ
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APPENDIX-L
TEACHING MODULE FOR EPILESY EDUCATION PROGRAM
Topic
:
Epilepsy
Group
:
Patients With Epilepsy attending the Neurology OPD.
Place of teaching
:
Neurology OPD.
Time
:
25 minutes
Size of the group
:
3-5 PWE.
Method
:
Explanation, discussion and clarification
Teaching Aid
:
Epilepsy and its Self- management Information Booklet.
Central objective
:
The patients with epilepsy improve their knowledge and self management in epilepsy thereby leading to a
better Quality of Life.
xlvi
Contributory objective:
The PWE gain information on
1. Epilepsy
2. List the causes of epilepsy
3. Identify the triggers of a seizure
4. Differentiate the stages of a seizure and its management
5. Discuss the first AID management of a seizure by the family members
6. Recall the diagnosis of epilepsy
7. Recall their medication, its dosage, and the common adverse effects to be reported
8. Identify the dietary intake to overcome some of the side effects of AED’s
9. List the need for regular medication intake
10. Identify the Support of the family
11. Overcome the myths of epilepsy
12. Enumerate the activities that can be done
13. List the activities that are to be avoided.
14. Identify the special considerations for women.
15. Recall the ten commandments for a seizure free life
xlvii
Introduction:
I am A. Seethalakshmi, here to teach you about the nature of epilepsy
Sl.
Contributory
No.
objective
1.
Content
Researcher’s
Participant’s
activity
activity
The PWE understand Epilepsy is a condition that is caused by repeated excessive neuronal Explaining
Listening and
about epilepsy
clarrifying
firing that leads to uncontrolled movements of some or all the parts of
the body.
Repeated and unprovoked seizures is called epilepsy
This varies from one to another.
2.
List the causes of
epilepsy
The causes for epilepsy range from
Explaining
Listening
1. No specific known cause/ idiopathic onset.
2. Head injury/ brain tumors/intracerebral hemorrhage
3. Birth injury or asphyxia
4. Stroke
5. Lack of sodium or minerals
6. Meningitis, encephalitis
7. Uncontrolled fever in young children
The causes also vary between individuals
3.
Identify the triggers
There may be specific trigger factors for seizures such as headache,
Questioning
Answering and
of a seizure
stress, missed medications, menstrual cycle in the women, food
and
Listening
xlviii
Sl.
Contributory
No.
objective
Content
allergies, exposure to extreme heat/hot water/flickering lights in some
Researcher’s
Participant’s
activity
activity
Explaining
people.
One may be able to identify the triggers and inform the family
members to obtain their help and support.
4.
Differentiate the
The first stage:
Explaining
Listening and
stages of a seizure
The individuals may feel depressed or angry and some may have a
using the EIB
asking
and its management
severe headache. These symptoms vary between individuals
questions
A sense of aura may be present ,the person may exhibit a vacant stare
that may last for a minute or two
The person may fall down with a loud cry and lose consciousness.
Second stage:
Seizures may start in one part of the body and spread to other parts.
Uncontrolled movements of the side of the face, head and neck, hands
and legs along with frothing at the mouth may be present.
Third stage:
The person looses consciousness, may go into deep sleep, lack of.
Headache and body pain may persist. The person requires rest for at
least 5-6 hours before they can get back to their normal routine; this
again depends on the severity of the seizures.
xlix
Sl.
Contributory
No.
objective
Content
Researcher’s
Participant’s
activity
activity
An individual with epilepsy does not require hospitalization for each
seizure but if the seizure is prolonged for 5- 10 minutes then the person
has to be hospitalized for the control of seizures by strong intravenous
AED’s.
5.
Discuss the first AID
management of a
seizure by the family
members
1. Remove all sharp and hard objects near the person so that injury can
be avoided.
2. Do not restrain the person and don’t hold the hands and legs forcibly
as this could lead to a fracture.
3. During the seizure an individual may lose control of the bowel and
bladder function. They may bite their tongue. One may fall down
and get hurt. Admission to a hospital after each seizure is not needed
but if a seizure lasts for more than 5 to 10 minutes continuously or
there is loss of consciousness for a prolonged period of time and has
difficulty in breathing then hospitalization is needed.
4. When a person has a seizure he or she has to be turned to one side
and the head has to be turned to the side
5. Remove any tight clothing
6. Do not insert anything into the mouth of the person having the
seizure.
l
Sl.
Contributory
No.
objective
6.
7.
Content
Recall the diagnosis
The diagnosis is made by the history,
of epilepsy
electroencephalogram and if needed a CT scan or an MRI.
Researcher’s
Participant’s
activity
activity
Explaining
Listening
Recall their
The common medications are : Eptoin, Gardenal, Tegretol, Explaining
Listening and
medication, its
Encorate, Valparin
clarrifying
dosage, and the
The medications Eptoin, Gardenal are available free of cost in
common adverse
selected hospitals throughout the state and can be obtained for a
effects to be reported
duration of 15 days with the prescription by a neurophysician
Common side effects experienced:
Swollen gums which can be managed by brushing and then
massaging the gums after brushing.
Skin rashes
and thickening of the skin, changes in the gait,
drowsiness, visual changes, diplopia and nystagmus.
If any of these changes are experienced one has to consult the
neurophysician immediately.
Some may experience tiredness/ drowsiness, anger and confusion.
Gastric irritability can be managed by adequate intake of liquids and
if needed an antacid may be prescribed.
If any adverse effects as diplopia, change in the gait and excessive
drowsiness are identified they have to be reported to bring a change
li
Sl.
Contributory
No.
objective
Content
Researcher’s
Participant’s
activity
activity
in the dosage of the drugs but one should not skip or change the
dosage of the medication by oneself.
8.
Identify the dietary
Calcium rich foods:
Explaining
Listening and
intake to overcome
Milk, fish, egg, meat, nuts, green leafy vegetables, ragi, greengram
using the EIB
observing
some of the side
dhal, soya, cauliflower, beetroot, cabbages, tomatoe, black grapes
effects of AED’s
should be taken in adequate amounts to prevent bone demineralization
due to prolonged intake of AED’s.
Iron rich foods :
Chicken, dates, dry grapes, peas, soyabeans, carrot, beetroot, greens,
cereals and pulses to reduce the risk of anemia.
Fiber rich diet: Include fruits and vegetables to prevent constipation.
9.
List the need for
Medications are to be taken preferably at the same time everyday so Explaining
regular intake of
that the blood levels are maintained to control the occurrence of a
medications.
seizure.
Listening
Medication should be taken as per the instruction of the physician
The physician may reduce the dosage if a person takes the medication
continuously for three to five years and has a seizure free period of at
least two years.
lii
Sl.
Contributory
No.
objective
10.
Identify the Support
Reminding about the regular intake of medicines
of the family
Reporting side effects if any.
Content
Researcher’s
Participant’s
activity
activity
Explaining
Listening
Avoid stigma or overprotection of family member with epilepsy.
11.
Overcome the myths
Epilepsy is not a communicable disease
about epilepsy
Epilepsy is not a mental disorder
Epilepsy is not caused by magic, possession by evil spirits and previous
sins.
Epilepsy is not cured by placing a hot iron and driving away evil spirits.
Holding an iron object will not stop a seizure and hence do not give
keys or iron objects to hold.
12.
Enumerate the
1. Routine activities
activities that can be
2. Less stressful jobs
done
3. Sleep for 7-8 hours every night
4. Take the medications at the correct time everyday to maintain the
blood levels of the drug
5. Eat a balanced diet at the right time everyday as decreased glucose
can also lead to a seizure
6. Take the AED’s even when one is sick and has to take other
medications
liii
Sl.
Contributory
No.
objective
Content
Researcher’s
Participant’s
activity
activity
7. Practice stress reduction techniques as deep slow breathing, sharing
ones difficulties with others, listening to soothing music, mild
exercises and walking to keep oneself healthy.
8. Take the AED’s after food
13.
List the activities
1. Avoid being awake late nights
Explaining and
that are to be
2. Avoid alcoholic beverages as it reduces the seizure threshold and
discussing
avoided.
Listening
therefore can lead to the occurrence of seizure.
3. Excessive consumption of coffee as it can lead to gastric irritability.
4. Avoid constipation.
5. Avoid repetitive thinking of events that are stressful.
6. Avoid bright, flickering lights and watching Television for a
prolonged period of time.
7. Do not climb on ladders or chairs to fix things
8. Avoid travelling in hot or sunny weather.
9. Avoid swimming
10. A person with epilepsy should not drive commercial vehicles.
14.
Identify the special
Seizures may occur prior to the menstrual cycle
considerations for
Pregnancy
women
Women can get married and have children but one has to come for
Explaining
Listening and
questioning
liv
Sl.
Contributory
No.
objective
Content
Researcher’s
Participant’s
activity
activity
Explaining
Listening
regular follow up both with the neurophysician and the obstetrician so
that the AED’s and supplements may be prescribed so that a seizure
does not affect the mother and the foetus.
15.
Recall the ten
commandments for a
seizure free life
1. Regular intake of antiepileptic drug for 3 to 5 years can prevent the
occurrence of seizures in 70 to 80 percent of people with epilepsy.
2. Intake of the medicine as per the physicians order and at the same
time everyday helps maintain the blood level of the drug and
thereby prevents seizures.
3. Epilepsy is not a communicable disease or a mental illness
4. Seizure does not stop by placing an iron object in the persons hand
5. Practising mild exercises, slow breathing, sharing your feelings with
trusted others and relaxation is helpful
6. The cause and type of epilepsy varies between individuals
7. Antiepeptic drugs are given free of cost in Government hospitals
and selected private hospitals for a period of 15 to 30 days on
prescription by the neurophysician.
8. If there is prolonged occurrence of seizures for 5 to 10 minutes then
one needs hospitalization
lv
Sl.
Contributory
No.
objective
Content
Researcher’s
Participant’s
activity
activity
Explaining and
Discussion
9. Epilepsy is not a hindrance in carrying out ones routine activities,
going to school or college and performing ones job
10. Epilepsy is not a hindrance to marriage and childbirth.
Conclusion
Epilepsy is a condition that can be managed, requires regularity in
medication intake and some lifestyle changes. Regular follow up is an
clarifying
essential component to identify any improvements and change in
medication dosage.
lvi
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