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非癫痫性发作患者的健康相关生活质量:社会人口学特征和耻辱感的作用。

Health related quality of life of people with non-epileptic seizures: The role of socio-demographic characteristics and stigma.

作者信息

Robson Catherine, Myers Lorna, Pretorius Chrisma, Lian Olaug S, Reuber Markus

机构信息

Department of Community Medicine, Faculty of Health Sciences, University of Tromsø - The Arctic University of Norway, N-9037 Tromsø, Norway.

The Northeast Regional Epilepsy Group, 820 Second Avenue, Suite 6C, New York, NY 10017, United States.

出版信息

Seizure. 2018 Feb;55:93-99. doi: 10.1016/j.seizure.2018.01.001. Epub 2018 Jan 12.

Abstract

PURPOSE

People with non-epileptic seizures (NES) consistently report poorer Health-Related Quality of Life (HRQoL) than people with epilepsy. Yet, unlike in epilepsy, knowledge of how social factors influence the HRQoL of adults with NES is limited. To add to the evidence base, this study explores the relationship between HRQoL and perceived stigma among adults with NES, and the role of socio-demographic characteristics.

METHODS

Data was gathered from a survey of 115 people living with the condition, recruited from online support groups. Participants provided socio-demographic and health-related data and completed a series of questions investigating their HRQoL (QOLIE-31) and stigma perceptions (10-item Epilepsy Stigma Scale).

RESULTS

Participants were found to experience high levels of perceived stigma (median 5.2, mean 4.9). A significant and moderate inverse correlation was observed between HRQoL and stigma (r - 0.474, p = < 0.001); suggesting higher perceptions of stigma contribute to poorer HRQoL among adults with NES. Stigma perceptions were found to be most strongly associated with the seizure worry (r = - 0.479), emotional wellbeing (r = - 0.421), and social functioning (r = 0.407) HRQoL domains. Participants who reported being in employment or education were found to have significantly better HRQoL than those who were not (p = < 0.001).

CONCLUSION

More (qualitative and quantitative) research is justified to understand how - and why - those with the condition experience stigmatisation, and the factors that impede and help facilitate the participation of people with NES in education and employment.

摘要

目的

非癫痫性发作(NES)患者一直报告称,其健康相关生活质量(HRQoL)比癫痫患者更差。然而,与癫痫不同的是,关于社会因素如何影响成年NES患者的HRQoL的了解有限。为了增加证据基础,本研究探讨了成年NES患者的HRQoL与感知耻辱感之间的关系,以及社会人口学特征的作用。

方法

数据收集自对115名NES患者的调查,这些患者是从在线支持小组招募的。参与者提供了社会人口学和健康相关数据,并完成了一系列调查其HRQoL(QOLIE - 31)和耻辱感认知(10项癫痫耻辱感量表)的问题。

结果

发现参与者有较高的感知耻辱感(中位数5.2,平均数4.9)。观察到HRQoL与耻辱感之间存在显著的中度负相关(r = - 0.474,p = < 0.001);这表明较高的耻辱感认知会导致成年NES患者的HRQoL较差。耻辱感认知与癫痫发作担忧(r = - 0.479)、情绪健康(r = - 0.421)和社会功能(r = 0.407)HRQoL领域的关联最为强烈。报告有工作或正在接受教育的参与者的HRQoL明显优于没有工作或正在接受教育的参与者(p = < 0.001)。

结论

有必要进行更多(定性和定量)研究,以了解患有这种疾病的人如何以及为何会受到污名化,以及阻碍和有助于促进NES患者参与教育和就业的因素。

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