Community integration, self-esteem, and perceived stigma in a Nigerian sample with epilepsy.

OBJECTIVE: The objective of the study was to investigate the levels, interrelationships, and associated factors of community integration (CI), perceived stigma (PS), and self-esteem in people living with epilepsy (PWE) in Anambra and Enugu States of south-east Nigeria. METHODS: This was a cross-sectional survey involving 70 consenting adults living with epilepsy consecutively recruited from three purposively sampled specialized clinics in Anambra State. The Reintegration to Normal Living Index, the Epilepsy Stigma Scale, and the Rosenberg Self-Esteem Scale were used to estimate CI, PS, and self-esteem, respectively among the participants. Data were analyzed at 0.05 level of significance. RESULTS: The mean age of the participants (28.6% females) was 34.91 ±â€¯16.21 years. The participants had moderate PS score (43.54 ±â€¯14.20), poor self-esteem score (17.63 ±â€¯6.12), and mild-to-moderately restricted CI score (67.83 ±â€¯24.72). Participants' PS, CI, and self-esteem significantly correlated with one another (p < 0.05) with PS and self-esteem being significant predictors of CI. Participants' PS had a significant correlation with their age at onset of epilepsy, while their self-esteem and CI significantly correlated with their seizure episodes (p < 0.05). Participants' PS and CI were significantly different across different categories of their occupational and educational statuses. Perceived stigma also varied across participants' marital status with divorced participants having the worst score (p < 0.05). CONCLUSION: People living with epilepsy had moderate PS, poor self-esteem, and mild-to-moderate CI, which correlated significantly with one another. Results suggest the possibility of using CI as an outcome for assessing the effectiveness of stigma and self-esteem interventions during epilepsy rehabilitation.

Community integration of people living with epilepsy in a Nigerian population.

BACKGROUND: Epilepsy is a chronic seizure disorder that affects numerous people worldwide. Community integration (CI) is the ultimate goal of rehabilitation of any chronic condition. There seems to be a dearth of research on CI among people living with epilepsy (PLWE). AIM: The present study was designed to investigate on the level of satisfaction with CI and its associated factors in a Nigerian PLWE. METHODOLOGY: This was a cross-sectional survey of 70 adult PLWE (28.6% females; mean age=34.91±16.21years) consecutively recruited from three purposively selected specialized clinics in Anambra State of South-eastern Nigeria. The Reintegration to Normal Living Index was used to assess the level of satisfaction with CI among the participants. Data was analysed using Spearman Rank Order Correlation, Mann-Whitney U and Kruskal-Wallis tests at 0.05 level of significance. RESULTS: The total level of satisfaction with CI among PLWE was poor (59.76±23.24). PLWE were severely restricted in nine out of the fourteen CI scores but were mildly or moderately restricted in the remaining five CI scores. The participants' total level of satisfaction with CI significantly correlated with their annual (r=-0.319; p=0.007), six-month (r=-0.275; p=0.021) and one-month (r=-0.221; p=0.025) episodes of seizures, and was significantly influenced by their occupational status (k=12.15; p=0.009) and highest educational attainment (k=12.39; p=0.006). CONCLUSION: Generally, the total level of satisfaction with CI among PLWE was poor. There is need for interventional programmes aimed at integrating PLWE into their various communities with special emphasis laid on unemployed and less educated ones having high seizure frequency.