藏族全面性强直阵挛性癫(癎)患者生活质量及其影响因素的调查

目的调查藏族地区全面性强直阵挛性癫癎患者生活质量及其影响因素。方法应用癫癎患者生活质量评定量表-31(QOLIE-31)对126例确诊为全面性强直阵挛性癫癎的藏族患者进行生活质量评定,并对影响其生活质量的因素进行分析。结果QOLIE-31总评分为(48.58±17.29)分,分项中对发作担忧评分最低[(32.92±22.97)分],药物影响的评分最高[(77.11±20.98)分]。单因素分析显示:不同性别、职业、婚姻状况、年龄、文化程度的生活质量评分差异有统计学意义(均P<0.05);而不同发作频率、治疗与否评分差异无统计学意义。多因素分析表明,年龄、起病年龄、职业、文化程度、经济状况、发作次数是影响藏族全面性强直阵挛性癫癎患者生活质量的因素(均P<0.05);其中年龄、职业影响生活质量多个方面,而病程、婚姻状况、性别不是影响因素。结论藏族全面性强直阵挛性癫癎患者的生活质量差;职业、经济状况、文化程度、年龄、起病年龄、发作频率是影响生活质量的因素;年龄、职业影响生活质量的多个方面。     

甘肃农村地区癫痫患者生活质量及其影响因素调查

目的研究甘肃农村地区成年癫痫患者的生活质量及其影响因素。方法采用癫痫患者生活质量量表-31(quality of life in epilepsy inventory,QOLIE-31)对甘肃省农村地区154例癫痫患者及149名正常对照进行生活质量评估,分析社会人口学因素(性别、年龄、婚姻状况、职业、教育程度等)和临床因素(癫痫起病年龄、病程、发作类型、发作频率、服用药物种数等)对患者生活质量的影响。结果患者生活质量得分低于对照组[(47.63±7.74)vs.(52.28±5.75)],差异有统计学意义(P<0.05)。不同性别、婚姻状况、职业、受教育程度、发作类型的患者生活质量得分无统计学差异(P>0.05),不同人均年收入、服用药物种数的患者生活质量得分有统计学差异(P<0.05)。经多因素线性回归分析,患者家庭人均年收入(β=3.115,P=0.002)、服用药物种数(β=3.261,P=0.027)是影响其生活质量的因素。结论成年癫痫患者生活质量较低,家庭经济状况、服用药物种类对患者生活质量影响较显著,合理选择药物是控制癫痫发作、减轻家庭经济负担、提高癫痫患者生活质量的有效措施。     

老年男性癫痫患者生活质量的影响因素分析及干预对策

目的分析影响老年男性癫痫患者生活质量的各个因素及相应干预对策。方法选取我院神经内科收治的52例门诊及住院癫痫患者为研究对象,以癫痫患者生活质量量表-89作为评分标准,对比分析婚姻状况、受教育程度、病程、发作类型、服药种类等对老年男性癫痫患者的生活质量的影响。结果已婚患者在药物影响、社会功能及生活质量总分方均面明显高于未婚患者(P0.05);受教育程度对担心发作、认知水平药物影响、社会功能及生活质量总分均有影响(P0.05);发作病程≥20a患者的生活质量明显低于病程20a患者(P0.05);发作类型、服药种类对生活质量均有显著影响(P0.05)。结论婚姻状况、受教育程度、病程、发作类型、服药种类等均对患者的生活质量存在不同程度的影响,需引起医护人员的足够重视。     

颞叶癫痫患者生活质量及其影响因素的研究

目的观察颞叶癫痫患者生活质量的状况,并探讨社会人口学、临床发作以及焦虑、抑郁等因素对患者生活质量的影响。方法对93例颞叶癫痫患者和100名健康对照者进行生活质量量表-31(QOL-31)、Zung氏抑郁自评量表(SDS)和Zung氏抑郁自评量表(SAS)测定。结果颞叶癫痫患者生活质量各项得分均明显低于健康对照组(P<0.001),焦虑和抑郁自评量表得分均明显高于健康对照组(P<0.001)。多元逐步回归分析显示,影响生活质量的主要因素为抑郁、发作严重程度、焦虑和病程。结论颞叶癫痫患者生活质量存在不同程度下降。发现和治疗颞叶癫痫患者的抑郁、焦虑等精神心理问题以及选择合理治疗方法、控制癫痫发作是提高生活质量、改善预后的重要前提。     

癫癎患者生活质量及其影响因素的研究

目的研究癫痫间患者的生活质量及其影响因素。方法采用癫痫间患者生活质量量表-31(QO-LIE-31)对56例确诊的癫痫间患者和46例对照者进行评价。结果癫痫间组患者QOL各项得分均显著低于对照组(P<0.05);全身性强直-阵挛发作(GTCS)和复杂部分性发作(CPS)患者QOL各项得分无显著差异(P>0.05);伴有抑郁的癫痫间患者在对发作的担忧、情绪健康、精力/疲乏和总体健康水平方面低于不伴有抑郁的癫痫间患者(P<0.05);服用1种抗癫痫间药物(AED)的患者与服用1种以上的患者比较,在对发作的担忧、综合生活质量、情绪方面、药物的影响以及总体健康水平方面得分显著降低(P<0.05)。结论癫痫间患者生活质量显著降低,抑郁和服用多种AED对生活质量影响较大。     

癫痫患者的生活质量及其影响因素的研究进展

癫痫使患者的生活质量显著下降。癫痫患者的抑郁、焦虑及其他心理精神方面的异常远高于社会一般人群;认知功能有明显下降;躯体健康及婚姻、就业等社会功能亦受影响。影响癫痫患者生活质量的因素包括:癫痫患者自身的认知、痫性发作本身的特点(发作频率、发作类型及严重程度、起病年龄和病程等)、药物不良反应、多药治疗及手术等。提高癫痫患者的生活质量,最根本的是控制癫痫发作,同时进行心理干预和认知-行为治疗等。     

成年癫痫患者生活质量的研究

目的运用QOLIE-31量表中文版调查评估广东地区成年癫痫患者的生活质量。方法对398例患者采用简单随机抽样,信函调查等调查方法进行调查,用SPSS 10.0软件进行统计学处理。结果198例不同性别间P>0.05.不同性别之间生活质量无显著性差异;婚姻在发作担忧、总的生活质量、感情幸福、精力和疲劳以及中国文化调适等方面有显著性差异P<0.05,不同经济状况之间在发作担忧和药物作用方面存在显著差异P<0.05;不同学历在社会功能一项P<0.05.表示不同学历在社会功能方面有显著性意义。结论在不同性别之间成年癫痫患者的生活质量无明显不同;婚姻、学历和经济状况对患者的生活质量有不同的影响。     

癫痫患者事件相关电位P300及影响因素研究

目的探讨癫痫患者事件相关电位P300的特点及影响因素。方法选择经临床及脑电图确诊的癫痫患者53例和21例与其年龄、性别、文化程度相匹配的健康正常人为研究对象,进行事件相关电位P300测定,并使用Pearson相关分析对其可能的影响因素进行分析。结果癫痫患者和对照组P3波潜伏期分别为(361.32±26.76)ms与(311.27±18.43)ms,P3波波幅分别为(3.38±1.52)μV与(6.79±1.93)μV,差异均有统计学意义(P0.01)。相关分析显示,癫痫患者P3波潜伏期与病程、发作频率及每次发作持续时间呈正相关(P均0.05),与起病年龄呈负相关(P0.01);P3波的波幅与病程、发作频率、每次发作持续时间呈负相关(P均0.05),与起病年龄呈正相关(P0.01);而与患者的年龄、受教育年限、服用抗癫痫药物的种类无明显相关性。结论癫痫患者存在事件相关电位P300异常,其变化特点与癫痫患者的起病年龄、病程、发作频率及每次发作持续时间相关。     

成年癫痫患者抑郁、焦虑状况及生活质量调查

目的调查成年癫痫患者抑郁、焦虑的患病率及可能的危险因素;评价抑郁及焦虑对癫痫患者生活质量的影响。方法采用Beck抑郁问卷(BDI)、贝克焦虑量表(BAI)及癫痫患者生活质量量表-31(QO-LIE-31中文版),对200例成年癫痫患者的抑郁、焦虑情况及生活质量进行评估。结果在200例癫痫患者中43.5%伴发抑郁,28.5%伴发焦虑,23%伴发抑郁及焦虑。发作频繁、无有薪职业是癫痫患者伴发抑郁的重要危险因素,无有薪职业是癫痫患者伴发焦虑的危险因素。抑郁组及抑郁伴焦虑组的QOLIE-31总分及各项评分均低于非抑郁非焦虑组(P=0.000);焦虑组的QOLIE-31总分(P=0.004)及发作的担忧(P=0.019)、认知功能(P=0.009)方面的得分均低于非抑郁非焦虑组。结论抑郁和焦虑是癫痫患者常见的精神共病,严重影响了癫痫患者的生活质量。积极控制发作、为癫痫患者提供更多的就业机会是改善癫痫患者生活质量的重要因素。     

良性癫痫儿童的生活质量

目的研究良性癫痫患儿的生活质量。方法采用癫痫患者生活质量量表对７７例良性癫痫儿童的生活质量进行测查评定，并与在年龄、性别、文化程度和学习成绩等方面严格匹配的７７名正常儿童进行对比。结果患儿组的生活质量明显低于正常组，与诊断疾病本身、病程、控制发作时间长短及长期服药等因素产生的心理障碍有关。结论除合理的药物治疗外，应对患儿进行包括心理干预的综合治疗。     

癫癎患者药物规范化治疗预后的前瞻性研究

目的探讨抗癫癎药物规范化治疗2年以上癫癎患者的预后及影响预后的危险因素。方法根据临床病史及脑电图确诊为癫癎,按照发作类型规范化药物治疗、定期随诊2年以上,630例癫癎患者中符合研究条件者108例。比较基线期3个月与规范化治疗2年后3个月平均每月癫癎发作频率。分析起病年龄、性别、规范化治疗前病程、病因、发作类型、发作类型种数、脑电图有无癫痫波、单药或联合用药8种因素与预后的关系。结果单因素分析中性别、发病年龄、病因分型、有无癫癎波与预后差异无统计学意义;规范化治疗前病程、发作类型、发作类型种数、单药／联合用药的预后有显著性差异（P〈0．01）;规范治疗前病程与预后呈简单线性关系;多因素：二元Logistic回归进一步分析得出需多药治疗是预后不佳的重要预测因子。结论癫癎患者药物规范化治疗2年后有效率达到78．7％（P=0．001,OR=6．729）;越早规范化治疗预后越好;需多药治疗是预后不佳的重要预测因子。     

Sleep disturbances, socioeconomic status, and seizure control as main predictors of quality of life in epilepsy

Improving quality of life is the most important goal for patients with epilepsy. To recognize the factors associated with quality of life in patients with epilepsy in Mexico, we performed a cross-sectional survey using the Quality of Life in Epilepsy 31 (QOLIE-31) inventory to assess the quality of life of 401 adult patients with epilepsy at the National Institute of Neurology and Neurosurgery of Mexico. Clinical and demographical data were collected. Multiple regression was used to determine which factors affected quality of life in our patients. The variables that most strongly predicted a lower QOLIE-31 total score after multiple regression were sleep disorders (P<0.001), socioeconomic status (P<0.001), female gender (P=0.002), and high seizure frequency (P=0.001). In our study, neither depression nor time of evolution of epilepsy had significant influence on QOLIE-31 scores.     

Eleven influential factors for quality of life in adults with epilepsy

BACKGROUND： Research focused on the quality of life of epileptic patients began only very recently in China; in particular, most research has focused on children, but less on epileptic adults. OBJECTIVE： To survey and analyze 11 influential factors for quality of life in adults with epilepsy by using quality of life epilepsy-31 scale. DESIGN： Cross-sectional study. SETTING： Department of Neurology, First Hospital Affiliated to Jinan University; Department of Neurology, First Affiliated Hospital of Wenzhou Medical College. PARTICIPANTS： A total of 107 adults with epilepsy for longer than one year were selected from Department of Neurology, First Hospital Affiliated to Jinan University between March 2004 and December 2006. The included patients met the Classification and Diagnostic Criteria of Epileptic Attack published by International Anti-Epilepsy League in 1981, and they provided informed consent. METHODS： General states, including course, attack frequency, marriage status, educational level, occupational types, economic status, attack types, drug types, and drug amount, were recorded. There were seven aspects in the Quality of Life Epilepsy-31 scale, including attack worry, life satisfaction, emotion, vigor/tiredness, drug influence, cognitive function, and social function. The scores positively correlated with the quality of life. Possible influential factors for quality of life were analyzed by one-way ANOVA and multivariate regression analysis. MAIN OUTCOME MEASURES： Course, attack frequency, marriage status, educational level, occupational types, economic status, attack types, drug types, drug amount, age, and sex. RESULTS： A total of 107 epileptic patients were included in the final analysis. Influential factors for quality of life in epileptic adults included attack frequency, educational level, economic status, attack types, drug amount, age, and course of disease （P 〈 0.05）. Among them, attack frequency negatively correlated with attack worry, life satisfaction, emotion, vigor/tir     

Factors affecting quality of life in adults with epilepsy in Taiwan: A cross-sectional,correlational study

PurposeThe purpose of this study was to assess eight factors considered important for quality of life in persons with epilepsy in order to determine which of these components affect quality of life in adults with epilepsy in Taiwan.MethodsA cross-sectional, correlational study using structured questionnaires assessed 260 patients with epilepsy purposively sampled from a medical center in Northern Taiwan. Health-related quality of life (HRQoL) was evaluated with the Quality of Life in Epilepsy—31 (QOLIE-31) questionnaire. Data also included personal and health-related characteristics, knowledge of epilepsy, efficacy in the self-management of epilepsy, and social support.ResultsScores for the QOLIE-31 were correlated with the following factors: (1) demographic characteristics of age, gender, and income; (2) sleep quality; (3) symptoms of anxiety and depression; (4) epilepsy-specific variables: seizure frequency; types, number, and frequency of antiepileptic drugs (AEDs); and adverse events of AEDs; and (5) social support. Stepwise regression analysis showed that seven factors were predictive for quality of life: anxiety, depression, adverse events of AEDs, social support, seizure frequency of at least once in three months, household income of NT$ 40,001–100,000, and male gender. These factors accounted for 58.2% of the variance of quality of life.SignificanceOur study assessed multiple factors in an examination of relationships and predictive factors for quality of life in adults with epilepsy in Taiwan. Knowledge of these contributing factors can assist health-care providers when evaluating patients with epilepsy to help target interventions for improving quality of life.     

Factors influencing on quality of life in people with epilepsy.

OBJECTIVES: To assess the influence of different factors on health-related QOL in adults with epilepsy in Moscow, Russia. METHOD: We evaluated quality of life in 242 patients (98 de novo and 144 previously inadequately treated) by using QOLIE-31. Partial cryptogenic or symptomatic epilepsy was diagnosed in 214 patients, in 28-idiopathic generalized epilepsy. Stepwise regression analysis was performed to assess the influence of different factors on QOL. RESULTS: In patients with epilepsy in Russia the total score of QOLIE-31 was rather low-42.13+/-4.14. Relationship of quality of life (total score) and frequency of seizures and duration of disease was analyzed. Frequency of seizures was the most significant parameter related to QOL (R=0.46 with total score). Duration of disease also correlated with QOL score (R=0.24 with total score). Significant but rather weak association (link) between frequency of seizures and almost all of subscales of quality of life was noticed. Duration of epilepsy correlated with less number of subscales: Energy/fatigue, Medication effects, Social functioning, Overall QOL subscales. When factors influencing on QOL were separately analyzed in newly diagnosed and previously treated patients frequency of seizures was the most important parameter in both groups. CONCLUSIONS: Frequency of seizures is the most important factor influencing on QOL in adults with epilepsy (newly diagnosed and previously treated).     

Research Use of the New Quality-of-Life in Epilepsy Inventory

Summary: Epilepsy is a heterogeneous disease with variable onset and prognosis. In general, patients with epilepsy have neuropsychological impairments. Their educational and occupational achievements may be lower than might be expected for their level of cognition. Some epilepsy patients suffer emotional distress, interictal behavioral disorders, and extreme social isolation. It is obvious that epilepsy and its sequelae impact on the patient's quality of life. What is not clear is the degree to which different factors contribute and the causes for extreme variance across patients. For example, the patients' perceptions of their disease affects quality of life more than actual seizure severity, but the mechanisms underlying this effect are not known. Quality-of-life research in epilepsy is in its infancy. In the future, such research will play an important role in assessing patient suffering, demonstrating the efficacy of treatments and interventions, and influencing medical economic decisions.     

Health-related quality of life in Russian adults with epilepsy: The effect of socio-demographic and clinical factors

ObjectiveThe aim of this study was to evaluate socio-demographic and clinical factors influencing the health-related quality of life (HRQOL) of adult patients with epilepsy in a naturalistic treatment setting in Russia.MethodsThe QOLIE-31 questionnaire and the Beck Depression Inventory (BDI) were completed by 208 patients with a broad clinical spectrum of epilepsy (the mean age was 31.49 ± 13.20 years and ranged from 18 to 74 years).ResultsIn Russian adult patients with epilepsy, lower mean QOLIE-31 scores were obtained compared with previously published international data for overall HRQOL, emotional well-being, and cognitive functioning and social functioning subscales (p < 0.001). Univariate analysis revealed that duration of epilepsy negatively correlated with all QOLIE-31 subscores (p < 0.05), except for emotional well-being (p = 0.1). In multivariate regression analysis, BDI depression score was the predictor of overall score and all QOLIE-31 domains, except for emotional well-being. Age could be considered as a predictor of cognitive and social functioning, medical effects, and the total QOLIE -31 score. Seizure frequency was a factor associated with all HRQOL domains, except for medication effects and emotional well-being, whereas gender, education, family status, seizure type, employment, lateralization of epileptic foci, number of antiepileptic drugs, and the reported adverse events did not significantly affect HRQOL.ConclusionThe present study has revealed that longer duration of epilepsy, older age, higher seizure frequency, and depression are the potential predictors of worse HRQOL in adult Russian patients with epilepsy.     

Factors associated with utilization of healthcare resources among epilepsy patients

PURPOSE: To determine those variables associated with utilization of healthcare resources in epilepsy patients. METHODS: We interviewed 256 epilepsy patients. Target variables included the number of clinic visits, ER visits and in-patient admissions over the past year and AEDs currently being used. Predictor variables were age, race/ethnicity, marital status, education, income, insurance, seizure frequency and QOLIE-10 results. We used univariate analysis to determine those factors associated with the target variables and multivariate analysis to ascertain those independently significant. RESULTS: On univariate analysis, higher seizure frequency and poorer QOLIE-10 scores were associated with the number of clinic visits, ER visits and in-patient admissions. Increased seizure frequency and male gender were associated with higher use of AEDs. Using ordinal logistic regression, QOLIE-10 scores was the only variable associated with the number of clinic visits. Both seizure frequency and QOLIE-10 scores were independently associated with the number of in-patient admissions while seizure frequency and male gender remained independently associated with AED use. Using binary logistic regression, QOLIE-10 scores and seizure frequency were independently associated with the number of ER visits. CONCLUSION: Seizure frequency and quality of life are major factors associated with utilization of healthcare resources in epilepsy patients.     

Effect of learning disabilities on academic self-concept in children with epilepsy and on their quality of life

Academic self-concept could significantly affect academic achievement and self-confidence in children with epilepsy. However, limited attention has been devoted to determining factors influencing academic self-concept of children with epilepsy. We aimed to analyze potentially significant variables (gender, frequency of seizures, duration of epilepsy, intellectual disability, learning disability and attention deficit hyperactivity disorder) in relation to academic self-concept in children with epilepsy and to additional domains of their quality of life. The study group consisted of 182 children and adolescents aged 9–14 years who completed the SPAS (Student's Perception of Ability Scale) questionnaire determining their academic self-concept and the modified Czech version of the CHEQOL-25 (Health-Related Quality of Life Measure for Children with Epilepsy) questionnaire evaluating their health-related quality of life. Using regression analysis, we identified learning disability as a key predictor for academic-self concept of children with epilepsy. While children with epilepsy and with no learning disability exhibited results comparable to children without epilepsy, participants with epilepsy and some learning disability scored significantly lower in almost all domains of academic self-concept. We moreover found that children with epilepsy and learning disability have significantly lower quality of life in intrapersonal and interpersonal domains. In contrast to children with epilepsy and with no learning disability, these participants have practically no correlation between their quality of life and academic self-concept. Our findings suggest that considerable attention should be paid to children having both epilepsy and learning disability. It should comprise services of specialized counselors and teaching assistants with an appropriate knowledge of epilepsy and ability to empathize with these children as well as educational interventions focused on their teachers and classmates.