Faculty of Public Health, Khon Kaen University, Khon Kaen, Thailand.
Faculty of Nursing, Khon Kaen University, Khon Kaen, Thailand.
Epilepsy Behav. 2014 Mar;32:49-54. doi: 10.1016/j.yebeh.2013.12.021. Epub 2014 Jan 28.
This cross-sectional study aimed to determine the number and types of falls and vehicular crashes with injuries , as well as some specific behavioral associations in people with epilepsy (PWE) in northeastern Thailand. Two hundred and three patients with epilepsy were randomly recruited from the university epilepsy clinic in Khon Kaen, who then completed an interview and a questionnaire. It was found that 84.5% of the patients were operating a vehicle on a regular basis (more than 3days a week), and 21.6% of those had been in a vehicle crash. Additionally, 25.6% of the patients had been involved in falls with injuries. Forty-three percent of the respondents had been involved in either a vehicular crash or a fall with an injury, with 39.7% of the accidents resulting in moderate to severe injuries. Medication compliance was estimated at 66%, while 59.1% said that they had little or no control over their seizures, and more than half the patients did not feel confident about their ability to take care of themselves or to take their antiepileptic drugs (AEDs) properly. In a multivariate model, the following factors significantly increased the risk of being in either a vehicular crash or a fall with an injury: being single, attaining a secondary or higher education, exercising at least three times a week, napping every day or more frequently, and having poor seizure control. The results of this study suggest that patients' poor medication adherence and lack of confidence in managing their seizures may contribute to accidents. Patients with epilepsy should be counseled to seek less risky behaviors and try to attend classes that provide education on AED management.
本横断面研究旨在确定在泰国东北部的癫痫患者(PWE)中发生跌倒和车辆事故的次数和类型,以及一些特定的行为关联。从孔敬大学癫痫诊所随机招募了 203 名癫痫患者,他们随后完成了访谈和问卷调查。结果发现,84.5%的患者经常开车(每周超过 3 天),其中 21.6%的患者曾发生过车辆事故。此外,25.6%的患者曾发生过跌倒受伤事件。43%的受访者曾发生过车辆事故或跌倒受伤事件,其中 39.7%的事故导致中度至重度受伤。药物依从性估计为 66%,而 59.1%的患者表示他们对自己的癫痫发作几乎没有或无法控制,超过一半的患者对自己照顾自己或正确服用抗癫痫药物(AEDs)的能力缺乏信心。在多变量模型中,以下因素显著增加了发生车辆事故或跌倒受伤的风险:单身、接受过中等或高等教育、每周至少锻炼三次、每天或更频繁地打盹,以及癫痫发作控制不佳。这项研究的结果表明,患者药物依从性差和对管理癫痫发作缺乏信心可能导致事故发生。应建议癫痫患者寻求风险较低的行为,并尝试参加提供 AED 管理教育的课程。