title: Does the concept of resilience contribute to understanding good quality of life in the context of epilepsy?
abstract: A significant body of research highlights negative impacts of epilepsy for individual quality of life (QOL). Poor seizure control is frequently associated with reporting of poor QOL and good seizure control with good QOL; however, this is not a universal finding. Evidence suggests that some people enjoy good QOL despite ongoing seizures while others report poor QOL despite good seizure control. Understanding the factors that influence QOL for people with epilepsy and the processes via which such factors exert their influence is central to the development of interventions to support people with epilepsy to experience the best possible QOL. We present findings of a qualitative investigation exploring influences and processes on QOL for people with epilepsy. We describe the clinical, psychological, and social factors contributing to QOL. In particular, we focus on the value of the concept of resilience for understanding quality of life in epilepsy. Based on our analysis, we propose a model of resilience wherein four key component sets of factors interact to determine QOL. This model reflects the fluid nature of resilience that, we suggest, is subject to change based on shifts within the individual components and the interactions between them. The model offers a representation of the complex influences that act and interact to either mitigate or further compound the negative impacts of epilepsy on individual QOL.
authors.affiliation: Department of Public Health & Policy, University of Liverpool, Liverpool, UK.
authors.forename: Adele
authors.initials: A
authors.lastname: Ring
authors.affiliation: Department of Public Health & Policy, University of Liverpool, Liverpool, UK. Electronic address: ajacoby@liv.ac.uk.
authors.forename: Ann
authors.initials: A
authors.lastname: Jacoby
authors.affiliation: Department of Molecular & Clinical Pharmacology, University of Liverpool, UK.
authors.forename: Gus A
authors.initials: GA
authors.lastname: Baker
authors.affiliation: Department of Molecular & Clinical Pharmacology, University of Liverpool, UK.
authors.forename: Anthony
authors.initials: A
authors.lastname: Marson
authors.affiliation: Department of Public Health & Policy, University of Liverpool, Liverpool, UK.
authors.forename: Margaret M
authors.initials: MM
authors.lastname: Whitehead
mesh_terms: D000328:Adult; D000368:Aged; D032882:Comprehension; D004827:Epilepsy / Q000175:diagnosis* / Q000523:psychology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011788:Quality of Life / Q000523:psychology*; D055500:Resilience, Psychological; D012189:Retrospective Studies; D012640:Seizures / Q000175:diagnosis / Q000523:psychology
keywords: Psychological acceptance; Qualitative research; Quality of life; Resilience; Social support; Vulnerability