ObjectiveTo investigate the effect of medical counseling games on ketogenic diet therapy for drug-resistant epilepsy children. MethodsA total of 98 children with drug-resistant epilepsy admitted to the neurology ward of Shenzhen Children's Hospital from January 2023 to June 2024 who were treated with ketogenic diet for the first time were selected as the study objects by random number table method, and were divided into observation group (n=49) and control group (n=49). The control group received the traditional multidisciplinary team health education mode, while the observation group received the ketogenic diet treatment based on the multidisciplinary team health education mode and participated in the customized medical counseling games intervention. The time of children reaching ketosis, the knowledge level of ketogenic diet caregivers and the retention rate of children on ketogenic diet were compared between the two groups. ResultsThe time of ketosis in observation group was earlier than that in control group (P<0.05). The knowledge level of the main caregivers of ketogenic diet and the retention rate of children with ketogenic diet at 3 months and 6 months in observation group were higher than those in control group (P<0.05). ConclusionThe use of medical counseling games in the ketogenic diet for medically refractory epilepsy is an effective therapeutic strategy that facilitates the early attainment of ketosis in children with medically refractory epilepsy, improves the knowledge of caregivers on the ketogenic diet, improves retention of children on the ketogenic diet, and serves to optimize the effectiveness of clinical outcomes, which may contribute to the quality of life of children with medically refractory epilepsy.
ObjectiveThis article aims to comprehensively retrieve and summarize the best evidence for the self-management of epilepsy in adolescents, so as to provide a reference for clinical medical staff and relevant decision makers. MethodsWe systematically searched Cochrane, Global Guidelines Collaboration (GIN), Scottish Interhospital Guidelines Network (SIGN), Joanna Briggs Institute (JBI), NICE, RANO (Nurses' Association of Ontario, Canada), UpToDate, BMJ, Medical Maitong, PubMed, International League Against Epilepsy, China National Knowledge Infrastructure, Wanfang Database and other databases and websites. All kinds of literature related to the self-management of epilepsy in adolescents were collected from the establishment of the database to April 18, 2023, including clinical decision-making, clinical guidelines,. Evidence summary, expert consensus, systematic review, etc. Four researchers were invited to evaluate the quality of the retrieved guidelines, and two researchers independently screened and evaluated the quality of the remaining literature. According to the opinions of professionals, data extraction and analysis were performed on the literature that met the inclusion criteria. ResultsA total of 9 articles were included, including 3 clinical guidelines, 3 expert consensus and 3 systematic reviews. We summarized the evidence in the literature in the following 8 aspects: Self-management initiation timing, monitoring management, psychological management, innovative self-management mode, information and support, medication management, daily life management and follow-up management. We identified 34 best pieces of evidence. ConclusionsThis article provides health care providers with the best evidence for the self-management of adolescents with epilepsy, guiding them to provide self-management education and counseling for adolescents with epilepsy through evidence-based methods, helping them to improve self-management ability, reduce seizures, reduce health services and healthcare costs, and improve quality of life.
ObjectiveThis study aims to assess the current state of caregivers' awareness and demand for wearable seizure detection devices in children with epilepsy. MethodsA convenience sampling approach was employed to select 207 caregivers of children with epilepsy, who met the predefined inclusion and exclusion criteria at Shenzhen Children's Hospital between April and June 2024. Data were gathered through general demographic surveys and a specialized questionnaire assessing caregivers' recognition of and demand for wearable seizure detection devices. ResultsThe findings revealed that the majority of caregivers were largely unaware of wearable seizure detection devices, yet exhibited substantial concern over the potential for undetected seizures. Notably, a significant proportion of caregivers expressed a keen interest in adopting such devices and demonstrated a willingness to use them on a long-term basis. A moderate positive correlation was observed between caregivers' apprehension about undetected seizures and their level of interest in using wearable monitoring devices (r=0.455, P<0.001). Furthermore, most caregivers indicated a willingness to accept devices with false alarm and false negative rates of ≤25%, preferring to receive seizure alerts within one minute of onset. The majority of participants also expressed that they would only consider using the device if its cost were covered by insurance. ConclusionCaregivers of children with epilepsy exhibit significant concern over undetected seizures, coupled with limited awareness of wearable seizure detection devices. However, they express strong interest in adopting such technologies. These findings underscore the imperative to continue advancing the functionality and accessibility of these devices, enhance public awareness, and further educate caregivers to foster greater confidence and trust in wearable epilepsy monitoring solutions.
Febrile infection-related epilepsy syndrome (FIRES) is a rare and severe epileptic encephalopathy characterized by critical illness, complex nursing requirements, the need for multidisciplinary collaboration, and high-intensity care during its acute phase. Based on a review of relevant literature and specific nursing practices, this article summarizes the latest advancements in the acute-phase care of children with FIRES. It focuses on aspects such as the management of status epilepticus, fever care, airway management, nutritional support and ketogenic diet, family support, and multidisciplinary collaboration. The aim is to provide a reference for clinical nursing practices and related research.