The Experiences of Mother in Taking Care for Toddlers with Febrile

Seizures

Jathu

Dwi

Wahyuni

and

Yenny

Sianturi

Health Polytechnics Jakarta III, Jl. Arteri JORR, Bekasi, Indonesia

Keywords: Febrile Seizures, Toddlers, Mother.

Abstract: Background: Febrile seizures on toddlers usually happened at home. It is usually handled by mother and

family by took the children to the hospital as they did not know how to handle their children with febrile

seizures. Objective: To explore mothers’ experiences in taking care of toddlers with febrile seizures in East

Jakarta. Methods: The data were collected by in-depth interview. In-depth interviews about the mother

experiences in taking care of toddlers with febrile seizures were conducted with 6 mothers. Interviews were

recorded using digital voice recorder and conducted in 2016. The researcher finding some key words, and

combining the key words become themes. Data validity was doing by clarification the results of interview to

all participants. The data were analyzed using the Collaizi approach. Results: Four themes emerged: the

family’s psychological responses, febrile seizures handling, obstacles in treating infants with febrile seizures

and the prevention of febrile seizures. Conclusion: The febrile seizures could be handling at home and

health services. The barriers in taking care of children with seizure were cost of the treatment and the fear of

recurrent seizure. The strategies in preventing febrile seizures included maintaining a healthy environment

and providing health food supplements, medication.

1 INTRODUCTION

Child health problems are one of the main problems

in the health sector that currently occur in Indonesia

(Hidayat, 2006). The degree of child health reflects

the health status of the nation, because children as the

next generation of the nation have capabilities that can

be developed in continuing the nation's development.

Based on these reasons, child health problems are

prioritized in planning or planning for national

development (Hidayat, 2006). Infant morbidity is the

second indicator in determining the degree of health

of children, because the value of health is a reflection

of the weak endurance of infants and toddlers. The

morbidity can also be affected by nutritional status,

guaranteed health services for children, child health

protection, children's social factors, and mother's

education. And one of the most common diseases

suffered by children is febrile convulsions or seizures

(Hidayat, 2006).

In the United States and Europe the prevalence

of febrile seizures ranges from 2.2% - 5.0%. In Asia

the prevalence of febrile seizures has doubled

compared to Europe and America. In Japan the

incidence of febrile seizures ranged from 8.3% -

9.9%, even in Guam the incidence of febrile seizures

reached 14% (Kharis, 2010). The incidence of

febrile seizures in Indonesia was reported to reach

2.0 - 4.0% in 2005-2006. Central Java Province 2.0-

3.0% and 2005 - 2006 Roesmani Semarang hospital

for cases reached 2.0% in 2004 - 2006 more often in

boys (Maryatongo, 2007). From the results of

previous studies it was found that febrile seizures

were more common in boys than in girls, with a ratio

that ranged from 1.4: 1.0 and 1.2: 1.0, and research

by Lumbantobing University of Indonesia's medical

faculty received 297 children with 165 febrile

seizures are boys and 132 girls. Comparison of boys

and girls is 1.2: 1.0 (Lumbantobing, 2007). Seizures

usually occur within 24 hours. First, when a fever

has a short duration with seizures, it can be tonic,

clonic, focal or akinetic. Generally, febrile seizures

stop on their own, as soon as a febrile seizure stops,

the child will be awake and conscious without any

neurological abnormalities (Fuadi, 2010). Fifty-six

percent of caregivers were very worried about the

potential harm of fever in their children when their

children had fever and ninety-one percent of

caregivers believed that a fever could cause harmful

effects (Crocetti M, Moghbeli N, 2001). Knowledge

100

Wahyuni, J. and Sianturi, Y.

The Experiences of Mother in Taking Care for Toddlers with Febrile Seizures.

DOI: 10.5220/0008203701000103

In Proceedings of the 1st International Conference of Indonesian National Nurses Association (ICINNA 2018), pages 100-103

ISBN: 978-989-758-406-0

of febrile seizures and their handling by mothers and

families who have a toddler with febrile seizures

needs to be explored so that family needs can be

determined in treating toddlers with febrile seizures

and the incidence of febrile seizures can be

prevented. Qualitative research with descriptive

phenomenology method can be done to find out the

experience of parents specifically for mothers in

caring for toddlers with febrile seizures because it

involves direct exploration, analysis and description

of certain phenomena.

2 METHODS

2.1 Methods

This research is a qualitative research with descriptive

phenomenological method which aims to obtain an

overview of the experience of mothers who care for

children with febrile seizures. This research used

Collaizi’s approach, with two times in depth interview

and clarification to the participants. Data were

collected from September to November 2016.

2.2 Location

The place for selecting participant is conducted in

the East Jakarta area.

2.3 Participants

The inclusion criteria of the participants are mothers

who directly care for their children who had febrile

seizures, with the age of children under five who had

febrile seizures, mothers who are able to share their

experiences in caring for children with febrile

seizures, mothers who are able to speak Indonesian

well and cooperative, and mothers who are available

and fully involved in the research and signed the

consent form as a participant.

2.4 Ethical Clearence

Ethical clearence of this study were obtained from

Ethical Committee Health Polytechnic Jakarta III.

3 RESULT

Participants in this study were 6 mothers who treated

toddlers with febrile seizures. Their age varies from

age 31 to 42 years. The education level of all

participants is high school, and all participants are

housewives. The toddlers who have experienced

seizures have varied ages, between 1 year to under 5

years, with the sex of 2 males and 4 females.

Another characteristic encountered was the

experience of caring for a child with febrile seizures,

only one participant had experience treating a child

with a previous febrile seizure.

After the data were analyzed using the Collaizi

approach, 4 themes were found as a result of this

study.

3.1 The First Theme is Psychological

Responses in Categories of Panic,

Confusion and Stress

"Panic... panic... I grab a spoon then, but still not

strong, then I just use a cloth... at the end my hand

becomes a victim, basically the feeling is already

mixed, it's panic...panic”(P1).

"I was confused and stressed especially when the

doctor said my child had a brain disorder and I was

more confused because my child had malnutrition

and was easily infected and eventually had seizures

and now Dengue Fever. "(P3).

3.2 The Second Theme is the Action

Taken in Handling Febrile Seizures

There were obtained sub-themes of handling by the

family and sub-themes of treatment by health

workers. In the sub-theme of handling carried out by

the family when the child experiences a seizure are

all different, in which identified as using a spoon,

giving a massage and bringing the child to a clinic or

hospital. The following is the participant's statement

that supports this sub-theme, namely:

"Panic... panic... then I take a spoon, but still not

strong" (P1)

"... because people tend to not having enough

knowledge to understand, seizures have never been

experience so I’ll just give my child a regular

squeeze, holding hand, the usual hands therapy,

palms, feet.."(P5)

"I wake up the father, say if G is having seizures. We

both then directly hurried ourselves to ride the

motorbike to Haji hospital"(P2)

"Alhamdulillah, it is directly handled, the drugs

inserted through the buttocks...and my child is

asleep, infused... thank God," (P1)

The Experiences of Mother in Taking Care for Toddlers with Febrile Seizures

101

"yeah... got the drugs injected through the infusion

like that..."(P2)

3.3 The Third Theme is the Obstacle in

Treating Toddlers with Febrile

Seizures

It’s obtained a sub-theme of problems in care. Some

of the things that the participants mentioned about

the problem in treatment were the problem of

recurrent seizures and costs.

"Yes, it's just worrying.. so once he got warmed up,

we’re going to be in hurry" (P5)

“Yeah, now if he got warmed up even just a tad bit,

it’s best for me to give him some medications, I’m

afraid his temperature will be high again.” (P6)

"Obstacles encountered are cost issues, my child is

not yet a member of Social Insurance Administration

Organization " (P4)

"The obstacles encountered are financing problems,

we don't have a identity card but we’ve got a Family

Card, hence we’re not yet a insurassurance

participant "(P3)

3.4 The Fourth Theme is How to

Overcome Obstacles in the Care of

Toddlers with Febrile Seizures

In this theme the sub-themes of prevention of febrile

seizures such as providing drugs, giving

supplements, providing nutritious food, providing a

clean environment and direct to health services

during recurrent seizures.

"Yeah, we check up on food, but we still don't know

since we don’t know every snacks he might’ve eaten

out there" (P1)

"We got medications or drugs prepared all settled in

home, in the past we lacked a lot of experience since

it was our first child, but now we are prepared. if the

seizures occurred, we got the medications

ready”(P2)

4 DISCUSSION

In the event of febrile seizures in toddlers, the

participants used signs in a similar respon among

participants, panicked, cried continuously, took a

spoon, confused about what to do, only held the legs

and arms of the children, or simply gave some

massages. Conditions like this that are the same as

those which occur in the psychological are irrational

decisions in the provision of care for sick children

(Lagerløv P, Loeb M, Slettevoll J, Lingjaerde OC,

2006).

Signs and symptoms of febrile seizures usually

occur in the first 24 hours of fever or the first day of

fever. The child will look strange for a few

moments, then stiffen, squeeze and roll his eyes.

Children are not responsive for some time, breathing

will be disrupted, and the skin will appear darker

than usual. After a seizure, the child will return to

normal soon (Dokter Indonesia Online,

2009). Febrile seizures are seizures that occur in an

increase in body temperature (rectal temperature

above 38◦C) caused by an extracranial process

(Budiman, 2006). Data obtained from participants

found that children with febrile seizures have signs

such as body fever, hands clenched and eyes glaring

upwards. This condition is in accordance with the

theories mentioned above and showed that the

participants had knowledge about sign and symtoms

of febrile seizures.

Handling seizures carried out by the family

varies according to what is obtained from the

participants, some bring to health services, some are

carried out by the family themselves. Handling based

on the theory is to put the child on the floor or bed

and keep it away from hard or sharp objects and free

the airway, keep the head to one side so that saliva or

vomiting can flow out of the mouth and do not put

anything in the child's mouth (Dokter Indonesia

Online, 2009). There were participants who took

care of them by putting a spoon in their child's

mouth when their child was having a seizure. This is

probably caused because the information obtained

from the participant's environment; if the child has a

seizure, place the spoon to hold his tongue. In

theory, the child's tongue will not be swallowed by a

child who has a seizure. But it seems that this

information was not received by the public.

As for handling febrile seizures in health

services, some participants said their children were

given medication through suppositories, and some

were handled by administering intravenous fluids.

Initial treatment at the hospital is usually

givenoxygen only when seizures still occur, if the

seizure stops then it is unnecessary. In addition, it is

also necessary to maintain water and electrolyte

balance and maintain blood pressure balance (Dokter

Indonesia Online, 2009).

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Obstacles experienced by participants who have

children with a history of febrile seizures include

concerns about recurrent febrile seizures and cost

problems. This is as stated by Gunawan, et al (2008),

that 20-50% of children with febrile seizures will

experience recurrent seizures of febrile seizures

(Gunawan, W., Kari, K., & Soetjiningsih,

2008). There were also participants who said their

children had febrile seizures up to nine times since

the first febrile seizure up to the last few months.

The funding problem presented by participants, this

is related to health insurance that is not yet owned by

participants, where participants who convey this

matter are transferred people who have not had time

to administer documents for health insurance.

The information on how to overcome obstacles

in the care of children with febrile seizures are

obtained such as providing drugs, giving

supplements, providing nutritious food, providing a

clean environment and directly to health services

when recurrent seizures occur. This is in line with

information that febrile seizure incident was most

frequently associated with a sudden increase in the

body temperature in 53.40% (Gontko-Romanowska

K, Żaba Z, Panieński P, Steinborn B, Szemień M,

Łukasik-Głębocka M, Ratajczak K, Chrobak A,

Mitkowska J, 2017). It is important for parents who

have toddlers with febrile seizures to keep their

children from various infections by maintaining a

healthy body and environment, providing nutritious

food, and additional supplements.

5 CONCLUSIONS

The incidence of febrile seizures in toddlers often

makes families, especially mothers, react differently

physically and psychologically. For the treatment of

seizures, it can be done at home or in health services.

Some obstacles that are felt by families with toddlers

who have febrile seizures include concerns about

recurrent seizures and cost constraints. Ways to

overcome obstacles include maintaining a healthy

environment, providing nutritious food,

supplementation and prepared medication.

ACKNOWLEDGEMENTS

The authors thank to the participants. This study was

supported by Health Polytechnic Jakarta III funding

by letter number HK.02.04/III.1/02857/2016 about

Determination of beginner research proposals,

Health Polytechnic Jakarta III.

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