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Epilepsia. 2016 Aug;57(8):1256-64. doi: 10.1111/epi.13441. Epub 2016 Jun 28.

Correlates of health-related quality of life in children with drug resistant epilepsy.

Author information

1
Department of Psychology, Hospital for Sick Children, Toronto, Ontario, Canada.
2
Department of Psychology, University of Toronto, Toronto, Ontario, Canada.
3
Departments of Psychiatry and Behavioural Neurosciences and Pediatrics, McMaster University, Hamilton, Ontario, Canada.
4
Departments of Paediatrics, Epidemiology & Biostatistics, University of Western Ontario, London, Ontario, Canada.
5
Division of Neurology, Department of Pediatrics, BC Children's Hospital, Vancouver, British Columbia, Canada.
6
Division of Neurology, Hospital for Sick Children, Toronto, Ontario, Canada.
7
Division of Diagnostic Imaging, Hospital for Sick Children, Toronto, Ontario, Canada.

Abstract

OBJECTIVE:

Health-related quality of life (HRQL) is compromised in children with epilepsy. The current study aimed to identify correlates of HRQL in children with drug resistant epilepsy.

METHODS:

Data came from 115 children enrolled in the Impact of Pediatric Epilepsy Surgery on Health-Related Quality of Life Study (PEPSQOL), a multicenter prospective cohort study. Individual, clinical, and family factors were evaluated. HRQL was measured using the Quality of Life in Childhood Epilepsy Questionnaire (QOLCE), a parent-rated epilepsy-specific instrument, with composite scores ranging from 0 to 100. A series of univariable linear regression analyses were conducted to identify significant associations with HRQL, followed by a multivariable regression analysis.

RESULTS:

Children had a mean age of 11.85 ± 3.81 years and 65 (56.5%) were male. The mean composite QOLCE score was 60.18 ± 16.69. Child age, sex, age at seizure onset, duration of epilepsy, caregiver age, caregiver education, and income were not significantly associated with HRQL. Univariable regression analyses revealed that a higher number of anti-seizure medications (p = 0.020), lower IQ (p = 0.002), greater seizure frequency (p = 0.048), caregiver unemployment (p = 0.010), higher caregiver depressive and anxiety symptoms (p < 0.001 for both), poorer family adaptation, fewer family resources, and a greater number of family demands (p < 0.001 for all) were associated with lower HRQL. Multivariable regression analysis showed that lower child IQ (β = 0.20, p = 0.004), fewer family resources (β = 0.43, p = 0.012), and caregiver unemployment (β = 6.53, p = 0.018) were associated with diminished HRQL in children.

SIGNIFICANCE:

The results emphasize the importance of child cognition and family variables in the HRQL of children with drug-resistant epilepsy. The findings speak to the importance of offering comprehensive care to children and their families to address the nonmedical features that impact on HRQL.

KEYWORDS:

Family; Health-related quality of life; Pediatric epilepsy

PMID:
27350597
DOI:
10.1111/epi.13441
[Indexed for MEDLINE]
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