Abstracts

Rationale: Quality of life (QOL) is a patient reported outcome centrsally important to understanding the health of people with chronic conditions including epilepsy. Although there are many QOL studies of children with epilepsy, few test theoretical models, and we are not aware of studies that test these models specifically from the child's perspective. Our aim is to test a model of epilepsy-specific QOL from the child's point of view. Methods: A published conceptual explanatory model of factors associated with QOL was tested using a structural equation modeling applied to child self-reported of biopsychosocial health and QOL, and clinical data. We recruited 486 children with active epilepsy, ages 8-15 from six pediatric neurology and epilepsy outpatient clinics across Canada. Results: Seizure status had a non-significant relationship with QOL; measured inteligence demonstarated a weak direct relatioship (r = .13). Child mental health (r = .27), parental support (r = .28) and peer support (r = .33) showed stronger direct associations. In addition, the relationship of parental support with QOL was strongly mediated through the child's mental health. Conclusions: Focusing on epilepsy-specific QOL from the child's perspective informs us that psychosocial factors may be more important than seizure status. When thinking about targets of QOL interventions, we urge clinicians to take into account children's perspectives as well as their parents. The child's point of view emphasizes the need to fascilitate supportinveness of parents, peers and mental health to improve QOL.