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Pan Y, Zhang X, Wen X, Yuan N, Guo L, Shi Y, Jia Y, Guo Y, Hao F, Qu S, Chen Z, Yang L, Wang X, Liu Y. Development and validation of a machine learning model for prediction of comorbid major depression disorder among narcolepsy type 1. Sleep Med 2024; 119:556-564. [PMID: 38810481 DOI: 10.1016/j.sleep.2024.05.045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2023] [Revised: 05/04/2024] [Accepted: 05/22/2024] [Indexed: 05/31/2024]
Abstract
BACKGROUND Major depression disorder (MDD) forms a common psychiatric comorbidity among patients with narcolepsy type 1 (NT1), yet its impact on patients with NT1 is often overlooked by neurologists. Currently, there is a lack of effective methods for accurately predicting MDD in patients with NT1. OBJECTIVE This study utilized machine learning (ML) algorithms to identify critical variables and developed the prediction model for predicting MDD in patients with NT1. METHODS The study included 267 NT1 patients from four sleep centers. The diagnosis of comorbid MDD was based on Diagnostic and Statistical Manual of Mental Disorders fifth edition (DSM-5). ML models, including six full models and six compact models, were developed using a training set. The performance of these models was compared in the testing set, and the optimal model was evaluated in the testing set. Various evaluation metrics, such as Area under the receiver operating curve (AUC), precision-recall (PR) curve and calibration curve were employed to assess and compare the performance of the ML models. Model interpretability was demonstrated using SHAP. RESULT In the testing set, the logistic regression (LG) model demonstrated superior performance compared to other ML models based on evaluation metrics such as AUC, PR curve, and calibration curve. The top eight features used in the LG model, ranked by feature importance, included social impact scale (SIS) score, narcolepsy severity scale (NSS) score, total sleep time, body mass index (BMI), education years, age of onset, sleep efficiency, sleep latency. CONCLUSION The study yielded a straightforward and practical ML model for the early identification of MDD in patients with NT1. A web-based tool for clinical applications was developed, which deserves further verification in diverse clinical settings.
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Affiliation(s)
- Yuanhang Pan
- Department of Neurology, Xijing Hospital, Air Force Medical University, Xi'an, PR China.
| | - Xinbo Zhang
- Department of Neurology, Xijing Hospital, Air Force Medical University, Xi'an, PR China.
| | - Xinyu Wen
- Department of Neurology, Xijing Hospital, Air Force Medical University, Xi'an, PR China.
| | - Na Yuan
- Department of Neurology, Xijing Hospital, Air Force Medical University, Xi'an, PR China.
| | - Li Guo
- Department of Psychiatry, Xijing Hospital, Air Force Medical University, Xi'an, PR China.
| | - Yifan Shi
- Department of Psychiatry, Xijing Hospital, Air Force Medical University, Xi'an, PR China.
| | - Yuanyuan Jia
- Encerebropathy Department, No.2, Baoji Hospital of Traditional Chinese Medicine, Baoji, PR China.
| | - Yanzhao Guo
- Encerebropathy Department, No.10, Xi'an Hospital of Traditional Chinese Medicine, Xi'an, PR China.
| | - Fengli Hao
- Department of Neurology, Xi'an Daxing Hospital, Xi'an, PR China.
| | - Shuyi Qu
- Department of Neurology, Xijing Hospital, Air Force Medical University, Xi'an, PR China.
| | - Ze Chen
- Department of Neurology, Xijing Hospital, Air Force Medical University, Xi'an, PR China.
| | - Lei Yang
- Department of Neurology, Xijing Hospital, Air Force Medical University, Xi'an, PR China.
| | - Xiaoli Wang
- Department of Neurology, Xijing Hospital, Air Force Medical University, Xi'an, PR China.
| | - Yonghong Liu
- Department of Neurology, Xijing Hospital, Air Force Medical University, Xi'an, PR China.
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Jalala SS, Veronese G, Diab M, Abu Jamei Y, Hamam R, Kagee A. Quality of life among residents of Gaza, Palestine: the predictive role of mental distress, fear of COVID-19, and social support. BMC Psychol 2024; 12:152. [PMID: 38491521 PMCID: PMC10943779 DOI: 10.1186/s40359-024-01642-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Accepted: 03/04/2024] [Indexed: 03/18/2024] Open
Abstract
BACKGROUND Living under siege and deteriorated health, social, educational, and economic conditions and isolation with scarce opportunities to fulfil basic needs and aspirations affect the civil population's mental health and perceived quality of life. In this cross-sectional investigation, we explored the consequences of mental distress, fear of COVID-19, and social support for QoL in the Gaza strip. METHODS Nine hundred seventy nine (32.9% males; 67.1% females; mean age was 35.2 years; s.d. = 11.4) adults were recruited in the Gaza strip. We used the Fear for COVID-19 scale (FCS-19), The WHOQOL-BREF Scale, Berlin Social Support Scale (BSSS), Depression Anxiety and Stress Scale (DASS). Pearson correlation coefficient was computed to assess relationships between quality of life, fear of COVID19, mental distress, and social support; a hierarchical regression analysis was used to assess the association between QoL as the dependent variable and demographic variables and fear of COVID19, mental health, and social support as the independent variables. RESULTS QoL was positively associated with perceived emotion, instrumental, and support seeking. Depression, anxiety, stress, and fear of COVID19 were negatively associated with quality of life. Gender was significantly associated with lower QoL. The study highlighted that the level of fear of COVID-19 was negatively influencing individuals' quality of life (QoL). This fear was negatively associated to psychological distress, gender, place of residence, and family type. Lower-educated and poorer participants had lower QoL scores. Conversely, female gender was notably linked to a lower QOL. The hierarchical regression confirmed that COVID-19 was an added burden for the Palestinian population. The fear of COVID-19 term added a 6.2% variance in QoL. In the final analysis, all predictors were statistically significant, with the fear of COVID-19 term recording a higher contribution of 22.5%, followed by depression term with 21.5%, perceived emotional 18.5%, income at 15.4%, and perceived instruments at 14.8% towards QoL. CONCLUSIONS Practitioners and policymakers must consider the severe violation of human rights when developing psychosocial programs to intervene in the COVID-19 crisis.
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Affiliation(s)
| | - Guido Veronese
- Department of Human Sciences and Education "R. Massa", University of Milano-Bicocca, Milan, Italy
- Department of Psychology, Stellenbosch University, Stellenbosch, Matieland, South Africa
| | - Marwan Diab
- Department of Psychology, Stellenbosch University, Stellenbosch, Matieland, South Africa.
| | | | - Rawya Hamam
- Gaza Community Mental Health Program, Gaza, Palestine
| | - Ashraf Kagee
- Department of Psychology, Stellenbosch University, Stellenbosch, Matieland, South Africa
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Yesuf W, Hiko D, Alemayehu E, Kusheta S, Shita A, Beyene M. Health-related quality of life in epilepsy and its associated factors among adult patients with epilepsy attending Mizan Tepi University Teaching Hospital, Southwest Ethiopia: a cross-sectional study. BMJ Open 2024; 14:e079165. [PMID: 38262645 PMCID: PMC10806578 DOI: 10.1136/bmjopen-2023-079165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Accepted: 01/04/2024] [Indexed: 01/25/2024] Open
Abstract
OBJECTIVE To determine the mean score of health-related quality of life in epilepsy and its associated factors among adult patients with epilepsy. DESIGN Institution-based cross-sectional study based on random case selection was conducted. SETTING The study was carried out at Mizan-Tepi University Teaching Hospital located in Southwest Ethiopia. PARTICIPANTS A total of 346 patients with epilepsy who visited the psychiatric clinic for follow-up for at least 3 months and who were 18 years or older were included in the study. MAIN OUTCOME MEASURE Health-related quality of life in epilepsy measured using quality-of-life in epilepsy (QOLIE)-31 health survey evaluated as a dependent variable with simple and multivariable linear regressions. RESULTS The overall weighted mean score of health-related quality of life was 55.6 (SD=20.9). Only 50.3% of patients scored above a total score of 50. Age (β=-0.35, 95% CI-0.46 to -0.23), anxiety (β=-6.79, 95% CI -9.26 to -4.32), depression (β=-7.36, 95% CI -10.16 to -4.55), low self-esteem (β=-5.29, 95% CI -8.07 to -2.51), perceived stigma (β=-3.62, 95% CI -6.30 to -0.94), taking medication two times or more times per day (β=-2.4, 95% CI -4.58 to -0.27), being illiterate (β=-4.1, 95% CI -6.87 to -1.31) and having more than two seizures for a year (β=-4.18, 95% CI -6.97 to -1.39) were negatively affecting health-related quality of life while income of >1000 birr per month (β=4.5, 95% CI 2.00 to 6.99), social support (β=0.34, 95% CI 0.27 to 0.40) and being free of seizure for a year (β=6.5, 95% CI 3.66 to 9.33) were positively affecting health-related quality of life. CONCLUSIONS Only half of the patients with epilepsy in the study area are leading a better quality of life and the overall mean health-related quality of life score is lower than the global mean score. Health-related quality of life was inversely associated with age, anxiety, depression, low self-esteem, perceived stigma, taking medication two times a day or more, being illiterate and experiencing more than two seizures in a year. Besides controlling seizures, public educational campaigns should be conducted to raise public awareness regarding the need for social support.
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Affiliation(s)
- Wudu Yesuf
- Department of Public Health, Mizan-Aman College of Health Sciences, Aman, Ethiopia
| | - Desta Hiko
- Department of Epidemiology, Jimma University College of Public Health and Medical Sciences, Jimma, Ethiopia
| | - Eshetu Alemayehu
- Department of Epidemiology, Jimma University College of Public Health and Medical Sciences, Jimma, Ethiopia
| | - Samuel Kusheta
- Department of Public Health, Hosanna College of Health Sciences, Hosanna, Ethiopia
| | - Abel Shita
- Department of Public Health, Mizan-Aman College of Health Sciences, Aman, Ethiopia
| | - Melkamu Beyene
- Department of Epidemiology, Mizan-Tepi University, Mizzan, Ethiopia
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Turki M, Ouali R, Ellouze S, Ben Ayed H, Charfi R, Feki H, Halouani N, Aloulou J. Perceived stigma among Tunisian healthcare workers during the COVID-19 pandemic. L'ENCEPHALE 2023; 49:582-588. [PMID: 36411122 PMCID: PMC9482834 DOI: 10.1016/j.encep.2022.08.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/10/2022] [Revised: 08/07/2022] [Accepted: 08/08/2022] [Indexed: 12/14/2022]
Abstract
BACKGROUND AND OBJECTIVES Stigma was a major issue during the COVID-19 pandemic. It posed a serious threat to the lives of healthcare workers (HCWs) who were expected to experience higher levels of stigma and increased psychological distress. This is the first survey to investigate forms and correlates of perceived stigma in Tunisian HCWs during the COVID-19 pandemic. METHODS A cross-sectional web-based survey was conducted between October 8th and November 10th 2020, among 250 Tunisian HCWs. Data were collected using an online questionnaire using the Google Forms® platform. We used a self-reported instrument measuring COVID-19-related stigma, and the Multidimensional Scale of Perceived Social Support (MSPSS) to measure the perceived adequacy of social support from three sources: family, friends, and significant other. RESULTS The mean stigma score was 18.6±8. Participants sometimes to often experienced stigma in their relationships with friends (22%), neighbors (27.2%), parents (22,4%), and in social activities (30.8%). This stigma was perceived mainly through avoidance (68.4%), and rarely through verbal (6%) or physical aggression (1.2%). The mean MSPSS total score was 5.26±1.24. In multivariate analysis, depression history (P<0.001), long working experience (P<0.001), having presented ageusia/anosmia (P=0.007) and lower total social support scale (P<0.001) were significantly associated with higher perceived stigma score. CONCLUSION Our findings showed that HCWs perceived stigma in professional, societal and familial domains. Social support from family, friends and others seemed to protect against perceived stigma. Proper health education targeting the public appears to be an effective method to prevent social harassment of both HCWs and COVID-19 survivors.
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Affiliation(s)
- M Turki
- Psychiatry "B" department, Hedi Chaker university hospital, 3029 Sfax, Tunisia; Faculty of medicine of Sfax, Sfax, Tunisia.
| | - R Ouali
- Psychiatry "B" department, Hedi Chaker university hospital, 3029 Sfax, Tunisia; Faculty of medicine of Sfax, Sfax, Tunisia
| | - S Ellouze
- Psychiatry "B" department, Hedi Chaker university hospital, 3029 Sfax, Tunisia; Faculty of medicine of Sfax, Sfax, Tunisia
| | - H Ben Ayed
- Preventive medicine and hospital hygiene, Hedi Chaker university hospital, 3029 Sfax, Tunisia; Faculty of medicine of Sfax, Sfax, Tunisia
| | - R Charfi
- Psychiatry "B" department, Hedi Chaker university hospital, 3029 Sfax, Tunisia; Faculty of medicine of Sfax, Sfax, Tunisia
| | - H Feki
- Preventive medicine and hospital hygiene, Hedi Chaker university hospital, 3029 Sfax, Tunisia; Faculty of medicine of Sfax, Sfax, Tunisia
| | - N Halouani
- Psychiatry "B" department, Hedi Chaker university hospital, 3029 Sfax, Tunisia; Faculty of medicine of Sfax, Sfax, Tunisia
| | - J Aloulou
- Psychiatry "B" department, Hedi Chaker university hospital, 3029 Sfax, Tunisia; Faculty of medicine of Sfax, Sfax, Tunisia
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Takahashi K, Fujikawa M, Ueno T, Ogawa M, Nakasato N, Maeda S. Network analysis of the relationship between social support and quality of life in patients with epilepsy. Epilepsy Behav 2023; 149:109504. [PMID: 37952414 DOI: 10.1016/j.yebeh.2023.109504] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2023] [Revised: 10/13/2023] [Accepted: 10/20/2023] [Indexed: 11/14/2023]
Abstract
BACKGROUND Identifying important types of social support for patients with epilepsy is valuable to construct an effective system for support in daily life. However, previous studies have been inconsistent in identifying the most important types of social support for better quality of life (QOL) due to the high correlations between the social support factors. The present study employed network visualization analysis to identify the relationships between QOL and types of social support. METHODS Two hundred and eighty-three patients with epilepsy (age range: 18 to 75 years) completed questionnaires of the Medical Outcomes Study Social Support Survey (MOS-SSS) and the Quality of Life in Epilepsy Inventory-31-Problems in the epilepsy monitoring unit at Tohoku University. The MOS-SSS was established to measure the four types of social support including emotional/informational support, tangible support, affectionate support, and positive social interaction. Our network visualization analysis represented the entire structure of the interrelationships between the four functions of social support and QOL. In addition, the relative importance of each function of social support were estimated by the centrality indices using three commonly used centrality indices: strength, betweenness, and closeness. RESULTS The visualized network showed that positive social interaction and emotional/informational support were directly associated with QOL, whereas tangible support and affectionate support were not. Positive social interaction had the highest value for all three centrality indices and affectionate support had the second highest. Therefore, positive social interaction had the strongest connection to the other functions of support. DISCUSSION Our network analysis and centrality indices findings showed that positive social interaction is the most important within the network of four types of social support and QOL. The emotional informational function is also important for directly improving QOL but is less related to the other functions. The affectionate function might be an indicator of whether a patient has a foundational relationship that leads to other functions of support. CONCLUSION These results showed the importance of increasing positive social interaction in the social environment of patients with epilepsy. Therefore, practitioners need to encourage patients with epilepsy to increase their positive social interactions such as doing something enjoyable with others or someone to associate for relaxation to ensure high QOL. Connections outside the epilepsy support are important, such as having fun regardless of epilepsy, rather than only providing emotional or tangible support for epilepsy.
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Affiliation(s)
- Kento Takahashi
- Graduate School of Education, Tohoku University, Sendai, Japan
| | - Mayu Fujikawa
- Department of Epileptology, Tohoku University Graduate School of Medicine, Sendai, Japan.
| | - Takashi Ueno
- Faculty of Comprehensive Welfare, Tohoku Fukushi University, Sendai, Japan
| | - Maimi Ogawa
- Department of Epileptology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Nobukazu Nakasato
- Department of Epileptology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Shunta Maeda
- Graduate School of Education, Tohoku University, Sendai, Japan
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Kasradze S, Gogatishvili N, Lazariashvili M, Lomidze G, Sander JW. Validation of the Georgian version of a Stigma Scale of Epilepsy. Epilepsy Behav 2023; 148:109502. [PMID: 37897863 DOI: 10.1016/j.yebeh.2023.109502] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Revised: 10/17/2023] [Accepted: 10/18/2023] [Indexed: 10/30/2023]
Abstract
INTRODUCTION Stigma Scale of Epilepsy (SSE), initially developed in Brazil, is accepted worldwide as a sensitive tool for assessing epilepsy-related stigma. We adapted and validated a Georgian version of SSE. MATERIALS AND METHODS The SSE originated in Brazil and was translated into Georgian by three independent experts through forward and backward translation. The final version was generated for validation after handling gross or conceptual inconsistencies between the source and the new format. We used Cronbach's alpha to assess the internal consistency of the Georgian version of SSE. To explore the construct of SSE subscales in the Georgian version, we used principal components and factor analysis. Varimax rotation was applied. The Kaiser-Meyer-Olkin Measure and Bartlett's test of sphericity were employed to assess the sampling adequacy. A probability <0.05 was considered statistically significant. RESULTS 87 adults, 32 (37 %) with epilepsy and 55 (63 %) without epilepsy were enrolled. The overall mean score of SSE was 19.5 (SD 10.1; min. 2, max. 53), and the differences between people with [20.7 (SD 8.9; min. 2, max. 53)] and without epilepsy [17.5 (SD 10.4; min. 3, max. 42)] were not statistically significant. Cronbach's alpha for the overall sample was 0.854; for the epilepsy cohort it was 0.876, and for individuals without epilepsy 0.823, indicating good SSE internal consistency. Kaiser-Meyer-Olkin Measure was 0.705 and Bartlett's test of sphericity was 926.2 (df 276; p < 0.001), suggesting acceptable sample adequacy. DISCUSSION The Georgian version of the SSE is a valid and reliable measurement tool for assessing epilepsy-related stigma determinants among the country's population.
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Affiliation(s)
- Sofia Kasradze
- Caucasus International University, 73 Chargali Str.,Tbilisi 0141, Georgia; Institute of Neurology and Neuropsychology, 83/11 Vazha-Pshavela Ave., Tbilisi 0186, Georgia
| | - Nino Gogatishvili
- Caucasus International University, 73 Chargali Str.,Tbilisi 0141, Georgia; Institute of Neurology and Neuropsychology, 83/11 Vazha-Pshavela Ave., Tbilisi 0186, Georgia
| | - Marine Lazariashvili
- Institute of Neurology and Neuropsychology, 83/11 Vazha-Pshavela Ave., Tbilisi 0186, Georgia; Ilia State University, 3/5 Kakutsa Cholokashvili Ave., Tbilisi 0162, Georgia
| | - Giorgi Lomidze
- European University, Faculty of Medicine, 17 Sarajishvili Str., Tbilisi 0189, Georgia.
| | - Josemir W Sander
- Department of Clinical & Experimental Epilepsy, UCL Queen Square Institute of Neurology, London WC1N 3BG, United Kingdom; Chalfont Centre for Epilepsy, Chalfont, St Peter SL9 0RJ, United Kingdom; Stichting Epilepsie Intellingen Nederland - SEIN, Heemstede 2103SW, Netherlands; Department of Neurology, West China Hospital, Sichuan University, Chengdu 610041, China
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Tsigebrhan R, Derese A, Kariuki SM, Fekadu A, Medhin G, Newton CR, Prince MJ, Hanlon C. Co-morbid mental health conditions in people with epilepsy and association with quality of life in low- and middle-income countries: a systematic review and meta-analysis. Health Qual Life Outcomes 2023; 21:5. [PMID: 36670421 PMCID: PMC9854052 DOI: 10.1186/s12955-022-02086-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Accepted: 12/29/2022] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND Comorbid mental health conditions are common in people with epilepsy and have a significant negative impact on important epilepsy outcomes, although the evidence is mostly from high-income countries. This systematic review aimed to synthesise evidence on the association between comorbid mental health conditions and quality of life and functioning among people with epilepsy living in low- and middle income countries (LMICs). METHODS We searched PubMed, EMBASE, CINAHL, Global Index medicus (GID) and PsycINFO databases from their dates of inception to January 2022. Only quantiative observational studies were included. Meta-analysis was conducted for studies that reported the same kind of quality of life and functioning outcome. Cohen's d was calculated from the mean difference in quality-of-life score between people with epilepsy who did and did not have a comorbid depression or anxiety condition. The protocol was registered with PROSPERO: CRD42020161487. RESULTS The search strategy identified a total of 2,101 articles, from which 33 full text articles were included. Depression was the most common comorbid mental health condition (33 studies), followed by anxiety (16 studies). Meta-analysis was conducted on 19 studies reporting quality of life measured with the same instrument. A large standardized mean effect size (ES) in quality of life score was found (pooled ES = -1.16, 95% confidence interval (CI) - 1.70, - 0.63) between those participants with comorbid depression compared to non-depressed participants. There was significant heterogeneity between studies (I2 = 97.6%, p < 0.001). The median ES (IQR) was - 1.20 (- 1.40, (- 0.64)). An intermediate standard effect size for anxiety on quality of life was also observed (pooled ES = -0.64, 95% CI - 1.14, - 0.13). There was only one study reporting on functioning in relation to comorbid mental health conditions. CONCLUSION Comorbid depression in people with epilepsy in LMICs is associated with poor quality of life although this evidence is based on highly heterogeneous studies. These findings support calls to integrate mental health care into services for people with epilepsy in LMICs. Future studies should use prospective designs in which the change in quality of life in relation to mental health or public health interventions across time can be measured.
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Affiliation(s)
- Ruth Tsigebrhan
- Centre for Innovative Drug Development and Therapeutic Trials for Africa (CDT-Africa), College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia.
- Department of Psychiatry, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia.
| | - Andualem Derese
- Department of Psychiatry, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Symon M Kariuki
- Neuroscience Unit, KEMRI-Wellcome Trust Research Programme, Kilifi, Kenya
- Department of Public Health, Pwani University, Kilifi, Kenya
- Department of Psychiatry, University of Oxford, Warneford Hospital, Warneford Lane, Oxford, UK
| | - Abebaw Fekadu
- Centre for Innovative Drug Development and Therapeutic Trials for Africa (CDT-Africa), College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
- Department of Psychiatry, WHO Collaborating Centre in Mental Health Research and Capacity-Building, School of Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
- Global Health and Infection Department, Brighton and Sussex Medical School, Brighton, UK
| | - Girmay Medhin
- Centre for Innovative Drug Development and Therapeutic Trials for Africa (CDT-Africa), College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
- Aklilu-Lemma Institute of Pathobiology, Addis Ababa University, Addis Ababa, Ethiopia
| | - Charles R Newton
- Neuroscience Unit, KEMRI-Wellcome Trust Research Programme, Kilifi, Kenya
- Department of Psychiatry, University of Oxford, Warneford Hospital, Warneford Lane, Oxford, UK
| | - Martin J Prince
- Centre for Global Mental Health, Health Services and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Charlotte Hanlon
- Centre for Innovative Drug Development and Therapeutic Trials for Africa (CDT-Africa), College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
- Department of Psychiatry, WHO Collaborating Centre in Mental Health Research and Capacity-Building, School of Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
- Centre for Global Mental Health, Health Services and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
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Karadžić T, Ristić AJ. Epilepsy on social media in Serbian, Croatian, and Bosnian languages. Epilepsy Behav 2022; 136:108912. [PMID: 36150303 DOI: 10.1016/j.yebeh.2022.108912] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Revised: 09/01/2022] [Accepted: 09/02/2022] [Indexed: 12/14/2022]
Abstract
INTRODUCTION The Internet and social media are becoming increasingly important medical information sources, bringing advantages and disadvantages. The extent of social media use may help to develop a strategy for providing relevant information, enhancing patients' social status, and the work of medical practitioners in chronic medical conditions such as epilepsy. AIM The aim of this study was to help better understand the factors of social media that may affect patients' knowledge of the disease, health education, emotional stability, thinking, and decisions in the treatment process. MATERIAL AND METHODS We studied the representation of epilepsy among social media users in Serbian, Croatian, and Bosnian languages. Our observational study analyzed 1000 randomized posts and videos on Facebook, Twitter, and YouTube, containing the keywords "epilepsy" or "seizure." Posts were divided into three categories: topics, data sources, and the nature of the engagement. RESULTS The most common topic among social media users was the stigmatization of patients (31%). The most prevalent data source was support groups for PWE (45.4%). The nature of the engagement was most dominant on the occasion of the exchange of information, i.e., advice (40%). CONCLUSION The participation of medical professionals on social media is not adequately represented in Serbian, Croatian, and Bosnian language platforms. The presence of medical professionals on social media could increase the credibility of the information available to users, educate patients, and reduce the prevalence of stigma.
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Lalatović S, Milovanović M, Krstić N. Stigma and its association with health-related quality of life in adults with epilepsy. Epilepsy Behav 2022; 135:108874. [PMID: 35973375 DOI: 10.1016/j.yebeh.2022.108874] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2022] [Revised: 07/15/2022] [Accepted: 08/03/2022] [Indexed: 11/18/2022]
Abstract
OBJECTIVE To explore the presence of felt and enacted stigma in people with epilepsy (PWE), members of a self-governing epilepsy organization and to evaluate the influence of both types of stigma on health-related quality of life (HRQoL) in PWE. METHODS Participants were 55 PWE (age range: 18-53 years), members of a non-governmental organization (further "NGO"). The sociodemographic and epilepsy-related variables were collected through structured interviews designed for the purpose of the study. Felt stigma was assessed with the Epilepsy Stigma Scale (ESS) and enacted stigma with the Questionnaire for episodes of discrimination against PWE. Quality of Life in Epilepsy Inventory (QOLIE-31) (Serbian version) was used for the evaluation of HRQoL. RESULTS The mean ESS score was 33.93 ± 14.50. Felt stigma was significantly associated with the male gender and the number of antiepileptic drugs (AEDs). Participants' mean score on the Questionnaire for episodes of discrimination was 2.80 ± 2.78. Enacted stigma was significantly correlated with male gender and number of AEDs, as well as with older age/longer duration of the disorder. Felt stigma scores were positively correlated with enacted stigma scores (p < 0.001), but only felt stigma scores were negatively related to QOLIE-31 overall score (p = 0.01). The combination of AEDs, seizure frequency, and felt stigma best explained the HRQoL in PWE (p < 0.001). CONCLUSION Felt and enacted stigma are moderately related, but only felt stigma appears to be a significant predictor of the deteriorating HRQoL in this sample. Interventions targeting felt stigma should be considered a part of comprehensive epilepsy care as well as educating the wider community about epilepsy.
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Affiliation(s)
- Staša Lalatović
- Faculty of Special Education and Rehabilitation, University of Belgrade, Visokog Stevana 2, 11000 Belgrade, Serbia.
| | - Maja Milovanović
- Faculty of Special Education and Rehabilitation, University of Belgrade, Visokog Stevana 2, 11000 Belgrade, Serbia; Department for Epilepsy and Clinical Neurophysiology, Institute of Mental Health, Milana Kašanina 3, 11000 Belgrade, Serbia.
| | - Nadežda Krstić
- Faculty of Special Education and Rehabilitation, University of Belgrade, Visokog Stevana 2, 11000 Belgrade, Serbia.
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Qin Y, Dai M, Chen L, Zhang T, Zhou N, Chen X. The relationship between ecological executive function and stigma among patients with epilepsy: The mediating effect of social support. Epilepsy Res 2022; 182:106919. [DOI: 10.1016/j.eplepsyres.2022.106919] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Revised: 03/24/2022] [Accepted: 03/29/2022] [Indexed: 11/03/2022]
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Kwon CS, Jacoby A, Ali A, Austin J, Birbeck GL, Braga P, Cross JH, de Boer H, Dua T, Fernandes PT, Fiest KM, Goldstein J, Haut S, Lorenzetti D, Mifsud J, Moshe S, Parko KL, Tripathi M, Wiebe S, Jette N. Systematic review of frequency of felt and enacted stigma in epilepsy and determining factors and attitudes toward persons living with epilepsy-Report from the International League Against Epilepsy Task Force on Stigma in Epilepsy. Epilepsia 2022; 63:573-597. [PMID: 34985782 DOI: 10.1111/epi.17135] [Citation(s) in RCA: 33] [Impact Index Per Article: 16.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Revised: 11/09/2021] [Accepted: 11/10/2021] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To review the evidence of felt and enacted stigma and attitudes toward persons living with epilepsy, and their determining factors. METHODS Thirteen databases were searched (1985-2019). Abstracts were reviewed in duplicate and data were independently extracted using a standardized form. Studies were characterized using descriptive analysis by whether they addressed "felt" or "enacted" stigma and "attitudes" toward persons living with epilepsy. RESULTS Of 4234 abstracts, 132 met eligibility criteria and addressed either felt or enacted stigma and 210 attitudes toward epilepsy. Stigma frequency ranged broadly between regions. Factors associated with enacted stigma included low level of knowledge about epilepsy, lower educational level, lower socioeconomic status, rural areas living, and religious grouping. Negative stereotypes were often internalized by persons with epilepsy, who saw themselves as having an "undesirable difference" and so anticipated being treated differently. Felt stigma was associated with increased risk of psychological difficulties and impaired quality of life. Felt stigma was linked to higher seizure frequency, recency of seizures, younger age at epilepsy onset or longer duration, lower educational level, poorer knowledge about epilepsy, and younger age. An important finding was the potential contribution of epilepsy terminology to the production of stigma. Negative attitudes toward those with epilepsy were described in 100% of included studies, and originated in any population group (students, teachers, healthcare professionals, general public, and those living with epilepsy). Better attitudes were generally noted in those of younger age or higher educational status. SIGNIFICANCE Whatever the specific beliefs about epilepsy, implications for felt and enacted stigma show considerable commonality worldwide. Although some studies show improvement in attitudes toward those living with epilepsy over time, much work remains to be done to improve attitudes and understand the true occurrence of discrimination against persons with epilepsy.
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Affiliation(s)
- Churl-Su Kwon
- Departments of Neurosurgery, Neurology and Population Health Sciences & Policy, Icahn School of Medicine, New York, New York, USA
| | - Ann Jacoby
- Department of Public Health and Policy, University of Liverpool, Liverpool, UK
| | - Amza Ali
- Kingston Public Hospital and University of the West Indies, Kingston, Jamaica
| | - Joan Austin
- Indiana University School of Nursing, Indianapolis, Indiana, USA
| | - Gretchen L Birbeck
- Epilepsy Division, University of Rochester, Rochester, New York, USA
- Epilepsy Care Team, Chikankata Hospital, Mazabuka, Zambia
| | - Patricia Braga
- Facultad de Medicina, Institute of Neurology, Universidad de la República, Montevideo, Uruguay
| | - J Helen Cross
- Developmental Neurosciences Programme, UCL-NIHR BRC Great Ormond Street Institute of Child Health, London, UK
| | - Hanneke de Boer
- SEIN - Epilepsy Institute in the Netherlands Foundation, Heemstede, The Netherlands
| | - Tarun Dua
- Department of Mental Health and Substance Abuse, World Health Organization, Geneva, Switzerland
| | - Paula T Fernandes
- Department of Sport Science, Faculty of Physical Education, UNICAMP, Campinas, Brazil
| | - Kirsten M Fiest
- Department of Critical Care Medicine and Department of Community Health Sciences, Hotchkiss Brain Institute, O'Brien Institute for Public Health, University of Calgary, Calgary, Alberta, Canada
| | - Jonathan Goldstein
- Departments of Neurology and Population Health Sciences & Policy, Icahn School of Medicine, New York, New York, USA
| | - Sheryl Haut
- Saul R. Korey Department of Neurology, Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, New York, USA
| | - Diane Lorenzetti
- Department of Community Health Sciences, University of Calgary and Health Sciences Library, University of Calgary, Calgary, Alberta, Canada
| | - Janet Mifsud
- Department of Clinical Pharmacology and Therapeutics, Faculty of Medicine and Surgery, University of Malta, Msida, Malta
| | - Solomon Moshe
- Saul R. Korey Department of Neurology, Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, New York, USA
- Department of Pediatrics and Dominick P. Purpura Department of Neuroscience, Albert Einstein College of Medicine, Bronx, New York, USA
| | - Karen L Parko
- Department of Neurology, University of California at San Francisco, San Francisco, California, USA
- Epilepsy Center, San Francisco VA Medical Center, San Francisco, California, USA
| | - Manjari Tripathi
- Department of Neurology, All India Institute of Medical Sciences, New Delhi, India
| | - Samuel Wiebe
- Department of Clinical Neurosciences and Department of Community Health Sciences, Hotchkiss Brain Institute, O'Brien Institute for Public Health, University of Calgary, Calgary, Alberta, Canada
| | - Nathalie Jette
- Departments of Neurology and Population Health Sciences & Policy, Icahn School of Medicine, New York, New York, USA
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Aldosary WS, Heena H, El-Bakri NK. Psychological self-security and self-concept among Saudi epilepsy patients at a tertiary care center in KSA. J Family Med Prim Care 2021; 10:3888-3891. [PMID: 34934697 PMCID: PMC8653478 DOI: 10.4103/jfmpc.jfmpc_261_18] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2018] [Revised: 09/15/2018] [Accepted: 06/04/2021] [Indexed: 11/24/2022] Open
Abstract
Objective: While psychological issues in epilepsy patients have been studied extensively, the phenomena of self-concept and self-security have not been adequately addressed in such patients. Therefore, the aim of the current study is to assess the levels of psychological self-security and self-concept among Saudi epilepsy patients. Methods: A case-control study was conducted on adult patients with epilepsy from the Epilepsy Monitoring Unit at King Fahad Medical City in Riyadh, Saudi Arabia. Healthy controls were obtained from the community. Demographic data including age, gender and education level were collected. Self-concept and self-security were assessed using validated scales. Descriptive statistics were obtained, and inferential testing was conducted. Results: Data from 145 subjects was entered in the final analysis, including 100 patients with epilepsy and 45 controls (females = 32%). A significantly higher level of psychological insecurity was found in PWE (people with epilepsy) compared to controls. No significant difference was noticed on self-concept level between PWE versus controls. Education level was significantly lower in PWE than in controls. Those with higher education levels scored lower on psychological insecurity, although this effect disappeared when the data were split by health status. Conclusion: Level of psychological self-security was higher in PWE than controls, while no difference in self-concept was observed. This study highlights the areas of focus needed in epilepsy-related social services in order to improve the psychological wellbeing of patients with epilepsy.
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Affiliation(s)
- Wardah S Aldosary
- Department of Mental Health, National Neurosciences Institutes, King Fahad Medical City, Riyadh, KSA
| | | | - Nahid K El-Bakri
- Department of Mental Health, National Neurosciences Institutes, King Fahad Medical City, Riyadh, KSA
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Ahmed GK, Elbeh K, Elserogy Y, Mostafa S. Effect of long-term administration of clonazepam, carbamazepine, and valproate on cognitive, psychological, and personality changes in adult epilepsy: a case–control study. MIDDLE EAST CURRENT PSYCHIATRY 2021. [DOI: 10.1186/s43045-021-00161-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Epilepsy can be treated with antiepileptic drugs (AEDs) which may have psychiatric and behavioral side effects. Additionally, the availability of new AEDs has increased, and our understanding of variability to combinations of several AEDs has evolved. Based on the treatment outcomes of carbamazepine, valproate, and clonazepam, this study aims to compare the cognitive function, personality, and psychological issues associated with these drugs and evaluate seizure-related factors related to them. Only 139 participants were included. Clonazepam was used as an add-on antiepileptic drug. Participants were categorized into five groups: group 1, carbamazepine; group 2, valproate; group 3, carbamazepine and clonazepam; group 4, valproate and clonazepam; and group 5, epileptic patients without AED. All participants were assessed using the Wechsler Adult Intelligence Scale (WAIS), Structured Interview for the Five-Factor Personality Model (SIFFM), Hamilton Anxiety and Depression Rating Scale, and Minnesota Multiphasic Personality Inventory-2 (MMPI-2).
Results
In the WAIS, group 1 had the worst mean of verbal intelligence quotient (IQ). Moreover, group 3 was more vulnerable in symptomatic response in all subscales of MMPI-2 except the masculinity–femininity subscale and a high percentage in moderate severity of anxiety and depression in the Hamilton scales.
Conclusions
The use of clonazepam and carbamazepine might increase the incidence of behavioral problems especially increased severity of anxiety and depression and decreased performance IQ compared with either clonazepam or carbamazepine alone. Moreover, patients with carbamazepine treatment might have more personality changes and lowered verbal IQ than others.
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Srikanth P, Vranda MN, Thomas PT, Raghvendra K. Quality of Life and Stigma among Women with Epilepsy during Their Reproductive Years. J Epilepsy Res 2021; 11:63-71. [PMID: 34395225 PMCID: PMC8357557 DOI: 10.14581/jer.21009] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2021] [Revised: 06/18/2021] [Accepted: 06/22/2021] [Indexed: 11/16/2022] Open
Abstract
Background and Purpose The purpose of this study was to understand the relationship between quality of life and stigma among reproductive age group women with epilepsy. Methods A cross-sectional descriptive study was conducted to assess the data from the 49 women with epilepsy from a tertiary care hospital in India. Quality of life was evaluated with the quality of life in epilepsy-31 questionnaire and stigma was evaluated with the stigma scale of epilepsy. Data also included socio-demographic and clinical characteristics. Results The mean age of the participants was 24.67±3.72 years. Quality of life total score (r=−0.485**) and seizure worry domain (r=−0.427**) were significantly negatively correlated with stigma total score at p<0.01 level. Being uneducated, married, unemployed, having children, having generalized tonic-clonic seizures, duration of illness (>10 years), and consuming levetiracetam, anti-epileptic drug (AED), were the significant contributing factors for low quality of life among women with epilepsy during the reproductive age group. Belonging to lower socio-economic status and taking more than two AEDs were also associated with lower quality of life among women with epilepsy, which are trending towards significance. Conclusions The study assessed the relationship between the quality of life and the Stigma scale of epilepsy and demonstrated the impact of stigma and quality of life on socio-demographic and clinical variables of women with epilepsy under the reproductive age group. To enhance the quality of life and reduce the stigma levels among women with epilepsy, some of the modifiable parameters can be considered by the multidisciplinary health care professionals from the findings of the current research.
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Sun L, Liu X, Weng X, Deng H, Li Q, Liu J, Luan X. Narrative therapy to relieve stigma in oral cancer patients: A randomized controlled trial. Int J Nurs Pract 2021; 28:e12926. [PMID: 33817894 DOI: 10.1111/ijn.12926] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Revised: 01/14/2021] [Accepted: 01/26/2021] [Indexed: 01/21/2023]
Abstract
AIMS AND OBJECTIVES This study aimed to evaluate the efficacy of narrative therapy in relieving stigma in oral cancer patients who underwent major surgical treatment. BACKGROUND Health-related stigma compromises mental health and life quality in people with physical or mental abnormalities. Narrative therapy has been implemented to overcome stigma among populations in a diversity of disease states. However, the effectiveness of narrative therapy in relieving stigma among patients with oral cancer is not known. DESIGN This study was a randomized controlled trial, in which 100 oral cancer patients were selected and randomly assigned to the 'narrative therapy' group, who received narrative therapy treatment in addition to standard care, and the 'control' group, who was provided standard care only. METHODS This research combined measurement of several questionnaires to evaluate stigma. Analysis of variance and paired t tests were employed for data analysis. RESULTS Findings in this study demonstrated that narrative therapy treatment effectively relieved oral cancer patients' sense of shame, reducing overall stigma and significantly improving self-esteem and social relationships. CONCLUSIONS Narrative therapy was demonstrated to be a promising therapeutic intervention for stigma relief in oral cancer patients. SUMMARY STATEMENT What is already known about this topic? Stigma is common among oral cancer patients, especially those who undergo major surgical resection. Psychological intervention is highly recommended in addition to postsurgical care. Narrative therapy might help relieve stigma among oral cancer patients. What this paper adds? Conventional postsurgical care did not improve oral cancer patients' psychological situation. A 7-week intervention of narrative therapy treatment significantly reduced stigma and enhanced sense of self-worth and social support among oral cancer patients. The implications of this paper: Narrative therapy can be clinically accepted as a therapeutic approach to assist oral cancer patients with stigma after major surgery. Tailored approaches, including patient-customized methods, should be encouraged in conducting narrative therapy.
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Affiliation(s)
- Liying Sun
- Department of Oral Surgery, Stomatological Hospital, Southern Medical University, Guangzhou, China
| | - Xueli Liu
- Department of Oral Surgery, Stomatological Hospital, Southern Medical University, Guangzhou, China
| | - Xiaoling Weng
- Department of Oral Surgery, Stomatological Hospital, Southern Medical University, Guangzhou, China
| | - Haiyan Deng
- Department of Oral Surgery, Stomatological Hospital, Southern Medical University, Guangzhou, China
| | - Qian Li
- Department of Oral and Maxillofacial Surgery, Qilu Hospital, Shandong University, Jinan, China
| | - Jingpeng Liu
- Department of Oral Surgery, Stomatological Hospital, Southern Medical University, Guangzhou, China
| | - Xiaorong Luan
- Department of Nursing, Qilu Hospital, Shandong University, Jinan, China
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Kakooza-Mwesige A, Kaddumukasa M, Koltai DC, Kaddumukasa MN, Nakasujja N, Kajumba M, Nakku J, Kolls BJ, Fuller AT, Teuwen DE, Haglund MM. Leveraging the lessons learned from studies on the cultural context of epilepsy care in Uganda: Opportunities and future directions. Epilepsy Behav 2021; 114:107302. [PMID: 32868221 DOI: 10.1016/j.yebeh.2020.107302] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2020] [Revised: 06/23/2020] [Accepted: 06/28/2020] [Indexed: 11/30/2022]
Abstract
In this summary paper, we review the body of research contained in this special issue, The Intersection of Culture, Resources, and Disease: Epilepsy Care in Uganda, and corollary recommendations for a way forward. We review key findings and conclusions for the studies, which tell a story of culture and care-seeking through discussions and data gleaned from a rich research landscape traversing community village dwellings, shared communal areas, churches, and urban hospitals. The voices and perspectives of over 16,000 study participants inclusive of people living with epilepsy, their neighbors and healthcare workers, traditional healers, and faith leaders are reported. From this, we synthesize findings and prioritize a set of recommendations to advance epilepsy care in Uganda. Progress will require infrastructure strengthening, multilevel educational investments, and an ambitious, extensive program of community sensitization. These proposed priorities and actions outline a way forward through formidable but surmountable challenges but require harmonized efforts by government and other relevant stakeholders, scholars, clinicians, and community leaders. This article is part of the Special Issue "The Intersection of Culture, Resources, and Disease: Epilepsy Care in Uganda".
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Affiliation(s)
- Angelina Kakooza-Mwesige
- Department of Paediatrics and Child Health, Makerere University College of Health Sciences, Mulago Hill Road, P.O.Box 7072, Kampala, Uganda; Department of Paediatrics and Child Health, Mulago National Referral Hospital, Pediatric Neurology Unit, Kampala, Uganda
| | - Mark Kaddumukasa
- School of Medicine, College of Health Sciences, Makerere University, P.O. Box 7072, Kampala, Uganda
| | - Deborah C Koltai
- Duke Division of Global Neurosurgery and Neurology, Department of Neurosurgery, Box 3807 Duke University Medical Center, Durham, NC 27705, USA; Duke University School of Medicine, Department of Neurology, Durham, NC, USA; Duke University School of Medicine, Department of Psychiatry and Behavioral Sciences, DUMC, Box 3119, Trent Drive, Durham, NC, USA.
| | - Martin N Kaddumukasa
- School of Medicine, College of Health Sciences, Makerere University, P.O. Box 7072, Kampala, Uganda; Department of Medicine, Mulago National Referral Hospital, Neurology Unit, Kampala, Uganda
| | - Noeline Nakasujja
- Department of Psychiatry, School of Medicine, Makerere University College of Health Sciences, P.O. Box 7072, Kampala, Uganda
| | - Mayanja Kajumba
- Department of Mental Health and Community Psychology, Makerere University School of Psychology, P.O. Box 7062, Kampala, Uganda
| | - Juliet Nakku
- Butabika National Referral Mental Hospital, P.O. Box 7017, Kampala, Uganda
| | - Brad J Kolls
- Duke Division of Global Neurosurgery and Neurology, Department of Neurosurgery, Box 3807 Duke University Medical Center, Durham, NC 27705, USA; Duke University School of Medicine, Department of Neurology, Durham, NC, USA; Duke Clinical Research Institute, Neuroscience Medicine, 300 W Morgan St, Durham, NC 27701, USA
| | - Anthony T Fuller
- Duke Division of Global Neurosurgery and Neurology, Department of Neurosurgery, Box 3807 Duke University Medical Center, Durham, NC 27705, USA; Duke Global Health Institute, 310 Trent Dr, Durham, NC 27710, USA; Duke University, School of Medicine, Durham, NC, USA
| | - Dirk E Teuwen
- UCB, Allée de la recherche 60, 1070 Brussels, Belgium
| | - Michael M Haglund
- Duke Division of Global Neurosurgery and Neurology, Department of Neurosurgery, Box 3807 Duke University Medical Center, Durham, NC 27705, USA; Duke Global Health Institute, 310 Trent Dr, Durham, NC 27710, USA; Duke University, School of Medicine, Durham, NC, USA
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Subotic A, Pricop DF, Josephson CB, Patten SB, Smith EE, Roach P. Examining the impacts of the COVID-19 pandemic on the well-being and virtual care of patients with epilepsy. Epilepsy Behav 2020; 113:107599. [PMID: 33238236 DOI: 10.1016/j.yebeh.2020.107599] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2020] [Revised: 10/21/2020] [Accepted: 10/24/2020] [Indexed: 10/22/2022]
Abstract
OBJECTIVE The emergence of SARS-CoV-2 (COVID-19) as a novel coronavirus resulted in a global pandemic that necessitated the implementation of social distancing measures. These public health measures may have affected the provision of care for patients with epilepsy. Social isolation may have also adversely affected well-being and quality of life due to informal and formal support networks becoming less accessible. The purpose of this qualitative study was to examine the lived experiences of patients with epilepsy and to see how their quality of life and healthcare has been affected by the COVID-19 pandemic. METHODS From April 27 to May 15, 2020 we performed remote interviews with 18 participants who had virtual appointments with their healthcare providers and were enrolled in the Calgary Comprehensive Epilepsy Program registry. Interviews were recorded and transcribed, after which transcripts were analyzed and coded into relevant themes using NVivo 12. RESULTS Three broad themes emerged throughout the interviews:1) impact of pandemic on informal and formal support systems; 2) impact of pandemic on healthcare provision; and 3) concerns about the impact of the pandemic on personal situations and society in the future. Participants reported anxiety and stress about decreased social engagement and activity cessations. Although face-to-face appointments were preferred, virtual care was well-received. Common concerns about the future included securing employment and burnout from balancing family responsibilities. Some patients also feared they would be stigmatized as society adapted to the situation. SIGNIFICANCE This study highlights the need for additional research in anticipation of the implementation of remote medicine in the management and treatment of epilepsy. It also highlights the tenacity of those living with epilepsy during difficult periods despite social and familial pressures. Raising awareness during this time about the lives and experiences of epilepsy patients can help challenge misconceptions and stigma in the workplace and wider society.
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Affiliation(s)
- Arsenije Subotic
- Hotchkiss Brain Institute, University of Calgary, Canada; Department of Clinical Neurosciences, University of Calgary, Canada
| | - Diana F Pricop
- Hotchkiss Brain Institute, University of Calgary, Canada; Department of Clinical Neurosciences, University of Calgary, Canada
| | - Colin B Josephson
- Hotchkiss Brain Institute, University of Calgary, Canada; Department of Community Health Sciences, University of Calgary, Canada; O'Brien Institute of Public Health, University of Calgary, Canada; Department of Clinical Neurosciences, University of Calgary, Canada; Centre for Health Informatics, University of Calgary, Canada
| | - Scott B Patten
- Department of Community Health Sciences, University of Calgary, Canada; Cuthbertson & Fischer Chair in Pediatric Mental Health, University of Calgary, Canada
| | - Eric E Smith
- Hotchkiss Brain Institute, University of Calgary, Canada; Department of Clinical Neurosciences, University of Calgary, Canada
| | - Pamela Roach
- Hotchkiss Brain Institute, University of Calgary, Canada; Department of Community Health Sciences, University of Calgary, Canada; O'Brien Institute of Public Health, University of Calgary, Canada; Department of Family Medicine, University of Calgary, Canada.
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Briggs FBS, Wilson BK, Pyatka N, Colón-Zimmermann K, Sajatovic MM. Effects of a remotely delivered group-format epilepsy self-management program on adverse health outcomes in vulnerable people with epilepsy: A causal mediation analysis. Epilepsy Res 2020; 162:106303. [PMID: 32151965 PMCID: PMC8019153 DOI: 10.1016/j.eplepsyres.2020.106303] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2020] [Revised: 01/31/2020] [Accepted: 02/22/2020] [Indexed: 10/24/2022]
Abstract
BACKGROUND People with epilepsy frequently experience negative health events (NHEs), such as emergency room visits or hospitalizations for epilepsy-related complications despite significant advances in care. We developed a novel remotely delivered group-format epilepsy self-management program ("Self-management for people with epilepsy and a history of negative health events"; SMART). In a 6-month randomized controlled trial (RCT), SMART participants had significant decreases in NHEs, as well changes in attitudes and behaviors compared to a wait-list (Sajatovic et al., 2018). This secondary analysis from the RCT characterizes the indirect causal effects of SMART on NHE improvements that may be mediated by specific improvements in self-management, self-efficacy, social support, quality of life, and depression symptom severity. METHODS Participants were adults with epilepsy and a NHE in the prior 6 months. There were 60 participants in each RCT arm (SMART versus wait-list) and assessments were conducted at baseline, 10 weeks and 24 weeks. The outcome was a binary variable measuring NHE improvement at week 24. A counterfactual-based mediation framework was used to determine whether improvements or changes in attitudes and behaviors at specific time points or across the study period, mediated the impact of SMART on NHE improvements. RESULTS At week 24, SMART contributed to significant improvements in NHEs compared to those in wait-list (odds ratio = 3.2, p = 0.015). SMART was significantly associated with improvements and changes in aspects of self-management, self-efficacy, quality of life, and depression symptom severity at week 10, and significant improvements between baseline and week 24 in overall self-management and quality of life. Mediation analyses demonstrated that a portion of the effect (∼20-30 %; p < 0.05) of SMART on NHE improvement was also indirectly mediated by early improvements in depression symptom severity and quality of life. CONCLUSIONS This mediation analysis of the SMART intervention demonstrates that in addition to its direct effect on improving NHEs in people with epilepsy, early improvements in depression symptom severity and quality of life indirectly mediated ∼20-30 % of the intervention's effect. These results demonstrate the promise of self-management approaches as a key component of an optimal healthcare model for people with epilepsy, particularly those with a recent history of NHEs.
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Affiliation(s)
- Farren B S Briggs
- Department of Population and Quantitative Health Sciences, School of Medicine, Case Western Reserve University, Cleveland, Ohio, United States
| | - Betsy K Wilson
- Department of Neurology, School of Medicine, Case Western Reserve University, Cleveland, Ohio, United States
| | - Nataliya Pyatka
- University Hospitals Cleveland Medical Center Neurological Institute, Cleveland, Ohio, United States; Louis Stokes Veterans Affairs Cleveland Medical Center, Cleveland, Ohio, United States
| | - Kari Colón-Zimmermann
- Department of Neurology, School of Medicine, Case Western Reserve University, Cleveland, Ohio, United States
| | - Martha M Sajatovic
- Department of Population and Quantitative Health Sciences, School of Medicine, Case Western Reserve University, Cleveland, Ohio, United States; Department of Neurology, School of Medicine, Case Western Reserve University, Cleveland, Ohio, United States; University Hospitals Cleveland Medical Center Neurological Institute, Cleveland, Ohio, United States; Department of Psychiatry, School of Medicine, Case Western Reserve University, Cleveland, Ohio, United States.
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Moser E, Chan F, Berven NL, Bezyak J, Iwanaga K, Umucu E. Resilience and life satisfaction in young adults with epilepsy: The role of person-environment contextual factors. JOURNAL OF VOCATIONAL REHABILITATION 2020. [DOI: 10.3233/jvr-191067] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Affiliation(s)
- Erin Moser
- University of Northern Colorado, Greeley, CO, USA
| | - Fong Chan
- University of Wisconsin-Madison, Madison, WI, USA
| | | | - Jill Bezyak
- University of Northern Colorado, Greeley, CO, USA
| | | | - Emre Umucu
- University of Texas at El Paso, El Paso, TX, USA
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Cengiz GF, Tanık N. Who is more important in stigmatization, family or friends? Epilepsy Behav 2020; 104:106880. [PMID: 31954999 DOI: 10.1016/j.yebeh.2019.106880] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2019] [Revised: 12/10/2019] [Accepted: 12/18/2019] [Indexed: 11/18/2022]
Abstract
INTRODUCTION Although the knowledge about epilepsy is rapidly increasing, the rate of stigmatization still remains high among patients. Since stigmatization is a condition that reduces the quality of life of patients and adversely affects the treatment response, it is very important to reveal the contributing factors. In this study, it was aimed to investigate which of the current social support resources of the patients are related to stigmatization, whether the support received from family or friends and a special person. MATERIALS AND METHODS A total of 60 patients with epilepsy (30 males and 30 females) were included in the study. Sociodemographic data form, stigma scale of epilepsy, and multidimensional scale of perceived social support were administered to all participants. RESULTS Duration of education from sociodemographic variables and duration of epilepsy from clinical variables were associated with stigma scores (for each other, p < 0.01). While a negative correlation was determined between friend support, special person support scores, and total social support score and stigma scores (p < 0.01, p < 0.001, p < 0.01, respectively), no significant relationship was detected between family support score and stigma score. CONCLUSIONS The findings of the study show that the support of a friend and a special person may be more important than the family support in patients with epilepsy. When evaluating these patients, questioning the type and adequacy of social support that they receive and taking necessary interventions (such as forming peer support groups) may be helpful in reducing the perceived stigmatization.
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Affiliation(s)
- Gül Ferda Cengiz
- Bozok University School of Medicine, Department of Psychiatry, Yozgat, Turkey.
| | - Nermin Tanık
- Bozok University School of Medicine, Department of Neurology, Yozgat, Turkey
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Iwuozo E, Obiako R, Ogunniyi A, Abubakar S. A comparative assessment of health-related quality of life in people with epilepsy and healthy controls in a tertiary hospital in Northwest Nigeria. SAHEL MEDICAL JOURNAL 2020. [DOI: 10.4103/smj.smj_61_19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Yogarajah M, Mula M. Social cognition, psychiatric comorbidities, and quality of life in adults with epilepsy. Epilepsy Behav 2019; 100:106321. [PMID: 31253548 DOI: 10.1016/j.yebeh.2019.05.017] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2019] [Revised: 05/01/2019] [Accepted: 05/16/2019] [Indexed: 10/26/2022]
Abstract
Deficits in social cognition are an increasingly recognized complication of epilepsy and contribute to the deficits in social functioning and well-being experienced by patients with epilepsy. Although there has been an increase in studies exploring the measurement and biology of social cognition in patients with epilepsy, there are relatively few examining its clinical implications. Those studies that have been published highlight that social cognitive deficits contribute to impaired quality of life (QoL) in patients with epilepsy, independent of other comorbidities such as depression, anxiety, seizure frequency, and impairment in other cognitive domains. This raises the possibility of novel therapeutic approaches to improving the social well-being of patients with epilepsy.
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Affiliation(s)
- Mahinda Yogarajah
- Atkinson Morley Regional Neuroscience Centre, St George's University Hospitals NHS Foundation Trust, London, United Kingdom; Institute of Molecular and Clinical Sciences, St George's University of London, United Kingdom.
| | - Marco Mula
- Atkinson Morley Regional Neuroscience Centre, St George's University Hospitals NHS Foundation Trust, London, United Kingdom; Institute of Medical and Biomedical Education, St George's University of London, United Kingdom
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Ridsdale L, McKinlay A, Wojewodka G, Robinson EJ, Mosweu I, Feehan SJ, Noble AJ, Morgan M, Taylor SJ, McCrone P, Landau S, Richardson M, Baker G, Goldstein LH. Self-Management education for adults with poorly controlled epILEpsy [SMILE (UK)]: a randomised controlled trial. Health Technol Assess 2019; 22:1-142. [PMID: 29717699 DOI: 10.3310/hta22210] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023] Open
Abstract
BACKGROUND Epilepsy is a common neurological condition resulting in recurrent seizures. Research evidence in long-term conditions suggests that patients benefit from self-management education and that this may improve quality of life (QoL). Epilepsy self-management education has yet to be tested in a UK setting. OBJECTIVES To determine the effectiveness and cost-effectiveness of Self-Management education for people with poorly controlled epILEpsy [SMILE (UK)]. DESIGN A parallel pragmatic randomised controlled trial. SETTING Participants were recruited from eight hospitals in London and south-east England. PARTICIPANTS Adults aged ≥ 16 years with epilepsy and two or more epileptic seizures in the past year, who were currently being prescribed antiepileptic drugs. INTERVENTION A 2-day group self-management course alongside treatment as usual (TAU). The control group received TAU. MAIN OUTCOME MEASURES The primary outcome is QoL in people with epilepsy at 12-month follow-up using the Quality Of Life In Epilepsy 31-P (QOLIE-31-P) scale. Other outcomes were seizure control, impact of epilepsy, medication adverse effects, psychological distress, perceived stigma, self-mastery and medication adherence. Cost-effectiveness analyses and a process evaluation were undertaken. RANDOMISATION A 1 : 1 ratio between trial arms using fixed block sizes of two. BLINDING Participants were not blinded to their group allocation because of the nature of the study. Researchers involved in data collection and analysis remained blinded throughout. RESULTS The trial completed successfully. A total of 404 participants were enrolled in the study [SMILE (UK), n = 205; TAU, n = 199] with 331 completing the final follow-up at 12 months [SMILE (UK), n = 163; TAU, n = 168]. In the intervention group, 61.5% completed all sessions of the course. No adverse events were found to be related to the intervention. At baseline, participants had a mean age of 41.7 years [standard deviation (SD) 14.1 years], and had epilepsy for a median of 18 years. The mean QOLIE-31-P score for the whole group at baseline was 66.0 out of 100.0 (SD 14.2). Clinically relevant levels of anxiety symptoms were reported in 53.6% of the group and depression symptoms in 28.0%. The results following an intention-to-treat analysis showed no change in any measures at the 12-month follow-up [QOLIE-31-P: SMILE (UK) mean: 67.4, SD 13.5; TAU mean: 69.5, SD 14.8]. The cost-effectiveness study showed that SMILE (UK) was possibly cost-effective but was also associated with lower QoL. The process evaluation with 20 participants revealed that a group course increased confidence by sharing with others and improved self-management behaviours. CONCLUSIONS For people with epilepsy and persistent seizures, a 2-day self-management education course is cost-saving, but does not improve QoL after 12-months or reduce anxiety or depression symptoms. A psychological intervention may help with anxiety and depression. Interviewed participants reported attending a group course increased their confidence and helped them improve their self-management. FUTURE WORK More research is needed on self-management courses, with psychological components and integration with routine monitoring. TRIAL REGISTRATION Current Controlled Trials ISRCTN57937389. FUNDING This project was funded by the National Institute for Health Research (NIHR) Health Technology Assessment programme and will be published in full in Health Technology Assessment; Vol. 22, No. 21. See the NIHR Journals Library website for further project information.
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Affiliation(s)
- Leone Ridsdale
- Department of Basic and Clinical Neurosciences, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Alison McKinlay
- Department of Basic and Clinical Neurosciences, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Gabriella Wojewodka
- Department of Basic and Clinical Neurosciences, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Emily J Robinson
- Department of Biostatistics and Health Informatics, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Iris Mosweu
- King's Health Economics, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Sarah J Feehan
- Department of Basic and Clinical Neurosciences, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Adam J Noble
- Department of Psychological Sciences, Institute of Psychology, Health and Society, University of Liverpool, Liverpool, UK
| | - Myfanwy Morgan
- Institute of Pharmaceutical Science, King's College London, London, UK
| | - Stephanie Jc Taylor
- Barts and The London School of Medicine and Dentistry, Queen Mary University of London, Centre for Primary Care and Public Health, London, UK
| | - Paul McCrone
- King's Health Economics, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Sabine Landau
- Department of Biostatistics and Health Informatics, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Mark Richardson
- Department of Basic and Clinical Neurosciences, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Gus Baker
- Department of Molecular and Clinical Pharmacology, University of Liverpool, Liverpool, UK
| | - Laura H Goldstein
- Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
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Depression and quality of life in patients with epilepsy in Northwest Greece. Seizure 2019; 66:93-98. [PMID: 30818183 DOI: 10.1016/j.seizure.2019.02.012] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2018] [Revised: 02/12/2019] [Accepted: 02/19/2019] [Indexed: 12/18/2022] Open
Abstract
PURPOSE The purpose of the present study was to compare depression and QoL between patients with epilepsy and healthy controls, evaluating potentially related factors to depression and QoL in patients with epilepsy in Northwest Greece. METHODS A case study was conducted in adult patients with epilepsy followed up at the University Hospital of Ioannina and in healthy controls. The Patient Health Questionnaire (PHQ-9) for depression's severity evaluation, the WHOQOL-BREF questionnaire for the QoL estimation and the Adverse Event Profile (AEP) questionnaire for the Antiepileptic Drugs (AEDs) adverse effects assessment were used. RESULTS Seventy patients with epilepsy and 70 controls were recruited. The PHQ-9 score was higher in patients compared to controls and slightly higher than reported in patients with epilepsy. PHQ-9 was significantly associated with the AEP score. Our patients had a poorer QoL compared to controls. The level of education, the AEP and the PHQ-9 scores were associated to QoL, the last two being the most powerful predictors of QoL. CONCLUSION Patients with epilepsy in Northwest Greece had higher rates of depression than reported in patients with epilepsy and poorer QoL compared to controls. The adverse effects of AEDs were related to depression in our study, while the adverse effects of AEDs and depression were more powerful predictors of QoL compared to demographics and other characteristics of epilepsy.
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Subki AH, Mukhtar AM, Al-Harbi RS, Alotaibi AK, Mosaad FG, Alsallum MS, Jan MMS. The Impact of Pediatric Epilepsy on Children and Families: A Multicenter Cross-Sectional Study. Clin Pract Epidemiol Ment Health 2018; 14:323-333. [PMID: 30972132 PMCID: PMC6407654 DOI: 10.2174/1745017901814010323] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2018] [Revised: 10/02/2018] [Accepted: 11/19/2018] [Indexed: 11/22/2022]
Abstract
Background and Objectives: Epilepsy is considered one of the most prevalent causes of morbidity in children. The aim of this study is to determine how epilepsy impacts the lives of children with epilepsy and their families. Methods: A translated version of the “Impact of Pediatric Epilepsy Scale” (IPES) questionnaire was completed by the 80 mothers of children with epilepsy, recruited at three hospitals in Jeddah, Saudi Arabia This is a validated self-administered questionnaire used to assess the impact of epilepsy on the lives of the child and family, as well as the quality of life (QoL) of the child. Results: The mean age of children epilepsy was 6.32 years (SD = 3.22). The mean IPES score was 6.28 (SD = 8.42) and the mean child’s QoL was 2.85 (SD= 0.83). 87.5% of the mothers rated their child’s QoL as low. IPES score was significantly associated with cause of seizure (β=0.259; 95%-CI= 0.263 - 10.334; p = 0.039). Child’s QoL was significantly associated with frequency of seizure (β=0.251; 95%-CI= 0.016 - 0.568; p= 0.039) and child’s nationality (β=-0.270; 95%-CI -0.252, -0.013; p= 0.031). Conclusions: Pediatric epilepsy may have a greater impact on the lives of the child and the family when it is not comorbid with cerebral palsy. Quality of life tends to be lower for non-Saudi children, and children with more frequent seizures. Therefore, these groups may need more support in managing the impact that epilepsy has on their daily functioning and quality of life.
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Affiliation(s)
- Ahmed Hussein Subki
- Department of Pediatrics, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Abdel Moniem Mukhtar
- Department of Family and Community Medicine, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Rakan Salah Al-Harbi
- Department of Pediatrics, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
| | | | - Faisal Ghazi Mosaad
- Department of Pediatrics, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Mohammed Saad Alsallum
- Department of Pediatrics, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Mohammed M S Jan
- Department of Pediatrics, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
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Do mentalization skills affect the perception of stigma in patients with epilepsy? Epilepsy Behav 2018; 88:49-53. [PMID: 30241053 DOI: 10.1016/j.yebeh.2018.08.022] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2018] [Revised: 08/17/2018] [Accepted: 08/17/2018] [Indexed: 11/21/2022]
Abstract
PURPOSE We aimed to study the relationship between the mentalizing ability and stigma in patients with epilepsy. METHODS Patients with epilepsy were administered the following battery of tests: Mini-International Neuropsychiatric Interview (MINI) form, Reading the Mind in the Eyes Test (Eyes Test), Stigma Scale of Epilepsy (SSE), Internalized Stigma of Mental Illness (ISMI) Scale, Beck Depression Inventory (BDI), and Beck Anxiety Inventory (BAI). RESULTS Assessment of an association between the Eyes Test score, ISMI Scale total score, and subscale scores revealed a negative significant correlation of Eyes Test scores with approval of stereotypes, perceived discrimination, stigma resistance, and total score. Eyes Test score and BDI scores appears to be significant predictor of internalized stigma among the clinical variables that were studied. A positive significant correlation was detected between BDI score and alienation, perceived discrimination, and total score. CONCLUSION The presence of a correlation between the mentalization and stigma perception in our study demonstrates that these two concepts are connected and that this connection needs further study. In particular, mentalization-based therapy can have an effect on the reduction of the stigma perceptions and in this way can improve the course of the disease, potentially improving the patients' quality of life.
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Brook RA, Rajagopalan K, Smeeding JE. Healthcare Costs and Absenteeism Among Caregivers of Adults with Partial-Onset Seizures: Analysis of Claims from an Employer Database. AMERICAN HEALTH & DRUG BENEFITS 2018; 11:396-403. [PMID: 30647827 PMCID: PMC6306097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 02/15/2018] [Accepted: 06/22/2018] [Indexed: 06/09/2023]
Abstract
BACKGROUND Partial-onset seizures are the most common type of seizures in patients with epilepsy. In addition to the significant impact on patients, the unpredictability of seizures often also affects family members or caregivers. Caregiver burden in relation to patient treatment may help to guide treatment choices for patients. Quantitative evidence about the relationship between workplace absences, costs, and treatment burden among caregivers of patients with partial-onset seizures is lacking. OBJECTIVE To compare direct and indirect healthcare costs and absences among employed caregivers of patients with partial-onset seizures who are receiving monotherapy or adjunctive therapy with antiepileptic drugs (AEDs). METHODS This retrospective study analyzed data of employed caregiver spouses of patients with partial-onset seizures and paired them with the patients into 2 groups based on the patient's therapy: the monotherapy cohort or the adjunctive therapy cohort (ie, >90 days of concomitant use of ≥2 AEDs). Patients and caregivers had to have ≥12 months of continuous data after the index date. Separate 2-part regression models were used to compare direct medical and prescription costs; indirect costs (ie, sick leave, short-term and long-term disability, and workers' compensation); and differences in work absences for caregivers. RESULTS The baseline caregivers' characteristics were similar in the monotherapy cohort (N = 238) and the adjunctive therapy cohort (N = 129). Caregivers' total direct costs were $4231 in the monotherapy cohort and $7217 in the adjunctive therapy cohort. The caregivers of patients in the monotherapy cohort were less likely to use inpatient hospital services than caregivers of patients in the adjunctive therapy cohort (1.3% vs 9.9%, respectively; P = .0016). The caregivers' total indirect costs were $912 and $1192 in the monotherapy and adjunctive therapy cohorts, respectively. Sick days were significantly lower in the monotherapy cohort (2.4 days vs 4.4 days annually; P <.0001), with an associated cost difference of $541. CONCLUSION Caregivers of patients with partial-onset seizures in the adjunctive therapy cohort had significantly greater medical and sick day costs than caregivers in the monotherapy cohort. These findings suggest that higher treatment burden among patients with epilepsy is associated with greater direct and indirect healthcare costs for their caregivers.
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Affiliation(s)
- Richard A Brook
- VP and Head of Retrospective Research, the JeSTARx Group, Newfoundland, NJ
| | - Krithika Rajagopalan
- VP and Head, Global HEOR & Market Access, Sunovion Pharmaceuticals, Marlborough, MA, during this study
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28
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Mehvari Habibabadi J, Naghibi N, Falahatian M, Izadi M. Research Paper: The Relationship Between Perceived Social Support and Self-Esteem in Patients With Epilepsy. CASPIAN JOURNAL OF NEUROLOGICAL SCIENCES 2018. [DOI: 10.29252/cjns.4.15.137] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
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Yeni K, Tulek Z, Simsek OF, Bebek N. Relationships between knowledge, attitudes, stigma, anxiety and depression, and quality of life in epilepsy: A structural equation modeling. Epilepsy Behav 2018; 85:212-217. [PMID: 30032810 DOI: 10.1016/j.yebeh.2018.06.019] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2018] [Revised: 06/08/2018] [Accepted: 06/11/2018] [Indexed: 10/28/2022]
Abstract
PURPOSE Epilepsy not only is a medical disorder characterized by seizures, but is also associated with stigma and a neurological disorder that affects quality of life. Insufficient knowledge and misconceptions about epilepsy that causes the development of negative attitudes towards patients with epilepsy increase the stigmatization and psychosocial problems and impact the quality of life. The aim of this study was to examine the relationship between epilepsy knowledge, attitude, stigma, anxiety and depression, and quality of life within the framework of structural equation modeling. METHOD This research was carried out between May 2015 and May 2016 at the Epilepsy Outpatient Clinic of Istanbul University Istanbul Faculty of Medicine. The Epilepsy Knowledge Scale, Epilepsy Attitude Scale, Stigma Scale, Hospital Anxiety and Depression Scale, and Quality of Life in Epilepsy Scale-10 (QOLIE-10) were used. To determine the relationship between the concepts, research hypotheses were created, and structural equation modeling was made. RESULTS Two hundred five patients were included in the study, 53.7% were women, and the mean age was 32.5. It was found that 72.2% had generalized seizures, and 46.3% had more than one seizure per month. According to our proposed model, knowledge had a moderate relationship with attitude (including stigma) (r = 0.50) that, in turn, had a strong relationship with mental health (r = -0.62) while a moderate relationship with quality of life (r = 0.45). Our findings revealed that proposed model accounted for 20% of the variance in quality of life and 39% of the variance in mental health (anxiety and depression). CONCLUSION Mental health and quality of life of patient with epilepsy are closely related to the knowledge, attitude, and perceived stigma of the patients. Therefore, educating/supporting patients can help increase the mental health and quality of life.
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Affiliation(s)
- Kubra Yeni
- Ondokuz Mayis University, Faculty of Health Sciences, Turkey
| | - Zeliha Tulek
- Istanbul University-Cerrahpasa, Florence Nightingale Faculty of Nursing, Turkey.
| | - Omer Faruk Simsek
- Istanbul Arel University, Faculty of Science and Letters, Department of Psychology, Turkey
| | - Nerses Bebek
- Istanbul University, Istanbul Medical Faculty, Department of Neurology, Turkey
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Baker D, Eccles FJR, Caswell HL. Correlates of stigma in adults with epilepsy: A systematic review of quantitative studies. Epilepsy Behav 2018; 83:67-80. [PMID: 29660506 DOI: 10.1016/j.yebeh.2018.02.016] [Citation(s) in RCA: 44] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2018] [Accepted: 02/16/2018] [Indexed: 01/21/2023]
Abstract
OBJECTIVES The aim of this review was to identify quantitative correlates, predictors, and outcomes of stigma in adults with epilepsy living in Western countries. METHODS To identify relevant literature, four academic databases (PsycINFO, CINAHL, PubMed, and Scopus) were systematically searched using key terms related to stigma and epilepsy. RESULTS Thirty-three research papers reporting findings from 25 quantitative studies of correlates of stigma in epilepsy were identified. The findings suggest that stigma can be predicted by demographic, illness-related, and psychosocial factors, although associations were found to be highly culturally specific. Outcomes of stigma in people with epilepsy were replicated more consistently across cultures, and its impact was significant. Detrimental effects included both worse physical health, including less effective management of the condition, and reduced psychological well-being, including difficulties such as depression and anxiety. IMPLICATIONS Educational initiatives and therapeutic interventions that aim to address stigma in people with epilepsy are recommended; however, these need to be culturally informed to ensure that they are valid and effective.
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Affiliation(s)
- David Baker
- Division of Health Research, Faculty of Health and Medicine, Furness College, Lancaster University, Lancaster LA1 4YG, United Kingdom
| | - Fiona J R Eccles
- Division of Health Research, Faculty of Health and Medicine, Furness College, Lancaster University, Lancaster LA1 4YG, United Kingdom.
| | - Helen L Caswell
- Department of Clinical Neuropsychology, Clinical Sciences Building, Salford Royal NHS Foundation Trust, Stott Lane, Salford M6 8HD, United Kingdom
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Alhagamhmad MH, Shembesh NM. Investigating the awareness, behavior, and attitude toward epilepsy among university students in Benghazi, Libya. Epilepsy Behav 2018; 83:22-27. [PMID: 29635116 DOI: 10.1016/j.yebeh.2018.03.021] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2018] [Revised: 03/14/2018] [Accepted: 03/14/2018] [Indexed: 10/17/2022]
Abstract
OBJECTIVE The aim of this study was to explore the level of knowledge regarding epilepsy and attitudes prevalent toward people with epilepsy (PWE) among Libyan university students in comparison with international data. METHODS A self-administrated questionnaire on awareness regarding epilepsy and behaviors toward PWE was distributed among undergraduate students enrolled in the University of Benghazi. The collected data were analyzed against responses from an Italian survey that utilized a similar questionnaire to explore epilepsy-related knowledge and attitudes among Italian university students in Rome (Mecarelli et al., 2007). RESULTS Out of the 500 interviewed students, 96% successfully completed the survey. Further, 96.6% asserted that they possessed some knowledge regarding epilepsy, gained mainly from their families (76.6%). A total of 57.5% considered epilepsy to be a psychiatric disorder while 11.6% recommended psychological tests for the diagnosis of epilepsy. Moreover, 37.5% believed in ancient superstitions, such as possession by evil forces, as the underlying cause of the condition, and 31.8% recommended traditional remedies to cure it. Further, 66.6% deemed epilepsy as a barrier for career prospects, 41% indicated that it presents an impediment in participation in sports, and 35% considered it as an obstacle in marriage. Additionally, epilepsy was perceived as a severe illness by 53.3% of the respondents and considered to be a moderately severe condition by 43.7%. The responses were found to be statistically significant (P<0.05) against the responses from the Italian study. CONCLUSION There is a reasonable level of awareness regarding epilepsy among Libyan students, though a lack of accuracy in the acquired knowledge exists. The ancient misconceptions regarding the nature of epilepsy and negative attitudes toward PWE appear to be rather common among the Libyan students. Consequently, the discrepancies in the views between the two surveys concerning the ways in which epilepsy is perceived and PWE are treated were extremely evident, thus reflecting the already established view that epilepsy faces greater stigma as a health condition in developing countries in comparison with Western nations.
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Affiliation(s)
- Moftah H Alhagamhmad
- University of Benghazi (Al-Arab Medical), Faculty of Medicine, Paediatric discipline, Benghazi, Libya; Benghazi Children's Hospital, Benghazi, Libya.
| | - Nuri M Shembesh
- University of Benghazi (Al-Arab Medical), Faculty of Medicine, Paediatric discipline, Benghazi, Libya; Benghazi Children's Hospital, Benghazi, Libya
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Dutta M, Murray L, Miller W, Groves D. Effects of Epilepsy on Language Functions: Scoping Review and Data Mining Findings. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2018; 27:350-378. [PMID: 29497749 DOI: 10.1044/2017_ajslp-16-0195] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/31/2016] [Accepted: 08/29/2017] [Indexed: 06/08/2023]
Abstract
PURPOSE This study involved a scoping review to identify possible gaps in the empirical description of language functioning in epilepsy in adults. With access to social network data, data mining was used to determine if individuals with epilepsy are expressing language-related concerns. METHOD For the scoping review, scientific databases were explored to identify pertinent articles. Findings regarding the nature of epilepsy etiologies, patient characteristics, tested language modalities, and language measures were compiled. Data mining focused on social network databases to obtain a set of relevant language-related posts. RESULTS The search yielded 66 articles. Epilepsy etiologies except temporal lobe epilepsy and older adults were underrepresented. Most studies utilized aphasia tests and primarily assessed single-word productions; few studies included healthy control groups. Data mining revealed several posts regarding epilepsy-related language problems, including word retrieval, reading, writing, verbal memory difficulties, and negative effects of epilepsy treatment on language. CONCLUSION Our findings underscore the need for future specification of the integrity of language in epilepsy, particularly with respect to discourse and high-level language abilities. Increased awareness of epilepsy-related language issues and understanding the patients' perspectives about their language concerns will allow researchers and speech-language pathologists to utilize appropriate assessments and improve quality of care.
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Affiliation(s)
- Manaswita Dutta
- Department of Speech and Hearing Sciences, Indiana University, Bloomington
| | - Laura Murray
- School of Communication Sciences and Disorders, Western University, London, Ontario, Canada
| | - Wendy Miller
- School of Nursing, Indiana University, Bloomington
| | - Doyle Groves
- School of Nursing, Indiana University, Bloomington
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Perceived epilepsy stigma mediates relationships between personality and social well-being in a diverse epilepsy population. Epilepsy Behav 2018; 78:7-13. [PMID: 29161631 DOI: 10.1016/j.yebeh.2017.10.023] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2017] [Revised: 10/20/2017] [Accepted: 10/20/2017] [Indexed: 11/20/2022]
Abstract
INTRODUCTION Perceived epilepsy stigma and reduced social well-being are prevalent sources of distress in people with epilepsy (PWE). Yet, research on patient-level correlates of these difficulties is lacking, especially among underserved groups. MATERIALS AND METHODS Racially/ethnically diverse adults with intractable seizures (N=60, 62% female; 79% Black, 20% Hispanic/Latino, 8% White) completed validated measures of personality (NEO Five Factor Inventory, NEO-FFI-3), perceived epilepsy stigma (Epilepsy Stigma Scale, ESS), and quality of life (Quality of Life Inventory in Epilepsy, QOLIE-89). Controlling for covariates, ordinary least-squares (OLS) regression evaluated the total, direct, and indirect effects of NEO-FFI-3 neuroticism and extraversion scores on epilepsy-related social well-being (i.e., combination of QOLIE-89 social isolation and work/driving/social function subscales, α=0.87), mediated through perceived stigma. RESULTS In separate models, higher levels of neuroticism (N) and lower levels of extraversion (E) were significantly and independently associated with greater perceived stigma (N path a=0.71, p=0.005; E path a=-1.10, p<0.005). Stigma, in turn, was significantly and independently associated with poorer social well-being (N path b=0.23, p<0.001; E path b=-0.23, p<0.001). Bias-corrected bootstrap confidence intervals (CIs) showed that neuroticism and extraversion were indirectly associated with social well-being through their respective associations with perceived stigma (N path ab=-0.16, 95% CIs [-0.347, -0.044]; E path ab=0.25, 95% CIs [0.076, 0.493]). CONCLUSION Higher neuroticism and lower extraversion covaried with stigma beliefs, and these may be markers of poor social outcomes in PWE. Mediation models suggest that targeting epilepsy stigma beliefs may be a particularly useful component to incorporate when developing interventions aimed at promoting social well-being in diverse PWE.
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Dibley L, Norton C, Whitehead E. The experience of stigma in inflammatory bowel disease: An interpretive (hermeneutic) phenomenological study. J Adv Nurs 2017; 74:838-851. [PMID: 29105144 DOI: 10.1111/jan.13492] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/16/2017] [Indexed: 01/13/2023]
Abstract
AIM To explore experiences of stigma in people with inflammatory bowel disease. BACKGROUND Diarrhoea, urgency and incontinence are common symptoms in inflammatory bowel disease. Social rules stipulate full control of bodily functions in adulthood: poor control may lead to stigmatization, affecting patients' adjustment to disease. Disease-related stigma is associated with poorer clinical outcomes, but qualitative evidence is minimal. DESIGN An interpretive (hermeneutic) phenomenological study of the lived experience of stigma in inflammatory bowel disease. METHODS Forty community-dwelling adults with a self-reported diagnosis of inflammatory bowel disease were recruited purposively. Participants reported feeling stigmatized or not and experiencing faecal incontinence or not. Unstructured interviews took place in participants' homes in the United Kingdom (September 2012 - May 2013). Data were analysed using Diekelmann's interpretive method. FINDINGS Three constitutive patterns-Being in and out of control, Relationships and social Support and Mastery and mediation-reveal the experience of disease-related stigma, occurring regardless of continence status and because of name and type of disease. Stigma recedes when mastery over disease is achieved through development of resilience-influenced by humour, perspective, mental well-being and upbringing (childhood socialization about bodily functions). People travel in and out of stigma, dependent on social relationships with others including clinicians and tend to feel less stigmatized over time. CONCLUSION Emotional control, social support and mastery over disease are key to stigma reduction. By identifying less resilient patients, clinicians can offer appropriate support, accelerating the patient's path towards disease acceptance and stigma reduction.
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Affiliation(s)
- Lesley Dibley
- Reader in Nursing Research and Education, University of Greenwich and Bart's Health NHS Trust, London, UK
| | - Christine Norton
- Professor of Clinical Nursing Research, King's College London, London, UK
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Ko JO, Lee MH. [Structural Equation Modeling on Health-Related Quality of Life in Adults with Epilepsy]. J Korean Acad Nurs 2017; 47:624-637. [PMID: 29151560 DOI: 10.4040/jkan.2017.47.5.624] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2017] [Revised: 09/15/2017] [Accepted: 09/17/2017] [Indexed: 11/09/2022]
Abstract
PURPOSE This study aimed to identify variables influencing the health-related quality of life (HRQoL) of adults with epilepsy in order to establish a structural model and design an intervention strategy to improve patients' HRQoL. METHODS The selected subjects were 212 patients with epilepsy aged between 18 and 70 years who were currently receiving treatment from hospital, general hospital, and clinic. They were surveyed using a structured questionnaire. RESULTS The goodness of fit measures of the final hypothetical model were as follows: χ²/df=2.51, GFI=.91, AGFI=.90, CFI=.96, SRMR=.04, NFI=.93, and RMSEA=.08. The major variables influencing the HRQoL of adults with epilepsy were epilepsy self-efficacy, depression, social support, and side effects of anti-epileptic drugs (AEDs), which were significant in the mentioned order, whereas the duration of AEDs use and perceived stigma did not show any effects. Six variables accounted for 75.6% of HRQoL. Variables having a direct and total effect on the HRQoL of adults with epilepsy were the side effects of AEDs, social support, epilepsy self-efficacy, and depression, and those with an indirect effect were the side effects of AEDs and social support. CONCLUSION It is necessary to accurately identify the side effects of AEDs in adults with epilepsy and accurately observe the physical changes caused by depression. In addition, it is imperative to establish an active and effective nursing intervention program to strengthen the self-efficacy of the patients and to improve their quality of life through social support provided by family members and medical professionals.
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Affiliation(s)
- Jeong Ok Ko
- Department of Nursing, Jeonbuk Science College, Jeongeup, Korea
| | - Myung Ha Lee
- College of Nursing, Chonbuk National University, Jeonju, Korea.
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Modi AC, Wagner J, Smith AW, Kellermann TS, Michaelis R. Implementation of psychological clinical trials in epilepsy: Review and guide. Epilepsy Behav 2017; 74:104-113. [PMID: 28734195 DOI: 10.1016/j.yebeh.2017.06.016] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2017] [Accepted: 06/11/2017] [Indexed: 01/15/2023]
Abstract
The International League Against Epilepsy (ILAE) Neuropsychiatry commission and United States Institute of Medicine report both identified cognitive and psychological comorbidities as a significant issue for individuals with epilepsy, with rates as high as 60%. However, there is a paucity of evidence-based treatments for many psychological conditions (e.g., learning disorders, cognitive disorders, behavioral disorders). Because of inherent challenges in the implementation of psychological therapy trials and specific considerations for the population with epilepsy, the focus of the current review was to provide guidance and recommendations to conduct psychological trials for individuals with epilepsy. Several key areas will be discussed, including selection of patients, trial design, psychological intervention considerations, outcomes and evaluation of results, publication of trial results, and special issues related to pediatric clinical trials. Rigorously designed psychological therapy trials will set the stage for evidence-based practice in the care of individuals with epilepsy, with the goal of improving seizures, side effects, and HRQOL.
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Affiliation(s)
- Avani C Modi
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, 3333 Burnet Ave., Cincinnati, OH 45229-3039, USA.
| | - Janelle Wagner
- College of Nursing, Medical University of South Carolina, Charleston, SC, USA; Comprehensive Epilepsy Program, Medical University of South Carolina, Charleston, SC, USA; Department of Pediatrics, Medical University of South Carolina, Charleston, SC, USA
| | - Aimee W Smith
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, 3333 Burnet Ave., Cincinnati, OH 45229-3039, USA
| | - Tanja S Kellermann
- Department of Neurosurgery, Medical University of South Carolina, Charleston, SC, USA
| | - Rosa Michaelis
- Department of Psychiatry, St. Marien-Hospital, Hamm, Germany; Integrative Curriculum for Anthroposophic Medicine (ICURAM), University Witten/Herdecke, Witten, Germany
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Characteristics associated with quality of life among people with drug-resistant epilepsy. J Neurol 2017; 264:1174-1184. [PMID: 28550480 PMCID: PMC5486549 DOI: 10.1007/s00415-017-8512-1] [Citation(s) in RCA: 70] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2017] [Revised: 04/19/2017] [Accepted: 05/06/2017] [Indexed: 12/02/2022]
Abstract
Quality of Life (QoL) is the preferred outcome in non-pharmacological trials, but there is little UK population evidence of QoL in epilepsy. In advance of evaluating an epilepsy self-management course we aimed to describe, among UK participants, what clinical and psycho-social characteristics are associated with QoL. We recruited 404 adults attending specialist clinics, with at least two seizures in the prior year and measured their self-reported seizure frequency, co-morbidity, psychological distress, social characteristics, including self-mastery and stigma, and epilepsy-specific QoL (QOLIE-31-P). Mean age was 42 years, 54% were female, and 75% white. Median time since diagnosis was 18 years, and 69% experienced ≥10 seizures in the prior year. Nearly half (46%) reported additional medical or psychiatric conditions, 54% reported current anxiety and 28% reported current depression symptoms at borderline or case level, with 63% reporting felt stigma. While a maximum QOLIE-31-P score is 100, participants’ mean score was 66, with a wide range (25–99). In order of large to small magnitude: depression, low self-mastery, anxiety, felt stigma, a history of medical and psychiatric comorbidity, low self-reported medication adherence, and greater seizure frequency were associated with low QOLIE-31-P scores. Despite specialist care, UK people with epilepsy and persistent seizures experience low QoL. If QoL is the main outcome in epilepsy trials, developing and evaluating ways to reduce psychological and social disadvantage are likely to be of primary importance. Educational courses may not change QoL, but be one component supporting self-management for people with long-term conditions, like epilepsy.
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Shi Y, Wang S, Ying J, Zhang M, Liu P, Zhang H, Sun J. Correlates of perceived stigma for people living with epilepsy: A meta-analysis. Epilepsy Behav 2017; 70:198-203. [PMID: 28431368 DOI: 10.1016/j.yebeh.2017.02.022] [Citation(s) in RCA: 57] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2017] [Revised: 02/12/2017] [Accepted: 02/12/2017] [Indexed: 01/25/2023]
Abstract
OBJECTIVE Epilepsy, one of the most common, serious chronic neurological diseases, is accompanied by different levels of perceived stigma that affects people in almost all age groups. This stigma can negatively impact the physical and mental health of people living with epilepsy (PLWE). Good knowledge of perceived stigma for PLWE is important. In this study, we conducted a meta-analysis to identify the correlates of perceived stigma for PLWE. METHODS Studies on factors associated with perceived stigma for PLWE, including sociodemographic, psychosocial, and disease-related variables, were searched in PubMed, PsychINFO, EMBASE, and Web of Science. RESULTS Nineteen variables (k>1) were included in the meta-analysis. For sociodemographic characteristics, findings revealed that the significant weighted mean correlation (R) for "residence" and "poor financial status" were 0.177 and 0.286, respectively. For disease-related characteristics, all variables of significance, including "seizure severity," "seizure frequency," "number of medicines," and "adverse event" (R ranging from 0.190 to 0.362), were positively correlated with perceived stigma. For psychosocial characteristics, "depression" and "anxiety" with R values of 0.414 and 0.369 were significantly associated with perceived stigma. In addition, "social support," "quality of life (QOLIE-31,89)," "knowledge," and "attitude," with R values ranging from -0.444 to -0.200 indicating negative correlation with perceived stigma. CONCLUSION The current meta-analysis evaluated the correlates of perceived stigma for PLWE. Results can serve as a basis for policymakers and healthcare professionals for formulating health promotion and prevention strategies.
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Affiliation(s)
- Ying Shi
- School of Nursing, Jilin University, Changchun, China
| | - Shouqi Wang
- School of Nursing, Jilin University, Changchun, China
| | - Jie Ying
- School of Nursing, Jilin University, Changchun, China
| | - Meiling Zhang
- School of Nursing, Jilin University, Changchun, China
| | - Pengcheng Liu
- School of Nursing, Jilin University, Changchun, China
| | | | - Jiao Sun
- School of Nursing, Jilin University, Changchun, China.
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Sajatovic M, Tatsuoka C, Welter E, Friedman D, Spruill TM, Stoll S, Sahoo SS, Bukach A, Bamps YA, Valdez J, Jobst BC. Correlates of quality of life among individuals with epilepsy enrolled in self-management research: From the US Centers for Disease Control and Prevention Managing Epilepsy Well Network. Epilepsy Behav 2017; 69:177-180. [PMID: 28139451 PMCID: PMC6205501 DOI: 10.1016/j.yebeh.2016.12.005] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2016] [Accepted: 12/12/2016] [Indexed: 11/29/2022]
Abstract
RATIONALE Epilepsy is a chronic neurological condition that causes substantial burden on patients and families. Quality of life may be reduced due to the stress of coping with epilepsy. For nearly a decade, the Centers for Disease Control (CDC) Prevention Research Center's Managing Epilepsy Well (MEW) Network has been conducting research on epilepsy self-management to address research and practice gaps. Studies have been conducted by independent centers across the U.S. Recently, the MEW Network sites, collaboratively, began compiling an integrated database to facilitate aggregate secondary analysis of completed and ongoing studies. In this preliminary analysis, correlates of quality of life in people with epilepsy (PWE) were analyzed from pooled baseline data from the MEW Network. METHODS For this analysis, data originated from 6 epilepsy studies conducted across 4 research sites and comprised 459 PWE. Descriptive comparisons assessed common data elements that included gender, age, ethnicity, race, education, employment, income, seizure frequency, quality of life, and depression. Standardized rating scales were used for quality of life (QOLIE-10) and for depression (Patient Health Questionnaire, PHQ-9). RESULTS While not all datasets included all common data elements, baseline descriptive analysis found a mean age of 42 (SD 13.22), 289 women (63.0%), 59 African Americans (13.7%), and 58 Hispanics (18.5%). Most, 422 (92.8%), completed at least high school, while 169 (61.7%) were unmarried, divorced/separated, or widowed. Median 30-day seizure frequency was 0.71 (range 0-308). Depression at baseline was common, with a mean PHQ-9 score of 8.32 (SD 6.04); 69 (29.0%) had depression in the mild range (PHQ-9 score 5-9) and 92 (38.7%) had depression in the moderate to severe range (PHQ-9 score >9). Lower baseline quality of life was associated with greater depressive severity (p<.001), more frequent seizures (p<.04) and lower income (p<.05). CONCLUSIONS The MEW Network Integrated Database offers a unique opportunity for secondary analysis of data from multiple community-based epilepsy research studies. While findings must be tempered by potential sample bias, i.e. a relative under-representation of men and relatively small sample of some racial/ethnic subgroups, results of analyses derived from this first integrated epilepsy self-management database have potential to be useful to the field. Associations between depression severity and lower QOL in PWE are consistent with previous studies derived from clinical samples. Self-management efforts that focus on mental health comorbidity and seizure control may be one way to address modifiable factors that affect quality of life in PWE.
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Affiliation(s)
- Martha Sajatovic
- Department of Psychiatry, Case Western Reserve University School of Medicine, Neurological and Behavioral Outcomes Center, University Hospitals Cleveland Medical Center, Cleveland, OH, United States; Department of Neurology, Case Western Reserve University School of Medicine, Neurological and Behavioral Outcomes Center, University Hospitals Cleveland Medical Center, Cleveland, OH, United States.
| | - Curtis Tatsuoka
- Department of Neurology, Case Western Reserve University School of Medicine, Neurological and Behavioral Outcomes Center, University Hospitals Cleveland Medical Center, Cleveland, Ohio
| | - Elisabeth Welter
- Department of Neurology, Case Western Reserve University School of Medicine, Neurological and Behavioral Outcomes Center, University Hospitals Cleveland Medical Center, Cleveland, Ohio
| | - Daniel Friedman
- Department of Neurology, New York University School of Medicine, New York, New York
| | - Tanya M. Spruill
- Department of Population Health, New York University School of Medicine, New York, New York
| | - Shelley Stoll
- Center for Managing Chronic Disease, University of Michigan, Ann Arbor, Michigan
| | - Satya S. Sahoo
- Department of Epidemiology and Biostatistics, of Neurology, & of Electrical Engineering and Computer Science Department, School of Medicine, Case Western Reserve University, Cleveland, Ohio
| | - Ashley Bukach
- Department of Psychiatry and Neurology, Case Western Reserve University School of Medicine, Neurological and Behavioral Outcomes Center, University Hospitals Cleveland Medical Center, Cleveland, Ohio
| | - Yvan A. Bamps
- Senior Research Project Coordinator, Emory University Rollins School of Public Health, Atlanta, Georgia
| | - Joshua Valdez
- Department of Epidemiology and Biostatistics, School of Medicine, Case Western Reserve University, Cleveland, Ohio
| | - Barbara C. Jobst
- Professor, Department of Neurology, Geisel School of Medicine at Dartmouth, Dartmouth College, Lebanon, New Hampshire
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Asadollahi A, Saberi LF, Havasi A, Kaveh MH. Psychometric Properties of the Persian Version of the Quality of Life in Epilepsy Inventory in the Later Life. J Epilepsy Res 2017; 6:59-65. [PMID: 28101476 PMCID: PMC5206101 DOI: 10.14581/jer.16012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2015] [Accepted: 06/06/2016] [Indexed: 11/03/2022] Open
Abstract
BACKGROUND AND PURPOSE The reports indicate on the incidence of seizure disorder about 1.5 per cent of the normal elderly population. The Quality of Life in Epilepsy Inventory (QOLIE-31) has been pervasive simple tool to screen seizure in the busy neurophysiological settings and monitoring. It was constructed as self-administered tool in two formats, 89 and 31-items. To the reliability and validity of the QOLIE-31 across older adults in the southwest Iran and discuss its role in the detection of health-related quality of elderly patients with epilepsy. METHODS About 73 older adults (mean age = 66.3 ± 1.71) were sampled from the eight hospitals and caring centres. They replied to the QOLIE-31. External and criterion validity was calculated by correlation to the SF-36 questionnaire, to check and validate the epilepsy specific dimensions. The QOLIE-31 includes seven subscales: overall quality of life, seizure worry, emotional well-being, energy/fatigue, cognitive, medication effects, and social function. RESULTS There was significant difference within sample groups regarding main variables (p < 0.05). The coefficients of Cronbach's alpha (α= 0.76), convergent validity (0.81), divergent validity (-0.21), external validity with overall score of SF-36 (0.87), and criterion validity (0.78) were estimated, which were significant at p < 0.01. The exploratory factor analysis demonstrated that the QOLIE-31 is organized into six factors, which clarifies 92 per cent of the scale's variance. Second-order confirmatory factor analysis pointed out that the factor is well matched up onto a principal factor. Consequently, the 6-factors model was well appropriate for the data by the fit index techniques for adjusting the scale (AGFI = 0.94, GFI = 0.96, RMSEA = 0.003, IFI = 0.90, NFI = 0.95, CFI = 0.95). CONCLUSIONS The results pointed to the well-adjusted reliability and psychometric properties of the QOLIE-31 and its usefulness for the relevant studies as well.
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Affiliation(s)
- Abdolrahim Asadollahi
- Australian Centre for Quality of Life, Deakin University, Melbourne, Australia; Department of Healthy Aging, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Laleh Fani Saberi
- Department of Community Health, Mazandaran University of Medical Sciences, Sari, Iran
| | - Ali Havasi
- Department of Social Work, University of Applied Science & Technology, Ahwaz, Iran
| | - Mohammad-Hossein Kaveh
- Department of Health Promotion, School of Health, Shiraz University of Medical Science, Shiraz, Iran
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Liu NF, Brown AS, Folias AE, Younge MF, Guzman SJ, Close KL, Wood R. Stigma in People With Type 1 or Type 2 Diabetes. Clin Diabetes 2017; 35:27-34. [PMID: 28144043 PMCID: PMC5241772 DOI: 10.2337/cd16-0020] [Citation(s) in RCA: 137] [Impact Index Per Article: 19.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
IN BRIEF This study quantitatively measures diabetes stigma and its associated psychosocial impact in a large population of U.S. patients with type 1 or type 2 diabetes using an online survey sent to 12,000 people with diabetes. A majority of respondents with type 1 (76%) or type 2 (52%) diabetes reported that diabetes comes with stigma. Perceptions of stigma were significantly higher among respondents with type 1 diabetes than among those with type 2 diabetes, with the highest rate in parents of children with type 1 diabetes (83%) and the lowest rate in people with type 2 diabetes who did not use insulin (49%). Our results suggest that a disturbingly high percentage of people with diabetes experience stigma, particularly those with type 1 or type 2 diabetes who are on intensive insulin therapy. The experience of stigma disproportionately affects those with a higher BMI, higher A1C, and poorer self-reported blood glucose control, suggesting that those who need the most help are also the most affected by stigma.
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Affiliation(s)
| | - Adam S. Brown
- The diaTribe Foundation, San Francisco, CA
- Close Concerns, San Francisco, CA
| | | | | | | | - Kelly L. Close
- The diaTribe Foundation, San Francisco, CA
- Close Concerns, San Francisco, CA
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Karlov VA, Inozemtseva OS. [Quality of life of adult patients with cryptogenic epilepsy]. Zh Nevrol Psikhiatr Im S S Korsakova 2016; 116:57-60. [PMID: 28005048 DOI: 10.17116/jnevro20161169257-60] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
AIM To determine a position of cryptogenic epilepsy (CE) in relation to idiopathic epilepsy (IE) and symptomatic epilepsy (SE) in the aspect of patients' quality-of-life. MATERIAL AND METHODS One hundred and fifty patients, including 90 with CE, 30 with SE and 30 with IE, were examined. The severity of epileptic seizures assessed with the NHS3, anxiety and depression assessed with the HADS, sleep disorders, quality-of-life measured with the Qolie-89 were studied. RESULTS AND CONCLUSION CE was similar to SE in many parameters but had a favorable course. The following factors were similar for CE and IE: family history of disease, differences between the severity of seizures and Qolie-89 scores. Quality-of-life was higher in CE compared to SE, despite the marked anxiety of patients. It has been concluded that CE, which is caused by both genetic and environmental factors, has an interim position between IE and SE.
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Affiliation(s)
- V A Karlov
- Evdokimov Moscow State University Of Medical Dentistry, Moscow, Russia
| | - O S Inozemtseva
- Evdokimov Moscow State University Of Medical Dentistry, Moscow, Russia
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Sung C, Lin CC, Connor A, Chan F. Disclose or not? Effect of impression management tactics on hireability of persons with epilepsy. Epilepsia 2016; 58:128-136. [DOI: 10.1111/epi.13619] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/20/2016] [Indexed: 11/30/2022]
Affiliation(s)
- Connie Sung
- Michigan State University; East Lansing Michigan U.S.A
| | | | | | - Fong Chan
- University of Wisconsin-Madison; Madison Wisconsin U.S.A
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Reiter SF, Bjørk MH, Daltveit AK, Veiby G, Kolstad E, Engelsen BA, Gilhus NE. Life satisfaction in women with epilepsy during and after pregnancy. Epilepsy Behav 2016; 62:251-7. [PMID: 27513352 DOI: 10.1016/j.yebeh.2016.06.025] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2016] [Revised: 06/15/2016] [Accepted: 06/16/2016] [Indexed: 11/25/2022]
Abstract
OBJECTIVE The aim of this study was to investigate life satisfaction in women with epilepsy during and after pregnancy. METHODS The study was based on the Norwegian Mother and Child Cohort Study, including 102,265 women with and without epilepsy from the general population. Investigation took place at pregnancy weeks 15-19 and 6 and 18months postpartum. Women with epilepsy were compared with a reference group without epilepsy. RESULTS The proportion of women with epilepsy was 0.6-0.7% at all three time points. Women with epilepsy reported lower life satisfaction and self-esteem both during and after pregnancy compared with the references. Single parenting correlated negatively with life satisfaction in epilepsy during the whole study period. Epilepsy was associated with lower levels of relationship satisfaction and higher levels of work strain during pregnancy and lower levels of self-efficacy and satisfactory somatic health 18months postpartum. Adverse life events, such as divorce, were more common in women with epilepsy compared with the references, and fewer women with epilepsy had a paid job 18months postpartum. SIGNIFICANCE Reduced life satisfaction associated with epilepsy during and after pregnancy showed that, even in a highly developed welfare society, women with epilepsy struggle. Mothers with epilepsy and their partners should be examined for emotional complaints and partnership satisfaction during and after pregnancy. Validated screening tools are available for such measures.
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Affiliation(s)
- Simone Frizell Reiter
- Department of Clinical Medicine, Section for Neurology, University of Bergen, Norway.
| | - Marte Helene Bjørk
- Department of Clinical Medicine, Section for Neurology, University of Bergen, Norway; Department of Neurology, Haukeland University Hospital, Bergen, Norway
| | - Anne Kjersti Daltveit
- Department of Public Health and Primary Health Care, University of Bergen, Norway; Medical Birth Registry of Norway, Division of Epidemiology, Norwegian Institute of Public Health, Bergen, Norway
| | - Gyri Veiby
- Department of Neurology, Haukeland University Hospital, Bergen, Norway
| | - Eivind Kolstad
- Department of Clinical Medicine, Section for Neurology, University of Bergen, Norway; Department of Neurology, Haukeland University Hospital, Bergen, Norway
| | - Bernt A Engelsen
- Department of Clinical Medicine, Section for Neurology, University of Bergen, Norway; Department of Neurology, Haukeland University Hospital, Bergen, Norway
| | - Nils Erik Gilhus
- Department of Clinical Medicine, Section for Neurology, University of Bergen, Norway; Department of Neurology, Haukeland University Hospital, Bergen, Norway
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Factors associated with perceived stigma among patients with epilepsy in Turkey. Epilepsy Behav 2016; 60:142-148. [PMID: 27206233 DOI: 10.1016/j.yebeh.2016.04.036] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2016] [Revised: 03/25/2016] [Accepted: 04/18/2016] [Indexed: 11/20/2022]
Abstract
PURPOSE Epilepsy is one of the most stigmatizing medical conditions. The purpose of this study was to examine the perception of stigma and factors associated with stigma. MATERIAL AND METHODS This descriptive cross-sectional study was carried out among patients attending an epilepsy outpatient clinic of a university hospital between February and October 2014. One hundred ninety-four patients who were over 18years of age, who were able to communicate, and who had a diagnosis of definite epilepsy constituted the study sample. Patients seizure-free for two years were excluded from the group. Three-item Jacoby's Stigma Scale was used to determine level of stigma, and Social Support Scale, Generalized Self-efficacy Scale, Epilepsy Knowledge Scale, and Epilepsy Attitude Scale were used to examine factors associated with stigma. RESULTS In total, 66 (34%) out of 194 subjects reported feeling stigmatized, with almost half of them (n=31) feeling highly stigmatized. Education, income, age at onset, seizure frequency in previous year, social support, and knowledge and attitudes towards epilepsy were significant factors determining scores on the stigma scale. It was also determined that stigma was associated with seeking help from mystics, disclosure of the diagnosis, and self-efficacy. CONCLUSION This study confirms the findings of previous studies that have identified the importance of both clinical and nonclinical factors in understanding the stigma of epilepsy. Findings support the need for social support, knowledge, and awareness to decrease the stigma associated with epilepsy.
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Herrmann LK, Welter E, Berg AT, Perzynski AT, Doren JV, Sajatovic M. Epilepsy misconceptions and stigma reduction: Current status in Western countries. Epilepsy Behav 2016; 60:165-173. [PMID: 27208826 PMCID: PMC6047062 DOI: 10.1016/j.yebeh.2016.04.003] [Citation(s) in RCA: 60] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2016] [Accepted: 04/02/2016] [Indexed: 11/26/2022]
Abstract
OBJECTIVE This systematized literature review identified reports describing epilepsy misconceptions in the developed Western countries and research interventions focused on reducing these misconceptions. MATERIALS AND METHODS English language publications from January 2004 to January 2015 that described original research conducted in Europe, North/Central/South America, or Australia on misconceptions about epilepsy among the general public were used for this review. RESULTS Eighty-one publications were selected. Most studies were conducted in the Americas (N=30) and Europe (N=31). Misconceptions and attitudes about epilepsy were assessed among clinical providers (N=9), family members of people with epilepsy (PWE) (N=5), teachers (N=11), students (N=22), and the general public (N=25). Most studies used structured questionnaires, sometimes adding open-ended questions. Misconceptions reflected socially exclusionary attitudes directed at PWE, ignorance about treatment, and overgeneralizations that are stigmatizing when applied to all PWE. Misconceptions were more prevalent in those with less education, lower socioeconomic status, and no exposure to PWE. There were only 12 intervention studies. While intervention studies were generally effective in improving attitudes, many were targeted to healthcare and education settings, were time-intensive, and impractical for broad general population implementation. None incorporated newer technology-based strategies regarding effective health communication approaches. CONCLUSIONS Types of epilepsy misconceptions were similar in reports published over the last decade, although most referred to misconceptions that have already been previously described. Existing questionnaires may fail to identify more subtle forms of current misconceptions and negative attitudes. Few interventional studies specifically target epilepsy stigma. Practical and broad scalable approaches to destigmatize epilepsy may help reduce misconceptions.
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Affiliation(s)
- Lynn K. Herrmann
- Northern Illinois University, College of Health and Human Sciences, DeKalb, Illinois
| | - Elisabeth Welter
- Case Western Reserve University School of Medicine and Neurological and Behavioral Outcomes Center, University Hospitals Case Medical Center, Cleveland, Ohio
| | - Anne T. Berg
- Ann & Robert H. Lurie Children’s Hospital of Chicago, Epilepsy Center, and Northwestern Feinberg School of Medicine, Dept. Pediatrics. Chicago, Illinois
| | - Adam T. Perzynski
- Center for Health Care Research and Policy. Case Western Reserve University, MetroHealth Medical Center, Cleveland, Ohio
| | - James Van Doren
- Case Western Reserve University School of Medicine and Neurological and Behavioral Outcomes Center, University Hospitals Case Medical Center, Cleveland, Ohio
| | - Martha Sajatovic
- Department of Psychiatry and of Neurology, Case Western Reserve University School of Medicine, Neurological and Behavioral Outcomes Center, University Hospitals Case Medical Center, Cleveland, OH, United States.
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Stigma as a key determinant of health-related quality of life in Parkinson's disease. Qual Life Res 2016; 25:3037-3045. [PMID: 27259581 DOI: 10.1007/s11136-016-1329-z] [Citation(s) in RCA: 56] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/25/2016] [Indexed: 10/21/2022]
Abstract
PURPOSE People with Parkinson's disease (PD) may experience stigma due to their visible features of movement and communication difficulties. This paper aimed to examine the role of experienced stigma in health-related quality of life (QOL), after controlling for personal and clinical characteristics. METHODS This is a preliminary analysis of a subset of baseline data from the Social Self-Management of Parkinson's Disease Study (SocM-PD), an ongoing 3-year prospective cohort study. Seventy-three people with PD (M age = 65.72, 29 women) participated in this study. Hierarchical multiple regression analyses were used to determine the role of stigma in QOL, after controlling for gender, disease severity, depression, and motor difficulties of daily living. RESULTS Significant correlations were found between QOL with gender (r = .26), disease severity (r = .38), depression (r = .65), motor difficulties of daily living (r = .71), and stigma (r = .83). After controlling for the significant covariates, stigma made a significant and unique contribution to the explanation of QOL by 13.7 % (p < 0.001). A final hierarchical multiple regression with stigma and the 4 covariates revealed an overall model that explained 77.8 % of the total variance of QOL (F [5, 63] = 48.79, p < 0.001). CONCLUSIONS Experienced stigma appears to be a key determinant of QOL in people with PD. The results suggest the importance of further understanding stigma in PD to develop possible intervention strategies. Future work is also needed to verify the results with a larger and longitudinal dataset of the SocM-PD.
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Chen HF, Tsai YF, Hsi MS, Chen JC. Factors affecting quality of life in adults with epilepsy in Taiwan: A cross-sectional, correlational study. Epilepsy Behav 2016; 58:26-32. [PMID: 27002941 DOI: 10.1016/j.yebeh.2016.02.019] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2015] [Revised: 02/12/2016] [Accepted: 02/12/2016] [Indexed: 10/22/2022]
Abstract
PURPOSE The purpose of this study was to assess eight factors considered important for quality of life in persons with epilepsy in order to determine which of these components affect quality of life in adults with epilepsy in Taiwan. METHODS A cross-sectional, correlational study using structured questionnaires assessed 260 patients with epilepsy purposively sampled from a medical center in Northern Taiwan. Health-related quality of life (HRQoL) was evaluated with the Quality of Life in Epilepsy-31 (QOLIE-31) questionnaire. Data also included personal and health-related characteristics, knowledge of epilepsy, efficacy in the self-management of epilepsy, and social support. RESULTS Scores for the QOLIE-31 were correlated with the following factors: (1) demographic characteristics of age, gender, and income; (2) sleep quality; (3) symptoms of anxiety and depression; (4) epilepsy-specific variables: seizure frequency; types, number, and frequency of antiepileptic drugs (AEDs); and adverse events of AEDs; and (5) social support. Stepwise regression analysis showed that seven factors were predictive for quality of life: anxiety, depression, adverse events of AEDs, social support, seizure frequency of at least once in three months, household income of NT$ 40,001-100,000, and male gender. These factors accounted for 58.2% of the variance of quality of life. SIGNIFICANCE Our study assessed multiple factors in an examination of relationships and predictive factors for quality of life in adults with epilepsy in Taiwan. Knowledge of these contributing factors can assist health-care providers when evaluating patients with epilepsy to help target interventions for improving quality of life.
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Affiliation(s)
- Hsiu-Fang Chen
- Department of Nursing, Chang Gung University of Science and Technology, Tao-Yuan, Taiwan
| | - Yun-Fang Tsai
- School of Nursing, College of Medicine, Chang Gung University, Tao-Yuan, Taiwan.
| | - Mo-Song Hsi
- Department of Neurology, Chang Gung Memorial Hospital at Taipei, Taiwan; Taiwan Epilepsy Association, Taiwan
| | - Jui-Chen Chen
- Department of Nursing, Chang Gung Memorial Hospital at Taipei, Taiwan; Taiwan Epilepsy Association, Taiwan
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Ring A, Jacoby A, Baker GA, Marson A, Whitehead MM. Does the concept of resilience contribute to understanding good quality of life in the context of epilepsy? Epilepsy Behav 2016; 56:153-64. [PMID: 26895477 DOI: 10.1016/j.yebeh.2016.01.002] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2015] [Revised: 12/31/2015] [Accepted: 01/02/2016] [Indexed: 12/15/2022]
Abstract
A significant body of research highlights negative impacts of epilepsy for individual quality of life (QOL). Poor seizure control is frequently associated with reporting of poor QOL and good seizure control with good QOL; however, this is not a universal finding. Evidence suggests that some people enjoy good QOL despite ongoing seizures while others report poor QOL despite good seizure control. Understanding the factors that influence QOL for people with epilepsy and the processes via which such factors exert their influence is central to the development of interventions to support people with epilepsy to experience the best possible QOL. We present findings of a qualitative investigation exploring influences and processes on QOL for people with epilepsy. We describe the clinical, psychological, and social factors contributing to QOL. In particular, we focus on the value of the concept of resilience for understanding quality of life in epilepsy. Based on our analysis, we propose a model of resilience wherein four key component sets of factors interact to determine QOL. This model reflects the fluid nature of resilience that, we suggest, is subject to change based on shifts within the individual components and the interactions between them. The model offers a representation of the complex influences that act and interact to either mitigate or further compound the negative impacts of epilepsy on individual QOL.
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Affiliation(s)
- Adele Ring
- Department of Public Health & Policy, University of Liverpool, Liverpool, UK
| | - Ann Jacoby
- Department of Public Health & Policy, University of Liverpool, Liverpool, UK.
| | - Gus A Baker
- Department of Molecular & Clinical Pharmacology, University of Liverpool, UK
| | - Anthony Marson
- Department of Molecular & Clinical Pharmacology, University of Liverpool, UK
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Jakobsen LA, Karshenas A, Bach FW, Gazerani P. Alterations in pain responsiveness and serum biomarkers in juvenile myoclonic epilepsy: an age- and gender-matched controlled pilot study. FUTURE NEUROLOGY 2016. [DOI: 10.2217/fnl.16.1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Introduction: Serum levels of several biomarkers along with sensory responsiveness were investigated in juvenile myoclonic epilepsy patients in comparison with healthy controls. Methods: Ten epileptic patients (36.1 ± 3.4 years) and ten gender- and age-matched healthy controls were recruited. Mechanical sensitivity, cold pressor tolerance and serum levels of BDNF, CGRP, PGE2, S100B and TNF-α were investigated. Results: Mechanical sensitivity to pinprick was lower in patients (p < 0.05) while cold pain tolerance threshold was higher. Serum level of BDNF was higher in patients compared with controls (p < 0.01). The same pattern was evident for CGRP (p < 0.05). Serum level of PGE2 was lower in patients (p < 0.01). Conclusion: Juvenile myoclonic epilepsy patients had an altered serum biomarker pattern and sensory perception in comparison with controls.
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Affiliation(s)
- Lydia Anja Jakobsen
- Department of Health Science & Technology, Faculty of Medicine, Aalborg University, Aalborg, Denmark
| | - Ali Karshenas
- Department of Neurology, Aalborg University Hospital, Aalborg, Denmark
| | | | - Parisa Gazerani
- SMI® & Laboratory for Cancer Biology, Department of Health Science and Technology, Faculty of Medicine, Aalborg University, Aalborg, Denmark
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