title: Socioeconomic status and self-management in epilepsy: comparison of diverse clinical populations in Houston, Texas.
abstract: We compared the scores on self-management and associated psychosocial scales of patients with epilepsy at two clinics in Houston, TX, USA, to determine if there were systematic differences associated with socioeconomic status (SES). Patients of low SES reported higher scores on overall, information, and safety management (P<0.03) and no differences on medication, seizure, and lifestyle management. The two groups were similar with respect to the pattern of high and low scores. Reported levels of self-efficacy, depression, social support, stigma, desire for control, and outcome expectations were higher for those of high SES (P<0.01). Knowledge of epilepsy and satisfaction with care were lower (P<0.01). Again, the patterns of high and low scores were similar. Tests of association between psychosocial factors and self-management revealed that people with higher levels of self-efficacy and social support also reported higher self-management (P<0.01) regardless of demographics, seizure frequency, and SES (P<0.05). These findings provide little support for SES-related disparities in self-management and suggest that the focus of strategies to improve self-management may be similar across diverse populations.
authors.affiliation: School of Public Health, University of Texas Health Science Center at Houston, Houston, TX 77225, USA. charles.e.begley@uth.tmc.edu
authors.forename: Charles E
authors.initials: CE
authors.lastname: Begley
authors.forename: Ross
authors.initials: R
authors.lastname: Shegog
authors.forename: Biebele
authors.initials: B
authors.lastname: Iyagba
authors.forename: Vincent
authors.initials: V
authors.lastname: Chen
authors.forename: Krishna
authors.initials: K
authors.lastname: Talluri
authors.forename: Stephanie
authors.initials: S
authors.lastname: Dubinsky
authors.forename: Michael
authors.initials: M
authors.lastname: Newmark
authors.forename: Nikki
authors.initials: N
authors.lastname: Ojukwu
authors.forename: David
authors.initials: D
authors.lastname: Friedman
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D004827:Epilepsy / Q000453:epidemiology / Q000523:psychology* / Q000628:therapy*; D005260:Female; D006801:Humans; D019359:Knowledge; D008297:Male; D008875:Middle Aged; D010555:Personality Inventory; D011581:Psychological Tests; D012648:Self Care / Q000379:methods*; D012923:Social Class; D057545:Social Stigma; D013223:Statistics as Topic; D011795:Surveys and Questionnaires; D013781:Texas / Q000453:epidemiology; D055815:Young Adult