Department of Epileptology, Tohoku University Graduate School of Medicine, Sendai, Japan.
Department of Epileptology, Tohoku University Graduate School of Medicine, Sendai, Japan; Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan.
Epilepsy Behav. 2021 Jul;120:107979. doi: 10.1016/j.yebeh.2021.107979. Epub 2021 May 4.
Acceptance of disability (AOD) is a key concept in rehabilitation psychology that enhances psychosocial adjustment of individuals with disability. However, the impact of AOD on well-being has never been examined for patients with epilepsy. The present study investigated whether AOD affects quality of life (QOL) in patients with epilepsy in the presence of other multiple aspects of epilepsy based on the biopsychosocial model.
We retrospectively reviewed 151 consecutive patients with epilepsy (77 men, aged 18-74 years) who underwent comprehensive assessment including long-term video-EEG monitoring, neuroimaging studies, and neuropsychological and psychosocial assessment in our epilepsy monitoring unit. Data were obtained from medical records and self-reported questionnaires. The outcome variable was QOL. Predictive variables included demographic characteristics, seizure-related variables (i.e., duration of epilepsy, seizure frequency, and number of antiepileptic drugs), psychological factors (i.e., AOD, depression, and self-stigma), and social factors (i.e., social support and education level). Acceptance of disability was measured by the Adaptation of Disability Scale-Revised (ADS-R), which we translated into Japanese with the original author's approval, and examined its internal consistency reliability. Data were analyzed using four hierarchical multiple regression analysis models.
The mean ADS-R score was 80 (range 45-115). The predictors accounted for 42% of the variance in QOL (R = 0.45, ΔR = 0.42, F[8, 141] = 14.47, p = 0.00). Higher AOD (p < 0.01), higher social support (p < 0.01), and lower depression scores (p = 0.02) were found to contribute significantly to higher overall QOL.
The present study revealed AOD as an important psychological concept, in addition to social support and depression as previously reported, to improve the QOL of patients with epilepsy. Acceptance of disability should be incorporated in the intervention to increase QOL of patients with epilepsy.
接受残疾（AOD）是康复心理学中的一个关键概念，它可以增强残疾个体的心理社会适应能力。然而，AOD 对癫痫患者幸福感的影响从未在基于生物心理社会模式的情况下进行过研究。
我们回顾性分析了在我们的癫痫监测单元接受综合评估的 151 例连续癫痫患者（77 名男性，年龄 18-74 岁）的资料，这些评估包括长期视频脑电图监测、神经影像学研究以及神经心理学和心理社会评估。数据来自病历和自我报告的问卷。结局变量是生活质量。预测变量包括人口统计学特征、与癫痫发作相关的变量（即癫痫持续时间、发作频率和抗癫痫药物数量）、心理因素（即 AOD、抑郁和自我污名）以及社会因素（即社会支持和教育程度）。采用经原作者批准的日本版残疾适应量表修订版（ADS-R）来测量残疾接受度，评估其内部一致性信度。采用四个层次的多元回归分析模型来分析数据。
平均 ADS-R 评分为 80 分（范围 45-115 分）。预测因子解释了生活质量方差的 42%（R=0.45，ΔR=0.42，F[8, 141]=14.47，p=0.00）。较高的 AOD（p<0.01）、较高的社会支持（p<0.01）和较低的抑郁评分（p=0.02）与整体生活质量较高显著相关。
本研究表明，AOD 是一个重要的心理概念，除了之前报道的社会支持和抑郁外，还可以改善癫痫患者的生活质量。应该将残疾接受度纳入干预措施，以提高癫痫患者的生活质量。
