UCLA Health’s Sandra Dewar inducted into American Academy of Nursing
'I don’t think you can expand the horizons of others unless you’ve expanded your own,' Dr. Dewar says.
The Academy's more than 2,800 fellows are nursing's most accomplished leaders in education, management, practice and research. The fellowship is awarded in recognition of extraordinary contributions to nursing and health care. The 2021 class of fellows includes 225 distinguished nurse leaders from 38 states, the District of Columbia and 17 countries.
“It’s quite amazing to me to receive this award as it’s been a long-standing career goal,” Dr. Dewar says. “It’s a tremendous sense of responsibility. The award is about leadership, but I don’t think you can expand the horizons of others unless you’ve expanded your own.”
Dr. Dewar credits her distinguished colleagues in the UCLA Seizure Disorder Center for contributing to her passion for understanding epilepsy in all its widely variable forms, and most recently, the School of Nursing faculty, notably Dr. Huibrie Pieters, for scholarly collaboration.
“As a clinician, the opportunity to have an academic sounding board has been enormously empowering,” Dr. Dewar says.
Research into surgery avoidance
Dr. Dewar’s most recent body of work centers on why patients often avoid surgery to treat epilepsy.
Her PhD thesis, which she completed in 2019, was titled “Perceptions of Illness Severity in Adults with Focal Drug-resistant Epilepsy." Since then, she has continued to work with people with epilepsy and their caregivers to explore the relationship between self-perceptions of disability and attitudes toward epilepsy surgery.
To understand why surgical options are underutilized for epilepsy, Dr. Dewar asked patients how they understand the risks and benefits of treatments.
“We are dealing with a complex chronic illness, for which there are now many new medicines and surgical therapies,” she says. But for a variety of reasons, many patients don’t make use of these treatments.
Often, she says, people coping with epilepsy underestimate the relative severity of their condition.
“Participants imagined that other peoples' seizures were comparatively worse than their own,” she says. This perception, she says, could inhibit people from seeking out specialized care or color their analysis of the benefit versus the danger of a surgical treatment.
Understanding relationship between patient and caregiver
As the research interviews evolved, the project grew to encompass many aspects of living with epilepsy.
“We realized that the way people think about their epilepsy care encompasses the caregiver,” she says. “The importance of supportive caregiving occurred so continuously that we decided to relook at the data from that perspective.”
That analysis led to a new understanding of the dynamic between adult patients and the family members who provide daily assistance. Through detailed conversations with the patients and families, Dewar and her colleagues found that patients would hide their symptoms or downplay the severity of the disease, to shield their caregivers from the stress of the illness.
Understanding this relationship, which she termed “reciprocal burden,” is critical to helping epilepsy specialists advise patients and families when it comes to treatment options.
Dr. Dewar’s current focus includes working with nurses around the world to develop education curricula that meet global needs for improved epilepsy care.
“Neuroscience specialization is not included in undergraduate or post-graduate nursing education, yet nurses play a major role in the delivery and advancement of speciality care for people with neurological disorders.”
Caroline Seydel is the author of this article.