The Care of Adult Patients with Newly Diagnosed Epilepsy - Essay Example

Research Proposal The care of adult patients with newly diagnosed epilepsy, a new seizure clinic Introduction General Overview Epilepsy has been a major health problem in most countries around the world. On the other hand, despite the efforts made for the limitation of the disease’s symptoms there have been no particular progress in the disease’s treatment. For this reason, the development of new health care units specifically for epilepsy is welcomed by the local communities. However, in most cases the measures taken and the standards set are not the appropriate ones. This usually happens because the whole procedure lacks of the appropriate preparation while in many cases there is no specific provision made for possible pitfalls of the treatment methods applied to patients. In the above context, the identification and the analysis of the requirements related with a new seizure clinic specifically involved in the treatment of epilepsy have been considered to be issues of significant advantage for patients around the world. The design and the development of such a clinic could help patients worldwide to improve their health on a daily basis by limiting the consequences and the symptoms of the disease. It should be noticed that the research on the particular issue (appearance and development of epilepsy) has been extensive and quite long. However, no particular improvement, on the health of patients suffering from the specific disease, has been noticed. It is perhaps the people involved do not comply with the rules set by the medical community or even they do not accept the significance of the disease for their health. In many cases, because of the usually short duration of the disease’s symptoms, persons suffered tend to deny their problem avoiding proceeding to the necessary treatment. Regarding this issue, the establishment of a new seizure clinic could lead to the increase of the volume and the quality of consultancy offered to patients but only in terms that the suggested measures are taken by patients and the proposed treatment is followed strictly. The ‘innovative characteristic’ of this clinic would be its target (limited to the treatment of the particular disease) and the quality of services provided to patients. Context of the study Current study will be involved specifically with the establishment of a new seizure clinic for people suffering from epilepsy. For this reason, all issues related with this disease’s appearance and the development (both from medical and from sociological perspective) are going to be examined thoroughly. Any potential negative influence will be also highlighted in order to avoid the establishment of private institutions without a specific qualification for the specific project. It should also be noticed that apart from the most ‘usual’ areas of study, current research avoids the implementation of extremely difficult rules that will be not applied by the patient. The importance in the procedure is the decision of the patient who seems to be influenced by the promotions made by people that have no particular licence agreement. In this cases, the experience of the writer and the feedback of the customer are going to be examined carefully trying to avoid any negative influence. Research questions Generally, it could be noticed that current research focuses on the following questions: a) which is the current standard of support provided to patients with epilepsy? b) Are there any treatment methods that could be characterized as significant regarding the limitation of the disease’s development? c) Which is the position of the state? Which are the specific provisions for the people suffering from epilepsy? d) Are there any prospects for the improvement of treatment provided to patients with epilepsy in the future? e) Which could be specifically the contribution of a new seizure clinic to the limitation of the disease’s expansion? f) are there any potential pitfalls in the methods used by the medical staff for the limitation of the disease’s treatment and g) would be there any chances for a clinic operating in the relevant area to survive? Which were the consequences of its owners’ decision to establish the particular firm? All these issues are going to be developed throughout the paper using as a basis the fact that there could be no satisfactory treatment of the disease until the world change. In its current format, treatments applied for the limitation of the disease’s results could be considered as quite effective – taking into account the expansion of the disease and the lack of appropriate support by the relevant administrative authorities. Research limitations It should be noticed that generally the conduction of a research related with the progress of a particular disease is a challenging task. For this reason all people involved in the research should be particularly careful in order to avoid putting their health in risk. On the other hand, the communication between the patient and the doctor has been a particularly challenging task mostly because in most cases patient does not recognizes the significance of his/ her problem and avoids using the suggested treatment, a decision that lead soon to the increase of the number and the quality of services provided for the treatment of this disease in many areas around the world. Towards this direction, obtaining data for the particular study has been proved to be a challenging task. In fact because of the relation of the disease with the person’s productivity, any comment on the symptoms appeared to people around the world is usually an issue not discussed. However, medical science has made significant progress towards the treatment of the disease but mainly in the long term. Literature Review The treatment of epilepsy presents many differentiations in accordance with the needs of the particular patient but mostly in accordance with the competencies of the medical staff involved. Towards this direction, the study of Chadwick (2006, 58) showed that “decisions about when to start or to stop antiepileptic drug (AED) treatment must be informed by reliable information of the natural history of epilepsy, the effect of treatment, and the social context of the individual; ultimately the patient will be the decision maker, the clinician or health-care professional, the provider and interpreter of information”. In other words, the role of the patient in the success of the treatment proposed in significant. However, it is necessary that all the appropriate measures are being taken in order for the suggested treatment to be in accordance with the condition of the particular patient avoiding the application of common treatment strategies among all patients in a specific healthcare unit. The influence of the patient’s position in a particular society in the treatment applied to him/ her proves that still there are differentiations when addressing the health problems of people belonging to specific social classes. Towards this direction, it has been supported by Chadwick (2006, 58) that “the most reliable information on the effect of intervention will come from randomised controlled trials in relevant populations of patients”. In other words, the treatment provided to patients with epilepsy will be differentiated among people belonging in different social classes presenting a relevant disadvantage of the people with lower financial ‘strength’. Another issue that would be examined here is the fact that epilepsy has been a disease with a relatively recent ‘history’. Referring to the case of USA as an example, Austin et al. (2006, 386) notice that “epilepsy as an issue for the public health community has a relatively short history in the United States; not since the 1970s, when Congress established the Commission for the Control of Epilepsy and Its Consequences and the publication of its formal report, "Plan for Nationwide Action on Epilepsy," has significant attention been paid to the public health implications of epilepsy”. This delay in the identification of the disease’s characteristics should be considered as a disadvantage compared to other diseases that have been extensively examined and analyzed in the medical community. It is noticeable that the study of Austin et al. (2006, 386) led to the conclusion that “until the U.S. Congress established a small epilepsy program at the Centers for Disease Control and Prevention (CDC) 12 years ago, the condition was practically invisible at all levels of organized public health”. However, epilepsy has been a disease with a long history in terms of the appearance of its symptoms. It seems that in the past the symptoms of this disease were related with other diseases and this could be the reason for the delay in the identification of the particular disease as a common one within the international community. An issue that should be mentioned here is the fact that epilepsy can present many forms in accordance with its causal reasons, the physical ‘strength’ of the individuals involved and its development through the time. There are cases where the development of epilepsy is slower even if the initial symptoms were more severe while in other cases symptoms can be developed rapidly even if initially a ‘non-aggressive’ type of epilepsy was diagnosed. Moreover, epilepsy has been proved to influence several parts of a person’s daily activities. In the case of women, the disease can have an ‘independent’ behaviour (in terms of its characteristics as they have been described through the scientific research in the relevant field). More specifically, in women, “pregnancy and delivery are obvious issues, fertility problems are more often encountered and they also seem to have a higher frequency of sexual problems while a large number of women with epilepsy experience seizure exacerbation in relation to the menstrual cycle and have higher frequencies of menstrual disturbances and polycystic ovaries; also, cosmetic problems affecting skin, hair or weight may also be drug induced” (Roste, 2007, 289). Because of the different development of the disease in women it is necessary that the treatment proposed will be appropriately ‘adapted’ to the needs of the particular case as they are evaluated through the relevant exams. Indicatively, the use of drugs should be ‘customized’ in the needs of each particular woman. Regarding this issue it has been found that “the use of antiepileptic drugs may influence the effect of contraceptives leading to unplanned pregnancies and contraceptives may affect the serum levels of antiepileptic drugs; however, the care of pregnant women with epilepsy requires attention to a number of guidelines and close cooperation between neurologist and gynecologist is recommended” (Roste, 2007, 289). In accordance with the above the treatment of epilepsy cannot be generated for all parts of population. It has to be decided on the needs of each particular patient taking into account the fact that the application of an inappropriate treatment can lead to severe health problems. Therefore, it is necessary for the medical staff involved to be particularly careful when examining patients with epilepsy. The identification of the disease is a major challenge for doctors. Its appropriate treatment could be regarded as an equally challenging task. Regarding the differences in the treatment of epilepsy between men and women it has been supported by Sare et al. (2007, 4) that “the incidence of epilepsy is the same in men and women yet more time and energy has been expended on "womens issues" in recent times”. The above assumption is based on a relevant survey of the British Epilepsy Association in 2004 which “conducted a nationwide survey of men with epilepsy (MWE), who had contacted their helpline in the previous year; the men were comfortable discussing their epilepsy and confident in asking for information while a majority felt the condition adversely affected their self-esteem and quality of life however most men expressed satisfaction with the quality of care and information they got from their general practitioners and their neurologist” (Sare et al., 2007, 4). To a similar point of view, the study of Freidl et al. (2007, 123) in which the attitude of 101 in and out patients with epilepsy examined, showed that “Nearly 60% of all 101 patients believe that "most people" would not allow a mental patient "to take care of their children", "most young women" would be "reluctant to date a man" who has been treated for a mental illness and "most employers would pass over" the application of a psychiatric patient in favour of another applicant while fifty five percent of the respondents assume that "most people think less of a person who has been in a mental hospital"”. It was also revealed that “gender, age and education had no influence on the overall results” (Freidl et al., 2007, 123) The evaluation of the above results could follow two different directions. In accordance with the first, more expected assumption, epilepsy is not considered to be a severe disease mostly because of the short duration of its symptoms. For this reason, it is not considered to be a major risk for health but it is rather regarded as a common disease which can be controlled if applying the appropriate treatment. However, under a different assumption, it could be stated that population is not appropriately informed on epilepsy and its risks. In this case, the responsibility belongs not only to the medical staff but mainly in the state which do not take the appropriate measures for the provision to the public of the necessary information regarding the diagnosis and the treatment of the particular disease. Methodology Current paper, as already mentioned above is going to examine the issue of effectiveness of new seizure clinic for adult patients with newly diagnosed epilepsy. In order to retrieve the necessary data for the evaluation of the role of the above clinic in the limitation of the disease among adults, we could use a combination of qualitative and quantitative data trying to limit the research on the part of the population involved or, alternatively, to address the relevant questions to people that have a knowledge of the disease’s symptoms, its treatment and its development through the time. In this context, the most appropriate methods for the examination of the issue under investigation would be the review of the literature revealed in the specific medical field and the use of a survey that will be developed accordingly. The combination of the theoretical views with the empirical data will offer the appropriate base for the formulation of a credible assumption regarding the potential value of a new seizure clinic in the limitation of the symptoms of the specific disease among adults. Research Paradigm 1. Qualitative Study As already stated above current paper will be based mainly on the views stated in the literature by the medical researchers (including possible experiments made in this field) while a series of data revealed through an appropriately structured survey will be also used for the evaluation of the disease’s structure, development and treatment. In its ‘qualitative’ aspect, current research will follow the method of ‘comparative analysis’ through the presentation of the views of the researchers in the particular issue and the comparisons of these views taking into account the conditions to which each researcher referred when conducting the relevant study. 2. Quantitative Study From another point of view, this of the empirical research, the subject examined in the particular study will be evaluated through the use of the following hypothesis: “The use of a new seizure clinic can be considered to be the appropriate solution for the limitation of the symptoms of epilepsy in the case of adult patients with newly diagnosed epilepsy”. The above hypothesis could be examined through the use of an appropriately structured survey taking into account that the issues stated by each participant would be related with his/ her personal experiences either as a patient or as a medical staff involved in the treatment of the particular disease. Method The empirical research of the issue under examination (as already presented above) will be based on the use of a questionnaire distributed among patients of a particular healthcare unit (preferable one with a high volume of similar cases). The views of the patients, as included in the questionnaire, will be then analyzed and evaluated using a common method of data analysis (possibly regression analysis). The statistical data revealed through the above research are going then to be compared with the results of other studies on the particular field in order to reveal any possible differentiations among specific parts of the population or to identify the influence of particular social or genetic characteristics to the development of the disease and its treatment. Discussion The identification of epilepsy as a disease can be proved a particular difficult task especially when its symptoms are not clear. On the other hand, the use of medical supplements in the disease’s limitation may fail especially at a primary stage because the respond of each person to a specific treatment suggested can be different. Regarding this issue, the study of Rytter et al. (2007) which referred to a study made among the residents of 1053 nursing homes, led to the conclusion that “: 116 of the 1053 residents (11%) used antiepileptic drugs; 83 of the 116 (72%) due to epilepsy. 17 residents used antiepileptic drugs against pain, and 14 as psychotropic drugs. 92 residents (79%) were using antiepileptic drugs on a regular basis; 77 used one antiepileptic drug, 14 residents used two such drugs and one resident used four antiepileptic drugs” (Rytter et al., 2007, 1185, see also Kawai, 2007, 299). In accordance with this study, the responsiveness of the patients in the treatment suggested can be differentiated in accordance with the personal attitudes and the pressures of the social environment. For this reason, the treatment of epilepsy cannot follow specific standards but should rather be ‘adapted’ on the needs and the potentials of each particular patient taking into account the conditions of his daily activities and his/ her ability to respond to the needs of a suggested treatment. References Austin, J., Carr, D., Hermann, B. (2006) Living Well: a review of progress since 2003. Epilepsy Behaviour, 9(3): 386-393 Chadwick, D. (2006) Starting and stopping treatment for seizures and epilepsy. Epilepsia, 47(1): 58-61 Freidl, M, Spitzl, S. Prause, W. (2007) The stigma of mental illness: Anticipation and attitudes among patients with epileptic, dissociative or somatoform pain disorder, 19(2): 123-129 Kawai, K. (2007) Less invasive treatment of intreactable epilepsy – vagus nerve stimulation and stereotactic radiosurgery. Brain Nerve, 59(4): 299-311 Roste, L., Tauboll, E. (2007) Women and epilepsy: review and practical recommendations. Expert Review of Neurotherapy, 7(3): 289-300 Rytter, E., Nakken, K. (2007) Use of antiepileptic drugs in nursing home residents. Tidsskr Nor Laegeforen, 3(127): 1185-1187 Read More