Effect of children's medical counseling games on improving compliance with ketogenic diet and ketosis status in children with drug-refractory epilepsy_Journal of Epilepsy

Authors：

SUN Linlin ,  YE Jinghua , WANG Fangping

Department of Neurology, Shenzhen Children’s Hospital, Shenzhen 518038, China;

Corresponding?author：

YE Jinghua, Email: yejh2008@163.com

Keywords：

Ketogenic diet; Children; Drug-resistant epilepsy; Medical counseling game; Compliance

DOI：

10.7507/2096-0247.202408006

Video：

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Objective To investigate the effect of medical counseling games on ketogenic diet therapy for drug-resistant epilepsy children. Methods A total of 98 children with drug-resistant epilepsy admitted to the neurology ward of Shenzhen Children's Hospital from January 2023 to June 2024 who were treated with ketogenic diet for the first time were selected as the study objects by random number table method, and were divided into observation group (n=49) and control group (n=49). The control group received the traditional multidisciplinary team health education mode, while the observation group received the ketogenic diet treatment based on the multidisciplinary team health education mode and participated in the customized medical counseling games intervention. The time of children reaching ketosis, the knowledge level of ketogenic diet caregivers and the retention rate of children on ketogenic diet were compared between the two groups. Results The time of ketosis in observation group was earlier than that in control group (P<0.05). The knowledge level of the main caregivers of ketogenic diet and the retention rate of children with ketogenic diet at 3 months and 6 months in observation group were higher than those in control group (P<0.05). Conclusion The use of medical counseling games in the ketogenic diet for medically refractory epilepsy is an effective therapeutic strategy that facilitates the early attainment of ketosis in children with medically refractory epilepsy, improves the knowledge of caregivers on the ketogenic diet, improves retention of children on the ketogenic diet, and serves to optimize the effectiveness of clinical outcomes, which may contribute to the quality of life of children with medically refractory epilepsy.

Citation： SUN Linlin, YE Jinghua, WANG Fangping. Effect of children's medical counseling games on improving compliance with ketogenic diet and ketosis status in children with drug-refractory epilepsy. Journal of Epilepsy, 2024, 10(6): 508-513. doi: 10.7507/2096-0247.202408006 Copy

1.	許海泉. 生酮飲食治療兒童難治性癲癇合并智力低下的研究. 醫學信息, 2018, 31(7): 57-60.
2.	Kwan P, Arzimanoglou A, Berg AT, et al. Definition of drug resistant epilepsy: consensus proposal by the ad hoc Task Force of the ILAE Commission on Therapeutic Strategies. Epilepsia, 2010, 51(6): 1069-1077.
3.	劉曉燕. 小兒難治性癲癇的研究進展. 第三軍醫大學學報, 2012, 34(22): 2240-2243.
4.	Sourbron J, Klinkenberg S, van Kuijk S, et al. Ketogenic diet for the treatment of pediatric epilepsy: review and meta-analysis. Childs Nerv Syst, 2020, 36(6): 1099-1109.
5.	Verrotti A, Iapadre G, Di Francesco L, et al. Diet in the treatment of epilepsy: what we know so far. Nutrients, 2020, 12(9): 2645.
6.	Jo Sourbron Sylvia Klinkenberg SMJV, Majoie HMHB. Ketogenic diet for the treatment of pediatric epilepsy: review and meta-analysis. Springer-Verlag GmbH Germany, part of Springer Nature 2020, 36: 1099-1109.
7.	胡青青, 蘇堂楓, 徐三清. 兒童難治性癲癇的治療進展. 國際兒科學雜志, 2022, 49(4): 226-230.
8.	李瑞暖, 謝苗瑩, 曾榕, 等. 基于文獻計量視角分析癲癇與生酮飲食的相關性研究. 實用臨床醫藥雜志, 2023, 27(8): 40-47.
9.	梁燕, 付國惠, 沈雷. 生酮飲食療法結合抗癲癇藥物治療小兒難治性癲癇的效果觀察. 中國實用醫刊, 2020, 47(23): 75-78.
10.	李丹, 楊琳, 黃紹平, 等. 生酮飲食添加治療難治性癲(癇)長期有效率、保留率分析及不良反應監測. 中華實用兒科臨床雜志, 2014, 29(22): 1737-1741.
11.	梁麗麗, 賈珊珊, 李霞, 等. 生酮飲食添加治療兒童難治性癲癇的臨床效果. 臨床醫學研究與實踐, 2022, 7(3): 21-24.
12.	寧澤淑, 楊理明, 廖紅梅, 等. 生酮飲食添加治療兒童難治性癲癇的臨床療效及隨訪研究. 中國醫師雜志, 2018, 20(11): 1676-1679.
13.	秦奎英, 王彬, 吳小花. 癌癥住院患兒Child Life干預研究進展. 護理與康復, 2024, 23(02): 98-101.
14.	Lowenstein DB, Cervenka MC, Mitchell L, et al. Child life services in an epilepsy monitoring unit. Clin Pediatr (Phila), 2018, 57(11): 1269-1274.
15.	吳小花, 諸紀華, 周紅琴, 等. ICU兒童醫療輔導的研究進展. 中華急危重癥護理雜志, 2021, 2(05): 448-453.
16.	黃華, 金婷, 李力. 醫療游戲輔導在腫瘤患兒PICC置管中的應用. 齊魯護理雜志, 2019, 25(3): 17-19.
17.	胡亞美, 江載芳主編. 諸福棠實用兒科學-下冊. 人民衛生出版社, 2002: 1850-1863.
18.	Kossoff EH, Sutter L, Doerrer SC, et al. Impact of child life services on children and families admitted to start the ketogenic diet. J Child Neurol, 2017, 32(9): 828-833.
19.	McDonald T, Cervenka MC. Ketogenic diet therapies for seizures and status epilepticus. Semin Neurol, 2020, 40(6): 719-729.
20.	楊榮榮. 照顧者同伴支持對難治性癲癇患兒生酮飲食治療依從性的效果研究. 中國醫科大學, 2022, 碩士學位論文.
21.	李貝貝, 胡靜, 邵麗. 生酮飲食方案應用于難治性癲癇患兒價值分析. 中國初級衛生保健, 2024, 38(3): 93-96.
22.	凌芳, 顧鶯, 胡菲, 等. 兒童醫療游戲輔導在學齡期重癥肺炎患兒中的應用研究. 上海護理, 2021, 21(2): 6-10.
23.	張倩, 郭錦麗, 黃永波, 等. 醫療游戲輔導對學齡期四肢骨折患兒心理狀態及疼痛的影響. 護理研究, 2022, 36(19): 3549-3553.

1. 許海泉. 生酮飲食治療兒童難治性癲癇合并智力低下的研究. 醫學信息, 2018, 31(7): 57-60.
2. Kwan P, Arzimanoglou A, Berg AT, et al. Definition of drug resistant epilepsy: consensus proposal by the ad hoc Task Force of the ILAE Commission on Therapeutic Strategies. Epilepsia, 2010, 51(6): 1069-1077.
3. 劉曉燕. 小兒難治性癲癇的研究進展. 第三軍醫大學學報, 2012, 34(22): 2240-2243.
4. Sourbron J, Klinkenberg S, van Kuijk S, et al. Ketogenic diet for the treatment of pediatric epilepsy: review and meta-analysis. Childs Nerv Syst, 2020, 36(6): 1099-1109.
5. Verrotti A, Iapadre G, Di Francesco L, et al. Diet in the treatment of epilepsy: what we know so far. Nutrients, 2020, 12(9): 2645.
6. Jo Sourbron Sylvia Klinkenberg SMJV, Majoie HMHB. Ketogenic diet for the treatment of pediatric epilepsy: review and meta-analysis. Springer-Verlag GmbH Germany, part of Springer Nature 2020, 36: 1099-1109.
7. 胡青青, 蘇堂楓, 徐三清. 兒童難治性癲癇的治療進展. 國際兒科學雜志, 2022, 49(4): 226-230.
8. 李瑞暖, 謝苗瑩, 曾榕, 等. 基于文獻計量視角分析癲癇與生酮飲食的相關性研究. 實用臨床醫藥雜志, 2023, 27(8): 40-47.
9. 梁燕, 付國惠, 沈雷. 生酮飲食療法結合抗癲癇藥物治療小兒難治性癲癇的效果觀察. 中國實用醫刊, 2020, 47(23): 75-78.
10. 李丹, 楊琳, 黃紹平, 等. 生酮飲食添加治療難治性癲(癇)長期有效率、保留率分析及不良反應監測. 中華實用兒科臨床雜志, 2014, 29(22): 1737-1741.
11. 梁麗麗, 賈珊珊, 李霞, 等. 生酮飲食添加治療兒童難治性癲癇的臨床效果. 臨床醫學研究與實踐, 2022, 7(3): 21-24.
12. 寧澤淑, 楊理明, 廖紅梅, 等. 生酮飲食添加治療兒童難治性癲癇的臨床療效及隨訪研究. 中國醫師雜志, 2018, 20(11): 1676-1679.
13. 秦奎英, 王彬, 吳小花. 癌癥住院患兒Child Life干預研究進展. 護理與康復, 2024, 23(02): 98-101.
14. Lowenstein DB, Cervenka MC, Mitchell L, et al. Child life services in an epilepsy monitoring unit. Clin Pediatr (Phila), 2018, 57(11): 1269-1274.
15. 吳小花, 諸紀華, 周紅琴, 等. ICU兒童醫療輔導的研究進展. 中華急危重癥護理雜志, 2021, 2(05): 448-453.
16. 黃華, 金婷, 李力. 醫療游戲輔導在腫瘤患兒PICC置管中的應用. 齊魯護理雜志, 2019, 25(3): 17-19.
17. 胡亞美, 江載芳主編. 諸福棠實用兒科學-下冊. 人民衛生出版社, 2002: 1850-1863.
18. Kossoff EH, Sutter L, Doerrer SC, et al. Impact of child life services on children and families admitted to start the ketogenic diet. J Child Neurol, 2017, 32(9): 828-833.
19. McDonald T, Cervenka MC. Ketogenic diet therapies for seizures and status epilepticus. Semin Neurol, 2020, 40(6): 719-729.
20. 楊榮榮. 照顧者同伴支持對難治性癲癇患兒生酮飲食治療依從性的效果研究. 中國醫科大學, 2022, 碩士學位論文.
21. 李貝貝, 胡靜, 邵麗. 生酮飲食方案應用于難治性癲癇患兒價值分析. 中國初級衛生保健, 2024, 38(3): 93-96.
22. 凌芳, 顧鶯, 胡菲, 等. 兒童醫療游戲輔導在學齡期重癥肺炎患兒中的應用研究. 上海護理, 2021, 21(2): 6-10.
23. 張倩, 郭錦麗, 黃永波, 等. 醫療游戲輔導對學齡期四肢骨折患兒心理狀態及疼痛的影響. 護理研究, 2022, 36(19): 3549-3553.

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Effect of children's medical counseling games on improving compliance with ketogenic diet and ketosis status in children with drug-refractory epilepsy

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