Abstracts

Rationale: Children with intractable epilepsy have been shown to have poor health-related quality of life (HRQL). The aim of this study was to identify predictors of HRQL in children with intractable epilepsy.Methods: Children with intractable epilepsy and being evaluated for epilepsy surgery were recruited into the study. Data were collected cross-sectionally during the period of evaluation before epilepsy surgery. Potential predictors that were evaluated included age, age at seizure onset, IQ, number of seizure medications, seizure frequency, parental education, socio-economic status (income), caregiver’s mood (depression and anxiety), and family factors (including family adaptation, resources and demands). HRQL was measured using Quality of Life in Childhood Epilepsy Questionnaire (QOLCE), a parent-rated epilepsy-specific instrument. Caregiver’s depression and anxiety were measured using Quick Inventory of Depressive Symptomatology (QIDS) and Generalized Anxiety Disorder (GAD) respectively. Family adaptation was assessed with the Family Adaptability, Partnership, Growth, Affection, and Resolve (Family APGAR); family resources was quantified using the Family Inventory of Resources for Management (FIRM), which assesses resources available to aid families’ adaptation to stressful events; family demands was measured using the Family Inventory of Life Events and Changes (FILE), which assesses the accumulation of simultaneous normal and non-normal life events and changes in life events. A series of bivariable analyses were done using linear regression to identify potential predictors of HRQL, followed by stepwise multivariable regression analysis.Results: 65 children, mean age 11.4 years (range: 4.0-18.6 years; SD= 4.3 years), consisting of 39 males and 26 females, with intractable epilepsy were recruited. The total QOLCE score was 60.3 (range: 18.6-94.2; SD=16.8). Higher depression and anxiety in caregivers, poorer family adaptation, fewer resources and higher demands were associated with lower HRQL on the bivariable analyses (p<0.010 for all). Age, age at seizure onset, IQ, number of seizure medications, seizure frequency, parental education and parental income were not associated with HRQL (all p>0.050). Stepwise regression showed that caregiver’s depression (β=-0.307, p=0.015) and family demands (β=-0.313, p=0.013) were significantly associated with HRQL in children with epilepsy.Conclusions: We have found that caregiver’s mood and family factors were associated with HRQL in children with intractable epilepsy. The findings highlight the importance of considering the family environment when evaluating HRQL and these factors could potentially serve as potential targets for interventions to improve HRQL in children with intractable epilepsy.