Amir M, Roziner I, Knoll A, Neufeld M Y
Department of Behavioral Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel.
Epilepsia. 1999 Feb;40(2):216-24. doi: 10.1111/j.1528-1157.1999.tb02078.x.
This study examined the influence of two psychosocial variables mediating between disease severity and quality of life (QoL) in epilepsy; social support and mastery (measured by locus of control and self-efficacy). A model placing these two variables as mediators between disease severity and QoL was tested with structural equation modeling.
Eighty-nine patients with epilepsy (58% men, age 36+/-12 years) were given the following instruments: Liverpool Seizure Severity Scale, Interpersonal Support Evaluation List, Epileptic Self-Efficacy Scale, Locus of Control scale, and the World Health Organization's Quality of Life Questionnaire, the WHOQOL.
Structural equation modeling showed good fit between the research model and the data (Bentler-Bonett Normalized Index of fit, 0.96; LISREL GFI, 0.95). Ninety percent of the variance of the WHOQOL was explained by a combination of disease severity, self-efficacy in epilepsy, social support, and locus of control. Mastery was found to mediate the correlation between disease severity and QoL, and social support was found to act as a mediator between disease severity and mastery.
The study findings emphasize the possibility of improving QoL among patients with epilepsy by counseling and treatment aimed at reinforcing their self-efficacy and locus of control, as well as by improving their SoS.
本研究探讨了两个心理社会变量在癫痫疾病严重程度和生活质量（QoL）之间的中介作用；社会支持和掌控感（通过控制点和自我效能感来衡量）。采用结构方程模型对将这两个变量作为疾病严重程度和生活质量之间中介变量的模型进行了检验。
对89例癫痫患者（58%为男性，年龄36±12岁）使用了以下工具：利物浦癫痫发作严重程度量表、人际支持评估量表、癫痫自我效能量表、控制点量表以及世界卫生组织生活质量问卷（WHOQOL）。
结构方程模型显示研究模型与数据拟合良好（Bentler-Bonett标准化拟合指数为0.96；LISREL的GFI为0.95）。WHOQOL的90%的方差可由疾病严重程度、癫痫自我效能感、社会支持和控制点的组合来解释。发现掌控感在疾病严重程度和生活质量之间起中介作用，社会支持在疾病严重程度和掌控感之间起中介作用。
研究结果强调了通过旨在增强患者自我效能感和控制点的咨询和治疗以及改善其社会支持来提高癫痫患者生活质量的可能性。
