Abstracts

RATIONALE: With advances in medical technology and the ability to successfully manage chronic health conditions, there has also been increasing interest in the impact of these conditions on the lives of individuals. A large body of literature exists documenting the often deleterious effects of chronic health conditions and their treatments on the quality of life of youth. Relatively little literature has investigated the impact of group psychosocial treatment for adolescents with chronic health conditions. The present study reports preliminary data on the impact of a group psychosocial intervention for adolescents with epilepsy and their parents on quality of life as measured by the Quality of Life for Adolescents with Epilepsy (Cramer, et al., 1999; QOLIE-AD-48)
METHODS: Pre and Post-Intervention ratings of quality of life using the QOLIE were obtained from adolescents with epilepsy and at least one of their parents participating in a 6 session (weekly) structured cognitive-behavioral group intervention. All of the adolescents were being treated with anti-epileptic medications while they participated in the group and some continued to experience seizures. Certain items on the QOLIE address symptoms or general health states that an intervention of this type would not be expected to impact even if successful (e.g. [dsquote]In the past 4 weeks, how often has your health limited heavy activities such as running, participating in very active sports (such as gymnastics, roller-blading, skiing?)). Therefore, prior to analysis of the data, the researchers identified [dsquote]critical items[dsquote] on the QOLIE for analysis in addition to the derived subscales and total score.
RESULTS: Using paired samples T-tests no significant pre- to post-treatment changes were found across the QOLIE subscales or total score. Due to the limited sample size (N=4), we performed a nonparametric sign analysis. When we looked at the type of change (e.g. positive/higher ratings on post-test, negative/lower ratings on post-test, no change) observed on the 8 subscales and the overall score, there was a significant trend toward positive change (Chi-square= 11.9, p=.003). Out of a possible 35 opportunities for a post-intervention change in subtest or total score across the four subjects, 21 were observed in a positive direction, nine in a negative direction and no change was observed in five instances. A similar trend was observed for type of change on the [dsquote]critical items[dsquote] (Chi-square= 15.34, p[lt].001) with many instances of no change occurring when the adolescent selected the highest level response at the time of the pre-test, therefore providing a ceiling effect in which there was no room for further improvement.
CONCLUSIONS: The preliminary data demonstrates a potential positive effect on adolescent quality of life as measured by the QOLIE from participation in a structured group psychosocial intervention for adolescents with epilepsy and their parents. The small sample size is an obvious limiting factor of the study. However, this data was collected through an ongoing research project. Additional subjects will be enrolled prior to the AES meeting and new analyses will be conducted.
[Supported by: Epilepsy Foundation of America/Shire]; (Disclosure: Grant - Epilepsy Foundation of America and Shire)