Psycho-educational therapy among Nigerian adult patients with epilepsy: a controlled outcome study

Olley, Benjamin O.; Osinowo, Helen O.; Brieger, William R.

doi:10.1016/s0738-3991(00)00087-2

Cited by 42 publications

(41 citation statements)

References 16 publications

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“…With regards to the other studies, three used random number tables to conduct block randomization [13][14][15]19] and two studies used random number tables to conduct cluster randomization [19,20]. One used a firstcome-alternate method of randomization [21].…”

Section: Sampling Methods (Randomisation)mentioning

confidence: 99%

The impact of rehabilitative services in the lives of adults and children with disabilities, in low-income and middle-income countries: an assessment of the quality of the evidence

Patel

Alavi

Lindfield

et al. 2012

Disability and Rehabilitation

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Section: Sampling Methods (Randomisation)mentioning

confidence: 99%

The impact of rehabilitative services in the lives of adults and children with disabilities, in low-income and middle-income countries: an assessment of the quality of the evidence

Patel

Alavi

Lindfield

et al. 2012

Disability and Rehabilitation

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“…Beck Depression Inventory is a well known and frequently used clinical and research instrument with excellent psychometric qualities for the assessment of a stable-trait-like property of depression. Its cultural validity and reliability have also been demonstrated for use in Nigeria (Olley et al, 2001).…”

Section: Methodsmentioning

confidence: 99%

“…The intervention was manualised and provided dyadic instruction focusing primarily on the cause and course of HIV/AIDS, its psychosocial impact and self-management skills. The protocol followed in the PE group was similar in procedure to one used among individuals with epilepsy in Nigeria (Olley et al 2001) and can be made available to readers on request. The WL group also received a total of four 1-hour sessions of individualized discussion that were mainly supportive in nature and not manualdriven.…”

Section: Methodsmentioning

confidence: 99%

“…Both anxiety and depression have been shown to be responsive to PE therapy used with other populations of non-HIV/AIDS patients (Helgeson et al, 1990;May & Pfafflin, 2002;Olley et al, 2001). Furthermore, there is evidence that health illiteracy may compound emotional states in HIV/ AIDS patients (Kalichman & Rompa, 2000) therefore, PE strategies for improving knowledge may be potentially effective to bring about adequate adjustment, particularly in Nigeria where motivation for testing is often hampered by inappropriate counseling and informed consent procedures (UNAIDS, 2000).…”

Section: Introductionmentioning

confidence: 99%

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Improving well-being through psycho-education among voluntary counseling and testing seekers in Nigeria: A controlled outcome study

2006

AIDS Care

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The present study evaluated the efficacy of an individualized psycho-education (PE) program in reducing psychological distress and risky sexual behavior and enhancing self-disclosure associated with an HIV diagnosis among attendees of a walk-in non-governmental voluntary counseling and testing (VCT) center in Nigeria. Ninety-four consecutive individuals were asked to complete a pre-counseling, baseline questionnaire detailing their sociodemographic characteristics, psychopathology, sexual practices, self-disclosure intention and coping behaviors. They were screened for HIV and post-test counseled. Sixty-seven individuals (72.2%) who tested positive were consecutively randomly assigned to one of two groups: a PE program (four 60-minute weekly manual driven sessions) (N=34) and a wait-list (WL) control group (N=33). The major outcome measures used were the Crown Crisp Experiential Index (CCEI), the Beck Depression Inventory (BDI) (Beck et al., (1961), self-report sexual practices in past three months, self-disclosure intention and the brief COPE. At four weeks post-intervention, significant reductions on all measures as well as reduction in risky sexual practices were observed in the treatment group compared with the wait-list group. Treatment group members were also significantly more likely to disclose their serostatus and accept their HIV status as a way of coping, compared with the wait-list group. Overall, support was found for the efficacy of a manual-driven PE program for self-disclosure, reduction of depression and improvement in safe sexual practices.

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“…[74][75][76] A fourth study 77 was published later. Psychological interventions have also been reviewed.…”

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confidence: 99%

Can an epilepsy nurse specialist-led self-management intervention reduce attendance at emergency departments and promote well-being for people with severe epilepsy? A non-randomised trial with a nested qualitative phase

Ridsdale

McCrone

Morgan

et al. 2013

Health Services and Delivery Research

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ObjectivesTo (1) describe the characteristics and service use of people with established epilepsy (PWE) who attend the emergency department (ED); (2) evaluate the economic impact of PWE who attend the ED; (3) determine the effectiveness and cost-effectiveness of an epilepsy nurse specialist (ENS)-led self-management intervention plus treatment as usual (TAU) compared with TAU alone in reducing ED use and promoting well-being; (4) describe patients' views of the intervention; and (5) explore their reasons for attending the ED.DesignNon-randomised trial with nested qualitative study.SettingThe EDs of three inner London hospitals. The EDs each offer similar services and support a similar local population, which made a comparison of patient outcomes reasonable.ParticipantsAdults diagnosed with epilepsy for ≥ 1 year were prospectively identified from the EDs by presenting symptom/discharge diagnosis. We recruited 85 of 315 patients with 44 forming the intervention group and 41 the comparison group.InterventionIntervention participants were offered two one-to-one outpatient sessions delivered by an ENS who aimed to optimise self-management skills and knowledge of appropriate emergency service use. The first session lasted for 45–60 minutes and the second for 30 minutes.Main outcome measuresThe primary outcome was the number of ED visits that participants reported making over the 6 months preceding the 12-month follow-up. Secondary outcomes were visits reported at the 6-month follow-up and scores on psychosocial measures.ResultsIn the year preceding recruitment, the 85 participants together made 270 ED visits. The frequency of their visits was positively skewed, with 61% having attended multiple times. The mean number of visits per participant was 3.1 [standard deviation (SD) 3.6] and the median was two (interquartile range 1–4). Mean patient service cost was £2355 (SD £2455). Compared with findings in the general epilepsy population, participants experienced more seizures and had greater anxiety, lower epilepsy knowledge and greater perceived stigma. Their outpatient care was, however, consistent with National Institute for Health and Clinical Excellence recommendations. In total, 81% of participants were retained at the 6- and 12-month follow-ups, and 80% of participants offered the intervention attended. Using intention-to-treat analyses, including those adjusted for baseline differences, we found no significant effect of the intervention on ED use at the 6-month follow-up [adjusted incidence rate ratio (IRR) 1.75, 95% confidence interval (CI) 0.93 to 3.28] or the 12-month follow-up (adjusted IRR 1.92, 95% CI 0.68 to 5.41), nor on any psychosocial outcomes. Because they spent less time as inpatients, however, the average service cost of intervention participants over follow-up was less than that of TAU participants (adjusted difference £558, 95% CI –£2409 to £648). Lower confidence in managing epilepsy and more felt stigma at baseline best predicted more ED visits over follow-up. Interviews revealed that patients generally attended because they had no family, friend or colleague nearby who had the confidence to manage a seizure. Most participants receiving the intervention valued it, including being given information on epilepsy and an opportunity to talk about their feelings. Those reporting most ED use at baseline perceived the most benefit.ConclusionsAt baseline, > 60% of participants who had attended an ED in the previous year had reattended in the same year. In total, 50% of their health service costs were accounted for by ED use and admissions. Low confidence in their ability to manage their epilepsy and a greater sense of stigma predicted frequent attendance. The intervention did not lead to a reduction in ED use but did not cost more, partly because those receiving the intervention had shorter average hospital stays. The most common reason reported by PWE for attending an ED was the lack of someone nearby with sufficient experience of managing a seizure. Those who attended an ED frequently and received the intervention were more likely to report that the intervention helped them. Our findings on predictors of ED use clarify what causes ED use and suggest that future interventions might focus more on patients' perceptions of stigma and on their confidence in managing epilepsy. If addressed, ED visits might be reduced and efficiency savings generated.Trial registrationCurrent Controlled Trials ISRCTN06469947.FundingThis project was funded by the NIHR Health Services and Delivery Research programme and will be published in full inHealth Services and Delivery Research; Vol. 1, No. 9. See the HSDR programme website for further project information.

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Psycho-educational therapy among Nigerian adult patients with epilepsy: a controlled outcome study

Cited by 42 publications

References 16 publications

The impact of rehabilitative services in the lives of adults and children with disabilities, in low-income and middle-income countries: an assessment of the quality of the evidence

The impact of rehabilitative services in the lives of adults and children with disabilities, in low-income and middle-income countries: an assessment of the quality of the evidence

Improving well-being through psycho-education among voluntary counseling and testing seekers in Nigeria: A controlled outcome study

Can an epilepsy nurse specialist-led self-management intervention reduce attendance at emergency departments and promote well-being for people with severe epilepsy? A non-randomised trial with a nested qualitative phase

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