Oxford Outcomes Ltd., Seacourt Tower, West Way, Oxford OX2 0JJ, United Kingdom.
Seizure. 2011 Dec;20(10):764-74. doi: 10.1016/j.seizure.2011.07.007. Epub 2011 Aug 9.
This study aimed to develop a conceptual model of the impact of partial onset or generalized epilepsy on children and adults in order to guide the identification of endpoints that capture patient perspectives in new treatment trials.
A systematic literature search was conducted in Embase and Medline to identify qualitative research reporting the impact of epilepsy on child and adult patients' lives. The search identified 20 publications describing 18 qualitative studies. Qualitative results were extracted from these publications into structured summary tables separately for impact on children and adults.
Results tables were reviewed by two qualitative researchers who identified 23 concepts/areas of impact. Concepts were largely universal between child and adult studies, although concept content did vary between age-groups, for example child relationship concerns were focused on developing friendships and problematic family relationships. For adults the concerns were problematic relationships with spouse or partner and fulfilling the family roles. Concepts influenced directly by epilepsy were cognitive, physical and seizure effects, other concepts such as future hopes, burden and self-esteem were influenced more indirectly by impact on other concepts. The 23 concepts were linked to form a conceptual model of the impact of epilepsy for patients guided by qualitative results reported by studies.
The conceptual model suggests potential areas of patients' lives that may be enhanced by effective treatment and allows for concepts of concern to both children and adults to be identified and explored as potential endpoints in trials of new epilepsy treatments.
本研究旨在构建部分性发作或全面性发作癫痫对儿童和成人影响的概念模型,以指导识别新治疗试验中反映患者视角的终点。
对 Embase 和 Medline 进行系统文献检索,以确定定性研究报告癫痫对儿童和成年患者生活影响的文献。检索共识别出 20 篇文献,描述了 18 项定性研究。将这些文献中的定性结果分别提取到针对儿童和成人影响的结构化摘要表中。
两名定性研究人员对结果表进行了审查,确定了 23 个影响概念/领域。概念在儿童和成人研究中基本是普遍存在的,尽管在年龄组之间概念内容存在差异,例如儿童的关系问题集中在发展友谊和有问题的家庭关系上。对于成年人,问题则集中在与配偶或伴侣的关系以及履行家庭角色上。受癫痫直接影响的概念是认知、身体和发作效应,而其他概念,如未来希望、负担和自尊,则更多地受到其他概念影响的间接影响。这 23 个概念被联系起来,形成了一个受研究中报告的定性结果指导的癫痫对患者影响的概念模型。
该概念模型提示了有效治疗可能改善的患者生活潜在领域,并允许识别和探讨儿童和成人共同关注的概念,作为新癫痫治疗试验的潜在终点。