Le stress parental chez les parents d'enfants atteints d'épilepsie réfractaire avant et après l'implantation de la stimulation du nerf vague

Aperçu: G.M.

Le but de cette étude était d'évaluer le stress parental chez les parents d'enfants atteints d'épilepsie réfractaire avant et après leur implantation de la stimulation du nerf vague (VNS);

Les parents d'enfants atteints d'épilepsie réfractaire ont complété l'indice de stress parental (PSI) dans le cadre d'une évaluation de psychologue avant et au moins 12 mois après l'obtention de l'implantation de VNS par leurs enfants. Le questionnaire PSI mesure le stress parental dans deux domaines;  Au total, 30 parents ont complété les questionnaires de PSI. Dix-sept de leurs enfants (56,7%) étaient des garçons. Les enfants âgés de 1 à 12 ans (7,43 ± 3,59 ans, moyenne ± DE). Après l'implantation du VNS, le score total moyen du stress parental a diminué de 282,1 ± 38,0 à 272,4 ± 42,9. Une diminution significative a été constatée sur la sous-échelle de conjoint du domaine parent. Pour les parents de garçons, les scores moyens significatifs de stress parentaux ont diminué de façon significative. Les scores moyens significatifs de stress parentaux ont également diminué de manière significative chez les parents d'enfants souffrant d'épilepsie sans autisme et qui n'ont pas diminué le nombre de différents anticonvulsivants utilisés après le VNS.Le VNS est un choix souhaitable pour traiter l'épilepsie réfractaire. Notre étude a montré que 12 mois ou plus après l'implantation de VNS, la fréquence des saisies et le stress parental ont généralement diminué. Cependant, dans certains cas particuliers, le stress parental peut augmenter et une aide externe peut être nécessaire pour soutenir ces patients et leurs parents. 

 

Pediatr Neonatol. 2017 May 17. pii: S1875-9572(16)30138-3. doi: 10.1016/j.pedneo.2017.03.001.

Parenting stress in parents of children with refractory epilepsy before and after vagus nerve stimulation implantation

Li ST¹, Chiu NC², Kuo YT³, Shen EY⁴, Tsai PC⁵, Ho CS⁶, Wu WH⁷, Chen JC⁸; VNS TCNS.

Collaborators (29)

Wang CY⁹, Kuo YT⁹, Wang HS¹⁰, Lin KL¹⁰, Hung PC¹⁰, Chang YC¹¹, Hung PL¹¹, Fan PC¹², Lee WT¹², Yang RC¹³, Ko FJ¹³, Lin LC¹³, Chou PC¹³, Tsai JD¹⁴, Hung KL¹⁵, Chen HJ¹⁵, Chang KP¹⁶, Hsu TR¹⁶, Ho CS¹⁷, Chiu NC¹⁷, Chen SJ¹⁸, Fan HC¹⁸, Lee HT¹⁹, Shen EY²⁰, Kuo HT²⁰, Chang MY²¹, Chang TM²¹, Li ST²², Yeh GC²³.

Author information

1

Department of Pediatrics, Hsinchu MacKay Memorial Hospital, Hsinchu, Taiwan; Graduate Institute of Business Administration, College of Management, Fu Jen Catholic University, New Taipei City, Taiwan.

2

Department of Pediatrics, MacKay Children's Hospital, Taipei, Taiwan; Department of Audiology and Speech Language Pathology, MacKay Medical College, New Taipei City, Taiwan; Mackay Junior College of Medicine, Nursing and Management, New Taipei City, Taiwan. Electronic address: ncc88@mmh.org.tw

3

Department of Pediatrics, Taipei Medical University - Shuang Ho Hospital, New Taipei City, Taiwan.

4

Department of Pediatrics, China Medical University Hospital, Taichung, Taiwan.

5

Clinic Psychologist, Department of Psychiatry, Cender Hospital, Taichung, Taiwan.

6

Department of Pediatrics, MacKay Children's Hospital, Taipei, Taiwan.

7

Healthcare Management, Yuanpei University of Medical Technology, Hsinchu, Taiwan.

8

Department of Statistics and Information Science, College of Management, Fu Jen Catholic University, New Taipei City, Taiwan.

9

Department of Pediatrics, Taipei Medical University-Shuang Ho Hospital, Taiwan.

10

Division of Pediatric Neurology, Chang Gung Children's Hospital, Taoyuan, Taiwan.

11

Department of Pediatrics, Chang Gung Memorial Hospital Kaohsiung, Taiwan.

12

Department of Pediatrics, National Taiwan University Hospital, Taiwan.

13

Department of Pediatrics, Kaohsiung Medical University Hospital, Taiwan.

14

Department of Pediatrics, Chung Shang Medical University Hospital, Taiwan.

15

Department of Pediatrics, Cathay General Hospital, Taiwan.

16

Department of Pediatrics, Taipei Veterans General Hospital, Taiwan.

17

Department of Pediatrics, MacKay Children's Hospital, Taiwan.

18

Department of Pediatrics, Tri-Service General Hospital, Taiwan.

19

Department of Neurosurgery, Taichung Veterans General Hospital, Taiwan.

20

Department of Pediatrics, China Medical University Hospital, Taiwan.

21

Department of Pediatrics, Changhua Christian Hospital, Taiwan.

22

Department of Pediatrics, Hsinchu MacKay Memorial Hospital, Taiwan.

23

Department of Pediatrics, Taipei Medical University Hospital, Taiwan.

Abstract

OBJECTIVES:

The purpose of this study was to evaluate parenting stress in parents of children with refractory epilepsy before and after their children received vagus nerve stimulation (VNS) implantation.

METHODS:

Parents of children with refractory epilepsy completed the Parenting Stress Index (PSI) under a psychologist's assessment before and at least 12 months after their children received VNS implantation. The PSI questionnaire measures parenting stress in two domains; a parent domain with seven subscales, and a child domain with six. Age, gender, epilepsy comorbidity, VNS implantation date, seizure frequency, and anticonvulsant history before and after VNS implantation were obtained from reviews of medical charts.

RESULTS:

In total, 30 parents completed the first and follow-up PSI questionnaires. Seventeen of their children (56.7%) were boys. The children aged from 1 to 12 years (7.43 ± 3.59 years, mean ± SD). After VNS implantation, the mean total parenting stress scores decreased from 282.1 ± 38.0 to 272.4 ± 42.9. A significant decrease was found on the spouse subscale of the parent domain. For the parents of boys, the mean total parenting stress scores decreased significantly. The mean total parenting stress scores also decreased significantly for parents of epileptic children without autism and who did not taper off the number of different anticonvulsants used after VNS.

CONCLUSIONS:

VNS is an advisable choice to treat refractory epilepsy. Our study showed that 12 months or more after VNS implantation, seizure frequency and parenting stress typically decreased. However, in some special cases the parenting stress may increase, and external help may be required to support these patients and their parents.

Copyright © 2017. Published by Elsevier B.V.

PMID: 28566195

DOI: 10.1016/j.pedneo.2017.03.001