Children's perspective of quality of life in epilepsy
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Abstract
Objective: To study child mental health, parental support, and social support of children with epilepsy as these relate to quality of life (QOL) using child self-report, seizure-related variables, and estimated verbal intelligence based on receptive vocabulary.
Methods: A cross-sectional structural equation model of baseline data from the QUALITÉ cohort study, which includes 6 Canadian child epilepsy ambulatory programs. A sample of 3,481 children were screened for the following eligibility: 8 to 14 years of age, with active or medication-managed epilepsy. Of 894 eligible children, 506 agreed to participate, of whom 26 were then excluded because of an inability to self-report based on a standard cutoff score of receptive vocabulary lower than 70. The primary outcome of child-reported QOL was measured using the Child Epilepsy QOL Questionnaire.
Results: From the child's perspective, epilepsy-specific QOL is strongly related to their mental health and social support but not to their seizures. Specifically, child mental health and peer support exhibit direct associations with QOL; parental support has both direct and indirect associations with QOL (via child mental health); estimated verbal intelligence exerts its strongest association with QOL through mental health; and seizure status exhibits a weak relationship to QOL only through mental health.
Conclusions: Among children with epilepsy aged 8 to 14 years, mental health and social support should be areas of focus in the assessment of QOL. Controlling seizures is insufficient care for influencing the child's perception of their life.
GLOSSARY
- AED=
- antiepileptic drug;
- CFI=
- comparative fit index;
- CI=
- confidence interval;
- QOL=
- quality of life;
- RMSEA=
- root-mean-square error of approximation;
- SRMR=
- standardized root-mean-square residual;
- TLI=
- Tucker-Lewis Index
Footnotes
↵* These authors contributed equally to this work.
QUALITÉ Study Group coinvestigators are listed on the Neurology® Web site at Neurology.org.
Go to Neurology.org for full disclosures. Funding information and disclosures deemed relevant by the authors, if any, are provided at the end of the article.
Editorial, page 1826
Supplemental data at Neurology.org
- Received August 21, 2014.
- Accepted in final form January 5, 2015.
- © 2015 American Academy of Neurology
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