The Relationship of Stigma and Quality of Life in Patients with Epilepsy / 대한간질학회지

BACKGROUND: Stigma may affect the interpersonal relationship and coping ability of epilepsy patients. This study was aimed to evaluate the degree of stigma and the relationship between the clinical factors, quality of life (QOL) and the stigma in epilepsy patients. METHODS: One hundred and sixty-three patients with epilepsy were included. The research instruments were questionnaires for collecting demographic and disease-specific data, the stigma and quality of life. The modified Kim Eun Ja's stigma scale (1997) was used. It consists of two domains (enacted stigma, felt stigma) and has 10 items. The quality of life was evaluated by QOLIE-31. To test the correlation between the clinical factors, QOL and the stigma, Pearson correlation coefficient and ANCOVA were used. RESULTS: 51.5% of all patients had stigma. There was a significant negative correlation (r=-0.585, p<0.01) between the total score of stigma and the QOL. Two domains of stigma were also negatively correlated with QOL as follows : felt stigma vs. QOL (r=-0.429, p<0.01) and enacted stigma vs. QOL (r=-0.542, p<0.01). The patients with higher seizure frequency had lower QOL (F=4.834, p=0.03). The clinical factors that could predict the degree of stigma were the seizure frequency (F=7.86, p=0.006), duration of seizure disorder (F=7.34, p=0.008), seizure pattern (F=4.48, p=0.036) and the number of AED (F=2.51, p=0.045). CONCLUSIONS: The felt stigma and the enacted stigma affected the QOL of epilepsy patients. These results suggest that psychosocial interventions are necessary to treat the negative reaction and depressed self-esteems of epilepsy patients in order to improve their QOL.

Clinical Factors Influencing Quality of Life in Patients with Epilepsy

BACKGROUND: Epilepsy has been known to adversely affect a patient's quality of life (QOL). We investigated the status of QOL and tested the influences of clinical factors upon QOL in epileptic patients. METHODS: We evaluated 125 adult patients (mean age, 30.4 years, male:female=1:0.86) with epilepsy. The demographic, social (marriage, employment, religion, education duration), and clinical data (seizure onset age, seizure pattern during the last 1 year, treatment duration, number of antiepileptic drug) were obtained. Quality of life in epilepsy-31 (QOLIE-31) and Beck Depression Inventory-Korean version (KBDI) were used. The relationships of demographic, social, and clinical factors with QOL in epileptic patients were evaluated. RESULTS: The mean subscores of QOLIE-31 items were 52.6 (medication effects), 50.9 (cognitive functioning), 50.9 (social functioning), 50.5 (energy/fatigue), 48.4 (seizure worry), 46.8 (overall QOL), and 45.7 (emotional well-being), and the overall score was 49.6. Sex, marriage, religion, and duration of treatment did not affect QOL. The age of patients had a weak linear positive correlation with overall QOL and emotional well-being. Employed patients had a significantly high score in overall QOL, emotional well-being, cognitive functioning, social functioning, and overall score. The patients given polytherapy had lower scores of QOLIE-31 items except seizure worry and energy/fatigue. Seizure free patients had significantly higher scores in seizure worry, overall QOL, social functioning, and overall score. Depression negatively influenced all subscales and overall score. CONCLUSIONS: Age, employment state, number of antiepileptic drugs, seizure pattern, and depression were significant clinical factors affecting QOL in patients with epilepsy.