Introduction
Epilepsy is a common paroxysmal and chronic seizure disorder affecting children as well as adults which is associated with misconceptions, myths, burden and social stigma.1 Studies done in various groups of population in many countries all over the world, especially in developing countries have uniformly stressed the need for improvement in Knowledge, Attitude and Practice (KAP) regarding epilepsy.2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14 KAP regarding epilepsy is expected to vary depending upon regional variations in awareness, understanding and cultural beliefs. Earlier many studies regarding KAP related to epilepsy are done in different segments of society like school teachers, higher school children, pharmacy students, dental students, health staff and general population. However only few studies are present amongst medical students.15, 9, 16, 17, 10, 18, 12, 13, 14, 19 Undergraduate medical students frequently come across epilepsy patient during their clinical postings in hospital. They may also come across such cases during their casualty postings. They may be first medical person to attend these cases and communicate with relatives. It is expected that they should have basic knowledge about nature of the disease, primary care to be given and answer queries of the relatives. Such type of study has not been conducted in our area. Hence to know KAP regarding epilepsy in final year M.B.B.S. medical students, this study was conducted. If medical students, who are expected as future competent physicians; when adequately oriented to this important medical problem, will be able to handle epilepsy cases and their relatives in a better way. Their expectations regarding improvement of KAP about epilepsy are also considered. Corrective measures in this regard may help them in better understanding of epilepsy disorder.
Materials and Methods
Study population
102 M.B.B.S. part II final year (9th semester) students from Dr. D.Y. Patil Medical College, Kolhapur, Maharashtra state, India.
Operational definitions
Scientific facts were assessed in knowledge area. Personal views of the participant towards epilepsy were assessed under attitude area. Minimum skills required in initial management of epilepsy case were assessed under practice area.
Sampling procedure
All the students at present studying in 9th semester, willing to participate in the study voluntarily were included in the study.
Sample size
Out of 150 students currently enrolled in 9th semester, willing students and students present on scheduled day; 102 students were enrolled for study after their verbal consent. Equal number of boys and girls participated in study.
Data collection
It was self administered questionnaire based data collection. Questionnaire had 34 questions related to information about knowledge (14), attitude (10) and practice (10) about epilepsy. A pre validated questionnaire used in earlier studies was used. 2, 7, 15, 9, 11 A scoring system was devised to quantify the knowledge and practices of students.
Results
Table 1
Overall correct answers in knowledge domain were 51%. Majority of the students have read or heard about epilepsy (76%). They were correct in answering about nature of the disease, age of occurrence, familial occurrence, and abnormality in electrical discharges. However, they were not able to answer about clinical presentation and treatment part of epilepsy. 87% students considered epilepsy as infectious and contagious, 80% considered it as disorder that can’t be controlled and cured and 61% thought that children with epilepsy require special class placement.Table 1
Table 2
Majority of students showed positive attitude in attitude domain regarding children with epilepsy (69%). However, 92% students answered that children with epilepsy should not work.Table 2
Table 3
58% students answered correctly to the questions asked in Practice regarding epilepsy domain. More than half 52% students were not involved anytime in first aid seizure management. However, 50-75 % students had fair theoretical information regarding management of acute seizure epidode.Table 3
Table 4
25% students answered that they didn’t receive training or orientation to epilepsy or management of epilepsy. 88-92% students suggested to include epilepsy topic in undergraduate syllabus and need to post final year students in emergency department in evening hours after completing their routine schedule.Table 4
Discussion
Epilepsy is a common paroxysmal and chronic seizure disorder affecting children as well as adults which is associated with misconceptions, myths and social stigma. These misconceptions, myths and social stigma lead to negative attitude towards epilepsy. Knowledge, Attitude and Practice towards medical problem of epilepsy has been studied at many places all over the world. There are regional variations depending upon level of literacy, cultural beliefs and practices. It has been studied amongst different segments of society like epilepsy patients, their family members, general population, school teachers, high school students, medical and paramedical students. Majority of the studies have observed inadequate KAP in study population. 2, 3, 4, 5, 8, 9, 16, 17, 11, 12, 13 These studies have underlined need to make positive efforts to improve KAP towards epilepsy. There are only few studies done in medical students of this part of country. These students are directly or indirectly involved in management and counseling of epilepsy patients during their clinical posting as well as in emergency department posting. Sometimes they may be the first person to interact with relatives of the epilepsy patient. Hence it is expected from then to have adequate knowledge, attitude and practice towards epilepsy. 16, 17, 12, 13, 14
This study endorses the inadequacy in KAP regarding epilepsy in medical students which is observed in other studies done in India and outside. Overall correct answers in knowledge domain were 51%. Majority of the students have read or heard about epilepsy (76%). They answered about nature of the disease, age of occurrence, familial occurrence, and abnormality in electrical discharges correctly. They were not having correct concepts about clinical presentation and treatment part of epilepsy. Surprisingly 87% students considered epilepsy as infectious and contagious, 80% considered it as disorder that can’t be controlled and cured and 61% thought that children with epilepsy require special class placement. Their knowledge domain needs to be strengthened. Our observation matches with similar observations found in studies done elsewhere. 2, 4, 5, 9, 17, 10, 12, 20
Students did better in attitude domain. Majority of students showed positive attitude in attitude domain regarding children with epilepsy (69%). Surprisingly 92% students answered that children with epilepsy should not work. Probably they were confused between high risk work and relatively safe work.
Students were just above adequacy in practice domain. 58% students answered correctly to the questions asked in Practice regarding epilepsy management domain. More than half, 52% students were not involved anytime in first aid seizure management. Probably that was the reason why they didn’t answer confidently to questions related to management of acute seizure attack. However, 50-75 % students had fair theoretical information regarding management of acute seizure episode. Similar observations were noted in other studies done in India and other countries. 4
We asked students regarding possible interventions regarding improvement in KAP regarding. 25% students reported that they didn’t receive training or orientation to epilepsy or management of epilepsy.88-92% students expressed to include epilepsy topic should be included in undergraduate syllabus and need to post final year students in emergency department in evening hours after completing their routine schedule to be more familiar with KAP regarding epilepsy and management of acute episode of seizures. As undergraduate medical curriculum is switching over to competency-based curriculum, it will be worth to consider their suggestions to address KAP regarding epilepsy in better way. Similar suggestions are made in similar other studies. 2, 4, 15, 16, 17, 10, 18, 21, 22, 12, 13, 14, 23, 24, 19, 20
Conclusions
Knowledge, Attitude and Practices of final year medical students showed 51% and 58% adequacy in knowledge and practice domain regarding epilepsy. They did better in attitude domain. There is need for adopting various teaching and learning methods for updating and improving their KAP regarding epilepsy.
Article DOI
