Effectiveness of a Self-efficacy Enhanced Program Using Cartoon Animation for Self-care Behaviors Among Schoolchildren with Epilepsy: A Quasi-experimental Study

Authors

  • Waraporn Kaewin Graduate Student, Master of Nursing Science Program (Pediatric Nursing), Ramathibodi School of Nursing, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Thailand.
  • Rutja Phuphibul Ramathibodi School of Nursing, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Thailand.
  • Anannit Visudtibhan Faculty of Medicine Ramathibodi Hospital, Mahidol University, Thailand.
  • Jumpee Granger Ramathibodi School of Nursing, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Thailand.

DOI:

https://doi.org/10.60099/prijnr.2024.263242

Keywords:

Cartoon Animation, Epilepsy, school children, Self-care behaviors, Self-efficacy

Abstract

Epilepsy is one of the most common chronic neurological diseases in children and may cause repeated seizures and complications. Thus, self-care behavior is vital for effective seizure control. This quasi-experimental study examined the effectiveness of the Self-efficacy Enhanced Program Using Cartoon Animation for self-care behaviors among school children with epilepsy. The study was conducted at a pediatric neurological clinic in the outpatient department of a tertiary hospital in Bangkok, Thailand. There were 42 children with epilepsy, aged 10 to 12 years, who participated in the study: 21 in the experiment group and 21 in the control group. The experimental group received the program, which used two cartoon animation videos to enhance self-care behaviors for eight weeks, while the control group received regular care only. The data were collected using demographic and self-care behavior questionnaires and were analyzed using chi-square and t-tests.
The results demonstrated that after program completion, the mean scores of total self-care behavior and subscale on medication taking, avoiding triggers seizures, and self-care of abnormal symptoms and seeking information in the experimental group were significantly higher than before receiving it and higher than those in the control group significantly. Nurses should use this program to increase self-care behaviors among children with epilepsy. However, testing the program in other settings with long-term follow-up is needed before it can be used widely.

References

World Health Organization. Epilepsy [Internet]. 2023 Feb 9 [cited 2023 Aug 9]. Available from: https://www.who.int/news-room/fact-sheets/detail/epilepsy

Centers for Disease Control and Prevention. Epilepsy data and statistics [Internet]. 2023 Mar 29 [cited 2023 Aug 9]. Available from: https://www.cdc.gov/epilepsy/data/index.html

Zack MM, Kobau R. National and state estimates of the numbers of adults and children with active epilepsy - United States, 2015. MMWR Morb Mortal Wkly Rep. 2017; 66(31):821-5. doi: 10.15585/mmwr.mm6631a1. DOI: https://doi.org/10.15585/mmwr.mm6631a1

Asawavichienjinda T, Sitthi-Amorn C, Tanyanont W. Prevalence of epilepsy in rural Thailand: a population-based study. J Med Assoc Thai. 2002;85(10):1066-73.

Wangphonphatthanasiri K. Survey of medical facilities in epilepsy care in Thailand. J DMS [Internet]. 2020 Sep 1 [cited 2024 Jan. 11];45(2):127-33 (in Thai). Available from: https://he02.tci-thaijo.org/index.php/JDMS/article/view/245536

Johnson E, Atkinson P, Muggeridge A, Cross JH, Reilly C. Impact of epilepsy on learning and behaviour and needed supports: views of children, parents and school staff. Eur J Paediatr Neurol. 2022;40:61-8. doi: 10.1016/j.ejpn.2022.08.001. DOI: https://doi.org/10.1016/j.ejpn.2022.08.001

Sakulrungjalas T. Effects of epilepsy on children: prevention and treatment. J Thai Nurse midwife Counc. 2018;33(4): 5-18 (in Thai). Available from: https://he02.tci-thaijo.org/index.php/TJONC/article/view/127521

Xu Z, Ayyappan S, Seneviratne U. Sudden unexpected death in epilepsy (SUDEP): what do patients think? Epilepsy Behav. 2015;42:29-34. doi: 10.1016/j.yebeh.2014.11.007. DOI: https://doi.org/10.1016/j.yebeh.2014.11.007

Pathak SJ, Yousaf MIK, Shah VB. Sudden unexpected death in epilepsy [updated 2022 Dec 19]. Treasure Island (FL): StatPearls Publishing [Internet]. 2024 Jan. Available from: https://www.ncbi.nlm.nih.gov/books/NBK559104/

Finsterer J, Scorza FA, Garg D, et al. Diverse pathophysiology of sudden unexpected death in epilepsy in children. Indian Pediatr. 2020;57(10):972-3. doi: 10.1007/s13312-020-2010-8. DOI: https://doi.org/10.1007/s13312-020-2010-8

O’Neal TB, Shrestha S, Singh H, Osagie I, Ben-Okafor K, Cornett EM, Kaye AD. Sudden unexpected death in epilepsy. Neurol Int. 2022;14(3):600-13. doi: 10.3390/neurolint14030048. DOI: https://doi.org/10.3390/neurolint14030048

Nagabushana D, S PK, Agadi JB. Impact of epilepsy and antiepileptic drugs on health and quality of life in Indian children. Epilepsy Behav. 2019;93:43-8. doi: 10.1016/j.yebeh.2019.01.021. DOI: https://doi.org/10.1016/j.yebeh.2019.01.021

Navik A, Aggarwal A, Singh A, Malhotra RK. Quality of life of developmentally normal children with epilepsy and their siblings. Cureus. 2023;15(8):e44067. doi: 10.7759/cureus.44067. DOI: https://doi.org/10.7759/cureus.44067

Rozensztrauch A, Kołtuniuk A. The quality of life of children with epilepsy and the impact of the disease on the family functioning. Int J Environ Res Public Health. 2022;19(4):2277. doi: 10.3390/ijerph19042277. DOI: https://doi.org/10.3390/ijerph19042277

Chong L, Jamieson NJ, Gill D, Singh-Grewal D, Craig JC, Ju A, Tong A. Children’s experiences of epilepsy: a systematic review of qualitative studies. Pediatrics.2016; 138(3):e20160658. doi: 10.1542/peds.2016-0658. DOI: https://doi.org/10.1542/peds.2016-0658

Tandon N, Radosavljevic M, Vucevic D, Radenkovic M, Jancic J, Samardzic J. Anti-seizure medications: challenges and opportunities. CNS Neurol Disord Drug Targets. 2024 Jan 8. doi: 10.2174/0118715273275793231030060833. DOI: https://doi.org/10.2174/0118715273275793231030060833

Lertsinudom S. Common issues in the use of antiepileptic drugs. North-Eastern Thai J Neurosci. 2000; 6(3):65-81 (in Thai).

Pauschek J, Bernhard MK, Syrbe S, Nickel P, Neininger MP, Merkenschlager A, et al. Epilepsy in children and adolescents: disease concepts, practical knowledge, and coping. Epilepsy Behav. 2016;59:77-82. doi: 10.1016/j.yebeh.2016.03.033. DOI: https://doi.org/10.1016/j.yebeh.2016.03.033

Lee YK, Ah YM, Choi YJ, Cho YS, Kim KJ, Lee JY. Antiepileptic drug adherence and persistence in children with epilepsy attending a large tertiary care children’s hospital. Epileptic Disord. 2016;18(4):408-17. doi: 10.1684/epd.2016.0871. DOI: https://doi.org/10.1684/epd.2016.0871

Turan Gürhopur FD, Işler Dalgiç A. The effect of a modular education program for children with epilepsy and their parents on disease management. Epilepsy Behav.2018; 78:210-8. doi: 10.1016/j.yebeh.2017.07.048. DOI: https://doi.org/10.1016/j.yebeh.2017.07.048

Shah NM, Hawwa AF, Millership JS, et al. Adherence to antiepileptic medicines in children: a multiple-methods assessment involving dried blood spot sampling. Epilepsia. 2013;54(6):1020-7. doi: 10.1111/epi.12126. DOI: https://doi.org/10.1111/epi.12126

Jacob L, Hamer HM, Kostev K. Adherence to antiepileptic drugs in children and adolescents: a retrospective study in primary care settings in Germany. Epilepsy Behav. 2017;75:36-41. doi: 10.1016/j.yebeh.2017.07.001. DOI: https://doi.org/10.1016/j.yebeh.2017.07.001

Modi AC, Wu YP, Rausch JR, Peugh JL, Glauser TA. Antiepileptic drug nonadherence predicts pediatric epilepsy seizure outcomes. Neurology. 2014;83(22):2085-90. doi: 10.1212/WNL.0000000000001023. DOI: https://doi.org/10.1212/WNL.0000000000001023

Kangwal C, Kongsaktrakol C, Maneesriwongul W, Visudtibhan A. Factors related to medication adherence among children with epilepsy. Rama Nurs J [Internet]. 2017 Jul 20 [cited 2023 Jul 11];23(1):44-59. Available from: https://he02.tci-thaijo.org/index.php/RNJ/article/view/67692

Bravo L, Killela MK, Reyes BL, Santos KMB, Torres V, Huang CC, Jacob E. Self-management, self-efficacy, and health-related quality of life in children with chronic illness and medical complexity. J Pediatr Health Care. 2020;34(4): 304-14. doi: 10.1016/j.pedhc.2019.11.009. DOI: https://doi.org/10.1016/j.pedhc.2019.11.009

Lua PL, Neni WS. Health-related quality of life improvement via telemedicine for epilepsy: printed versus SMS-based education intervention. Qual Life Res. 2013; 22(8):2123-32. doi: 10.1007/s11136-013-0352-6. DOI: https://doi.org/10.1007/s11136-013-0352-6

Bandura A, Freeman WH, Lightsey R. Self-efficacy: the exercise of control. J Cogn Psychother. 1997;13:158-66. DOI: https://doi.org/10.1891/0889-8391.13.2.158

Wonkompa S, kayapart S, Arreerard W. A development of 2D animation cartoon on overweight children problem campaign. J Sci Technol MSU. 2012;31(2):155-63. Available from: https://www.thaiscience.info/journals/Article/JSMU/10888220.pdf

Bandura A. Social learning theory. New Jersy: Englewood Cliffs, NJ: Prentice-Hall; 1977.

National Research Council (US) Panel to Review the Status of Basic Research on School-Age Children. Development during middle childhood: the years from six to twelve. In: Collins WA, editor. Washington, DC: National Academies Press; 1984.Available from: https://www.ncbi.nlm.nih.gov/books/NBK216778/

Faught RE, Weiner JR, Guérin A, Cunnington MC, Duh MS. Impact of nonadherence to antiepileptic drugs on health care utilization and costs: findings from the RANSOM study. Epilepsia. 2009;50(3):501-9. doi: 10.1111/j.1528-1167.2008.01794.x DOI: https://doi.org/10.1111/j.1528-1167.2008.01794.x

Sakthong P, Suriyapakorn B. Medication-related quality of life in Thai epilepsy patients. J Epilepsy Res. 2019;9(2):139-46. doi: 10.14581/jer.19016. DOI: https://doi.org/10.14581/jer.19016

Sunsalah N, Ua-Kit N. The effect of perceived self-efficacy promoting program on self-care behavior among school age children with thalassemia. JNSCU. 2016; 28(1): 103-12 (in Thai). Available from: https://he01.tci-thaijo.org/index.php/CUNS/article/view/74822/60373

Pinyo M, Sananreangsak S, Teerarungsikul, N. Effect of empowerment program on perceived self-efficacy in self-care of school-age children with leukemia undergoing chemotherapy. Chonburi Hosp J.2019;44(1):3-12 (in Thai).

Onthong K, Teerarungsikul N, Sananreangsak S. The effect of program enhancing self-efficacy in self-care on allergy prevention behaviors among school age children with allergic rhinitis. JFONUBUU. 2021;29(2):36-46 (in Thai). Available from: https://he02.tci-thaijo.org/index.php/Nubuu/article/view/251861/171143

Lumnoi U. The effect of perceived self-efficacy program on self-management behavior among school-age children with asthma. Bangkok: Chulalongkorn University;2008 (in Thai). Available from: https://doi.nrct.go.th/ListDoi/listDetail?Resolve_DOI=10.14457/CU.the.2008.1260

Choojan S, Thongbai W, Kummabut J. The effects of self-efficacy and family support promotion program on consumption behaviors among late school aged children with overweight. JBCN Bangkok. 2016;32(1):31-43 (in Thai). Available from: https://he01.tci-thaijo.org/index.php/bcnbangkok/article/view/64274

Modi AC, Guilfoyle SM, Mann KA, Rausch JR. A pilot randomized controlled clinical trial to improve antiepileptic drug adherence in young children with epilepsy. Epilepsia. 2016;57(3):e69-75. doi: 10.1111/epi.13289. DOI: https://doi.org/10.1111/epi.13289

Modi AC, Glauser TA, Guilfoyle SM. Supporting treatment adherence regimens in young children with epilepsy and their families: trial design and baseline characteristics. Contemp Clin Trials. 2020;90:105959. doi: 10.1016/j.cct.2020.105959. DOI: https://doi.org/10.1016/j.cct.2020.105959

Modi AC, Guilfoyle SM, Glauser TA, Mara CA. Supporting treatment adherence regimens in children with epilepsy: a randomized clinical trial. Epilepsia. 2021;62(7):1643- 55. doi: 10.1111/epi.16921. DOI: https://doi.org/10.1111/epi.16921

Winning AM, Mara CA, Williford DN, Guilfoyle SM, Buschhaus S, Modi AC. A randomized clinical trial to support adherence regimens in children with epilepsy: examining potential mechanisms of change. Epilepsy Behav. 2023; 147:109393. doi: 10.1016/j.yebeh.2023.109393. DOI: https://doi.org/10.1016/j.yebeh.2023.109393

Saengow VE, Pavarojkit P, Phonsing S. Educational program to improve drug adherence in pediatric epilepsy patients and caregivers in limited resource area. J Pediatr Epilepsy. 2019;8(2):44-8. doi: 10.1055/s-0039-1694706. DOI: https://doi.org/10.1055/s-0039-1694706

Sukthip R. Factors related to self-care agency among children with epilepsy [master's thesis]. [Bangkok, Thailand]: Mahidol University; 2000.

Fleeman N, Bradley PM. Care delivery and self-management strategies for children with epilepsy. Cochrane Database Syst Rev [Internet]. 2022 Apr 27 [cited 2023 Jul 4];3(3):CD 006245. doi: 10.1002/14651858.CD006245.pub4. DOI: https://doi.org/10.1002/14651858.CD006245.pub4

Leviton A, Patel AD, Loddenkemper T. Self-management education for children with epilepsy and their caregivers. a scoping review. Epilepsy Behav.2023;144:109232. doi: 10.1016/j.yebeh.2023.109232. DOI: https://doi.org/10.1016/j.yebeh.2023.109232

Downloads

Published

2024-03-21

How to Cite

1.
Kaewin W, Phuphibul R, Visudtibhan A, Granger J. Effectiveness of a Self-efficacy Enhanced Program Using Cartoon Animation for Self-care Behaviors Among Schoolchildren with Epilepsy: A Quasi-experimental Study. PRIJNR [Internet]. 2024 Mar. 21 [cited 2024 May 23];28(2):321-32. Available from: https://he02.tci-thaijo.org/index.php/PRIJNR/article/view/263242