Objective: The objective was to evaluate the knowledge and attitude of parents of children with epilepsy toward the disease. Methods: Inthis cross-sectional, descriptive study, parents of 60 children with epilepsy from pediatric neurology clinic of All India Institute ofMedical Sciences were enrolled. Data on epilepsy were collected using pre-tested and validated self-developed knowledge, belief, andattitude questionnaire (α=0.85, 0.89). Results: The mean knowledge and attitude scores of parents of the children with epilepsy were9.82±3.9 (2-22) and 31.25±9.27 (0-40), respectively. Parents of the children with epilepsy had poor 50 (83.3%, scores &lt;60%) to fairknowledge scores (60-70%). Majority of the parents 33 (55%) had excellent attitude (≥80%), while 11 (18.3%), 6 (10%), and 10 (16.7%)parents had good, fair, and poor attitude, respectively. Correlation between knowledge and attitude was found to be very weak andnegative (r=−0. 039, p=0.77) with few misconception related to disease and clear idea about the activities to be performed with/withoutcaution. Conclusion: There is a need for developing informational booklet and conducting educational sessions on epilepsy for theparents in particular and public in general

Gulati, Shefali

Joshi, Poonam

Manju, V M

English

Atharva Scientific Publications (E-Jounals)

Vol 2 | Issue 2 | Apr - Jun 2015 Indian J Child Health 76
Manju et al. Epilepsy and knowledge and attitude of parents
Original Article
A study to assess the knowledge and attitude of parents of children with epilepsy
V M Manju1, Poonam Joshi2, Shefali Gulati2
From 1Department of Nursing Services, 2Department of Pediatrics, All India Institute of Medical Sciences. New Delhi, India
Correspondence to: V M Manju, Department of Nursing Services, All India Institute of Medical Sciences. New Delhi, India. 
Phone: +91-9496089442, E-mail: manju.v.vm@gmail.com
Received - 28 March 2015 Initial Review - 08 May 2015 Published Online - 30 May 2015
Abstract
Objective: The objective was to evaluate the knowledge and attitude of parents of children with epilepsy toward the disease. Methods: In 
this cross-sectional, descriptive study, parents of 60 children with epilepsy from pediatric neurology clinic of All India Institute of 
Medical Sciences were enrolled. Data on epilepsy were collected using pre-tested and validated self-developed knowledge, belief, and 
attitude questionnaire (α=0.85, 0.89). Results: The mean knowledge and attitude scores of parents of the children with epilepsy were 
9.82±3.9 (2-22) and 31.25±9.27 (0-40), respectively. Parents of the children with epilepsy had poor 50 (83.3%, scores <60%) to fair 
knowledge scores (60-70%). Majority of the parents 33 (55%) had excellent attitude (≥80%), while 11 (18.3%), 6 (10%), and 10 (16.7%) 
parents had good, fair, and poor attitude, respectively. Correlation between knowledge and attitude was found to be very weak and 
negative (r=−0. 039, p=0.77) with few misconception related to disease and clear idea about the activities to be performed with/without 
caution. Conclusion: There is a need for developing informational booklet and conducting educational sessions on epilepsy for the 
parents in particular and public in general.
Key words: Attitude, Beliefs, Epilepsy, Knowledge
According to the World Health Organization definition, “a diagnosis of epilepsy is made in the presence of recurring seizures, at least two unprovoked ones.” 
Approximately 45,000 children under the age of 15 develop 
epilepsy each year. Population-based studies have reported 
the prevalence rate of 3.6-4.2/1000 children in developed 
countries; and approximately double these rates in developing 
countries [1-5]. Theprevalence rates of epilepsy in India are 
similar to those of developed nations [6]. Beliefs, attitudes, and 
misconceptions toward the disease still exist, and families do 
not easily accept the disease and its treatment regimen. These 
“stigma” and misconceptions are due to lack of information and 
knowledge toward the disease.
The attitude toward the people with epilepsy is influenced 
by the degree of knowledge of condition [7-9]. Parents play 
a major role in decision-making about the treatment of their 
children and beliefs about health and illness affect their 
decision regarding the choice of treatment. This information of 
knowledge of parents might help to get a comprehensive picture 
of children who are being treated in epilepsy clinics, looking 
beyond seizure control, and may assist in planning the holistic 
care, giving special attention to social and psychological impact 
epilepsy has on these children. The objective of our study was 
to investigate the knowledge, beliefs, and attitude of parents of 
children with epilepsy toward the disease, which can contribute 
to the quality of life (QoL) of these children.
METHODS
This study was conducted in pediatric neurology clinic (OPD) 
of a tertiary care teaching institution of north India between 
January and December 2013. Data were collected from parents 
of 60 children with epilepsy using pretested and validated 
self-developed knowledge, belief, and attitude questionnaire 
(α=0.85, 0.89). The calculated sample size was 60 on calculation 
on the basis of mean score of QoL in epilepsy children 
as 75.5±20.8 [10] with 95% confidence and 5% absolute 
precision. Structured knowledge questionnaire had total 
7-items, each one had further sub-items. The items were related 
to causes, signs, first aid management of epilepsy (maximum 
score 25), 16-items were related to the beliefs associated with 
epilepsy, and activities (13-items) that can be undertaken by 
children with epilepsy. Attitude scale had 10-items measured 
on 5-point Likert scale. Children with epilepsy were enrolled 
using consecutive sampling technique.
The inclusion criteria for enrolling sample were: children 
with epilepsy between 5 and 18 years and on treatment for 
6 months or more, not having any other chronic illness; 
children and their parents who could understand/read/write 
Hindi and willing to participate in the study. Ethical clearance 
was taken from ethics committee of the institute. Informed 
written consent was taken from the parents and assent from the 
children. Confidentiality of information and anonymity of the 
Vol 2 | Issue 2 | Apr - Jun 2015 Indian J Child Health 77
Manju et al. Epilepsy and knowledge and attitude of parents
subjects was maintained. Subject data sheet was used to collect 
the demographic profile of respondents. Data were analyzed 
using descriptive and inferential statistics using SPSS 17.0.
RESULTS
Mean age of children with epilepsy was 9.06±2.68 years. Mean 
age (year) at the time of onset of seizures and diagnosis was 
5.9±3.5 and 6.17±3.5, respectively. Majority of the children 
were male 42 (70%) and attending school 49 (81.67%). Most 
of the children 31 (51.7%) had generalized seizures followed by 
partial seizures 22 (36.7%). 47 (78.3%) children had frequency 
of seizures less than 1/month, and majority were on one 
antiepileptic drug 24 (40%), followed by two antiepileptic drugs 
18 (30%), and remaining were on more than two drugs. Majority 
of the caregivers at home were mothers 53 (89.83%). Mean age 
of parents (father and mother) was 39.39±5.8 and 33.64±7 years.
For majority parents (96.7%), the primary source of 
information for epilepsy was medical doctor, while for few, 
friends 11 (18.3%); internet 9 (15%), school and TV 4 (6.7% 
each), folk/spiritual healer 2 (3.3%), and family 1 (1.7%) 
were also the primary source of information along with 
pediatrician/doctor. The mean knowledge and attitude scores 
of parents of children with epilepsy were 9.82±3.9 (2-22) and 
31.25±9.27 (0-40), respectively.
Majority parents 50 (83.3%) had poor knowledge (<60%), 
few 9 (15%) had fair knowledge (60-70%) and only 1 (1.7%) 
had excellent knowledge (≥80%) about epilepsy. Majority 
parents 33 (55%) had excellent attitude (≥80%), while parents 
with good, fair, and poor attitudes were 11 (18.3%), 6 (10%), 
and 10 (16.7%), respectively. Correlation between knowledge 
and attitude was found to be very weak and negative (r=−0. 
039, p=0.77). The knowledge and attitude did not find any 
association with the select variables like education, occupation 
of parents, type of family, type of seizures, and frequency of 
seizures (p>0.05).
The study showed that majority respondents did not have 
misconceptions and false beliefs related to epilepsy as shown in 
Table 1. Myths related to epilepsy disease were: it can be cured 
completely with medicines 43 (71.7%). Thirty parents (50.8%) 
said that a child affected with epilepsy should not wear medical 
identification band, epilepsy is a form of mental disorder 48 
(81.4%), a child cannot have epileptic seizures when plays outside 
in sun 41 (69.5%), sudden change in mood of child cannot cause 
epilepsy 43 (71.7%), and person cannot have epileptic seizures 
when he/she is very angry about something 44 (73.3%).
Majority of the parents believed that activities that can be 
performed without caution were television viewing 28 (46.7%), 
walking 32 (53.3%), eating 37 (61.7%), shower bath 27 (45%), 
listening loud music 23 (38.3%), and household activities 
40 (66.7%) (Table 2). There were some activities that could 
be done with caution were group games like cricket, football 
29 (48.3%) and outdoor games 26 (43.3%), whereas some 
activities that parents believed not to be done were swimming 
44 (73.3%), driving 28 (46.7%), and tub bath 30 (50%).
DISCUSSION
Present study revealed that majority of the parents 50 (83.3%) 
had poor knowledge about the disease per se and about the 
Table 1: Misconceptions and beliefs among parents related to epilepsy (n=59)
Misconceptions and beliefs No Yes Don’t know
Epilepsy can be transmitted by contact 51 (86.4) 3 (5.1) 5 (8.5)
Epilepsy can be controlled with medicines 5 (8.5) 46 (77.9) 8 (13.6)
Epilepsy can be cured completely with medicines 4 (6.8) 43 (72.9) 12 (20.3)
A child with epilepsy can go to school 6 (10.2) 50 (84.7) 3 (5.1)
A child with epilepsy can perform well in studies 21 (35.5) 35 (59.4) 3 (5.1)
A child with epilepsy should not participate in any physical activities at school 41 (69.5) 12 (20.3) 6 (10.2)
Anticonvulsant medications can be stopped if there are no more seizures 51 (86.4) 3 (5.1) 5 (8.5)
A person with epilepsy should wear medical identification band 30 (50.8) 6 (10.2) 23 (39.0)
A child with epilepsy inherits it from his/her parent 47 (78.3) 6 (10) 6 (10)
Changes in the phases of the moon (e.g., full moon or new moon nights) can cause 
a person with epilepsy to have epileptic seizures
49 (83.1) 2 (3.4) 8 (13.5)
Epilepsy is a form of mental illness 48 (81.4) 7 (11.8) 4 (6.8)
A child can have epileptic seizures when he/she plays out in the sun for a long time 41 (69.5) 10 (16.7) 8 (13.3)
Sudden changes in weather (for example, too much heat/cold/humidity/rain) can 
cause a person to have epileptic seizures
46 (76.7) 12 (20) 1 (1.7)
Certain foods/drinks can make a person have epileptic seizures 51 (85) 6 (10) 2 (3.3)
A person has epileptic seizures due to sudden changes in his/her mood 43 (71.7) 10 (16.7) 4 (6.7)
A person has epileptic seizures when he/she is very angry about something 44 (73.3) 10 (16.7) 5 (6.7)
Vol 2 | Issue 2 | Apr - Jun 2015 Indian J Child Health 78
Manju et al. Epilepsy and knowledge and attitude of parents
triggering factors that may precipitate epilepsy 58 (96.7%) 
and the measures to be taken immediately 34 (56.7%). A few 
were completely unaware of the first aid measures 6 (10%) and 
many parents 10 (16.7%) expressed that they would opt for 
unscientific methods like placing keys in the hands of child, 
putting spoon in the mouth of the child, making the child smell 
shoe or tie the hands and legs. In occasion of epileptic attack, 
some parents decided to first consult faith healer 7 (11.7%) and 
priest 9 (15%). Self 13 (21.7%) and ayurveda 2 (3.3%) treatment 
were also sought for. The findings are in contrast to the findings 
given by Frank-Briggs and Alikor [11] in which parents were 
found to have good knowledge and attitude. Sakubita et al. [12] 
also found out that knowledge and understanding of epilepsy 
among parents was fairly good and attitude of parents toward 
epilepsy treatment was positive. They also registered low levels 
of contagion beliefs as in the present study.
Though the range of knowledge remains fair to poor, 
majority had ideas about the activities those could be performed 
with/without caution by their children, which is a positive 
fact that can lead to better practices. The attitude of parents 
toward children with epilepsy is influenced by the level of their 
knowledge about the condition. In our study, we found that 
parents had good attitude toward the epilepsy despite fair to 
poor knowledge about the disease. Majority parents 33 (55%) 
had an excellent attitude (≥80%) in contrast to the findings 
revealed by Dung-Dung et al. [13] which was predominantly 
negative. The study showed less misconceptions and false 
beliefs related to epilepsy whereas Zaini et al. [14] reported 
significant misconceptions among parents. Having positive 
believes would have contributed to the positive attitude 
revealed by majority of the parents.
Small sample size, single center cross-sectional study with 
purposive and consecutive sampling of the children limits 
the generalizability of the findings. The present study may 
have several implications and recommendations. Health care 
professionals have to play very important role in educating, 
parents of the affected children and the public in general, about 
the disease, causes, triggering factors and first aid measures to 
be taken at the time of onset of seizures. Periodic public lectures 
and informational booklet on epilepsy addressing to the issues 
can be used in disseminating information about the disease and 
its management.
CONCLUSION
In our study, majority of the parents of children with epilepsy 
had poor to fair knowledge scores; however, majority of them 
had an excellent attitude toward the disease. There is a need for 
developing informational booklet and conducting educational 
sessions on epilepsy for the parents in particular and public in 
general.
REFERENCES
1. Beilmann A, Napa A, Sööt A, Talvik I, Talvik T. Prevalence of 
childhood epilepsy in Estonia. Epilepsia. 1999;40(7):1011-9.
2. Sidenvall R, Forsgren L, Heijbel J. Prevalence and characteristics 
of epilepsy in children in northern Sweden. Seizure. 
1996;5(2):139-46.
3. Sridharan R, Murthy BN. Prevalence and pattern of epilepsy in 
India. Epilepsia. 1999;40(5):631-6.
4. Nicoletti A, Reggio A, Bartoloni A, Failla G, Sofia V, Bartalesi F, 
et al. Prevalence of epilepsy in rural Bolivia: a door-to-door 
survey. Neurology. 1999;53(9):2064-9.
5. Christianson AL, Zwane ME, Manga P, Rosen E, Venter A, 
Kromberg JG. Epilepsy in rural South African children – 
prevalence, associated disability and management. S Afr Med J. 
2000;90(3):262-6.
6. Gadgil P, Udani V. Pediatric epilepsy: The Indian experience. 
J Pediatr Neurosci. 2011;6 Suppl 1:S126-9.
7. Sell-Salazar F. Psychosocial aspects of childhood epilepsy. 
Medicina. 2009;69:3-7.
Table 2: Activities that can be undertaken by children with epilepsy (n=57)
Activities Not to be 
done (f, %)
Can be done with 
caution (f, %)
Can be done without 
caution (f, %)
Do not know
Group games (e.g. cricket, football) 3 (5.3) 29 (54.7) 23 (40.5) 2 (3.5)
Outdoor games 7 (12.3) 26 (45.6) 22 (38.6) 2 (3.5)
Television viewing 4 (7.0) 19 (33.3) 28 (49.1) 6 (10.5)
Swimming 44 (77.2) 9 (15.8) 3 (5.3) 1 (1.7)
Walking 1 (1.7) 23 (40.4) 32 (56.1) 1 (1.7)
Dancing 2 (3.4) 20 (35.1) 34 (64.1) 1 (1.7)
Eating 0 20 (35.1) 37 (64.9) 0
Driving 28 (49.1) 14 (24.6) 14 (24.6) 1 (1.7)
Shower baths 4 (7.0) 23 (40.4) 27 (47.4) 2 (3.4)
Tub baths 30 (52.6) 11 (19.3) 6 (10.5) 10 (17.5)
Loud music 16 (28.1) 12 (21.1) 23 (40.4) 6 (10.5)
Going to discotheques 16 (28.1) 8 (14.0) 13 (22.8) 20 (35.1)
Household activities 1 (1.7) 15 (26.3) 40 (70.2) 1 (1.7)
Vol 2 | Issue 2 | Apr - Jun 2015 Indian J Child Health 79
Manju et al. Epilepsy and knowledge and attitude of parents
8. El Sharkawy G, Newton C, Hartley S. Attitudes and practices of 
families and health care personnel toward children with epilepsy 
in Kilifi, Kenya. Epilepsy Behav. 2006;8(1):201-12.
9. Parmar RC, Sahu DR, Bavdekar SB. Knowledge, attitude and 
practices of parents of children with febrile convulsion. J Postgrad 
Med. 2001;47(1):19-23.
10. Haneef Z, Grant ML, Valencia I, Hobdell EF, Kothare SV, 
Legido A, et al. Correlation between child and parental 
perceptions of health-related quality of life in epilepsy using 
the PedsQL.v4.0 measurement model. Epileptic Disord. 
2010;12(4):275-82.
11. Frank-Briggs AI, Alikor EA. Knowledge and attitudes of parents 
toward children with epilepsy. Ann Afr Med. 2011;10(3):238-42.
12. Sakubita CC. Knowledge, attitudes and practices about 
epilepsy among parents of children living with epilepsy. 
Available form http://www.dspace.unza.zm:8080/xmlui/
handle/123456789/2061. [Last accessed on March 02, 2015]
13. Dung-Dung AA, Singh HK, Kumari S, Gupta M, Raval M, 
Rajender G. Knowledge, attitude and perception of caregivers of 
children with epilepsy. Delhi Psychiatry J. 2009;12:274-5.
14. Zaini LE, Atteyah DM, Aldisi WM, Abdulkarim HA, Alhelo RF, 
Alhelali HA, et al. parent’s knowledge and attitudes towards 
children with epilepsy. Pediatri Ther. 2013;3:157. 
Funding: None; Conflict of Interest: None Stated
How to cite this article: Manju VM, Joshi P, Gulati S. A study 
to assess the knowledge and attitude of parents of children with 
epilepsy. Indian J Child Health.  2015;2(2):76-79.


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