Objective To develop and preliminarily evaluate a case management-based care program for preschool children with epilepsy. Methods The study consisted of three phases: a cross-sectional survey of 22 hospitals, development of the care program via Delphi method (17 experts), and a non-concurrent controlled trial involving 104 children (52 each in control and intervention groups). Results The developed program comprised 6 domains and 33 items. After one month of intervention, the intervention group showed significantly higher medication adherence (P=0.012) and caregiver knowledge scores (P<0.001) compared to the control group. Conclusion The case management-based care program is feasible and effective in improving medication adherence and caregiver knowledge in preschool children with epilepsy.
Objective To summarize the best evidence for posture management in children and adolescents with neurodevelopmental disorders, and to provide an evidence-based reference for clinical posture management, musculoskeletal deformity prevention and functional outcome improvement. Methods The evidence-based question was formulated using the PIPOST framework. A systematic search was performed following the 6S evidence model in UpToDate, BMJ Best Practice, Web of Science, Cochrane Library, PubMed, CNKI, CBM, VIP and Wanfang Data, from January 2021 to May 2026. ResultsA total of 35 articles were included, consisting of 5 guidelines, 20 systematic reviews/Meta-analyses, 8 randomized controlled trials and 2 expert consensuses. Twelve pieces of best evidence were extracted across 6 domains: 24-hour posture management, disease-specific interventions, assessment tools, stratified functional intervention, nighttime postural support and emerging technologies. ConclusionThe summarized best evidence for posture management in children and adolescents with neurodevelopmental disorders helps standardize clinical postural interventions, reduce the risk of musculoskeletal deformities, and support stratified, individualized rehabilitation management.
To report a case of a 1-year-old female child admitted to the hospital with recurrent convulsions and diagnosed as West syndrome, also known as infantile spasms (IS). The child had been experiencing convulsions for 4 months prior to admission, characterized by forward head tilt and flexion of the limbs, with 8 ~ 10 episodes per day. After admission, West syndrome was identified by EEG and imaging evaluation, and adrenocorticotropic hormone (ACTH) shock therapy was started on day 5 of admission, supplemented with peripherally inserted central catheter (PICC), gastric protection, calcium and potassium supplementation and other supportive measures. During the course of treatment, the nursing team implemented meticulous monitoring and assessment to ensure that the child's vital signs were stabilized, and potential side effects were detected and treated in a timely manner. After 14 days of treatment, the child had no further spasticity episodes during 3 ~ 14 days, and was discharged from the hospital with continued oral hormone intake and regular follow-up. During the nursing process, the nursing staff provided psychological support and education to the child and her family to help the family understand the disease and enhance their ability to manage it. In addition, personalized nutritional support and monitoring were provided to ensure the healthy growth of the child. The successful management of this case not only enhanced the quality of clinical care, but also provided useful reference and inspiration for similar cases.
Objective To investigate the compliance of ketogenic diet in children with refractory epilepsy and its correlation with the curative effect, and to provide support and basis for the implementation and improvement of the long-term management of ketogenic diet in this patient population. MethodsA total of 106 children and their families who were followed up on ketogenic diet in the Department of Pediatrics of Fudan University from March 2019 to January 2022 in the Department of Ketogenic Multidisciplinary Treatment (MDT) were selected by convenience sampling method. General data questionnaire and ketogenic compliance questionnaire were used for investigation and follow-up. ResultsThe mean compliance of ketogenic diet in refractory epilepsy children was (13.27±3.68). The compliance scores of ketogenic children with different therapeutic effects and cognitive functions were significantly different. The compliance score was significantly correlated with the therapeutic effect and cognitive level, that is, the higher the therapeutic effect of ketogenic diet in children with higher compliance score, the better the cognitive improvement. ConclusionThe compliance of ketogenic diet in children with refractory epilepsy needs to be further improved. Improving the compliance of ketogenic diet is of great significance for the efficacy of ketogenic diet. Medical staff should actively develop the corresponding intervention program and follow-up management mode to further improve the treatment compliance of children's families, improve the treatment effect and improve the quality of life of children's families.