The development of The Epileptic Seizure Parental Burden Scale: A validity and reliability study

Published:November 30, 2022DOI:


      • The stages of the study show that the Epilepsy Parental Seizure Burden Scale (EPSBS) is a valid, reliable measurement tool.
      • EPSBS can be used as a measurement tool in studies designed to determine care burden and socioeconomic burden in epilepsy.



      It is common for parents to shoulder the burden of care for their children with chronic diseases. However, there are no robust scales to measure the burden of care of parents of children with epilepsy. This study aimed to develop the “Epileptic Seizure Parental Burden Scale (ESPBS)” and evaluate its psychometric properties.

      Materials and methods

      This was a methodological study. The sample consisted of 333 voluntary parents of children with epilepsy. Data were analyzed using the Statistical Package for Social Sciences (SPSS v. 25) at a significance level of p < .05. Content validity, item-total correlation, explanatory factor analysis (EFA), confirmatory factor analysis (CFA), the “upper- and lower-27 percent rule,” Cronbach's alpha coefficient, and the split-half reliability method were used for psychometric analysis.


      The scale consisted of 15 items and two subscales. The Kaiser-Meyer-Olkin (KMO) was 0. 961, for which Bartlett's test of sphericity was significant (X2 = 5079.527, p < .001), indicating sampling adequacy and correlation between the items for factor analysis. The scale had item-total item correlations of 0.311 to 0.741. The Explanatory Factor Analysis (EFA) revealed a two-factor structure. According to the confirmatory factor analysis, x2/df, GFI, AGFI, CFI, and RMSEA were 2.012, 0.93, 0.91, 0.97, and 0.055, respectively. These values were very close to a good fit. The items had factor loadings of 0.508 to 0.890. The total scale explained 60.432% of the total variance. The scale had a Cronbach's alpha of 0.93. The split-half reliability indicated a significant (p < .001) and high (r = 0.890) correlation.


      The Epileptic Seizure Parental Burden Scale (ESPBS) has high psychometric properties. It is a valid and reliable instrument that can measure the epileptic seizure burden of parents of children with epilepsy.


      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'


        • Allers K.
        • Essue B.M.
        • Hackett M.L.
        • Muhunthan J.
        • Anderson C.S.
        • Pickles K.
        • Jan S.
        The economic impact of epilepsy: A systematic review.
        BMC Neurology. 2015; 25: 245
        • Baca C.B.
        • Barry F.
        • Vickrey B.G.
        • Caplan R.
        • Berg A.T.
        Social outcomes of young adults with childhood-onset epilepsy: A case-sibling-control study.
        Epilepsia. 2017; 58: 781-791
        • Bagozzı R.P.
        • Yi Y.
        On the evaluation of structural equation models.
        Journal of the Academy of Marketing Science. 1988; 16: 74-94
        • Bardakçı S.
        • Gürbüz R.B.
        Marka Güven Ölçeğinin Türk Kültürüne Uyarlanması: Geçerlik ve Güvenirlik Çalışması.
        İşletme Araştırmaları Dergisi. 2020; 12: 1684-1692
        • Beghi E.
        Addressing the burden of epilepsy: Many unmet needs.
        Pharmacological Research. 2016; 107: 79-84
        • Berg A.T.
        • Kaiser K.
        • Dixon-Salazar T.
        • Elliot A.
        • McNamara N.
        • Meskis M.A.
        • Rozek C.
        Seizure burden in severe early-life epilepsy: Perspectives from parents.
        Epilepsia Open. 2019; 4: 293-301
        • Bielen I.
        • Friedrich L.
        • Sruk A.
        • Prvan M.P.
        • Hajnšek S.
        • Petelin Ž.
        • Jacoby A.
        Factors associated with perceived stigma of epilepsy in Croatia: a study using the revised epilepsy stigma scale.
        Seizure. 2014; 23: 117-121
        • Boateng G.O.
        • Neilands T.B.
        • Frongillo E.A.
        • Melgar-Quiñonez H.R.
        • Young S.L.
        Best practices for developing and validating scales for health, social, and behavioral research: A primer.
        Frontiers in Public Health. 2018; 6: 149
        • Buck D.
        • Smith M.
        • Appleton R.
        • Baker G.A.
        • Jacoby A.
        The development and validation of the Epilepsy and Learning Disabilities Quality of Life (ELDQOL) scale.
        Epilepsy & Behavior. 2007; 10: 38-43
        • Buelow J.
        • Miller W.
        • Fishman J.
        Development of an epilepsy nursing communication tool: Improving the quality of interactions between nurses and patients with seizures.
        The Journal of Neuroscience Nursing. 2018; 50: 74
        • Büyüköztürk Ş.
        Sosyal bilimler için veri analizi el kitabı.
        4. bs. Pegem Akademi, Ankara2010
        • Çapık C.
        Geçerlik ve güvenirlik çalışmalarında doğrulayıcı faktör analizinin kullanımı.
        Anadolu Hemşirelik ve Sağlık Bilimleri Dergisi. 2014; 17: 196-205
        • Çapık C.
        • Gözüm S.
        • Aksayan S.
        Kültürlerarası ölçek uyarlama aşamaları, dil ve kültür uyarlaması: Güncellenmiş rehber.
        Florence Nightingale Journal of Nursing. 2018; 26: 199-210
        • Davis L.L.
        Instrument review: Getting the most from a panel of experts.
        Applied Nursing Research. 1992; 5: 194-197
        • Eom S.
        • Caplan R.
        • Berg A.T.
        Behavioral problems and childhood epilepsy: Parent vs child perspectives.
        The Journal of Pediatrics. 2016; 179: 233-239
        • Espie C.A.
        • Watkins J.
        • Duncan R.
        • Espie A.
        • Sterrick M.
        • Brodie M.J.
        • Curtice L.
        Development and validation of the Glasgow Epilepsy Outcome Scale (GEOS): a new instrument for measuring concerns about epilepsy in people with mental retardation.
        Epilepsia. 2001; 42: 1043-1051
        • Fornell C.V.
        • Larcker D.F.
        Evaluating structural equations models with unobservable variables and measurement error.
        Journal of Marketing Research. 1981; 18: 39-50
        • Hair J.F.
        • Black W.C.
        • Anderson R.E.
        • Babın B.J.
        Multivariate data analysis.
        7th ed. New Jersey, Prentice Hall2010
        • Hosoyama H.
        • Matsuda K.
        • Mihara T.
        • Usui N.
        • Baba K.
        • Inoue Y.
        • Arita K.
        Long-term outcomes of epilepsy surgery in 85 pediatric patients followed up for over 10 years: A retrospective survey.
        Journal of Neurosurgery: Pediatrics. 2017; 19: 606-615
        • Hoyle R.H.
        Structural equation modeling: Concepts, issues, and applications.
        Sage, 1995
        • İlhan M.
        • Çetin B.
        • Kinay İ.
        Standart Testlere Yönelik İnanç Ölçeği’nin (STYİÖ) Türkçe Uyarlaması: Geçerlik ve Güvenirlik Çalışması.
        Mustafa Kemal Üniversitesi Sosyal Bilimler Enstitüsü Dergisi. 2015; 12: 161-189
        • International League Againist Epilepsy (ILAE)
        (Access to) (Access on: 04.04.2022)
        • International Test Commission (ITN)
        Guidelines for translating and adapting tests.
        International Journal of Testing. 2018; 18: 101-134
        • Jarvie S.
        • Espie C.A.
        • Brodie M.J.
        The development of a questionnaire to assess knowledge of epilepsy: I General knowledge of epilepsy.
        Seizure. 1993; 2: 179-185
        • Karakis I.
        • Cole A.J.
        • Montouris G.D.
        • San Luciano M.
        • Meador K.J.
        • Piperidou C.
        Caregiver burden in epilepsy: Determinants and impact.
        Epilepsy Research and Treatment. 2014; 2014
        • Karakoç A.G.D.F.Y.
        • Dönmez L.
        Ölçek geliştirme çalışmalarında temel ilkeler.
        Tıp Eğitimi Dünyası. 2014; 13: 39-49
        • Karimi N.
        • Heidari M.
        Knowledge and attitudes toward epilepsy among school teachers in west of Iran.
        Iranian Journal of Neurology. 2015; 14 (Knowledge and attitudes toward epilepsy among school teachers in West of Iran - PMC ( 130
        • Kuramochi I.
        • Iwayama T.
        • Horikawa N.
        • Shimotsu S.
        • Watanabe S.
        • Yamanouchi H.
        • Yoshimasu H.
        Development and validation of the epilepsy self-stigma scale.
        Epilepsia open. 2021; 6: 748-756
        • Lim K.S.
        • Wu C.
        • Choo W.Y.
        • Tan C.T.
        Development and validation of a public attitudes toward epilepsy (PATE) scale.
        Epilepsy & Behavior. 2012; 24: 207-212
        • Ngugi A.K.
        • Bottomley C.
        • Kleinschmidt I.
        • Sander J.W.
        • Newton C.R.
        Estimation of the burden of active and life-time epilepsy: A meta-analytic approach.
        Epilepsia. 2010; 51: 883-890
        • Owolabi L.F.
        • Owolabi S.D.
        • Taura A.A.
        • Alhaji I.D.
        • Ogunniyi A.
        Prevalence and burden of epilepsy in Nigeria: A systematic review and meta-analysis of community-based door-to-door surveys.
        Epilepsy & Behavior. 2019; 92: 226-234
        • Prevos-Morgant M.
        • Leavy Y.
        • Chartrand D.
        • Jurasek L.
        • Shafer P.O.
        • Shinnar R.
        • Goodwin M.
        Benefits of the epilepsy specialist nurses (ESN) role, standardized practices and education around the world.
        Revue Neurologique. 2019; 175: 189-193
        • Seçer İ.
        SPSS ve LISREL ile pratik veri analizi [practical data analysis with SPSS and LISREL].
        Anı Yayıncılık, Ankara2015
        • Şencan H.
        Reliability and validity in social and behavioral measurements.
        Seçkin Publishing, Ankara2005
        • Sönmez V.
        • Alacapınar G.
        Sosyal bilimlerde ölçme aracı hazırlama.
        Anı Yayıncılık, 2016
        • Townshend K.H.
        • Dorris L.
        • McEwan M.J.
        • Aylett S.E.
        • Brodie M.J.
        • O’Regan M.
        • Espie C.A.
        Development and validation of a measure of the impact of epilepsy on a young person’s quality of life: Glasgow epilepsy outcome scale for young persons (GEOS-YP).
        Epilepsy & Behavior. 2008; 12: 115-123
        • Widjaja E.
        • Guttmann A.
        • Tomlinson G.
        • Snead III, O.C.
        • Sander B.
        Economic burden of epilepsy in children: A population-based matched cohort study in Canada.
        Epilepsia. 2021; 62: 152-162
        • Yaşlıoğlu M.M.
        Sosyal bilimlerde faktör analizi ve geçerlilik: Keşfedici ve doğrulayıcı faktör analizlerinin kullanılması.
        İstanbul Üniversitesi İşletme Fakültesi Dergisi. 2017; 46: 74-85
        • Yorulmaz D.S.
        • Çınar S.
        • Kanbay Y.
        Epilepsi Tanısı Alan Çocukların ve Ailelerinin Deneyimleri ve Nöbet Yükleri: Fenomenolojik Bir Araştırma.
        Turkiye Klinikleri J Health Sci. 2021; 6: 734-744