@2024 Afarand., IRAN

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ISSN: 2252-0805    The Horizon of Medical Sciences 2016;22(4):299-306

Background
Epilepsy is one of the most common neurological disorders [1] and the reason of disability and sickness in childhood [2, 3].
Previous Studies
... [4-18]. Performing family-based empowerment program for caregivers of patients with multiple sclerosis has improved the level of knowledge, attitude and the practice of these people [19] ... [20].
Aim(s)
This study aimed to investigate the effect of empowerment program on self-efficacy of mothers with epileptic children in the fields of psychological adaptation, support winning and information obtaining.
Research type
The study is a randomized clinical trial of pre and post groups with a control group.
Research society, place and time
The study population consisted of mothers with epileptic children admitted to the neurology ward of Ghaem Mashhad Hospital in 2014.
Sampling method and number
The achieved sample size was 50 (the total number of 100 patients). The sampling method of the research was easy; eligible mothers and children were specified from among the hospitalized and discharged patients of the last year and were divided into experimental and control groups through random assignment using the file numbers depending on the oddness or parity of them. Inclusion criteria were the child’s age ranging from 1 to 12 years, the minimum time of 6 months of diagnosing the child’s disease, lack of mother’s participation in similar training program, the mother’s ability for completing the questionnaires, the possibility of making phone calls with the mother, having the greatest role for caregiving by the mother, no history of taking drugs by the mother, absence of any chronic physical illness for the mother, and lack of any other serious illness in the child. The exclusion criteria involved not participating in meetings for more than one session and not taking care of the child by the mother over a week while following up.
Used devices&materials
Data collection tools were a form for demographic information and Caregiver Self-efficacy Questionnaire. Demographic data form was designed in two parts; information about the mother (caregiver) and information about the patient (the child). Caregiver`s (the mother) individual, family and social information included 14 questions about the variables of age, education, the woman’s occupation, job status (self-employed, retired, etc.), marital status, the man’s occupation, the man’s level of education, monthly income, monthly expenses for caregiving, the duration of caregiving, its experiences, the hours of caregiving, hours of taking care by the servant and recent medical problems which were completed by asking the mother. Information about the patient (the child) contained 7 questions regarding gender, age, educational status, state of residence, medical diagnosis, history of epilepsy in the family and other medical problems that were completed by asking from the mother and referring to the medical files of the child. Caregiving Self-efficacy Questionnaire consists of 35 questions and 5 dimensions measuring the mother’s self-efficacy in the fields of psychological adaptation, gaining support and accessing care information. Each item is scored from zero to 100 and the closer the items are to 100, the higher the self-efficacy is. The reliability of the questionnaire was obtained 80% by Zhang and through calculating Cronbach's alpha coefficient for the entire tool and each of its dimensions. The four-week reliability of the test-retest has been calculated 64% to 85% for the entire tool and each of its dimensions [11]. In order to confirm the reliability of this tool, the Persian version reliability of each of its five dimensions was reassessed through internal consistency; such that before the study, this tool was completed for 10 mothers in one occasion and then the Cronbach's alpha was calculated between 0.73 to 0.81 for different dimensions. In order to determine the scientific validity of the tools, content validity came to use and data collection tool was given to 10 professors, scholars and faculty members of Mashhad Nursing University after preparing and translating it for the validity determination. Then, items with content validity index of less than 0.7 were deleted or modified and the ultimate tool was deployed. Since the research was conducted in experimental and control groups, the intervention was done merely for the experimental group and the control group received none. Empowerment program was performed based on the steps and procedures mentioned in the model as a group discussion during five one-hour sessions with an interval of 4 days for the experimental group as follows: 1) Understanding the threat: the perceived intensity and susceptibility in these mothers were increased through enhancing the levels of their knowledge and awareness about the process of epilepsy, severity of the side effects, treatment process and their current status. 2) Problem solving: problem solving was conducted through group discussion. The researchers discussed by giving objective examples of their own and the things they did to solve the problem and they participated in selecting the solutions practically. Moreover, in this stage, the mothers shared the techniques of increasing self-efficacy, and educational cards and CDs regarding a summary of the training sessions were granted to the mothers at the end of each session. 3) Evaluation: At this stage, the mothers` level of empowerment was assessed by the researcher; such that the mothers indicated the skills in the previous step practically. A time of 1.5 months was given to the mother to perform the acquired pattern [21, 22]. Final evaluation or post-test phase was carried out 1.5 months after the last session of empowerment for the experimental and the control groups simultaneously. Data was analyzed using SPSS 11.5 software through independent and paired statistical T-tests (to compare the mean scores of efficiency dimensions within and between the two groups before and after the intervention), Chi square test, Fisher exact test and analysis of covariance (to examine the effect of demographic variables in both groups).
Findings by Text
The mean age of mothers in the experimental and control groups was 32.80 ± 6.90 and 32.60 ± 6.80, respectively. The mean duration of caregiving to patients in the experimental and the control group were 42.30 ± 37.70 and 32.40 ± 31.90 months, respectively. The experimental and control groups were significantly different in terms of educational level (p <0.03) and employment status (p <0.012) and the groups were not homogeneous in these two variables, however, these two variables did not have a significant effect on improving the mother`s self-efficacy either simply or mutually (p>0.05). On the other hand, both experimental and control groups were homogeneous in terms of other demographic variables and no significant difference was observed between the two groups (p>0.05; Table 1). The mean scores of self-efficacy in the aspects of psychological adaptation, winning support and obtaining information did not have a significant difference between the two groups before the intervention (p>0.05), but a significant difference was revealed after the intervention between the two groups (p <0.001). Moreover, the mean scores after the intervention in the experimental group were significantly more than before the intervention (p <0.001) but after the intervention the mean scores in the control group decreased compared to before the intervention and this reduction was only significant in terms of psychological adaptation and gaining support (p <0.001; Table 2).
Main comparison to the similar studies
... [23-27]. Irfan Oglu et al. demonstrated in their study that there is a positive relationship between knowledge, awareness and attitude about epilepsy, and the level of social support won by children with epilepsy and their parents and siblings[28] ... [29].
Suggestions
It is recommended to use empowerment program for caregivers of adult patients with epilepsy or caregivers of other chronic patients and patients with epilepsy, or family-based empowerment of patients with epilepsy.
Limitations
The limitations of this study include lack of exact control over research units in educating through other sources and the media, and the problems of rural mothers for attending the meetings.
Conclusions
Empowerment program increases the self-efficacy of mothers with epileptic children in the fields of psychological adaptation, winning support and obtaining information.
Acknowledgments
Many thanks are addressed to professors, Ghaem Hospital staff and the mothers.
Conflict of interest
Non-declared
Ethical Permissions
This research was accomplished after obtaining the approval of the Ethics Committee of Mashhad University of Medical Sciences and the consent of the subjects. All ethical issues were observed. This study was registered in the Iran`s Clinical Trial Site with the code of IRCT2015012720827N1.
Funding Sources
This article is taken from the Thesis of MA degree as an approved project with the number of 276/1/930542 and dated 7.12.2014.

TABLES and CHARTS

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