Abstracts

Rationale: People with epilepsy in China suffer from severe stigma and discrimination due to traditional and superstitious views, contributing to tremendous psychological, economic and social burdens. In view of their professionalism, the prevalent stigmatizing attitudes among medical staff may directly lead to diagnostic overshadowing and consequent worsening of physical health care for patients with epilepsy. Previous studies have indicated that discrepancies may exist in performance toward epilepsy among medical workers, but only few related studies were done in China. Methods: In this study, taking hospital hierarchy into consideration, we compared knowledge, attitudes and practice (KAP) toward epilepsy among staff from different levels of hospitals in Southern China for the first time. An adapted and structured questionnaire was administered to medical personnel from tertiary (n=451) and basic-level (n=448) hospitals, respectively. Survey items included the following: (1) 5-item for knowledge related to epilepsy, (2) 14-item for attitudes toward epilepsy, and (3) 6-item for first-aid practice of epileptic seizures. Descriptive statistics and multivariable linear regression were used to assess differences between both samples. Results: The mean score of knowledge about epilepsy was higher among medical staff in tertiary hospitals than that of basic-level hospitals (3.99±0.55 vs. 3.00±0.77, respectively, p < 0.001). Nearly half of staff in basic-level hospitals held that epilepsy could be caused by evil spirits/evil eyes or transmitted from other patients, whereas only 25% in tertiary hospitals agreed with this statement. Compared to those in basic-level hospitals, medical staff in higher level of hospitals demonstrated less stigmatizing attitudes toward people with epilepsy (2.97±0.80 vs. 2.35±0.79, respectively, p < 0.001). The overall correct answer rate for first-aid measures about seizures was moderate level (49.6%) in tertiary hospitals and low level (37.5%) in basic-level hospitals. Especially, almost three-fourth of medical workers in basic-level hospitals chose to consult traditional Chinese medicine practitioners or witch doctors, such as pressing philtrum and “Hukou” to waken them, while only 19.7% in tertiary hospitals would take the same measure. Conclusions: Our findings demonstrated more favorable awareness and attitudes toward people with epilepsy among medical staff in higher level of hospitals. However, the overall KAP toward epilepsy among health care professionals in Southern China was still some way off meeting those in some Western countries. A greater emphasis must be placed to promote knowledge dissemination and popularize first-aid measures related to epilepsy among professionals, especially for whom working in basic-level hospitals, with aim to finally promote a better living environment for patients with epilepsy in China. Funding: National Natural Science Foundation of China (Grant nos. 81771407)