Title

Prevalence, reasons, and consequences of pre-marriage disclosure or concealment of epilepsy disorder in the marital lives of women in Karachi, Pakistan

Date of Award

2012

Document Type

Thesis

Degree Name

Master of Science in Nursing (MScN)

Department

School of Nursing and Midwifery, Pakistan

Abstract

Globally, epilepsy is the third most common neurological disorder in primary health care settings. Its prevalence rate is higher among females, as compared to males, in Pakistan. Epilepsy has severe implications on women's social domain of life especially in matrimonial affairs. They face hurdles, discrimination, and rejection, due to the negative perception and social stigma attached to this disease. Therefore, female patients and their parents are apprehensive whether to disclose or conceal the diagnosis at the time of marriage negotiations. Objective:The purpose of this study was to identify the rate of prevalence, reasons, and consequences of disclosure or concealment of epilepsy diagnosis at the time of women's marriage negotiations. Methodology:This descriptive cross-sectional study included 381 married women with epilepsy. from a tertiary healthcare setting in Karachi, Pakistan. A purposive sampling method was used for the study. A self-reported questionnaire was administered to collect the data. Descriptive and inferential statistics were implied for data analysis. Results:The present study shows that 64% of the participants disclosed the epilepsy diagnosis to their prospective spouse and in-laws, at the time of marriage negotiations. The three key reasons for the pre-marriage disclosure of epilepsy identified in this study include anticipating disruption in the matrimonial relationship, trustworthiness in the marital relationship, and acceptance from the prospective spouse after knowing the history of the disease. Whereas respondent have reported four major reasons for the concealment of epilepsy: to prevent proposal rejection, stigma, pressurized by their own family to hide, and myths and misperceptions regarding epilepsy. Study findings also revealed that married epileptic women who have disclosed or concealed are suffering from deleterious consequences. Furthermore, the study has shown a significant association of the socio-economic factors with the pre-marriage disclosure of epilepsy. Conclusion:This study concludes that pre-marriage disclosure of epilepsy is a crucial and a complex decision because it carries numerous benefits as well as harms for women in the different domains of life. However, honestly sharing the history of epilepsy at the time of marriage negotiation is more helpful, as epilepsy requires follow-up in the clinic and compliance to medication for a prolonged period. Moreover, disclosure helps to get financial support, physical assistance, and affectionate support.

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