امکان سنجی مداخله شناختی- رفتاری خود مدیریتی اطفال: مقابله آشکارا و شخصی با صرع (COPE)

A pilot study was conducted to examine the feasibility and satisfaction of an integrated cognitive-behavioral and self-management intervention for youth with epilepsy (YWE) and caregivers. The Coping Openly and Personally with Epilepsy (COPE) intervention was based on empirically supported cognitive-behavioral techniques and theory driven self-management content. Content of the intervention consists of epilepsy education, primary and secondary coping skills. Children and adolescents ages 10–15, who had been diagnosed with epilepsy for at least six months (ICD-9345 codes), had at least average intelligence, no history of a serious mental illness, were not currently being treated for major depression, and lived within an 80 mile radius were considered eligible. Nine youth and their caregivers completed the COPE program and provided self-report data on feasibility, accuracy, and satisfaction of the COPE program. Caregivers and youth reported a high level of satisfaction with the COPE program, and findings support the feasibility and accuracy of the intervention content and delivery. Results provide a foundation for future randomized, controlled, clinical trials to examine the effectiveness of the COPE program for youth with epilepsy and their caregivers.

Self-efficacy for seizure management is one cognitive aspect of self-management and has been defined as the belief in one's abilities to initiate, maintain, and complete tasks related to daily epilepsy self-management.8 Indeed, self-efficacy for seizure management is related to attitudes towards epilepsy, seizure worry, and depressive symptoms in YWE.5, 6 and 14 Further, adult studies have documented that self-efficacy contributes significantly to later self-management outcomes, even when considered with social support,15 and adults report high self-efficacy for specific tasks such as taking medication and obtaining social support but not for sleep behaviors, exercising, and stress reduction behaviors.16 Thus, individuals with epilepsy may have less self-confidence (self-efficacy) in their ability to engage in health enhancing behaviors and would likely benefit from interventions that teach and promote these self-management behaviors. However, psychological interventions tailored towards YWE are sparse, and only a few have included aspects of self-management.2 None have targeted self-efficacy.

In conclusion, this pilot feasibility and satisfaction study has provided valuable information for researchers to continue the development of self-management programs for YWE and their caregivers. Common challenges to psychosocial intervention RCTs include recruitment and accessibility barriers; however, we must develop practical solutions to these barriers and revise intervention content and design based on pilot findings. Future studies may have a significant impact on the comprehensive care of YWE and their caregivers by addressing previous limitations and providing empirical support for self-management interventions.