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在埃塞俄比亚东北沃洛地区公立医院就诊的癫痫患者的生活质量及其相关因素:一项横断面研究。

Quality of life and its associated factors among epileptic patients attending public hospitals in North Wollo Zone, Northeast Ethiopia: A cross-sectional study.

机构信息

School of Nursing, College of Health Sciences, Woldia University, Woldia, Amhara, Ethiopia.

School of Public Health, College of Health Sciences, Woldia University, Woldia, Amhara, Ethiopia.

出版信息

PLoS One. 2021 Feb 23;16(2):e0247336. doi: 10.1371/journal.pone.0247336. eCollection 2021.

Abstract

BACKGROUND

Epilepsy is thought to be caused by witchcraft, evil spirit, and God's punishment for sins in many developing countries. As a result, people with epilepsy and their families usually suffer from stigma, discrimination, depression, and other psychiatric problems. Thus, this study aimed to assess the quality of life and its associated factors among epileptic patients attending public hospitals in North Wollo Zone, Northeast Ethiopia.

METHODS

An institution-based cross-sectional study design was employed in this study. A simple random sampling technique was utilized. Health-related quality of life was measured based on the total score of the Quality of Life in Epilepsy Inventory (QOLIE-31) instrument. Data were entered into Epi-data 3.1 statistical package and exported to SPSS Version 20 for further analysis. Linear regression models were used to assess the relationship between quality of life and the independent variables. Statistically significant values were declared at a P-value of < 0.05.

RESULTS

A total of 395 patients participated in the study making the response rate 98.5%. The mean age of the participants was 32.39 ±10.71 years. More than half, 199 (50.4%) of epileptic patients had an overall weighted average health related quality of life score of mean and above. Male sex (B = 4.34, 95%CI, 0.41, 8.27, P = 0.03), higher educational status (B = 7.18, 95%CI, 1.39, 13.00, P = 0.015) and age at onset of epilepsy (B = 0.237, 95%CI, 0.02, 0.45, P = 0.035) were associated with increased health related quality of life score. On the other hand, family history of epilepsy (B = -4.78, 95%CI,-9.24,-0.33, P = 0.035), uncontrolled seizure (B = -11.08, 95%CI,-15.11,-7.05, P < 0.001), more than 5 pre-treatment number of seizures (B = -4.86, 95%CI,-8.91,-0.81, P = 0.019), poor drug adherence (B = -11.65, 95%CI,-16.06,-7.23, P < 0.001), having moderate (B = -4.526, 95%CI,-8.59,-0.46, P = 0.029) to sever (B = -12.84, 95%CI,-18.30,-7.37, P < 0.001) anxiety and depression, believing that epilepsy is caused by evil spirit (B = -7.04, 95%CI,-11.46,-2.61, P = 0.002), drinking alcohol (B = -5.42, 95%CI,-10.72,-0.13, P = 0.045), and having other co-morbidities (B = -9.35, 95%CI,-14.35,-4.36, P < 0.001) were significantly negatively associated with the health related quality of life score among epileptic patients.

CONCLUSIONS

Only around half of the epileptic patients have a good health-related quality of life. In addition, multiple variables including family history, uncontrolled seizure, and poor drug adherence were associated with quality of life among epileptic patients. Hence, targeting these variables in epilepsy management is recommended.

摘要

背景

在许多发展中国家,癫痫被认为是由巫术、邪灵和上帝对罪恶的惩罚引起的。因此,癫痫患者及其家属通常会遭受污名、歧视、抑郁和其他精神问题。因此,本研究旨在评估在埃塞俄比亚东北沃洛州公立医院就诊的癫痫患者的生活质量及其相关因素。

方法

本研究采用基于机构的横断面研究设计。采用简单随机抽样技术。根据生活质量在癫痫中的影响量表(QOLIE-31)的总分来衡量健康相关生活质量。数据输入 Epi-data 3.1 统计软件包,并导出到 SPSS 版本 20 进行进一步分析。线性回归模型用于评估生活质量与自变量之间的关系。具有统计学意义的值在 P 值 < 0.05 时宣布。

结果

共有 395 名患者参加了这项研究,应答率为 98.5%。参与者的平均年龄为 32.39 ±10.71 岁。超过一半,199 名(50.4%)癫痫患者的总体加权平均健康相关生活质量评分均值以上。男性(B = 4.34,95%CI,0.41,8.27,P = 0.03)、较高的教育程度(B = 7.18,95%CI,1.39,13.00,P = 0.015)和癫痫发作年龄(B = 0.237,95%CI,0.02,0.45,P = 0.035)与健康相关生活质量评分的增加相关。另一方面,癫痫家族史(B = -4.78,95%CI,-9.24,-0.33,P = 0.035)、未控制的癫痫发作(B = -11.08,95%CI,-15.11,-7.05,P < 0.001)、治疗前癫痫发作次数超过 5 次(B = -4.86,95%CI,-8.91,-0.81,P = 0.019)、药物依从性差(B = -11.65,95%CI,-16.06,-7.23,P < 0.001)、中度(B = -4.526,95%CI,-8.59,-0.46,P = 0.029)至重度(B = -12.84,95%CI,-18.30,-7.37,P < 0.001)焦虑和抑郁、认为癫痫是由邪灵引起的(B = -7.04,95%CI,-11.46,-2.61,P = 0.002)、饮酒(B = -5.42,95%CI,-10.72,-0.13,P = 0.045)和患有其他合并症(B = -9.35,95%CI,-14.35,-4.36,P < 0.001)与癫痫患者的健康相关生活质量评分显著负相关。

结论

只有大约一半的癫痫患者有良好的健康相关生活质量。此外,包括癫痫家族史、未控制的癫痫发作和药物依从性差在内的多种变量与癫痫患者的生活质量相关。因此,建议在癫痫管理中针对这些变量进行治疗。

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