title: Determining the disease management process for epileptic patients: A qualitative study.
abstract: BACKGROUND
  Epilepsy exposes patients to many physical, social, and emotional challenges. Thus, it seems to portray a complex picture and needs holistic care. Medical treatment and psychosocial part of epilepsy remain central to managing and improving the patient's qualify of life through team efforts. Some studies have shown the dimensions of self-management, but its management process of epilepsy patients, especially in Iran, is not clear. This study aimed to determine the disease management process in patients with epilepsy in Iran.
  
  
  METHODS
  This qualitative approach and grounded theory study was conducted from January 2009 to February 2012 in Isfahan city (Iran). Thirty-two participants were recruited by the goal-oriented, and snowball sample selection and theoretical sampling methods. After conducting a total of 43 in-depth interviews with the participants, the researchers reached data saturation. Data were analyzed using Strauss and Corbin method.
  
  
  RESULTS
  With a focus on disease management process, researchers found three main themes and seven sub-themes as a psychosocial process (PSP). The main themes were: perception of threat to self-identity, effort to preserve self-identity, and burn out. The psychosocial aspect of the disease generated one main variable "the perception of identity loss" and one central variable "searching for self-identity."
  
  
  CONCLUSIONS
  Participants attributed threat to self-identity and burn out to the way their disease was managed requiring efforts to preserve their identity. Recommendations consist of support programs and strategies to improve the public perception of epilepsy in Iran, help patients accept their condition and preserve self-identity, and most importantly, enhance medical management of epilepsy.
authors.affiliation: Social Determinants of Health Research Center, Yasuj University of Medical Sciences, Yasuj, Iran.
authors.forename: Nazafarin
authors.initials: N
authors.lastname: Hosseini
authors.affiliation: Department of Psychiatric Nursing, Community Based Psychiatric Nursing Care Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
authors.forename: Farkhondeh
authors.initials: F
authors.lastname: Sharif
authors.affiliation: Department of Nursing, Tarbiat Modares University, Tehran, Iran.
authors.forename: Fazlollah
authors.initials: F
authors.lastname: Ahmadi
authors.affiliation: Department of Neurology, Isfahan University of Medical Sciences, Isfahan, Iran.
authors.forename: Mohammad
authors.initials: M
authors.lastname: Zare
keywords: Epilepsy; Iran; grounded theory; management; qualitative research; seizure