Lin Chung-Ying, Burri Andrea, Fridlund Bengt, Pakpour Amir H
Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hung Hom, Hong Kong.
School of Clinical Sciences, Faculty of Health and Environmental Sciences, Auckland University of Technology, New Zealand.
Epilepsy Behav. 2017 Feb;67:60-65. doi: 10.1016/j.yebeh.2016.12.012. Epub 2017 Jan 13.
The purpose of this study was to understand the mediating effects of female sexual functioning in the association between medication adherence and quality of life (QoL) in Iranian women with epilepsy (WWE).
Women's sexual functioning was measured using Female Sexual Function Index; QoL using Quality of Life in Epilepsy; epilepsy severity using Liverpool Seizure Severity Scale; subjective medication adherence using Medication Adherence Report Scale; and objective medication adherence using serum level for antiepileptic drugs in 567 WWE. Medication adherence was measured at baseline, while women's sexual functioning, QoL, and epilepsy severity were measured at the 6-month follow-up. Structural equation modeling and regression models were conducted to examine the mediating role of women's sexual functioning.
The mediating effects of sexual functioning in the relationship between medication adherence (including subjective and objective measures) and QoL were supported in the total score of Female Sexual Function Index (coefficient=0.415, SE=0.117, p<0.001 for subjective medication adherence; coefficient=1.980, SE=0.446, p<0.001 for objective medication adherence). Seizure severity was significantly associated with QoL but only when objective medication adherence was measured (coefficient=-0.094, SE=0.036, p=0.009).
Our results extended the importance of medication adherence from symptom reduction to the beneficial effects of women's sexual functioning and QoL. Health care providers should be aware of these additional benefits of medication adherence and use these arguments to encourage female patients to take their medication, which can eventually increase their sexual satisfaction and overall QoL.
本研究旨在了解女性性功能在伊朗癫痫女性患者（WWE）的药物依从性与生活质量（QoL）之间的关联中所起的中介作用。
使用女性性功能指数测量女性性功能；使用癫痫生活质量量表测量生活质量；使用利物浦癫痫发作严重程度量表测量癫痫严重程度；使用药物依从性报告量表测量主观药物依从性；并使用567名WWE患者的抗癫痫药物血清水平测量客观药物依从性。在基线时测量药物依从性，而在6个月随访时测量女性性功能、生活质量和癫痫严重程度。进行结构方程模型和回归模型以检验女性性功能的中介作用。
在女性性功能指数总分中，性功能在药物依从性（包括主观和客观测量）与生活质量之间的关系中起中介作用得到支持（主观药物依从性的系数=0.415，标准误=0.117，p<0.001；客观药物依从性的系数=1.980，标准误=0.446，p<0.001）。癫痫严重程度与生活质量显著相关，但仅在测量客观药物依从性时（系数=-0.094，标准误=0.036，p=0.009）。
我们的结果扩展了药物依从性的重要性，从减少症状到对女性性功能和生活质量的有益影响。医疗保健提供者应意识到药物依从性的这些额外益处，并利用这些论据鼓励女性患者服药，这最终可以提高她们的性满意度和整体生活质量。
