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Parental Concerns in Children with Febrile Convulsions
Febrile seizures (FSs) are an age-related phenomenon occurring in 2 to 4% of children younger than 5 years of age and are the most common neurological disorder in infants and young children. An FS is a terrifying event for most parents and can lead to many concerns among parents such as fear of death, fear of recurrent insomnia, crying, anorexia, and dyspepsia.   However, parental concerns in children with FS may not be fully addressed during routine clinical practice. Recently, the term psychospirituality has entered psychological and religious discourse as a loose designation for the integration of the psychology and spirituality. As a broad term, it can denote a variety of positions between psychology and spirituality: a supplementation, integration, identification, or conflation of the two fields. Herein, we present our observations about parental concerns in children with FS to attract attention to the psychospiritual status of parents in FS.
In the literature, varying data about parental concerns have been reported among parents of children with FS. Parmar et al analyzed 140 parents of consecutive children presenting with FS. Effects of FS on the parents included fear of death (90%), followed by insomnia (34.3%), anorexia (32.9%), crying (20%), and fear of epilepsy (20%). Kanemura et al noted that 41% of the parents of children with FS reported fear of death. They also found that a higher percentage of parents without prior knowledge of FS presumed that FSs were harmful compared with parents with prior knowledge of FS. Baumer et al analyzed 50 parents of children with first FS. Only three parents thought that their child was dying or dead in response to the open-ended question. A much larger proportion of parents (70%) admitted that they had thought their child was likely to die (58%) or was dying (54%) or dead (18%) in response to direct questioning. In another series, the most common fear expressed was that the child might be dead or might die from the seizure (70.9%) and fear of intellectual disability (41.9%). Fifty-two (35.9%) parents were also worried that the child might be paralyzed or might suffer from some form of physical handicap later in life. Kolahi and Tahmooreszadeh reported causes of concern among parents of children with FS as follows: the state of their child's health in the future (95%), fear of recurrence (66%), mental retardation (48%), paralysis (31%), physical disability (30%), and learning dysfunction (22%). There was fear of visual defect, hearing loss, memory loss, brain defect, delay in walking, drug adverse effects, coma, and death in 33% of the mothers who responded.
In this last series, the ratio of death concern in mothers was lower than in other series, most probably due to sociocultural differences in the societies.
In our clinical practice, aside from crying, insomnia, fear of recurrence, fear of epilepsy, and brain injury at varying rates, we have noted fear of death in most parents of children with FS. The fear of death was more common in parents of children with first FS than others. However, some parents do not have any fear of death because they believe following spiritual teachings about death: death is a discharge from the duties of life; it is a rest, a change of residence, and a transformation of existence; it is an invitation to eternal life, a beginning, and the introduction to the immortal life. Just as life comes into the world through an act of creation and is appointed and determined, departure from the world is also created and determined and is planned wisely and purposively.
In conclusion, we would like to emphasize that most parents of children with FS have many concerns including fear of death in many cultures in the world; therefore, we think that aside from medical interventions, pediatric neurologists, pediatricians, and family physicians should support parents psychospiritually because the World Health Organization discerns four dimensions of health, namely physical, social, mental, and spiritual health.
Article published online:
29 September 2022
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