Survey of Public Awareness, Attitudes, and Understanding toward Epilepsy in Hong Kong

To the Editor: We read with interest the article by Fong and Hung (1). Our group had conducted a similar survey in Hong Kong as a pilot collaborative project headed under the original author, Professor C. W. Lai (2,3). During the First Conference of the World Association of Chinese Epileptologists (WACE) held in Taiwan (1998), the Public Attitudes Study Group (PASG) was organized. The objective was to compare the public attitudes of countries sharing the same Chinese ethnicity, culture and language in Asia using the same questionnaire within the same time period (1998–1999). The PASG members were authorized the use of the original Chinese version of the “Public Awareness, Attitude and Understanding of Epilepsy” questionnaire as a comparison of four Asian countries (China, Taiwan, Hong Kong, Singapore and Malaysia) in 1998–1999. The Singaporians (4) and Malaysians (5) had published their pilot data. Our data in the Hong Kong Special Administrative Region was also presented in Hong Kong (6) and Taiwan (7) with proceedings published both locally and in Taiwan. Thus, the authors were not the first to publish this survey data in Hong Kong. Moreover, we had the permission of the original author to use the original Chinese version of the questionnaire as a comparison among five Chinese-speaking countries in Asia, be it in Mandarin or Cantonese, as the written Chinese language is still the same in all Chinese speaking communities. We all adopted the same questionnaire with only ten questions, authorized by the original author, Professor C. W. Lai. The authors modified the original version and added new questions to the survey with a total of 13 questions, thus invalidating direct comparison with data from Western countries. We can draw a correspondence between our questions and the questions in the Fong and Hung study. Our original “Questions on Awareness” (Q1–Q3) were labeled as “Familiarity” by the authors. Their questions Q2 and Q3 were equivalent to our Q3 and Q2 respectively. Our “Attitudes (Prejudice) towards Epilepsy” (Q4–Q7) questions were categorized by the authors into separate groups, e.g., Q4 and Q5 of our questionnaire became Q12 and Q13 of theirs. Our Q6 was omitted. Our Q7 was transferred to “Myths and Misunderstandings about Epilepsy” in their Table 4. The authors added two questions (Q10, Q11) asking specifically about “Women with Epilepsy,” which was not the intention of our original query. Our “Understanding of Epilepsy” (Q8) question, with multiple possible answers, was omitted except for Q4 answering one particular issue. Our Q9 question corresponds to their Q6 question. They had added extra questions 7–9 to their questionnaire. Similarly, our Q10 query, with multiple answers, was replaced by the single answer of their Q7. The addition of extra questions in their Tables 4 and 5 may be relevant in Hong Kong; however, these questions had not been tested in the original surveys in China and Taiwan (2,3). Thus, the direct comparison of questions 1–6, with the same survey conducted on the western countries such as West Germany, Finland, USA, Italy, Denmark (Table 6) are not directly valid. Thus, the authors should not conclude that the attitudes in HKSAR are negative. Our findings were different. We found that our cohort was more positive in their attitude towards people with epilepsy, except for the marriage issue.