ABSTRACT

Corresponding Author:
Dr. Rajendra Kumar Sureka,
#47, Sanjay Marg,
Hathroi Scheme,
Jaipur, Rajasthan.
E-mail: rsureka@rediffmail.com

ABSTRACT

BACKGROUND

Aim of this study is to assess and compare knowledge, attitude and practice amongst nursing students and MBBS students in a tertiary care centre.

MATERIALS AND METHODS

All participants completed the self-administered questionnaire after signing the consent to participate in the study. A questionnaire was designed to test the knowledge on aetiology and treatment, attitude in dealing with persons with epilepsy and familiarity with various forms of treatment and management. Possible difference in answers were analysed amongst nursing and MBBS students.

RESULTS

Majority of students with both groups had heard about epilepsy. Around 40% of MBBS students in comparison to nursing students approx. 27% believed that epilepsy is a mental illness. Around 76% of nursing students in comparison to MBBS students approx. 50% believed that epilepsy creates hindrance in normal life. Majority of individuals think that epilepsy is curable. More than 75% of participants in both groups had opinion that epilepsy can be treated with allopathic medicine.

CONCLUSIONS

Lots of superstition and misbelief exists amongst health care providers. Present study also depicts the same.

KEYWORDS

Knowledge, Attitude, Practice, Epilepsy

BACKGROUND

Epilepsy is one of the commonest neurological disorders with marked sociocultural stigma.¹ Epilepsy afflicts 50 million people all over the world, almost 80% of whom belong to developing countries and nearly three fourths of these patients do not receive the appropriate treatment.² Further studies have reported the global incidence of epilepsy to be generally between 5 to 10 cases per 1000 people. The all inclusive rate includes the incidence of 50 people per 100,000 persons and these incidences are multifactorial that vary according to the seizure types, seizure presentation and antiepileptic drugs administered.³ It is estimated that there are more than 10 million persons with epilepsy in India. Its prevalence is about 1% in our population.⁴ The prevalence is higher in the rural (1.9%) compared to urban population (0.6%).^5,6 In developing countries like India, lots of

DISCUSSION

The study shows knowledge, attitude and practice amongst medical students (200) and nursing students (211).

KNOWLEDGE

Most of the participants from both the groups had heard about epilepsy. Group A (Nursing Students) had heard about epilepsy (77.73%) through studies, journals and newspaper. In similar studies from Italy (96.0%),^{, 9}Canada (91.0%),¹⁰ Brazil (91.3%),¹¹ Malaysia (86.5%),¹² participants had heard about epilepsy. And 87% of medical students (group B) had heard about epilepsy. Similar studies from Jordan¹³ and Malaysia¹² showed that around 77.6% of medical students had heard about epilepsy. In group B, 25% of students knew someone (members and friends) suffering from epilepsy while 46% students from a study in Southern Nigeria had witnessed persons with epilepsy. We think it is probably due to increase in awareness on epilepsy which helps them to recognise as compared to our studies. Around 54% of group A participants considered epilepsy is an organic brain disease, 27% thought as mental illness and 25% thought as a birth defect/blood disorder and supernatural cause was enumerated by 5% of nursing students followed by evil spirit 0.95%.

Whereas 59% of group B participants thought epilepsy is an organic brain disease, 40% thought as mental illness. A similar study from Malaysia¹² showed 39.7% of the undergraduate students stated that epilepsy is a form of mental illness. This reflects the level of misconception and stigma associated with epilepsy in nursing students as compared to MBBS students.

ATTITUDE

Misconception about epilepsy is widely prevalent in developing regions. In our study, 76% of participants in group A thought epilepsy creates hindrance in life as compared to group B i.e. 50%. It is surprising to know that 33% of participants of group A thought that an epileptic person should not marry and 47% thought that they cannot have normal sexual relationship and around 30% thought an epileptic person should not work/play. While in group B, 1-2% thought epileptic person should not marry/study/work. Our study shows that misconception about epilepsy in nursing students is much more and it needs to be taken care of by spreading awareness about epilepsy. Most negative attitude towards a person with epilepsy was from Jordan where students refused to marry (50.5%) and children with epilepsy would have disability (44.4%).¹³ The mistaken belief of putting shoe/onion on an epileptic person’s face, placing bunch of keys in hands or other practices has been observed in more than 16% of students (Group A). In a study by Falavinga A et al,¹⁴ these mistaken ideas were observed in 38.8% of the sample. Another Brazilian study¹¹ demonstrated that 71% of the first year students of health care related disciplines and 32% of the last year students follow these practices.

PRACTICE

It is encouraging to know that around 78% participants in both groups were of view that allopathic medicine is the major stay of treatment for epilepsy. Group A participants believed that epilepsy could be treated with homeopathic (72%) and ayurvedic (81%) treatment. Whereas in group B, 40% thought epilepsy can be treated with homoeopathic medicine and 50% thought epilepsy can be treated with ayurvedic medicine. Most Indians have an abiding faith in the indigenous Ayurvedic form of treatment. Another reason for popularity of Ayurvedic medicines is the easy accessibility to practitioners of the system, especially in rural India. It is surprising in a study from medical community [Northern Nigeria] where majority of respondents (47%) opted for spiritual methods. This was followed by orthodox (34%) and use of traditional herbal medicines (19%) for treating epilepsy.¹⁵ The use of spiritual healing is even worse in the study, most commonly reported treatment methods were - holy Quran (71.4%), medication (71.3%) and herbs (29.3%)¹⁵. In a study of medical students of Southern Nigeria around 47.9%¹⁶ would take them to church while some of the health care persons would put some object in mouth to protect the tongue. Whereas in our study, around 22% participants of groups A would take the person to a priest and around 27% would take the person to a tantric. Around 50% of participants in both groups believed that missing a dose of their antiepileptic drug results in an epileptic attack. These data suggest lack of information about assistance and safe handling of seizures in these health care courses.

CONCLUSIONS

The study shows that the nursing students and MBBS students were familiar with epilepsy. But major gaps exist in their attitude and practice in regards to this disease. Nursing students’ knowledge and attitude about epilepsy needs to improve as they provide care to epileptics. Regular organisation of awareness camps about epilepsy could be of immense help for medical students and nurses.