title: "I don't want them to look at me and think of my illness, I just want them to look at me and see me": Child perspectives on the challenges associated with disclosing an epilepsy diagnosis to others.
abstract: OBJECTIVE
  Disclosure of a concealable stigmatized identity, such as epilepsy, to those external to the nuclear family can be complex. Among children living with epilepsy (CWE), diagnosis disclosure has been identified as a quality-of-life issue and a source of psychosocial distress. Despite this, limited empirical evidence exists regarding the disclosure experiences of CWE. This study aimed to identify the contextual factors that act as challenges for CWE when disclosing their epilepsy diagnosis to others external to the nuclear family.
  
  
  METHODS
  This qualitative exploratory study consisted of individual interviews with 29 CWE (aged 6-16 years; mean age=11.17 years; S.D.=2.85). Participants were recruited from a tertiary referral unit in the neurology department of a pediatric hospital and through a national epilepsy association. Interviews were audiotaped and transcribed verbatim. Data were thematically analyzed.
  
  
  RESULTS
  The five main challenges to epilepsy diagnosis disclosure for children were: 1) CWE's desire for normalcy, 2) out of sight but in the mind, 3) contending with negative responses to disclosure, 4) the complexity of epilepsy, and 5) self and others' perceptions of epilepsy.
  
  
  CONCLUSIONS
  These findings provide valuable insight into the factors that present difficulties and impede epilepsy diagnosis disclosure among CWE. Such knowledge is important in informing engagements between health-care professionals (HCPs) and CWE. In particular, HCPs should remain cognisant of the challenges CWE face as they: (i) strive for normalcy and (ii) grapple with comprehending their complex neurological condition. Tackling such disclosure challenges could serve to enhance life quality, improve CWE's openness with others about epilepsy, and consequently work toward reducing epilepsy-related misconceptions and stigma.
authors.affiliation: School of Nursing and Human Sciences, Faculty of Science and Health, Dublin City University, Dublin 9, Ireland.
authors.forename: Ailbhe
authors.initials: A
authors.lastname: Benson
authors.affiliation: School of Nursing and Human Sciences, Faculty of Science and Health, Dublin City University, Dublin 9, Ireland. Electronic address: veronica.lambert@dcu.ie.
authors.forename: Veronica
authors.initials: V
authors.lastname: Lambert
authors.affiliation: School of Nursing and Human Sciences, Faculty of Science and Health, Dublin City University, Dublin 9, Ireland.
authors.forename: Pamela
authors.initials: P
authors.lastname: Gallagher
authors.affiliation: Neurology Department, Temple Street Children's University Hospital, Temple Street, Dublin 1, Ireland.
authors.forename: Amre
authors.initials: A
authors.lastname: Shahwan
authors.affiliation: Indiana University School of Nursing, Indiana University Purdue University Indianapolis, 3040 N Ramble Road West, Bloomington, IN 47408, USA.
authors.forename: Joan K
authors.initials: JK
authors.lastname: Austin
mesh_terms: D002648:Child; D002675:Child, Preschool; D004827:Epilepsy / Q000175:diagnosis / Q000523:psychology*; D005260:Female; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D010465:Perception; D036301:Qualitative Research; D011788:Quality of Life / Q000523:psychology*; D057545:Social Stigma; D013240:Stereotyping
keywords: Challenges; Children with epilepsy; Concealment; Diagnosis disclosure; Epilepsy; Qualitative research; Stigma