EFFECTS OF PSYCHO-EDUCATION ON PSYCHOLOGICAL DISTRESS AND BURDEN OF CARE ON CAREGIVERS OF CHILDREN AND ADOLESCENTS WITH EPILEPTIC SEIZURES IN THE FEDERAL NEURO-PSYCHIATRIC HOSPITAL, BENIN

Abstract

Background: Epilepsy is one condition widely reported as capable of causing psychological difficulties and distress to caregivers. Evidence has shown that social, psychological and behavioural aspects of epilepsy are among the least understood and most neglected in research in Low and Middle Income Countries (Ani et al 2011). This study investigated the effect of a psycho educational intervention that includes behavioural training intervention for caregivers to use functional behaviour analysis (FBA) to manage aggressiveness in children with epilepsy. Methodology: The study used a pre and post design involving 40 caregivers of children and adolescent clinically diagnosed with epileptic seizure disorder. The sampling level of stress and anxiety were determined at baseline and repeated at immediate post-intervention and repeated at 2 weeks post-intervention using the Hospital Anxiety Depression Scale, (HADS), and the Zarit Burden Interview (ZBI). The General Health Questionnaire (GHQ-12) and Knowledge of Epilepsy Questionnaire (KOE) were also administered at baseline and repeated at the immediate post and 2 weeks post-intervention. The intervention used comprised of (3) sessions. Each session consisted of interactive lecture, group discussion and problem-solving. While data analysis for the pre and post was performed using Statistical Package for the Social Sciences (SPSS version 20) software to achieve Summary and inferential statistics were used. Socio-demographic details of caregivers and their children were presented using numbers and proportions for categorical variables, percentages for continuous variables and Mean and Standard Deviation for continuous measures. Comparison of the effect of the intervention was carried out using Repeated Measures ANOVA of the outcome variables at three-time points (baseline, immediate post and second post-intervention). At a level of significance of (0.005) Results: The social demographic characteristics of the respondents showed that 28 (70%) of them attained secondary education, 34(85%) were currently employed and 31(77%) lived in a monogamous family setting and about one-third of the respondents 27(67%) were currently married. The predominant occupation among the respondents was trading/business 20(58%) while the characteristics of the respondents’ spouses showed that 36(90%) were currently employed. There was a significant reduction in mean HADS scores from baseline to two weeks post-intervention (Mean diff: 7.786, P = <0.001) and from immediate post-intervention to two weeks post-intervention (Mean diff: 4.536, P = 0.025). ZBI also showed a significant reduction in mean Burden of care scores from baseline to immediate post-intervention, and baseline to two weeks post-intervention time point (Mean diff: 14.143, P = 0.004) and (Mean diff: 20.643, P = <0.001) respectively. These findings indicate significant reductions in anxiety and depression and burden from baseline that were sustained through to the second post-intervention assessment. The study also found a significant decline in the proportion of caregivers meeting the cut-off for psychological distress on the GHQ between the immediate post-intervention time point 33(91.7%) and two weeks post-intervention 19(67.9%) which was statistically significantly (p<0.001). However, there was no significant change in Knowledge. Conclusion: Findings from this study show that training that includes behavioural intervention for managing aggression can be associated with reduced anxiety and depression, as well as a burden for caregivers of children and adolescents with epileptic seizures. Therefore, supporting caregivers of children with epilepsy with such training could go a long way in reducing the burden of care on the family