Social functioning, psychological functioning, and quality of life in epilepsy.
OBJECTIVE
Part of our research intended to explain "Quality of Life" (QoL) differences between people with epilepsy. To this end, a series of already existing generic and disease-specific health status measures were used. In this study, they were considered as determinants of people's QoL, whereas QoL itself was conceived as a general "value judgment" about one's life.


METHODS
From the records of four outpatient clinics, 210 persons with epilepsy were randomly selected. During their visit to the outpatient clinic, they completed a questionnaire assessing, among other things, health perceptions and social and psychological functioning. Additional information about their medical and psychosocial status was gathered from the patient files. Data were analysed by using a hierarchical regression analysis.


RESULTS
In decreasing order of importance, "psychological distress," "loneliness," "adjustment and coping," and "stigma perception" appeared to contribute most significantly to the outcome QoL as judged by the patients themselves, regardless of their physical status. In the final model, none of the clinical variables (onset, seizure frequency, side effects of antiepileptic drugs) contributed significantly anymore to the patients' "quality-of-life judgement." Apparently the effect of other variables such as seizure frequency and health perceptions, medication and side effects, life fulfillment, self-esteem, and mastery is mediated by these variables.


CONCLUSIONS
Because all of the variance in QoL of the patients was explained by the psychosocial variables included in this study, health professionals should be aware of the significance of the psychosocial functioning of the patients and the role it plays in the achievement of a good QoL. Both informal and professional support may be an adjunct to conventional treatment. In future research, this issue should be given high priority.
Suurmeijer
T P
TP
Department of Sociology/Interuniversity Centre for Social Science Theory and Methodology (ICS), University of Groningen, Groningen, The Netherlands. thsuurmeijer@med.rug.nl
Reuvekamp
M F
MF
Aldenkamp
B P
BP
D000223:Adaptation, Psychological; D000328:Adult; D000553:Ambulatory Care; D000927:Anticonvulsants / Q000009:adverse effects; D001294:Attitude to Health; D015897:Comorbidity; D004827:Epilepsy / Q000175:diagnosis* / Q000453:epidemiology / Q000523:psychology; D005260:Female; D006304:Health Status; D006801:Humans; D008297:Male; D009426:Netherlands / Q000453:epidemiology; D011788:Quality of Life; D012044:Regression Analysis; D012107:Research Design; D020377:Self Efficacy; D018434:Sickness Impact Profile; D012917:Social Adjustment; D012944:Social Support; D013315:Stress, Psychological / Q000175:diagnosis / Q000453:epidemiology; D013859:Thiocarbamates
D000927:Anticonvulsants; D013859:Thiocarbamates; C017157:cycloate