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Fulltext The needs and problems in epilepsy caregiving: a qualitative exploration

Lua, Pei Lin, Nor Khaira Wahida Khairuzzaman, Zariah Abdul Aziz, Foo, Jimmy Lee Kok

ASEAN Journal of Psychiatry, 2015;16(1):116-126.
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Objective: Living with epilepsy imposes great challenges on both patients and their family caregivers but most researchers only explored the impact on patients, with less attention given to family caregivers. Our study intended to explore the needs and problems of epilepsy family caregivers of epilepsy patients encountered during the caregiving process. Methods: Respondents were recruited from the Neurology Clinic of Hospital Sultanah Nur Zahirah (HSNZ), Kuala Terengganu. A semi-structured interview was conducted using openended and broad questions asking about their general experience in caregiving, daily routine activities, caregiving effects, caregiving difficulties and caregivers’ needs. The interviewed data were later transcribed into verbatim before further analysis using the QSR International’s NVivo10 software. Results: Fifteen Malay Muslim family caregivers between the age of 19 and 66 years participated. Most were females (53%), married (67%), with education level at secondary school or equivalent (73%) and were homemakers (40%). In particular, respondents expressed the need for extra support from their family members and experts in terms of physical (care relief), mental, and financial aspects. In addition, the major caregiving problems identified included: (i) emotional disturbances (sad, angry, depressed, and anxious); (ii) care giving challenges (family adjustments, physical burden, psychological burden, and time management); and (iii) financial issues (not working and limited family income). Some advantages in caregiving were also reported. Conclusion: In conclusion, their experiences while taking care of their loved ones in terms of feelings, beliefs and needs exposed the difficulties in caregiving, causing substantial emotional pressure which could later lead to poor quality of caregiving. ASEAN Journal of Psychiatry, Vol. 16 (1): Januray – June 2015: XX XX.

Study site: Neurology Clinic of Hospital Sultanah Nur Zahirah (HSNZ), Kuala Terengganu.
Oral diosmectite reduces stool output and diarrhea duration in children with acute watery diarrhea

Dupont C, Foo JL, Garnier P, Moore N, Mathiex-Fortunet H, Salazar-Lindo E, et al.

Clin Gastroenterol Hepatol, 2009 Apr;7(4):456-62.
PMID: 19268266 DOI: 10.1016/j.cgh.2008.12.007

Diosmectite is a clay used to treat children with acute watery diarrhea. However, its effects on stool output reduction, the key outcome for pediatric antidiarrheal drugs, have not been shown.
Two-hourly versus 3-hourly feeding for very low birthweight infants: a randomised controlled trial

Ibrahim NR, Kheng TH, Nasir A, Ramli N, Foo JLK, Syed Alwi SH, et al.

Arch. Dis. Child. Fetal Neonatal Ed., 2017 May;102(3):F225-F229.
PMID: 27671836 DOI: 10.1136/archdischild-2015-310246

OBJECTIVE: To determine whether feeding with 2-hourly or 3-hourly feeding interval reduces the time to achieve full enteral feeding and to compare their outcome in very low birthweight preterm infants.
DESIGN: Parallel-group randomised controlled trial with a 1:1 allocation ratio.
SETTING: Two regional tertiary neonatal intensive care units.
PATIENTS: 150 preterm infants less than 35 weeks gestation with birth weight between 1.0 and 1.5 kg were recruited.
INTERVENTIONS: Infants were enrolled to either 2-hourly or 3-hourly interval feeding after randomisation. Blinding was not possible due to the nature of the intervention.
MAIN OUTCOME MEASURES: The primary outcome was time to achieve full enteral feeding (≥100 mL/kg/day). Secondary outcomes include time to regain birth weight, episode of feeding intolerance, peak serum bilirubin levels, duration of phototherapy, episode of necrotising enterocolitis, nosocomial sepsis and gastro-oesophageal reflux.
RESULTS: 72 infants were available for primary outcome analysis in each group as three were excluded due to death-three deaths in each group. The mean time to full enteral feeding was 11.3 days in the 3-hourly group and 10.2 days in the 2-hourly group (mean difference 1.1 days; 95% CI -0.4 to 2.5; p=0.14). The mean time to regain birth weight was shorter in 3-hourly group (12.9 vs 14.8 days, p=0.04). Other subgroup analyses did not reveal additional significant results. No difference in adverse events was found between the groups.
CONCLUSION: 3-hourly feeding was comparable with 2-hourly feeding to achieve full enteral feeding without any evidence of increased adverse events.
TRIAL REGISTRATION NUMBER: ACTRN12611000676910, pre-result.

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