Institute of Child Development, University of Minnesota.
Department of Pediatrics, University of Minnesota.
J Pediatr Psychol. 2019 Nov 1;44(10):1224-1233. doi: 10.1093/jpepsy/jsz063.
Medical factors that put adolescents and young adults (AYA) with epilepsy at risk for poor health-related quality of life (HRQOL) are well-established. Less known is whether medical risk is associated with decreases in global psychological well-being and how self-management self-efficacy might contribute to resilience. The current study seeks to (a) examine the relationship between medical risk and both HRQOL and psychological well-being in AYA with epilepsy and (b) investigate the potential moderating role of self-management self-efficacy.
A sample of 180 AYA with epilepsy, aged 13-24 years, was recruited from clinic and community settings and completed questionnaires. A medical risk gradient composed of seizure frequency, antiepileptic drugs, and other health problems was created. HRQOL, psychological well-being, and self-management self-efficacy were assessed.
Medical risk was negatively associated with HRQOL, such that youth with greater risk scores reported lower HRQOL (r = -0.35, p < .01). However, there was no significant relationship between medical risk and psychological well-being (r = -0.08, p = .31). Self-efficacy was positively correlated with HRQOL and well-being (r = 0.50, p < .01; r = 0.48, p < .01). A moderation effect was detected, such that the positive effect of self-efficacy on HRQOL differed across medical risk levels.
Cultivating psychological strengths, as opposed to solely addressing medical problems, may be a promising intervention target when treating AYA with epilepsy, including those navigating healthcare transitions. Self-efficacy predicted HRQOL at most levels of risk, suggesting an important modifiable intrinsic factor that may promote resilience.
医学因素使青少年和年轻成人（AYA）癫痫患者面临健康相关生活质量（HRQOL）下降的风险，这一点已得到充分证实。不太为人所知的是，医学风险是否与整体心理幸福感下降有关，以及自我管理自我效能感如何有助于恢复力。本研究旨在：（a）研究 AYA 癫痫患者的医学风险与 HRQOL 和心理幸福感之间的关系；（b）调查自我管理自我效能感的潜在调节作用。
从诊所和社区环境中招募了 180 名年龄在 13-24 岁的 AYA 癫痫患者，完成了问卷调查。创建了由癫痫发作频率、抗癫痫药物和其他健康问题组成的医学风险梯度。评估了 HRQOL、心理幸福感和自我管理自我效能感。
医学风险与 HRQOL 呈负相关，即风险评分较高的青少年报告 HRQOL 较低（r = -0.35，p < 0.01）。然而，医学风险与心理幸福感之间没有显著关系（r = -0.08，p = 0.31）。自我效能感与 HRQOL 和幸福感呈正相关（r = 0.50，p < 0.01；r = 0.48，p < 0.01）。检测到调节效应，即自我效能感对 HRQOL 的积极影响在不同的医学风险水平上有所不同。
培养心理优势，而不仅仅是解决医学问题，可能是治疗 AYA 癫痫患者（包括那些正在过渡医疗保健的患者）的一种有前途的干预目标。自我效能感预测了大多数风险水平的 HRQOL，这表明这是一个重要的可调节内在因素，可能促进恢复力。
