الفهرس 
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Abstract
Epilepsy is a chronic disease that is characterized by two or more unprovoked seizures and affects about 50 million people around the world. Most seizures in children’s are provoked by somatic disorders originating outside the brain, such as high fever, infection, syncope, head trauma, hypoxia and toxins. Epilepsy in children has wide repercussions on social, emotional, and overall family functioning, particularly in families where younger children are affected and in those with single parents. Children with epilepsy have more emotional, behavioral, and cognitive difficulties than children in the general, also, families of a child with epilepsy have been found to experience significantly more stress, anxiety, and restrictions in family life than other families. Simulation is defined as “the process by which we are trying to achieve results approximating clinical practice as closely as possible. It is a teaching method where, following a certain scenario, students experience the actual dimensions of their future professional roles, which helps them to be more quickly integrated into the workforce of the healthcare sector. In nursing science, simulation is used for teaching theoretical and clinical skills, while focusing on the promotion of the critical thinking of students. Simulation enables students to work in an environment closely resembling that of a hospital and helps them to gain healthcare and nursing experiences, even before they start working as professionals. Simulation training program help the mothers to increase their knowledge about epilepsy, it’s all about management and to decrease stress, depression and anxiety level which in return help the mothers to manage their children, apply first aid measures effectively which contribute to the improvement of children’s health status, decrease frequency of seizure attack and prevent severe complication .
The Purpose of the Study was to: Evaluate the effect of simulation training on seizure management and anxiety level among mothers of Children with epilepsy through the following objectives:
• Assess mother’s management and practices about epilepsy to detect their needs.
• Design and implementing nursing intervention based on simulation training on seizure management and anxiety level among mothers of epileptic children according to their needs.
• Evaluate the effect of simulation training for mothers on seizure management and anxiety level.
Hypotheses:
The following Research Hypotheses are formulated to achieve the purpose of the study:
1. Mothers who receive simulation training will have a higher level of knowledge about
epilepsy and simulation on posttest than pretest.
2. Mothers who receive simulation training will have a higher level of seizure management
practice on posttest than pretest.
3. Mothers who receive simulation training will have less anxiety level on posttest than pretest.
Research design:
A quasi-experimental design (pre and posttest) was used to evaluate effect of simulation training on seizure management and anxiety level among mothers of Children with epilepsy.
Setting:
This study was conducted in the three areas, the first and second for data collection in Pediatric Medical Department and Pediatric Outpatient Clinic at Menoufia University Hospital Shibeen El-Kom Teaching Hospital in Menoufia Governorate, Egypt. The third one for nursing intervention was implemented in the General Lab in Pediatric Nursing Department in the Faculty of Nursing, Menoufia University.
Sample:
Purposive sample of 60 mothers admitted with their epileptic children at the previously mentioned settings and willed to participate in the study.
Instruments of the Study:
Three instruments were utilized for data collection:
Instrument One:
Structured interview questionnaire sheet. It was divided into four parts:
• Part one: Social characteristics of studied mothers.
• Part two: Social characteristics of children.
• Part three: Mothers’ knowledge about epilepsy.
• Part four: mothers’ knowledge about simulation.
Instrument Two:
Structured Observational Checklist to assess mothers’ performance before, during and after the seizure.
It was divided into three parts:
• Part one: Immediate assessment on child before seizure attack.
• Part two: Management of children during seizure attack.
Part three: Management of children after seizure attack.
Instrument Three: Hamilton Anxiety Rating Scale (HAM-A).
The Main Results of the Study Showed That:
1- Less than half of studied mothers (40%) were aged between 30 to < 40 years with mean
of 32.4 ± 5.1 years.
2- Majority of the studied mothers had university education (46.7%), while 13.3% of them
had secondary school education, and approximately one third of them had post graduate
education (28.3%).
3- Regarding marital status, 83.3% of them were married and 13.3% were divorced.
4- Approximately three quarters of the studied mothers were housewives (71.7%).
5- The mean score of mothers’ knowledge on pretest were 4.5 ± 1.2 compared to 21.3 ± 1.on posttest.
6- Majority of the mothers had more good knowledge on posttest compared to pretest (95% vs. 0% respectively).
7- Mothers had higher mean total score of management practices on posttest compared to pretest (34.2 ± 3.4 vs. 7.2 ± 2.5 respectively).
8- The majority of the mothers had more satisfactory performance on posttest compared to pretest (98.3% vs. 0%) respectively.
9- Approximately all the mothers had fewer level of anxiety on posttest than on pretest.
10- The mean score of 14 parameters of Hamilton anxiety rating scale was decreased from 159.9 ± 26.1 on pretest to 34.8 ± 13.1 on posttest.
11- There was statistically significant positive correlation between total knowledge score and total practices score on posttest
The Study Concluded That:
The current study concluded that the hypotheses were accepted and the implementation of simulation training program improved mothers’ knowledge and practices about epilepsy on posttest than on pretest. Also, it contributed to lower levels of anxiety in the mothers on posttest than on pretest, which in return decreased frequency of seizure attack in their children.
Based on the Finding of the Current Study and Conclusion, the following Recommendations are Suggested:
A. Recommendations for Caregiver Practice:
1. Ongoing in-service education programs about epilepsy should be designed and implemented at all pediatric department especially in out-patient clinics to improve mothers’ knowledge and practices of epilepsy.
2. Integrating simulation training into pediatric medical department to improve caregivers’ knowledge and practice regarding the most common chronic disease.
3. Maintain suitable health institution in all community areas which children with epilepsy and their mothers can contact in emergency situation to provide safe life intervention and satisfy all their suspected needs.
4. Reinforce the importance of developing a standard for seizure teaching for mothers of children with epilepsy that includes initial recognition and care, medication administration and post medication.
B. Recommendations for Education:
1. All family members should maintain a therapeutic psychological and physical environment for children with epilepsy which help children to explore the world, master the developmental tasks of childhood and satisfy all recommendations for all aspects of child growth and development.
2. Different methods of teaching and learning such as group discussion, presentations, demonstration and re-demonstration should be used for improving caregivers’ knowledge about epilepsy in outpatient clinics.
3. Libraries containing books, electronic media and internet access for all caregivers should be established at outpatient clinics and should contain scientific materials regarding epilepsy and application of simulation training and up to date care for their children with epilepsy.
4. Standardized simulation training for children with epilepsy should be integrated into pediatric nursing curriculum.
C. Recommendations for Research:
1. Future studies should be applied on a larger sample of mothers in other pediatric medical departments to investigate the effect of simulation training on seizure management and anxiety level among the mother of children with epilepsy to ensure the generalizability of results.