Page 188 - Encyclopedia of Nursing Research

ETHiCS OF RESEARCH n 155

The prevalence of active epilepsy, defined Problems most commonly found in children
as having had a seizure in the past 5 years include attention problems, anxiety, social
or taking daily antiepileptic medication, is isolation, depression, behavior problems, E
between 4.3 and 9.3 per 1,000. in approxi- and academic underachievement (Austin &
mately 70% of new cases of epilepsy, there is Dunn, 2000). Research in children suggests
no specific identified cause. in the remaining that behavior problems are already evident
30%, the risk factors for epilepsy are severe at the time of the first recognized seizure
head trauma, infection in the central nervous (Austin et al., 2001). The most common prob-
system, and stroke. in the United States, the lems found in adults with epilepsy are unem-
prevalence of epilepsy is lower in Whites ployment, depression, social isolation, and
than in non-Whites, although the reasons problems with adjustment. Unemployment
for these differences are not clear (Hauser & may be twice as high in persons with epi-
Hesdorffer, 1990). lepsy as in the general population (Hauser &
Remission of epilepsy, defined as 5 years Hesdorffer, 1990). Factors generally associ-
without seizures, is more common among ated with quality-of-life problems are severe
persons with generalized seizures, those and frequent seizures, presence of comor-
with no neurological deficits, and those with bidities, cognitive deficits, negative attitudes
a younger age of onset. Approximately 70% toward having epilepsy, and lack of a sup-
of persons with epilepsy can be expected to portive family environment.
enter remission (Hauser & Hesdorffer, 1990). Research to provide an evidence base
The major treatment of epilepsy is anti- for care of persons with epilepsy is grow-
epileptic medication. Most epilepsy is well ing. However, studies are still needed (a) to
controlled with such treatment, but approxi- understand the factors that lead to quality-
mately 20% of persons continue to experience of-life problems, (b) to test nursing interven-
seizures despite treatment with medications. tions that prevent or reduce quality of life
When partial seizures originate from a well- problems, and (c) to test self-management
defined focus in an area of the brain that interventions for adults as well as children
could be excised without serious neurolog- with epilepsy and their families. Diiorio
ical deficits, surgery to remove the affected et al. (2009) have developed and pilot tested
part of the brain is an option. Other treat- an innovative Web-based, self-management
ments for epilepsy have been tried with some intervention for adults with epilepsy. Nurses
success. The ketogenic diet, which consists of should play a major role in developing
food high in fat and low in carbohydrates, knowledge to guide nursing practice in with
has been used since the 1920s. Recently, there persons with epilepsy.
has been increased interest in the ketogenic
diet as a treatment. Another recent treatment Joan K. Austin
is the vagus nerve stimulator, which sends
electrical energy to the brain via the vagus
nerve (Epilepsy Foundation, n.d.).
Most nursing research has been devoted Ethics of rEsEarch
to the impact of epilepsy on the quality of
life. Some persons have severe quality-of-life
problems that prevent them from engaging Over the years, violation of human rights
in fully productive lives. The exact preva- along with advances in science and technol-
lence of these problems is difficult to estab- ogy has led to important codes of conduct,
lish because most studies have been carried policy statements, and ethical guidelines
out on clinic samples, that is, on persons with that influence the ethics of research. Outside
seizures that are more difficult to control. of nursing, important past codes of conduct