Abstract：Objective To understand the status of screen exposure in children with epilepsy and analyze the influencing factors for screen exposure time, providing a scientific basis for managing screen exposure in these children. Methods A convenience sampling method was used to select 275 children with epilepsy from outpatient clinics or those undergoing 24-hour electroencephalogram monitoring at two tertiary hospitals in Jinan from March to June 2023. Their parents (fathers or mothers) completed a questionnaire to collect data on screen exposure, parental screen regulation behaviors, and related information about the children and their families. The Wilcoxon rank-sum test or the Kruskal-Wallis H test was used to conduct a univariate analysis of the average screen exposure time of children on school days and weekends, as well as the daily average screen exposure time. A multivariate logistic regression analysis was used to identify the risk factors for children whose screen exposure time exceeded the recommended guidelines (average screen exposure time on school days >1 hour or average on weekends >2 hours). Results The median screen exposure duration on school days was 40 minutes, while on weekends it was 120 minutes. Among the children studied, 23.1% (63/273) had average screen exposure time exceeding 1 hour on school days, and 42.5% (117/275) had average screen exposure time exceeding 2 hours on weekends. Four children experienced seizures while using screen devices. Multivariate logistic regression analysis indicated that using screen devices shortly before sleep, lower educational levels of parents, caregivers discussing screen content with children, and longer seizure durations in children were risk factors for exceeding recommended guidelines (P<0.05). Conclusions Some children with epilepsy have a screen exposure time exceeding the recommended guidelines. A longer seizure duration, lower parental education levels, and permissive digital parenting are closely associated with children's screen exposure time exceeding the recommended guidelines. Families and children exhibiting these characteristics should be prioritized for attention and health education.
Tombeau Cost K, Korczak D, Charach A, et al. Association of parental and contextual stressors with child screen exposure and child screen exposure combined with feeding[J]. JAMA Netw Open, 2020, 3(2): e1920557. PMID: 32022883. DOI: 10.1001/jamanetworkopen.2019.20557.
Janssen X, Martin A, Hughes AR, et al. Associations of screen time, sedentary time and physical activity with sleep in under 5s: a systematic review and meta-analysis[J]. Sleep Med Rev, 2020, 49: 101226. PMID: 31778942. PMCID: PMC7034412. DOI: 10.1016/j.smrv.2019.101226.
Tezol O, Yildiz D, Yalcin S, et al. Excessive screen time and lower psychosocial well-being among preschool children[J]. Arch Pediatr, 2022, 29(1): 61-66. PMID: 34758931. DOI: 10.1016/j.arcped.2021.10.003.
Pohl D, Alpous A, Hamer S, et al. Higher screen time, lower muscular endurance, and decreased agility limit the physical literacy of children with epilepsy[J]. Epilepsy Behav, 2019, 90: 260-265. PMID: 30342878. DOI: 10.1016/j.yebeh.2018.05.010.
Lang J, Jeschke S, Herziger B, et al. Prejudices against people with epilepsy as perceived by affected people and their families[J]. Epilepsy Behav, 2022, 127: 108535. PMID: 35026561. DOI: 10.1016/j.yebeh.2021.108535.
elen Yolda? T, Günbey C, De?erliyurt A, et al. Behavioral problems of preschool children with new-onset epilepsy and one-year follow-up: a prospective study[J]. Epilepsy Behav, 2019, 92: 171-175. PMID: 30660968. DOI: 10.1016/j.yebeh.2018.12.025.
Arundell L, Parker K, Timperio A, et al. Home-based screen time behaviors amongst youth and their parents: familial typologies and their modifiable correlates[J]. BMC Public Health, 2020, 20(1): 1492. PMID: 33004013. PMCID: PMC7528232. DOI: 10.1186/s12889-020-09581-w.
Sun GW, Shook TL, Kay GL. Inappropriate use of bivariable analysis to screen risk factors for use in multivariable analysis[J]. J Clin Epidemiol, 1996, 49(8): 907-916. PMID: 8699212. DOI: 10.1016/0895-4356(96)00025-x.
Chen JY, Strodl E, Wu CA, et al. Screen time and autistic-like behaviors among preschool children in China[J]. Psychol Health Med, 2021, 26(5): 607-620. PMID: 33227216. DOI: 10.1080/13548506.2020.1851034.
25 Chen L, Shi J. Reducing harm from media: a meta-analysis of parental mediation[J]. Journal Mass Commun Q, 2019, 96(1): 173-193. DOI: 10.1177/1077699018754908.
26 Benedetto L, Ingrassia M. Digital parenting: raising and protecting children in media world[M]//Benedetto L, Ingrassia M. Parenting—Studies by an Ecocultural and Transactional Perspective. Rijeka: IntechOpen, 2020: Ch. 8.
27 Valcke M, Bonte S, De Wever B, et al. Internet parenting styles and the impact on Internet use of primary school children[J]. Comput Educ, 2010, 55(2): 454-464. DOI: 10.1016/j.compedu.2010.02.009.
Lin YY, Lee WT, Yang HL, et al. Screen time exposure and altered sleep in young children with epilepsy[J]. J Nurs Scholarsh, 2020, 52(4): 352-359. PMID: 32396281. DOI: 10.1111/jnu.12558.
Pons M, Bennasar-Veny M, Ya?ez AM. Maternal education level and excessive recreational screen time in children: a mediation analysis[J]. Int J Environ Res Public Health, 2020, 17(23): 8930. PMID: 33271768. PMCID: PMC7730269. DOI: 10.3390/ijerph17238930.
Collier KM, Coyne SM, Rasmussen EE, et al. Does parental mediation of media influence child outcomes? A meta-analysis on media time, aggression, substance use, and sexual behavior[J]. Dev Psychol, 2016, 52(5): 798-812. PMID: 26914217. DOI: 10.1037/dev0000108.
Fisher RS, Acharya JN, Baumer FM, et al. Visually sensitive seizures: an updated review by the epilepsy foundation[J]. Epilepsia, 2022, 63(4): 739-768. PMID: 35132632. DOI: 10.1111/epi.17175.
