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Implementation of an Epilepsy Self-Management Protocol

Cole, Kimberly A.; Gaspar, Phyllis M.

Journal of Neuroscience Nursing: February 2015 - Volume 47 - Issue 1 - p 3–9
doi: 10.1097/JNN.0000000000000105

ABSTRACT It is essential that patients with epilepsy receive educational information about their disease and its management, but there is dissatisfaction with the education received. The purposes of this evidence-based project were to examine the current knowledge level and disease management behaviors of patients with epilepsy in an outpatient clinic and to measure the effectiveness of implementing a self-management protocol using the Epilepsy Self-Management Scale (ESMS). Pender’s health promotion model and Rogers’ diffusion of innovation theory were used to guide the development and completion of this project. An evidence-based epilepsy self-management protocol was developed and implemented at an outpatient neurology clinic by an interprofessional clinic team that consisted of (a) evaluation of self-management behaviors (ESMS), (b) individual education using the ESMS and developed resources, (c) follow-up telephone call, and (d) measurement of outcomes of the self-management protocol (patient self-management [ESMS] and process). Twenty patients participated in all or portions of the protocol. Scores on the ESMS increased from preimplementation to postimplementation of the protocol (t = −2.67). Seizure management and information management were identified as the most difficult self-management areas. Recommended changes in protocol implementation include adding information about safety measures such as medical alert bracelets and driving to the educational packets. Follow-up telephone calls were discontinued because of difficulties reaching patients. The results of this study suggest that the ESMS is an acceptable tool for evaluating patients’ self-management behaviors. Epilepsy self-management protocols need to include both verbal and written educational materials. Educating patients with epilepsy about positive self-management behaviors may lead to better health outcomes.

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Questions or comments about this article may be directed to Kimberly A. Cole, DNP FNP-BC, at She is an Assistant Professor in the Department of Neurology, University of Toledo, Toledo, OH.

Phyllis M. Gaspar, PhD RN, is a Professor, University of Toledo, Toledo, OH.

The authors declare no conflicts of interest.

Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal’s Web site (

© 2015 American Association of Neuroscience Nurses