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Horaib W, Alshamsi R, Zabeeri N, Al-Baradie RS, Abdel Wahab MM. Quality of Life and the Perceived Impact of Epilepsy in Children and Adolescents in the Eastern Province of the Kingdom of Saudi Arabia. Cureus 2021; 13:e20305. [PMID: 34912654 PMCID: PMC8664370 DOI: 10.7759/cureus.20305] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/09/2021] [Indexed: 12/03/2022] Open
Abstract
Objectives This cross-sectional study aimed to assess the perceived impact of epilepsy on children and adolescents and analyze its aspects. Materials and methods The study included patients with epilepsy aged between and two and 19 years old in three major hospitals in the Eastern Province of Saudi Arabia. Data were collected through an online survey. Results The mean score percentage of the quality of life (QOL) assessment was 65.6. This study showed better mean score QOL percentages in males (67), adolescents (65), patients with higher family income and socioeconomic status (64), and those living in Al Jubail (71). QOL was negatively associated with seizure frequency, the number of fears, problems, and concerns, and longer treatment duration. The most common concerns in children and adolescents with epilepsy are having/starting a relationship with others and what people at school will think if they have a seizure. The most common problems were lack of concentration and feeling short-tempered or grumpy. Continuing with education was the most common fear for the future. The most common concern of parents/caregivers was their ability to keep up with schoolwork. The QOL of participants who preferred to keep their epilepsy a secret (69) and those who used magazines and books (71) as one of the sources of information was better than that of those who did not. Conclusion Better QOL was found in males, adolescents, patients with higher family income, those living in Al Jubail, who preferred to keep their epilepsy a secret, and those who used magazines and books as sources of information. However, the QOL was negatively associated with seizure frequency, the number of fears, problems, and concerns that the patients/caregivers had, and longer treatment duration.
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Affiliation(s)
- Wesal Horaib
- Neurology, King Fahd Hospital of the University, Khobar, SAU
| | - Razan Alshamsi
- Neurology, Imam Abdulrahman Bin Faisal University, Dammam, SAU
| | - Najwa Zabeeri
- Family and Community Medicine, Imam Abdulrahman Bin Faisal University, Dammam, SAU
| | - Raidah S Al-Baradie
- Neuroscience and Pediatric Neurology, Neuroscience Center, King Fahad Specialist Hospital, Dammam, SAU
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Psychopathology and Quality of Life in Children with Epilepsy: A Cross-Sectional Study. Indian J Pediatr 2021; 88:712-714. [PMID: 33576951 DOI: 10.1007/s12098-021-03685-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/09/2020] [Accepted: 01/27/2021] [Indexed: 10/22/2022]
Abstract
The study examined the relationship between psychopathology, seizure-related variables, and quality of life in children with epilepsy. Seventy-nine children with active epilepsy (Mean = 10.1 y, SD = 2.68) were consecutively recruited from the outpatient services of an advanced pediatric hospital. The Quality-of-Life in Childhood Epilepsy questionnaire and the Childhood Psychopathology Measurement Schedule (CPMS) were administered to the parents. The most compromised health-related quality of life (HRQOL) domain was the general health domain (Mean = 61.70, SD = 26.81). The mean intelligence quotient (IQ) score was 81.59 (SD = 12.34) and only 20% had IQs in the normal average range. The mean CPMS score was 7.41 (SD = 5.41). The psychopathology score and the IQ explained 43% of the variance in the total HRQOL score (F = 28.67, P = 0.0001) in the regression analysis. Childhood epilepsy is a significant public health concern and a multidisciplinary approach to management would help in addressing the multiple needs of the children with epilepsy and their families.
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Pachange PN, Dixit JV, C AM, Goel AD. Quality of Life among Middle and Secondary School Children with Epilepsy. J Neurosci Rural Pract 2021; 12:490-494. [PMID: 34376960 PMCID: PMC8322960 DOI: 10.1055/s-0041-1725242] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Objectives
Epilepsy is a leading cause of disability in school-going children. The objectives of this study were to estimate the prevalence of epilepsy in middle and secondary school children and to assess their quality of life (QOL).
Materials and Methods
This was a cross-sectional study done in schools under the municipal corporation area of Latur Taluka, Maharashtra. At school, children were screened for epilepsy and the positive children were visited at home. Children with confirmed epilepsy were used to calculate prevalence. The QOL of children diagnosed to have epilepsy was assessed using Quality of Life in Childhood Epilepsy Questionnaire (QOLCE-55) version 1.0.
Statistical Analysis
Mean scores in scales and subscales of QOLCE-55 were calculated. Association between variables was analyzed using unpaired/independent
t
-test and analysis of variance. Statistically significance was fixed for a
p
-value less than 0.05.
Results
Prevalence of epilepsy in middle and secondary school children was found to be 3.20 per 1000. In QOLCE-55, physical functioning was the most compromised, with the lowest mean QOL score (mean = 58.3, standard deviation = 20.66). Present age of the child, age at the first seizure episode, and time interval since last seizure had a statistically significant relation with QOL. The treatment gap was found to be 70.4%.
Conclusions
Assessment of QOL in children with epilepsy is important for effective and comprehensive management of epilepsy.
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Affiliation(s)
| | - J V Dixit
- Department of Community Medicine, Government Medical College, Aurangabad, Maharashtra, India
| | - Arjun M C
- Community Medicine & Family Medicine, All India Institute of Medical Sciences, Bhubaneswar, Orissa, India
| | - Akhil Dhanesh Goel
- Community Medicine & Family Medicine, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
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Fong CY, Chang WM, Kong AN, Rithauddin AM, Khoo TB, Ong LC. Quality of life in Malaysian children with epilepsy. Epilepsy Behav 2018; 80:15-20. [PMID: 29396357 DOI: 10.1016/j.yebeh.2017.12.032] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/09/2017] [Revised: 12/24/2017] [Accepted: 12/24/2017] [Indexed: 10/18/2022]
Abstract
BACKGROUND Children with epilepsy (CWE) are at risk of impaired quality of life (QOL), and achieving a good QOL is an important treatment goal among CWE. To date, there are no published multiethnic QOL studies in Asia. Our study aimed to: i) investigate the QOL of multiethnic CWE in Malaysia as reported by both the child and parent; ii) determine the level of agreement between child-self report and parent-proxy report QOL; and iii) explore potential correlates of sociodemographic, epilepsy characteristics, and family functioning with QOL in CWE. METHODS Cross-sectional study of all CWE aged 8-18years old with at least 6months' duration of epilepsy, minimum reading level of primary school education Year 1, and attending mainstream education. Quality of life was measured using the parent-proxy and child self-report of Quality of Life Measurement for Children with Epilepsy (CHEQOL-25) questionnaire. Total and subscale CHEQOL-25 scores were obtained. The levels of parent-child agreement were determined using intraclass correlation coefficients (ICC). Family functioning was assessed using the General functioning subscale (GF-12). RESULTS A total of 115 CWE and their parents participated in the study. In general, Malaysian parents rated children's total CHEQOL-25 scores poorer than the children themselves [mean total parent score: 68.56 (SD: 10.86); mean total child score: 71.82 (SD: 9.55)]. Agreement between child and parent on the CHEQOL-25 was poor to moderate (ICC ranged from 0.31-0.54), with greatest discordance in the epilepsy secrecy domain (ICC=0.31, p=0.026). Parent and child were more likely to agree on more external domains: intrapersonal/social (ICC=0.54, p<0.001) and interpersonal/emotional (ICC=0.50, p<0.001). Malay ethnicity, focal seizure and high seizure frequency (≥1 seizure per month) were associated with lower CHEQOL-25 scores. There was a significant but weak correlation between GF-12 and parent-proxy CHEQOL-25 Total Scores (r=-0.186, p=0.046). CONCLUSION Our results emphasize the importance to have the child's perspective of their QOL as the level of agreement between the parent and child reported scores were poor to moderate. Malaysian CWE of Malay ethnicity, those with focal seizures or high seizure frequency are at risk of poorer QOL.
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Affiliation(s)
- Choong Yi Fong
- Division of Paediatric Neurology, Department of Paediatrics, Faculty of Medicine, University Malaya, Kuala Lumpur, Malaysia.
| | - Wei Mun Chang
- Division of Paediatric Neurology, Department of Paediatrics, Faculty of Medicine, University Malaya, Kuala Lumpur, Malaysia; Paediatric Department, Hospital Raja Permaisuri Bainun, Ipoh, Perak, Malaysia
| | - Ann Nie Kong
- Division of Paediatric Neurology, Department of Paediatrics, Faculty of Medicine, University Malaya, Kuala Lumpur, Malaysia
| | | | - Teik Beng Khoo
- Paediatric Neurology Unit, Paediatric Institute, Hospital Kuala Lumpur, Malaysia
| | - Lai Choo Ong
- Division of Paediatric Neurology, Department of Paediatrics, Faculty of Medicine, University Malaya, Kuala Lumpur, Malaysia
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Childhood epilepsy and ADHD comorbidity in an Indian tertiary medical center outpatient population. Sci Rep 2018; 8:2670. [PMID: 29422636 PMCID: PMC5805699 DOI: 10.1038/s41598-018-20676-8] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2017] [Accepted: 01/22/2018] [Indexed: 12/17/2022] Open
Abstract
This study aimed to assess the prevalence of Attention Deficit Hyperactivity Disorder (ADHD) and its characteristics and risk factors in children with epilepsy at a tertiary medical center in New Delhi. Children with active epilepsy, aged 6 to 12 years, were assessed for ADHD using DSM-IV-TR criteria. Epilepsy and psychiatric characteristics, sociodemographic indicators, and use of antiepileptic drugs were analyzed for differences between the ADHD and non-ADHD groups. Among the 73 children with epilepsy, 23% (n = 17) had comorbid ADHD, of whom 59% (n = 10) had predominantly inattentive type, 35% (n = 6) combined type, and 6% (n = 1) predominantly hyperactive-impulsive type. Lower IQ scores, epileptiform EEG activity, not attending school, and male sex were significantly associated with comorbid ADHD in children with epilepsy. Groups were similar in terms of age, socioeconomic indicators, family history of psychiatric disorders, seizure frequency in the last six months, seizure etiology, and seizure type. Epilepsy is a common pediatric neurological condition with frequent psychiatric comorbidities, including ADHD. Specialists should collaborate to optimize treatment for children with epilepsy and ADHD, especially for families in developing countries where the burden of disease can be great.
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Schaffer Y, Ben Zeev B, Cohen R, Shufer A, Geva R. Memory, Executive Skills, and Psychosocial Phenotype in Children with Pharmacoresponsive Epilepsy: Reactivity to Intervention. Front Neurol 2017; 8:86. [PMID: 28484417 PMCID: PMC5399087 DOI: 10.3389/fneur.2017.00086] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2016] [Accepted: 02/24/2017] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Recent studies on pharmacoresponsive epilepsies demonstrate specific memory, executive functions (EF), and psychosocial deficits in this group. These deficits are often undertreated, and little is known about the neuropsychological factors that may support moderation of the deficits through intervention. The aim of this study was to explore the effects of a structured cognitive behavioral group intervention on both memory and emotional domains and to evaluate the factors influencing its efficacy. METHODS The feasibility study implemented a newly designed intervention for children with pharmacoresponsive epilepsies (N = 33, aged 9-14 years, 51% girls), hypothesizing that memory and psychosocial symptoms in children with pharmacoresponsive epilepsies are sensitive to intervention using structured memory and psychosocial modules in a weekly group session setting. Comparable memory and psychosocial assessments were used to evaluate performance at baseline and post-intervention. Results were compared to age- and education-matched healthy controls (N = 27, aged 9-14 years). RESULTS Pre-post-intervention comparisons show improvements in STM (p < 0.01, η2 = 0.358), optimism (p < 0.05, η2 = 0.245), and self-efficacy (p < 0.05, η2 = 0.164). Unique negative relations between memory deficits and psychosocial phenotype were seen in epilepsy patients and not in controls in response to the intervention. EF moderated this intervention effect (p < 0.05, η2 = 0.252), whereas psychosocial status and pharmacological profile did not. CONCLUSION Cognitive behavioral therapy focusing on memory and psychosocial perceptions for children with pharmacoresponsive epilepsies seems promising, with greater improvement in memory and psychosocial functioning in children with more affected EF.
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Affiliation(s)
- Yael Schaffer
- Department of Psychology, Bar-Ilan University, Ramat Gan, Israel
- The Gonda Multidisciplinary Brain Research Center, Bar-Ilan University, Ramat Gan, Israel
| | - Bruria Ben Zeev
- The Neurology Department at Sheba Medical Center, Ramat Gan, Israel
| | - Roni Cohen
- Department of Pediatric Neurology and Epilepsy Center, Schneider Children’s Medical Center of Israel, Petach Tikva, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Avinoam Shufer
- Department of Pediatric Neurology and Epilepsy Center, Schneider Children’s Medical Center of Israel, Petach Tikva, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Ronny Geva
- Department of Psychology, Bar-Ilan University, Ramat Gan, Israel
- The Gonda Multidisciplinary Brain Research Center, Bar-Ilan University, Ramat Gan, Israel
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BANSAL D, AZAD C, GUDALA K, DASARI A. Predictors of health related quality of life in childhood epilepsy and comparison with healthy children: findings from an Indian study. Turk J Med Sci 2017; 47:490-498. [DOI: 10.3906/sag-1511-148] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2015] [Accepted: 07/26/2016] [Indexed: 11/03/2022] Open
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Didsbury MS, Kim S, Medway MM, Tong A, McTaggart SJ, Walker AM, White S, Mackie FE, Kara T, Craig JC, Wong G. Socio-economic status and quality of life in children with chronic disease: A systematic review. J Paediatr Child Health 2016; 52:1062-1069. [PMID: 27988995 DOI: 10.1111/jpc.13407] [Citation(s) in RCA: 82] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2016] [Accepted: 09/05/2016] [Indexed: 11/28/2022]
Abstract
Reduced quality of life (QoL) is a known consequence of chronic disease in children, and this association may be more evident in those who are socio-economically disadvantaged. The aims of this systematic review were to assess the association between socio-economic disadvantage and QoL among children with chronic disease, and to identify the specific socio-economic factors that are most influential. MEDLINE, Embase and PsycINFO were searched to March 2015. Observational studies that reported the association between at least one measure of social disadvantage in caregivers and at least one QoL measure in children and young people (age 2-21 years) with a debilitating non-communicable childhood disease (asthma, chronic kidney disease, type 1 diabetes mellitus and epilepsy) were eligible. A total of 30 studies involving 6957 patients were included (asthma (six studies, n = 576), chronic kidney disease (four studies, n = 796), epilepsy (14 studies, n = 2121), type 1 diabetes mellitus (six studies, n = 3464)). A total of 22 (73%) studies reported a statistically significant association between at least one socio-economic determinant and QoL. Parental education, occupation, marital status, income and health insurance coverage were associated with reduced QoL in children with chronic disease. The quality of the included studies varied widely and there was a high risk of reporting bias. Children with chronic disease from lower socio-economic backgrounds experience reduced QoL compared with their wealthier counterparts. Initiatives to improve access to and usage of medical and psychological services by children and their families who are socio-economically disadvantaged may help to mitigate the disparities and improve outcomes in children with chronic illnesses.
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Affiliation(s)
- Madeleine S Didsbury
- Centre for Kidney Research, The Children's Hospital at Westmead, New South Wales, Australia
| | - Siah Kim
- Centre for Kidney Research, The Children's Hospital at Westmead, New South Wales, Australia
| | - Meredith M Medway
- Centre for Kidney Research, The Children's Hospital at Westmead, New South Wales, Australia
| | - Allison Tong
- Centre for Kidney Research, The Children's Hospital at Westmead, New South Wales, Australia
| | - Steven J McTaggart
- Child and Adolescent Renal Service, Lady Cilento Children's Hospital, Brisbane, Queensland, Australia
| | - Amanda M Walker
- Department of Paediatrics, University of Melbourne, Melbourne, Victoria, Australia.,Paediatric Nephrology, The Royal Children's Hospital, Melbourne, Victoria, Australia
| | - Sarah White
- Sydney School of Public Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Fiona E Mackie
- Department of Nephrology, Sydney Children's Hospital at Randwick, Sydney, New South Wales, Australia
| | - Tonya Kara
- Department of Paediatric Nephrology, Starship Children's Hospital, Auckland, New Zealand
| | - Jonathan C Craig
- Centre for Kidney Research, The Children's Hospital at Westmead, New South Wales, Australia.,Sydney School of Public Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Germaine Wong
- Centre for Kidney Research, The Children's Hospital at Westmead, New South Wales, Australia.,Sydney School of Public Health, The University of Sydney, Sydney, New South Wales, Australia.,Centre for Transplant and Renal Research, Westmead Hospital, Sydney, New South Wales, Australia
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9
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Choi HY, Kim SE, Lee HW, Kim EJ. Social Behavioral Problems and the Health-Related Quality of Life in Children and Adolescents with Epilepsy. Psychiatry Investig 2016; 13:488-495. [PMID: 27757126 PMCID: PMC5067342 DOI: 10.4306/pi.2016.13.5.488] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/30/2015] [Revised: 03/07/2016] [Accepted: 03/21/2016] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVE The purpose of this study was to investigate the impact of specific behavioral problems on the health-related quality of life (HRQOL) in children and adolescents with epilepsy. METHODS Children and adolescents with epilepsy (n=92; age range=6-17 years) and their mothers completed questionnaires about behavioral problems, HRQOL, socio-demographics, and epilepsy-related variables. To determine significant predictor variables of the HRQOL, the stepwise regression analyses and partial correlations were performed to adjust for other behavioral problems and covariates. RESULTS The analyses revealed that an increase in social behavioral problems and delinquent behavior was associated with a decrease in the HRQOL. Lower levels of maternal education and the number of antiepileptic drugs were also associated with a decline in the HRQOL; the HRQOL and social behavioral problems remained significantly correlated after adjusting for maternal education level, number of antiepileptic drugs, and non-social behavioral problems. CONCLUSION Parents and practitioners should provide intervention if behavioral problems, particularly social behavioral problems, are observed in children or adolescents with epilepsy.
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Affiliation(s)
- Hee-Yeon Choi
- Department of Psychiatry, Ewha Womans University School of Medicine, Seoul, Republic of Korea
| | - Song E Kim
- Department of Neurology, Ewha Womans University School of Medicine, Seoul, Republic of Korea
| | - Hyang Woon Lee
- Department of Neurology, Ewha Womans University School of Medicine, Seoul, Republic of Korea
| | - Eui-Jung Kim
- Department of Psychiatry, Ewha Womans University School of Medicine, Seoul, Republic of Korea
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Iqbal M, Amirsalari S, Radfar S, Haidari MR. Effects of parental gender and level of education on the quality of life and general health of pediatric patients with epilepsy: An outpatient cross-sectional survey. Epilepsy Behav 2016; 60:118-123. [PMID: 27206229 DOI: 10.1016/j.yebeh.2016.04.037] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/16/2016] [Accepted: 04/18/2016] [Indexed: 10/21/2022]
Abstract
The quality of life (QOL) of children with epilepsy has been widely studied, and several problems related to cognition, behavior, social lives, and physical activity among these children have been reported. Family life and parental care are important aspects of the lives of these patients. The impact of parental education on the QOL of pediatric patients with epilepsy is an understudied topic, especially in developing countries. In this study, we investigated the QOL and general health (GH) of patients with epilepsy presenting at the pediatric neurology clinic at Baqiyatallah Hospital and a private clinic. The Quality of Life in Childhood Epilepsy (QOLCE) questionnaire, which is a 92-item epilepsy-specific questionnaire covering physical activity, well-being, cognition, behavior, social activity, overall QOL, and GH, was used for interviewing parents. A total of 106 patients (m=61, 57.5% and f=45, 42.5%) aged 5-17years (mean: 10.31±2.91) participated in the study. Overall, there was no significant difference between the QOL and GH results of male and female patients. However, the maternal education level had a significant impact on the overall QOL (high school: 3.02±0.85 vs. B.Sc.: 3.67±0.61, p<0.05) and GH (high school: 2.81±0.79 vs. B.Sc.: 3.8±0.94, p<0.05) of male patients, while paternal education had no significant effect. A multiple linear regression showed that the maternal education level had an independently significant association with the physical activity of the patients (p=0.02, CI: 1.4-6.25), and the paternal education level had an independently significant association with the well-being of the patients (p=0.02, CI: 0.43-5.36). In addition, the maternal education level (high school vs. B.Sc.) had a significant effect on physical activity, well-being, cognition, and behavior for all of the patients (p<0.05), while the paternal education level (high school vs. B.Sc.) had no significant impact. However, in a comparison of high school vs. higher education, paternal education had a significant effect on patients' physical activity and well-being (p<0.05). We conclude that parental levels of education play a significant role in various aspects of the lives and GH of children with epilepsy. Maternal education, in particular, plays a significant role in GH and the overall QOL of male patients. Further research is suggested to identify the socioeconomic and cultural factors responsible for these findings.
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Affiliation(s)
- Meisam Iqbal
- Faculty of Medicine, Baqiyatallah University of Medical Sciences, Tehran, Islamic Republic of Iran
| | - Susan Amirsalari
- Department of Paediatrics, Faculty of Medicine, Baqiyatallah University of Medical Sciences, Tehran, Islamic Republic of Iran.
| | - Shokofeh Radfar
- Department of Psychiatry, Faculty of Medicine, Baqiyatallah University of Medical Sciences, Tehran, Islamic Republic of Iran
| | - Mohsen Reza Haidari
- Section of Neuroscience, Department of Neurology, Faculty of Medicine, Baqiyatallah University of Medical Sciences, Tehran, Islamic Republic of Iran.
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11
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Awoyale T, Onajole AT, Ogunnowo BE, Adeyemo WL, Wanyonyi KL, Butali A. Quality of life of family caregivers of children with orofacial clefts in Nigeria: a mixed-method study. Oral Dis 2016; 22:116-22. [PMID: 26456150 PMCID: PMC4744119 DOI: 10.1111/odi.12379] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2015] [Revised: 09/09/2015] [Accepted: 09/15/2015] [Indexed: 11/27/2022]
Abstract
BACKGROUND Orofacial clefts (OFCs) are common birth defects that may impose a large burden on the health and psychosocioeconomic well-being of affected individuals and families. This study aims to identify qualitative factors that affect the quality of life (QOL) of family caregivers of children with OFCs. METHODS A mixed-method study in which family caregivers of OFCs children were consecutively recruited from cleft clinics over a 3-month period. Quantitative data were analyzed using SPSS version 17 and focus group discussion by framework analysis. RESULTS A total of 107 caregivers participated in the entire study, and 24 caregivers participated in the focus group discussions. About 50% of the children had cleft lip and palate (CLP), 28% with cleft lips only (CL) and 23.4% with cleft palate only (CP). Poor access to specific information and lack of empathy of professionals affected the quality of life and delivery of family-centered care. CONCLUSIONS To improve the quality of life of family caregivers, individual-focused counseling sessions should be organized for caregivers soon after birth. This will provide an opportunity to discuss the laid out plans for supportive care. It will also be as an avenue to address the arising social issues by health professionals and counselors.
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Affiliation(s)
- T Awoyale
- Lagos University Teaching Hospital, Lagos, Nigeria
| | - A T Onajole
- Community Health and Primary Care, University of Lagos, Lagos, Nigeria
| | - B E Ogunnowo
- Department of Community Health, University of Lagos, Lagos, Nigeria
| | - W L Adeyemo
- Department of Oral and Maxillofacial Surgery, University of Lagos, Lagos University Teaching Hospital, Lagos, Nigeria
| | - K L Wanyonyi
- King's College London Dental Institute, London, UK
| | - A Butali
- Department of Oral Pathology, Radiology and Medicine, Dows Institute for Dental Research, College of Dentistry, University of Iowa, Iowa City, IA, USA
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Amudhan S, Gururaj G, Satishchandra P. Epilepsy in India II: Impact, burden, and need for a multisectoral public health response. Ann Indian Acad Neurol 2015; 18:369-81. [PMID: 26713005 PMCID: PMC4683872 DOI: 10.4103/0972-2327.165483] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Epilepsy is a common neurological disorder whose consequences are influenced socially and culturally, especially in India. This review (second of the two part series) was carried out to understand the social impact and economic burden to develop comprehensive program for control and prevention of epilepsy. Epilepsy is known to have adverse effect on education, employment, marriage, and other essential social opportunities. Economic burden associated with epilepsy is very high with treatment and travel costs emerging as an important contributing factor. A vicious cycle between economic burden and poor disease outcome is clear. There is no significant change in the perception, stigma, and discrimination of epilepsy across the country despite improvement in educational and social parameters over the time. The huge treatment gap and poor quality of life is further worsened by the associated comorbidities and conditions. Thus, a multidisciplinary response is needed to address the burden and impact of epilepsy which calls for an integrated and multipronged approach for epilepsy care, prevention, and rehabilitation. Service delivery, capacity building, integration into the existing program, mobilizing public support, and increasing public awareness will be the hallmarks of such an integrated approach in a public health model.
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Affiliation(s)
- Senthil Amudhan
- Department of Epidemiology, Centre for Public Health, Bangalore, Karnataka, India
| | - Gopalkrishna Gururaj
- Department of Epidemiology, Centre for Public Health, Bangalore, Karnataka, India
| | - Parthasarathy Satishchandra
- Director/Vice-chancellor and Professor of Neurology, National Institute of Mental Health and Neurosciences, Bangalore, Karnataka, India
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13
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Schaffer Y, Ben Zeev B, Cohen R, Shuper A, Geva R. Auditory verbal memory and psychosocial symptoms are related in children with idiopathic epilepsy. Epilepsy Behav 2015; 48:53-60. [PMID: 26057205 DOI: 10.1016/j.yebeh.2015.04.069] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2015] [Revised: 04/21/2015] [Accepted: 04/29/2015] [Indexed: 10/23/2022]
Abstract
OBJECTIVE Idiopathic epilepsies are considered to have relatively good prognoses and normal or near normal developmental outcomes. Nevertheless, accumulating studies demonstrate memory and psychosocial deficits in this population, and the prevalence, severity and relationships between these domains are still not well defined. We aimed to assess memory, psychosocial function, and the relationships between these two domains among children with idiopathic epilepsy syndromes using an extended neuropsychological battery and psychosocial questionnaires. METHODS Cognitive abilities, neuropsychological performance, and socioemotional behavior of 33 early adolescent children, diagnosed with idiopathic epilepsy, ages 9-14years, were assessed and compared with 27 age- and education-matched healthy controls. RESULTS Compared to controls, patients with stabilized idiopathic epilepsy exhibited higher risks for short-term memory deficits (auditory verbal and visual) (p<0.0001), working memory deficits (p<0.003), auditory verbal long-term memory deficits (p<0.0021), and more frequent psychosocial symptoms (p<0.0001). The severity of auditory verbal memory deficits was related to severity of psychosocial symptoms among the children with epilepsy but not in the healthy controls. SIGNIFICANCE Results suggest that deficient auditory verbal memory may be compromising psychosocial functioning in children with idiopathic epilepsy, possibly underscoring that cognitive variables, such as auditory verbal memory, should be assessed and treated in this population to prevent secondary symptoms.
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Affiliation(s)
- Yael Schaffer
- Department of Psychology, Bar-Ilan University, Ramat Gan 5290002, Israel; The Gonda Multidisciplinary Brain Research Center, Bar-Ilan University, Ramat Gan 5290002, Israel
| | - Bruria Ben Zeev
- Pediatric Neurology Institute, The Edmond and Lily Safra Children's Hospital, Sheba Medical Center, Ramat Gan, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Roni Cohen
- Institute of Pediatric Neurology, Schneider Children's Medical Center of Israel, Petach Tikva, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Avinoam Shuper
- Institute of Pediatric Neurology, Schneider Children's Medical Center of Israel, Petach Tikva, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Ronny Geva
- Department of Psychology, Bar-Ilan University, Ramat Gan 5290002, Israel; The Gonda Multidisciplinary Brain Research Center, Bar-Ilan University, Ramat Gan 5290002, Israel.
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Rana P, Mishra D. Quality of life of unaffected siblings of children with chronic neurological disorders. Indian J Pediatr 2015; 82:545-8. [PMID: 25640066 DOI: 10.1007/s12098-014-1672-4] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2014] [Accepted: 12/18/2014] [Indexed: 11/27/2022]
Abstract
OBJECTIVE To study quality of life (QoL) of the siblings of children with chronic neurological disorders. METHODS Between 1st August and 30th September, 2013, 50 children aged 12-18 y, whose child sibling was suffering from a chronic neurological disorder, were enrolled (Study group). Fifty age- and sex- matched siblings of apparently non-neurologically affected children were enrolled as controls (Control group). Those with more than one affected child or any affected adult in the family were excluded. QoL was assessed by a validated version of the WHOQOL-BREF in Hindi, and QoL was compared between cases and controls. RESULTS The disorders in the index cases included cerebral palsy, 18 (15 with epilepsy); autism, 15; mental retardation, 12 and epilepsy, 5. The QoL in all domains was significantly poorer in the study group as compared to the controls. 64% study group children had insufficient knowledge about their sibling's condition. More than 1/4th study subjects faced difficulties in studies, play or work. There was no difference among the groups with regard to number of siblings who had 'dropped from the school'. CONCLUSIONS The QoL of unaffected siblings of children with chronic neurological disorders was significantly impaired. Health-workers may consider including older siblings of neurologically affected children during family-counseling sessions, to provide information and suggest coping strategies. This intervention is likely to improve the functioning of the family unit as a whole.
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Affiliation(s)
- Pratyaksha Rana
- Department of Pediatrics, Maulana Azad Medical College and associated Lok Nayak Hospital, Delhi, 110002, India
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Gulati S, Yoganathan S, Chakrabarty B. Epilepsy, cognition and behavior. Indian J Pediatr 2014; 81:1056-62. [PMID: 25073691 DOI: 10.1007/s12098-014-1530-4] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2014] [Accepted: 06/27/2014] [Indexed: 02/08/2023]
Abstract
Epilepsy is defined as two or more unprovoked seizures. Epileptic patients have intellectual disability and behavioral co-morbidities to the tune of up to 25 and 75% respectively. Various factors like underlying etiology, socioeconomic environment at home, age at onset, seizure semiology, seizure descriptors like duration, severity and frequency, therapy related adverse effects secondary to antiepileptic drugs and epilepsy surgery have been implicated for the causation of cognitive and behavioral impairment in epilepsy. Cognitive epilepsy has emerged as a specific entity. This may manifest as a transient behavioral or cognitive change, insidous onset subacute to chronic encephalopathy or more catastrophic in the form of nonconvulsive status epilepticus. Cognitive impairment seen in epileptic children include difficulties in learning, memory, problem solving as well as concept formation. Anxiety, depression and attention deficit hyperkinetic disorders are the most common psychiatric co-morbidities seen. Investigating a child with epilepsy for cognitive and behavioral impairment is difficult as these tests would require cooperation from the patient's side to a significant extent. A rational approach towards treatment would be judicious selection of antiepileptic drugs, treatment of underlying cause, appropriate management of behavioral co-morbidities including psychopharmacotherapy and a trial of immunotherapy (particularly in cognitive epilepsies), wherever appropriate.
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Affiliation(s)
- Sheffali Gulati
- Division of Pediatric Neurology, Department of Pediatrics, All India Institute of Medical Sciences, New Delhi, 110029, India,
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Arya V, Gehlawat VK, Kaushik JS, Gathwala G. Assessment of parent reported quality of life in children with epilepsy from Northern India: A cross-sectional study. J Pediatr Neurosci 2014; 9:17-20. [PMID: 24891896 PMCID: PMC4040025 DOI: 10.4103/1817-1745.131473] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVE The objective of the following study is to assess parent reported quality of life (QOL) in children with epilepsy and to assess the demographic and clinical factors, which influence the QOL in children with epilepsy. STUDY PARTICIPANTS We consecutively enrolled 40 children aged from 2 years to 14 years with active epilepsy who had undergone a comprehensive evaluation for epilepsy. MATERIALS AND METHODS Parents were enquired on baseline demographic variables including age, gender, socio-economic status and parental education. Clinical details of epilepsy including the type of epilepsy, seizure frequency were assessed. QOL was evaluated with the parent reported quality of life in childhood epilepsy (QOLCE) questionnaire. RESULTS A total of 40 children were enrolled of which 55% (22/40) were males and the mean (standard deviation [SD]) age of enrolled children was 10.6 (2.7) years. The majority came from a rural background (80% [32/40]), were from lower (15 [37.5%]) or middle (23 [57.5%]) socio-economic status, with almost half (22 [55%]) of mothers being educated until high school. The overall mean (SD) QOL score was 66.7 (4.83). Lowest mean (SD) scores were observed in self-esteem (45.2 [7.3]) subscale and subscales with higher QOL scores included control/helplessness (82.1 [8.51]), anxiety (81.6 [12.55]) and social stigma (95.0 [11.6]). Parental education, socio-economic status (P = 0.96), frequency of seizure (P = 0.34) or type of epilepsy (P = 0.92) did not significantly affect the overall QOL among children with epilepsy. CONCLUSION Our study concluded that overall QOL was compromised in Indian children with epilepsy. Demographic factors like parental education, socio-economic status and clinical factors like frequency of seizure or type of seizure did not significantly affect the QOL of epileptic children.
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Affiliation(s)
- Vandana Arya
- Department of Pediatrics, Pt. B D Sharma Postgraduate Institute of Medical Sciences, Rohtak, Haryana, India
| | - Virender Kumar Gehlawat
- Department of Pediatrics, Pt. B D Sharma Postgraduate Institute of Medical Sciences, Rohtak, Haryana, India
| | - Jaya Shankar Kaushik
- Department of Pediatrics, Pt. B D Sharma Postgraduate Institute of Medical Sciences, Rohtak, Haryana, India
| | - Geeta Gathwala
- Department of Pediatrics, Pt. B D Sharma Postgraduate Institute of Medical Sciences, Rohtak, Haryana, India
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Thomson L, Fayed N, Sedarous F, Ronen GM. Life quality and health in adolescents and emerging adults with epilepsy during the years of transition: a scoping review. Dev Med Child Neurol 2014; 56:421-33. [PMID: 24237329 DOI: 10.1111/dmcn.12335] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/25/2013] [Indexed: 11/29/2022]
Abstract
AIMS The aims of this study were to (1) search the literature in order to identify the challenges facing adolescents and emerging adults with epilepsy; and (2) categorize these issues within both the framework of the International Classification of Functioning, Disability and Health (ICF) and an empirical model of quality of life (QOL) in childhood epilepsy. METHOD We systematically searched PsycINFO, Ovid MEDLINE and Web of Science for studies reporting on QOL and health identified in people with epilepsy aged 12 to 29 years. Studies were limited to those that were published in the last 20 years in English, presenting the patient perspective. Data were extracted and charted using a descriptive analytical method. Identified issues were classified according to the ICF and QOL frameworks. RESULTS Fifty four studies were identified. Another 62 studies with potentially useful information were included as an addendum. The studies highlight a range of psychosocial issues emphasizing peer acceptance, social isolation, and feelings of anxiety, fear, and sadness. INTERPRETATION The ICF and QOL constructs represent useful starting points in the analytical classification of the potential challenges faced by adolescents with epilepsy. Progress is needed on fully classifying issues not included under these frameworks. We propose to expand these frameworks to include comorbidities, impending medical interventions, and concerns for future education, employment, marriage, dignity, and autonomy.
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Affiliation(s)
- Lauren Thomson
- Undergraduate Program, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada
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Bhalla D, Chea K, Chamroeun H, Vichea C, Huc P, Samleng C, Sebbag R, Gérard D, Dumas M, Oum S, Druet-Cabanac M, Preux PM. Comprehensive evaluation of the psychosocial parameters of epilepsy: A representative population-based study in Prey Veng (Cambodia). Epilepsia 2013; 54:1342-51. [DOI: 10.1111/epi.12218] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/08/2013] [Indexed: 11/26/2022]
Affiliation(s)
- Devender Bhalla
- INSERM UMR 1094; Tropical Neuroepidemiology; Limoges France
- School of Medicine; Institute of Neuroepidemiology and Tropical Neurology; CNRS FR 3503 GEIST; University of Limoges; Limoges France
- Centre Hospitalier Universitaire; Limoges France
- Cambodian Society of Neurology; Phnom Penh Cambodia
| | - Kimly Chea
- University of Health Sciences; Phnom Penh Cambodia
| | - Hun Chamroeun
- Cambodian Society of Neurology; Phnom Penh Cambodia
- University of Health Sciences; Phnom Penh Cambodia
- Department of Neurology; Calmette Hospital; Phnom Penh Cambodia
| | - Chan Vichea
- Department of Neurology; Calmette Hospital; Phnom Penh Cambodia
| | - Pierre Huc
- INSERM UMR 1094; Tropical Neuroepidemiology; Limoges France
- School of Medicine; Institute of Neuroepidemiology and Tropical Neurology; CNRS FR 3503 GEIST; University of Limoges; Limoges France
| | - Chan Samleng
- Cambodian Society of Neurology; Phnom Penh Cambodia
- University of Health Sciences; Phnom Penh Cambodia
- Department of Neurology; Calmette Hospital; Phnom Penh Cambodia
| | - Robert Sebbag
- Department of Access to Medicines; Sanofi; Gentilly France
| | - Daniel Gérard
- Department of Access to Medicines; Sanofi; Gentilly France
| | - Michel Dumas
- INSERM UMR 1094; Tropical Neuroepidemiology; Limoges France
- School of Medicine; Institute of Neuroepidemiology and Tropical Neurology; CNRS FR 3503 GEIST; University of Limoges; Limoges France
| | - Sophal Oum
- University of Health Sciences; Phnom Penh Cambodia
| | - Michel Druet-Cabanac
- INSERM UMR 1094; Tropical Neuroepidemiology; Limoges France
- School of Medicine; Institute of Neuroepidemiology and Tropical Neurology; CNRS FR 3503 GEIST; University of Limoges; Limoges France
- Centre Hospitalier Universitaire; Limoges France
| | - Pierre-Marie Preux
- INSERM UMR 1094; Tropical Neuroepidemiology; Limoges France
- School of Medicine; Institute of Neuroepidemiology and Tropical Neurology; CNRS FR 3503 GEIST; University of Limoges; Limoges France
- Centre Hospitalier Universitaire; Limoges France
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Nadkarni J, Jain A, Dwivedi R. Quality of life in children with epilepsy. Ann Indian Acad Neurol 2012; 14:279-82. [PMID: 22346017 PMCID: PMC3271467 DOI: 10.4103/0972-2327.91948] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2011] [Revised: 03/09/2011] [Accepted: 08/18/2011] [Indexed: 11/23/2022] Open
Abstract
Background: Epilepsy is a chronic medical condition with many co-morbid features. It has been observed that children with epilepsy (CWE) have a compromised quality of life (QOL). Objective: To assess the QOL in CWE and to study the various factors affecting QOL among CWE. Materials and Methods: The sample consisted of 102 CWE aged 5–15 years of either sex. QOL was measured by Quality of Life in Childhood Epilepsy (QOLCE) questionnaire, a 76-item, parent-reported questionnaire. Cronbach alpha was used to determine the internal consistency of the subscales and Pearson correlation to determine construct validity. The t-test and analysis of variance were used to compare mean QOLCE scores. Results: Factors affecting QOL included age, place of residence, socioeconomic condition, maternal education, seizure type and frequency and number of antiepileptic drugs. Conclusion: CWE have a relatively compromised QOL and comprehensive care needs to go beyond the attempt of controlling seizures.
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Affiliation(s)
- Jayashree Nadkarni
- Department of Pediatrics, Gandhi Medical College and Kamla Nehru Hospital, Bhopal, Madhya Pradesh, India
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Singh H, Aneja S, Unni KES, Seth A, Kumar V. A study of educational underachievement in Indian children with epilepsy. Brain Dev 2012; 34:504-10. [PMID: 21959125 DOI: 10.1016/j.braindev.2011.08.011] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2011] [Revised: 08/31/2011] [Accepted: 08/31/2011] [Indexed: 10/17/2022]
Abstract
BACKGROUND Epilepsy is a chronic disorder that significantly affects learning and behavior. Children with epilepsy are much more vulnerable for educational problems than with any other chronic illness. OBJECTIVES The study was conducted to assess the extent of educational problems and factors associated with educational underachievement in Indian children with epilepsy. METHODS It was a case control study and included 100 cases of 6-16 years age of epilepsy, 50 healthy children (control A) and 50 children with persistent asthma (control B). Their demographic and disease variables were evaluated. The educational performance was assessed by using a predesigned semi structured open ended questionnaire to parents and by teacher's report. Psychological evaluation was done in first step by using a standard questionnaire, childhood psychopathology measurement schedule. In second step, those have shown poor educational performance or significant score in standard questionnaire underwent detailed psychiatric evaluation. RESULTS Educational problems were reported in cases (36%), control A (2%) and control B (16%). Demographic or disease variables were not associated with educational problems in cases except that boys were more affected than girls. On psychiatric evaluation psychopathological illnesses (47%) like attention deficit hyperkinetic disorder, conduct disorder and depression were found to be commonly associated with poor educational performance (47%) followed by decreased learning opportunities (22.2%) and borderline intelligence (19.4%) in children with epilepsy. CONCLUSION Educational problems are commoner in children with epilepsy than with asthma. Psychopathological problems are commonly associated with educational underachievement in children with epilepsy. Therefore periodic psychosocial assessment, counseling and support must be provided to improve the psychosocial adjustment in children with epilepsy.
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Affiliation(s)
- Harpal Singh
- Department of Pediatrics, Lady Hardinge Medical College and Kalawati Saran Children's Hospital, New Delhi, India.
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Quality of life in children with epilepsy. Indian Pediatr 2011; 48:893-6. [DOI: 10.1007/s13312-011-0137-3] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2010] [Accepted: 02/02/2011] [Indexed: 11/25/2022]
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Arafa MA, Zaher SR, El-Dowaty AA, Moneeb DE. Quality of life among parents of children with heart disease. Health Qual Life Outcomes 2008; 6:91. [PMID: 18980676 PMCID: PMC2590598 DOI: 10.1186/1477-7525-6-91] [Citation(s) in RCA: 78] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2008] [Accepted: 11/03/2008] [Indexed: 11/16/2022] Open
Abstract
Background Quality of life of parents of chronically ill children has become increasingly important as the mortality rates associated with such illnesses have decreased and survival rates have increased. Aim To describe the Health related quality of life (HRQOL) of parents whose children are suffering from heart diseases and to identify the most important factors that could affect it. Methods A cross sectional study was conducted in Alexandria, Egypt in the two main hospitals that treat children with heart diseases. 400 parents of children with heart diseases were recruited and a comparison group (400) of parents of children with minor illnesses were included from both hospitals. Socioeconomic and disease related data were collected, SF36 was used to collect data regarding the QOL. MANOVA was used to compare the SF-36 scores between groups and to explore the impact of different variables. Results In all SF-36 subscales, parents of children with heart diseases reported significantly poorer HRQOL, except for pain subscale. The most striking differences were for General Health, Vitality and role limitation physical. Factors that had a significant impact of HRQOL were severity of illness, type of heart disease in addition to age of child, having multiple children, financial situation and presence of comorbid condition. The mean scores for different domains were the lowest for younger age, rheumatic heart disease and female children. Conclusion QOL of parents of children with heart diseases was significantly impaired and it was influenced by several factors; mainly related to the clinical status of the child. Psychological status, social support and reassurance of the parents should be considered when making treatment decision for their children.
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Affiliation(s)
- Mostafa A Arafa
- Epidemiology Department, High Institute of Public Health, Alexandria University, Alexandria, Egypt.
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Soria C, Bulteau C, El Sabbagh S, Jambaqué I, Bobet R, Dellatolas G. La qualité de vie chez l’enfant avec épilepsie : revue de la littérature. Arch Pediatr 2008; 15:1474-85. [DOI: 10.1016/j.arcped.2008.06.022] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2007] [Revised: 04/14/2008] [Accepted: 06/27/2008] [Indexed: 10/21/2022]
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Soria C, El Sabbagh S, Escolano S, Bobet R, Bulteau C, Dellatolas G. Quality of life in children with epilepsy and cognitive impairment: a review and a pilot study. Dev Neurorehabil 2007; 10:213-21. [PMID: 17564862 DOI: 10.1080/13638490601111129] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Various methods have recently been proposed to assess the physical, psychological or social dimensions of quality of life (QoL) in children with epilepsy (CwE) and their families. Some methods are based exclusively on parental report and others emphasize the importance of an interview with the patient himself. In children with epilepsy and severe cognitive deficit only parental report is possible in practice; however, some parental based methods to evaluate QoL in CwE have excluded children with cognitive deficit. The present pilot study explores which items are suitable for a parental-based QoL evaluation in CwE and special educational needs, and the most frequently reported parental concerns in this special population of children.
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Affiliation(s)
- Carmen Soria
- Institut National de la Santé et de la Recherche Médicale INSERM, Unite 780, Villejuif, France.
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Datta SS, Premkumar TS, Fielding S, Chandy S, Kumar S, Eagles J, Cherian A. Impact of pediatric epilepsy on Indian families: influence of psychopathology and seizure related variables. Epilepsy Behav 2006; 9:145-51. [PMID: 16725375 DOI: 10.1016/j.yebeh.2006.04.011] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2006] [Revised: 04/09/2006] [Accepted: 04/11/2006] [Indexed: 11/15/2022]
Abstract
The impact of epilepsy on families has been little studied in the developing countries, where it is the most common neurological disorder among children. In Vellore, India, the impact on 132 families who had a child with epilepsy was rated with the Impact of Pediatric Epilepsy on the Family Scale (IPES). An adverse impact was experienced by 42% of families. Multivariate statistical analysis revealed four factors that were significantly associated with high impact: fewer years since diagnosis (OR=0.81, 95% CI=0.71-0.93), fewer months since last seizure (OR=0.58, 95% CI=0.39-0.87), treatment with multiple antiepileptic drugs (OR=4.34, 95% CI=1.22-15.52), and increased behavior problem scores on the Child Behavior Checklist (OR=1.10, 95% CI=1.05-1.14). Factor analysis of the IPES was also conducted as a comparison with earlier findings in a developed country. We suggest that early monotherapy should be employed whenever possible and that early recognition and treatment of associated psychological problems may help to reduce the burden on families.
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Farasat S, Kossoff EH, Pillas DJ, Rubenstein JE, Vining EP, Freeman JM. The importance of parental expectations of cognitive improvement for their children with epilepsy prior to starting the ketogenic diet. Epilepsy Behav 2006; 8:406-10. [PMID: 16446120 DOI: 10.1016/j.yebeh.2005.12.002] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2005] [Revised: 11/03/2005] [Accepted: 12/09/2005] [Indexed: 11/27/2022]
Abstract
Although the success rates and complications of various treatment options for children with intractable epilepsy have been described, the actual expectations of parents for these treatments are less clear. Since 1998, parents at our institution have written their goals in a letter before starting their children on the ketogenic diet. One hundred consecutive letters were evaluated. The most common first goal was seizure improvement, second was anticonvulsant reduction, and third was cognitive improvement. Ninety percent requested improvement in cognition or alertness. These expectations were either met or exceeded at 6 months in 52-60% of children. Achieving or surpassing parental expectations for cognitive improvement correlated with longer diet duration (P=0.04), but meeting goals for seizure or anticonvulsant reduction did not. Cognitive improvement (P<0.001) and >90% seizure reduction (P=0.04) at 6 months positively correlated with longer eventual diet duration. Expectations for cognitive improvement need to be discussed prior to beginning the ketogenic diet.
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Affiliation(s)
- Sharifeh Farasat
- Department of Pediatrics, The Johns Hopkins Medical Institutions, Baltimore, MD 21287, USA
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Gupta N, Mattoo SK. Carers' perspective in quality of life in epilepsy. Indian J Pediatr 2006; 73:105-6; author reply 106. [PMID: 16444076 DOI: 10.1007/bf02758275] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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