[Structural Equation Modeling on Health-Related Quality of Life in Adults with Epilepsy]

The effect of epilepsy self-management on productivity at work

BACKGROUND

Epilepsy is a significant public health concern and the most common neurological disorder. Lack of understanding of the disease may magnify the challenges faced by employees with epilepsy, including effective management of symptoms, and full participation in workplace and work productivity.

AIM

Study aimed to evaluate epilepsy self-management skills of working individuals with epilepsy and to determine the impact of it on productivity at work.

METHODS

The study adopted a cross-sectional design and involved 111 individuals with epilepsy. Data collection was carried out using a socio-demographic characteristics form, the "Epilepsy Self-Management Scale" and the "Endikot Work Productivity Scale."

RESULTS

The average age was 35.76 ± 3.39 in the study. The majority of the participants (57.7 %) were women. Additionally, 33.3 % were private sector employee, and 39.6 % held a bachelor's degree. The mean score of the Epilepsy Self Management Scale was 3.91 ± 0.15, the total score of Endikot Work Productivity Scale was 39.84 ± 6.33. A negative significant correlation was observed between epilepsy self management and work productivity. Moreover, women (3.94 ± 0.17) and healthcare workers (3.97 ± 0.06) had higher scores of epilepsy self management. While men (40.43 ± 0.15) demonstrated higher productivity scores, public servants (35.61 ± 0.34) had lower scores compared to others (p < 0.05).

CONCLUSIONS

The findings of this study suggest that improved self-management of epilepsy among working individuals leads to increased work productivity. The epilepsy-management skills of women and healthcare workers was higher. Furthermore, men exhibited lower productivity levels, while woman and public servants displayed higher.

Age and sex differences in social support among children and adolescents with epilepsy

OBJECTIVE

This study aimed to explore what differences exist in the perceived frequency of social support and the importance of social support according to age and sex among children and adolescents with epilepsy.

METHOD

We employed an explorative cross-sectional design to examine a sample of 320 children and adolescents with epilepsy using the child and adolescent social support scale (CASSS).

RESULT

There is a significant relationship between sex and age and the importance of support from classmates and friends. For the dependent variables that were not affected by the age-sex interaction, we analyzed the main effects of these dependent variables of sex and age separately. We discovered that girls with epilepsy received a higher level of support from their parents and classmates than boys. Besides, compared with adolescents, children with epilepsy consider parental support more valuable. Also, children with epilepsy attach more importance to support from their teachers than adolescents. In contrast, adolescents with epilepsy receive a higher level of support from their friends than children.

CONCLUSION

Social support varies by age and sex in children and adolescents with epilepsy. Understanding the social support of children with epilepsy at various developmental stages and for different sexes can help provide a healthier environment for children and adolescents to grow up in. The results of this study provide a basis for formulating corresponding intervention programs for children and adolescents with epilepsy according to age and sex.

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

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.

Determination of self-efficacy of patients diagnosed with epilepsy

This study was conducted to determine the self-efficacy of patients diagnosed with epilepsy. This descriptive-correlational study was conducted between November-December 2020 with individuals diagnosed with epilepsy and living in the eastern province of Turkey. The sample of the study consisted of individuals diagnosed with epilepsy (101 persons) who were living in this province and agreed to participate in the study. According to the findings obtained from the study, the Epilepsy Self-efficacy Scale Total Mean Score of the individuals was found to be 226.38 ± 45.23. The scale does not have a cut-off point, and the total score that can be obtained from the scale varies between 0 and 310. An increase in the score obtained indicates high self-efficacy. It can be said that the self-efficacy levels of the sampled individuals are also high. It was found that there was a negative correlation between the first diagnosis age and the seizure management sub-dimension, and a positive statistically significant correlation between the age of the individuals and the age of the first seizure. The Epilepsy Self-efficacy Scale Total Mean Score of the individuals was found to be statistically high in those who received information regarding the disorder and used their drug/drugs regularly. It is suggested to conduct the study in larger groups. It is recommended to carry out studies to increase epilepsy self-efficacy.

Factors associated with self-efficacy among patients with epilepsy in Turkey

PURPOSE

This study aimed to determine the self-efficacy levels of individuals with epilepsy and also compare individuals' self-efficacy with sociodemographic and epilepsy-related characteristics.

MATERIAL AND METHODS

The cross-sectional study was carried out with 200 individuals with epilepsy who were suitable for the inclusion criterias. Data were collected using patient information form which includes sociodemographic and clinical characteristics and Epilepsy Self-Efficacy Scale for evaluating epilepsy-related self-efficacy levels of patients.

RESULTS

The self-efficacy levels of the patients were moderate. Education, gender, occupational status, income, seizure frequency, regular use of medication, the number of drugs used, patient behavior following a drug-related problem, family support, the ability to obtain information about the illness, and hiding the illness from other people were significant factors determining scores on the epilepsy self-efficacy scale.

CONCLUSION

This study confirms the findings of previous studies that were conducted to determine factors affecting self-efficacy. In order to increase self-efficacy, the findings show that there is a need for social support, education of epilepsy individuals, and information and awareness in society.

[A Structural Equation Model of Health-Related Quality of Life among Older Women Following Bilateral Total Knee Replacement]

PURPOSE

This study aimed to develop and test a structural equation model of health-related quality of life among older women following bilateral total knee replacement based on a literature review and Wilson and Cleary's model of health-related quality of life.

METHODS

One hundred ninety three women who were diagnosed with osteoarthritis, were older than 65 years, and were between 13 weeks and 12 months of having a bilateral total knee replacement were recruited from an outpatient clinic. Data were collected from July 2017 to April 2018 using a structured questionnaire and medical records. Data were analyzed using SPSS/WIN 22.0, AMOS 22.0, and Smart PLS 3.2.4.

RESULTS

The fitness of the hypothetical model was good, with coefficients of determination (R²) ranging between .28 and .75 and predictive relevance (Q²) between .26 and .73. The standardized root mean square residual of the model fit indices for the hypothetical model was .04; which explained 64.2% of physical and 62.5% of mental health-related quality of life. Self-efficacy, symptom status, functional status, and general health perceptions had a significant direct effect on physical health-related quality of life, while social support, symptom status, and general health perceptions had a significant direct effect on participants' mental-health-related quality of life.

CONCLUSION

To improve the physical and mental quality of life of older women who receive bilateral knee replacement, nursing-based intervention strategies that reduce symptoms, improve functional status, and increase health perceptions, self-efficacy, and social support are needed. The most important factor is the symptom status.