ATTITUDE OF PEOPLE TOWARDS EPILEPSY AND IT'S EFFECT ON SOCIETY

ATTITUDE OF PEOPLE TOWARDS EPILEPSY AND IT’S EFFECT ON SOCIETY

ABSTRACT

Introduction – The reaction to epilepsy is shaped by traditional indigenous beliefs. Therefore this study assessed the societal attitude and social support towards people living with Epilepsy in Ogbomoso. Methodology- The study adopted cross sectional descriptive design using 410 respondents selected through multistage sampling technique. Information was collected from the respondents using standardized instrument of Interviewer Administered Questionnaire (IAQ), Attitudinal Scale and Social Support Scale. Data were analysed using descriptive and inferential statistics at 0.05 level of significance. Results – In terms of attitude, 273 (68%) of respondents strongly agreed that PWE would be a burden to the family, 251 (62%) expressed fear during seizures, 215 (53.8%) were of the opinion that PWE should not get manned: 258 (64.5%) would not definitely help someone with seizure,258 (64.5%) would not stay in the room with person with epilepsy. There was a significant association between respondent area of residence and their attitude (X2  = 16.320, P =0.012).  Conclusion  –  It  was  concluded  that  there  was  a  misconception  about epilepsy resulting in negative attitude and poor social support towards People Living with Epilepsy.

CHAPTER ONE

INTRODUCTION

1.1     Background of the Study

Epilepsy is the most common non-infectious neurologic disease in African Countries, including Nigeria (Attotey & Reidpath 2007) and it remains a major medical and social problem (Bagley, 2007). Historically, epilepsy was believed to be a sacred disease, i.e, the result of the invasion of the body by a god. It was thought that only a god could deprive a healthy man of his senses, throw him to ground, convulse him and then rapidly restore him to his former self again  (Reynolds, 1988). The word ‘lunatic’ was first applied to sufferers of epilepsy as gods were thought to occupy heavenly spheres, one of which was the moon. In contrast, mad people were referred to as “maniacs” whose madness was a result of invasion of the body by devils or evil spirits (Osuntokun, 1978). In the Gospel according to Saint Mark Chapter 4, it was a foul spirit that was cast out of the young man with fits. The “Dictator Perpetuus” of the Roman Empire, the great Julius Caesar likely had epilepsy on the basis of documented four attacks that were probably complex partial seizures. Also, it is possible that he had attacks as a child and as a teenager. His son, Caesarion, and his great-great-great grand nephews Caligula and Britannicus also had seizures. The etiology of epilepsy in this Julio-Claudia family is probably linked to inheritance (Hughes, 2010). This historical legacy has continued to influence public attitude to epilepsy making it a dreaded disease. These believes have resulted in patients with epilepsy (PWE) being ostracized, stigmatized and misunderstood. The social implications are serious.

For instance, in Madagascar, Patients with epilepsy are refused burial in the family grave (Osuntokun, 1978). In many Africa countries, people with epilepsy are out-casts (Awaritife & Ebie, 2008) as Africans believe that the disease results from visitation of the devil, effect of witch-craft, the revenge of an aggrieved ancestral spirit or consumption of something harmful in utero (Mkadir, 2009). Suicide or attempted suicide is not uncommon among Nigerians who suffer from epilepsy. The patient with epilepsy is likely to dropout of school, lose his job, find it impossible to marry, lose his wife or her husband, and be tormented to the extent of becoming a Vagrant Vagabond (Awaritife & Ebie, 20008). Given this background, there is a good reason for the increased concern about information on the societal attitude and social support towards people living with epilepsy.  A better understanding of societal attitudes to mental illness and its treatment is an important prerequisite to the realization of successful community based programme (Mkadir, 2009) in order for nurses in the community based health facilities to protect the rights of those living with epilepsy and to sensitively develop services that will address their needs. It is vital to gain a more accurate knowledge of the societal attitudes and social support towards individual with epilepsy across a specific region and population group. There are three common approaches used to reproduce negative attitudes in the communities. These are education, contact and protest (Corrigan, 2012) which are major roles of nurses in the communities. Nurses seek to provide facts about mental illness in order to get rid of community held myths through health education. Contact (home visitation by public health nurses) aims to provide a human face on mental illness and hopes that treatment works. Protest (advocacy) aims to hold back biased messages and challenges commonly held toward mental illness. In some situations, education and contact have been found to be an effective strategy used to reduce mental health stigma among individuals (charyton, Elliot, Lu, & Moore, 2009).

1.2       Statement of Problem

Epilepsy is one of the global health issues affecting more than 65 million people  worldwide, out of which 80% of those affected reside in developing countries (WHO, 2011) more than 50% of this figure are children below the age of 16years  (Thurman & Efy, 2011). In Nigeria, the estimated prevalence of epilepsy varies from 8 to 13 per thousand people (Kabir, Iliyasu, Abubakar & Farinyaro, 2012). Misconceptions have led to social isolation for the individual with epilepsy and in many cases, for his or her family also (Dekker, 2009). It is therefore no great surprise that the myths and prejudice that have surrounded epilepsy have resulted in the stigmatization of people with the disorder (Vercarolis, 2009). Stigma is often a daily companion and can negatively affect an individual quality of life (QOL). It is a major contributor to the burden associated with epilepsy. Reducing the stigma of epilepsy is therefore a key to reducing its impact and improving quality of life. Effective educational programme needs to be developed and implemented to reduce the stigma of epilepsy. In African countries, the disorder is enrobed in superstitions, discrimination and stigma. Persons with epilepsy are at risk of developing a variety of psychological problems including depression, anxiety and psychosis – The socio-cultural attitudes continue to have a negative impact on management of epilepsy. Religious and socio-cultural beliefs influence the nature of treatment and care received by people with epilepsy. There is need to carryout an investigation of attitude of people towards epilepsy and it’s effect on society.

1.3     Research Questions

The study answered the following questions

1.   What are the societal beliefs of the respondent regarding the causes, symptoms and treatment of epilepsy?

2.   What are the societal attitudes towards the persons living with epilepsy in urban and rural communities of Ogbomoso?

3. What are the levels of social support towards the persons living with epilepsy in urban and rural communities of Ogbomoso?

4.   What are the socio-demographic factors responsible for different societal attitudes and levels of social support towards the persons with epilepsy in urban and rural communities of Ogbomoso?

1.4     Research Objectives

The general objective of this study is to investigate attitude of people towards epilepsy and its effect on the society

The specific objectives of the study include:

i.      Determine the societal  beliefs of Ogbomoso communities  regarding the causes, symptoms and treatment of epilepsy

ii.     Assess the societal attitudes towards people living with epilepsy in Urban and Rural communities of Ogbomoso;

iii.   Determine the levels of social support towards people living with epilepsy in urban and rural communities of Ogbomoso, and

iv.    Evaluate the socio-demographic factors responsible for different societal attitude and levels of social support towards the persons with epilepsy.

1.5     Significance of the Study

Stigmatized attitude is accepted as one of the major barriers to the appropriate treatment of persons living with epilepsy. Actions to address the stigma and discrimination associated with epilepsy are being organized in the developed countries but little has been done to address the issue in Nigeria. Prior to embarking on such programme in Nigeria, the base –line attitude that will be object of change must be assessed.

This study would provide information on societal attitude and provision of social support towards person with epilepsy. This information would help in developing educational programmes which seek to reduce stigma and discrimination towards people with epilepsy.

The study might be a source of policy formulation, legislation and successful integration of mental health promotion, treatment and rehabilitation into the primary health care services in Nigeria.

1.7       Delimination of the Study

This study was delimited to individual between 18 to 64 years of age residing in urban and rural communities of Ogbomoso in Oyo State, Nigeria. It was delimited to the respondent irrespective of their religious application, educational level, employment status, socio- economic status and ethnicity.