Abstracts

Rationale: Clinical research indicates that children who have chronic illnesses, such as epilepsy, have a higher incidence of psychosocial problems. A key contributing factor is the ability of parents to cope with the chronic illness: excessive parental anxiety, restriction of activities, lack of communication and support. The quality of life of children with epilepsy can be improved by empowering their families and carers to successfully deal with the condition through coping resources. Methods: In this study, sense of coherence and coping strategies of parents of 44 Maltese children with epilepsy, aged between 2-14 years were evaluated using a health team approach. Parents were selected from records of children attending the Children’s Outpatients Clinic, in Malta’s Main General Hospital. Parents of children who had other disabilities and medical conditions besides epilepsy, were excluded. Two questionnaires were used: Anthonovsky’s Sense of Coherence (SOC) and a semi-structured questionnaire assessing parental attitudes and behaviour towards the child’s epilepsy, including demographic data of respondent, medications taken and general information on the child’s epilepsy. Results: There was a high response rate (> 80%). Spearman Rho test used to correlate each concept questioned means of SOC analyses using open way ANOVA. Thirty two mothers and 12 fathers fitted the inclusion criteria over a six month period and accepted to take part (aged 18-57 years); their children were 63% male and 36% female. All children were in main stream education. Sixty six percent said they had no idea what the child felt about his/her condition; while 43% of children were reported to be concerned if it would eventually go away and 68% of children complained about having to take medication everyday. The more frequent seizures, the less spoken about in family (P<0.05), 20% said that their relatives were reluctant to be left with child. Their greatest concerns were that child hurts during seizures (43%). The parents’ SOC was found to be related to their age and education (p<0.02), number of children (p<0.001), and the types of seizures their child had (p<0.02). SOC was also found to be significantly correlated with time elapsed since onset of epilepsy (p<0.02), the frequency of seizures (p<0.05), feelings of isolation (p<0.02), various parenting strategies (p<0.05. Conclusions: Such SOC analysis of parents’ attitudes and coping behaviours would aid in improving the quality of life of the children, by empowering their parents to deal successfully with the condition. Higher SOC indicated an improvement in the social skills of child who was better able to form normal peer relationships family and to adapt. The more accurate the appraisal by the parents of the condition, the better was the use of problem solving strategies. These results provide the basis for using a health team approach in the development of psychological and social support and family intervention services in paediatric health care systems for these families.