Abstracts

Rationale: The diagnosis of epilepsy in a child is difficult for families and may be accompanied with fear, anxiety and uncertainty. Gold standard diagnostic testing for this diagnosis is video EEG, which requires multi-stage preparation and expected behaviors during the EMU admission. Along with families, team members of the paediatric neurology department identified the current education package as a potential area for improvement. More specifically, concerns regarding the complexity (length, clarity, high-level wording and lack of visual appeal) of the existing 4-page education package were noted. Much literature highlights the benefits of the EMU admission for determining diagnosis. However, a gap in literature was identified about effectively preparing patients and families for EMU admissions. We aimed to determine if a simplified, visually engaging and family focused educational packages improves family preparation and decreases anxiety prior to admission.  Methods: A quality improvement (QI) framework was implemented to design and evaluate a new education package and compare it to the existing one. Since there was no evaluation tool to assess differences in understanding, readiness and anxiety for the admission between the groups, a 17-item qualitative and quantitative survey was developed based on QI and health education literature. The first 10 items on the survey assessed agreement with statements related to readiness, understanding and anxiety; the next 7 items explored these themes qualitatively. Using sequential enrolment of patients, the first group received the original education material by mail and then completed the de novo survey once admitted. Based on feedback from the first group and resources from other programs, a modified education package was created. While the new package still incorporated core messages, it consisted of a 1-page flyer, written at a grade-6 reading level geared towards parents and teens, as well as a visually appealing and interactive presentation for younger children. The second group received this new education material by email and also completed the survey.  Results: The study took place in the second largest paediatric EMU in Ontario. A total of 18 families were surveyed over a 13-week period, consisting of 9 families in each group. Fifteen surveys were completed by parents, and three were completed together (parents and children). A comparison of quantitative survey results between the two groups showed a trend in improvement of understanding and readiness, decreased anxiety and better medication preparation in the second group. Analysis of the qualitative responses revealed that both groups felt they had received adequate information. While the first group expressed concerns regarding unclear expectations of stay and procedural understanding (i.e. medication changes); the second group expressed satisfaction with procedural understanding and clear expectations of their stay. Participants preferred receiving information in a digital format including videos, website and emails.  Conclusions: While this QI project did not employ statistical sampling, families report they were better equipped for an EMU admission using an interactive and visually appealing format. Our hope is that this type of education package will be used in other centers to increase understanding, readiness and decrease anxiety. These findings add to a body of knowledge that does not currently exist and future research should be conducted over a longer period of time with a larger population and a validated survey tool.  Funding: No funding