Crenças e atitudes sobre epilepsia infantil adaptação transcultural do instrumento the epilepsy beliefs and attitudes scale
Zanni, Karina Piccin
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The childhood epilepsy is a chronic neurological disorder, most common in childhood, associated with profound psychosocial limitations in daily life in epileptic children. These limitations may be related to the characteristics of the disease as the age of onset, severity and type of epilepsy and the lack of information that is still as one of the factors that most contribute to the stigma and discrimination. The association between the variables of epilepsy and the presence of wrong beliefs can lead to decreased academic performance and the presence of problems of psychosocial adjustment. This study aimed to identify and compare beliefs about epilepsy in parents and teachers of epileptic children and to verify the insertion of these children in regular schools and special. To achieve the purposes of this research were carried out two studies: Study 1 aimed to complete the process of transcultural adaptation of the instrument The Epilepsy Beliefs and Attitudes Scale (EBAS) - Adult Version and submit a version in Portuguese for use in Brazil and Study 2 aimed to investigate the number of epileptic children who attended regular schools and special cities involved in the research, compare the school attendance among children with epilepsy and children with typical development or other chronic diseases, identifying variables of epilepsy related to type of school that children attend, in addition to compare the beliefs of parents and teachers of children with epilepsy. Participated in Study 1, 17 toplevel professionals who have made the conceptual, of items, operational and semantics equivalence, and 545 adults who answered the Brazilian version of EBAS - Adult Version whose answers were considered to analyze the psychometric characteristics of the instrument including Alpha Cronbach's, factor analysis and test-retest reliability. The results showed that the concepts learned by the instrument were considered relevant to our culture and its items as appropriate to their ability to represent these concepts in the target population, and provide good semantic equivalence between the final version in Portuguese and original. The index of consistency for the overall scale was 0.89, the factorial analysis confirmed the original structure with three subscales (neurological, metaphysics and environmental/psychophysics) and test-retest showed that the instrument is reliable. Were participants of Study 2, 205 people, with 91 children aged between 7 and 14 years, 56 parents and 56 teachers, and 2 teenagers involved with the pre-test. Seven instruments were used to collect data: 1) Data sheets of identification and characterization of the family, the child and the teacher; 2) Brazil Criterion of Economic Classification 2008; 3) Classification of Engel; 4) Data sheet to record the frequency the school year; 5) Brazilian Version of EBAS - Adult Version. The data obtained by means of the instruments were analyzed descriptively and compared, using the Statistic Software Minitab - Version 12.1, using the Student t test, Mann-Whitney, chi-square and logistic regression. The results showed that children from special schools when compared to children from regular schools had severe disease and higher frequency of crises, beginning early and duration of epilepsy, and consume a greater number of medicines and make school attendance lower. Logistic regression analysis showed that age of onset and severity of illness, number of drugs used and the presence of comorbidities were related to the type of school that children attend. No differences were found statistically significant between the beliefs of parents and teachers, though both have made more inappropriate beliefs and attitudes than adequate to the epileptic child. It is concluded that this study helped to identify issues related to the processes of inclusion of children with epilepsy, identifying difficulties and limitations that interfere with the schooling of these students as well as the choice of attending school.