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Mini Review Volume 6 Issue 2
Psychosocial rehabilitation of people with mental disorders and epilepsy
Antonia Regina Ferreira Furegato,1 Gabriela Carrion Degrande Moreira2
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1Nursing, Senior Full Professor of EERP/USP, Brazil
2Nursing, PhD in Sciences by EERP/USP, Professor of the Nursing Course at FEI/FAFRAM, Brazil
Correspondence: Gabriela Carrion Degrande Moreira, Nursing, PhD in Sciences by EERP/USP, Professor of the Nursing Course at FEI/FAFRAM
Received: January 20, 2021 | Published: March 16, 2023
Citation: Furegato ARF, Moreira GCD. Psychosocial rehabilitation of people with mental disorders and epilepsy. Int Phys Med Rehab J. 2021;6(2):35-36. DOI: 10.15406/ipmrj.2021.06.00277
Abstract
Over the years, mental disorders have been discretely associated with epilepsy.
Objective: To carry out an integrative literature review on the psychosocial rehabilitation of people with mental disorders associated with epilepsy.
Methods: BVS, LILACS, PAHO, BDENF, Pubmed and Medline databases and virtual libraries were searched, using the terms: “psychiatric rehabilitation and nursing and epilepsy”; “Psychiatric rehabilitation and nursing and epilepsy”; “Psychiatric rehabilitation and nursing and epilepsy”.
Results and discussion: sample consisted of 7 articles. Patients supported by a specialist nurse are well informed and have a high degree of satisfaction. Nurses are well positioned to work with patients' strengths in relation to self-efficacy and potentially resilient coping.
Conclusion: Clinical observation, interventions and nursing care help people with epilepsy as well as supporting and guiding their caregivers, being essential in the psychosocial rehabilitation process, health education and encouraging self-care with innovative and individualized interventions, promoting people's autonomy with epilepsy. We consider it important to promote studies and rehabilitation programs aimed at people with epilepsy, especially those who have associated mental disorder in view of their psychosocial organization in the simultaneous experience of two chronic diseases.
Keywords: psychiatric rehabilitation, nursing, epilepsy, mental health
Introduction
Over the years, mental disorders have been discretely associated with epilepsy. However, this association may have a high magnitude related to the health needs of these people, as well as in the activities of the teams and the management of health services.
During the evolution of humanity, the person with epilepsy suffered and suffers from stigmas and fears and it is necessary, in this pandemic related to covid-19 (new coronavirus), to redefine the meaning of life of these people and their caregivers. Thus, psychosocial rehabilitation and differentiated care become essential for patients with epilepsy.
Objective
Conduct a integrative literature review on the psychosocial rehabilitation of people with mental disorders associated with epilepsy.
Methods
It is a integrative review of the literature carried out in BVS, LILACS, PAHO, BDENF, Pubmed and Medline databases and virtual libraries, accessed in February 2021. In its construction, the terms “psychiatric rehabilitation and nursing” were used. and epilepsy ”; “Psychiatric rehabilitation and nursing and epilepsy”; “Psychiatric rehabilitation and nursing and epilepsy”. The keywords for the research were identified from Mesh Terms (Medical Subject Headings) and Decs (Health Sciences Descriptors). Full and free articles were included as a type of document in indexed journals, considering the languages Portuguese, English and Spanish.
Integrative literature review is a specific review method to provide a comprehensive and relevant view on a given topic that is useful for practice and / or research.1
The elaboration of the research question was based on the PICO strategy, in which "P" refers to the study population (people with mental disorders and epilepsy); “I” to the studied intervention or to the variable of interest (psychosocial rehabilitation); “C” when compared to another intervention (however it was not the objective of this study) or the absence of the variable of interest (psychosocial rehabilitation); “O” refers to the outcome of interest (psychosocial rehabilitation).2
The PICO method allows information to be properly interpreted so that objective and effective strategies for approaching the problem can be outlined.3
Thus, the guiding question for this integrative review was: "What aspects are related to psychosocial rehabilitation of people with mental disorders and epilepsy?"
The articles found in the databases were read in full and the selected articles make up the sample for this work. The data found were treated and analyzed based on the guiding question and the results organized in a table to facilitate the analysis of the theme addressed.
Results and discussion
No articles published in the BVS, LILACS, PAHO and BDENF were found. In Pubmed there were 11 publications, of which 4 were full articles and MEDLINE included 31 publications, 12 of which were complete articles.
After reading the articles, the sample for this review consisted of 7 articles, with 5 articles from the Medline database and 2 from Pubmed.
In a study carried out in Uganda, the needs considered most important were: crisis control, management of behavioral and psychiatric difficulties, nursing, nutritional care and later, physical and cognitive rehabilitation.4
Evidence from controlled clinical trials suggests that patients supported by a specialist nurse are well informed and have a high degree of satisfaction, according to the British study.5 Epilepsy and its interface with mental disorders is present in the health services of the mental health care network, both in emergencies, community services and even long psychiatric hospitalizations.
The development of a scale in the United States called the Life Changes Scale in Epilepsy (LCES) has started. Once psychometrically tested, it can serve as a valuable tool for advanced practice nurses who care for adults with epilepsy in hospital, outpatient and community settings. LCES can allow a brief assessment of the ways in which patients' lives have been affected by epilepsy, thus allowing nurses to develop nursing interventions specifically targeted at these patients.6
A study carried out with people hospitalized for epilepsy and stroke, showed that clay therapy had a positive impact on the levels of hopelessness of neurological patients for the purposes of rehabilitation, both in the hospital and at home after discharge.7
Nurses are well positioned to work with patients' strengths in relation to self-efficacy and potentially resilient coping.8
The most common health problems reported / observed were: behavioral (46.1%), followed by psychosocial problems (23.0%), physiological problems (20.6%) and environmental problems (10.3%). The health problems of patients with epilepsy, during the preparatory phase of the transition process from pediatric to adulthood, were also emphasized. They state that the identification of health problems through the Omaha System can improve the management of adolescents with epilepsy, including prevention, nursing care, social support and therapeutic interventions.9
Coleman et al.10 propose a model for constructing post-surgical meaning, evident in the narratives of patients undergoing anterior temporal lobotomy (ATL), providing a new perspective on long-term psychosocial results. This model contributes to our understanding of the patient's well-being and quality of life, by recognizing the active role that patients play in creating their own sense of normality after epilepsy surgery.
Conclusion
Nurses are professionals who must be prepared to work with people with epilepsy, their family members and the health team, developing actions at different levels of health care.
Clinical observation and nursing interventions and care to help people with epilepsy as well as supporting and guiding their caregivers go through various perspectives, being fundamental in the psychosocial rehabilitation process, health education and encouraging self-care with innovative and individualized interventions , promoting autonomy for people with epilepsy.
We consider it important to promote studies and rehabilitation programs aimed at people with epilepsy, especially those who have associated mental disorder in view of their psychosocial organization in the simultaneous experience of two chronic diseases.
Acknowledgments
None.
Conflicts of interest
There is no conflict of interest.
References
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- Miller WR, Bakas T, Weaver MT, et al. The life changes in epilepsy scale: development and establishment of content and face validity. Clin Nurse Spec. 2015;29(2):95–99.
- Akhan LU, Kurtuncu M, Celik S. The effect of art therapy with clay on hopelessness levels among neurology patients. Rehabil Nurs. 2017;42(1):39–45.
- Edward K-L, Cook M, Stephenson J, et al. The impact of brief lifestyle self-management education for the control of seizures. Br J Nurs. 2019;28(6):348–354.
- Cui C, Li Shuang-Zi, Zheng Xian-Lan, et al. Health Assessment of chinese adolescents with epilepsy in the preparatory phase of transition process from pediatric to adulthood:a single-center study using the omaha system. J Pediatr Nurs. 2019;49:e2-e7.
- Coleman H, McIntosh A, Wilson SJ. A patient-centered approach to understanding long-term psychosocial adjustment and meaning-making, 15 to 20 years after epilepsy surgery. Epilepsy Behav. 2020;102:106.
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