PRELIMINARY STUDY INTO THE RESPONSIVENESS OF THE QUALITY OF LIFE IN CHILDHOOD EPILEPSY QUESTIONNAIRE TO EPILEPSY SURGERY
Abstract number :
1.398
Submission category :
Year :
2003
Submission ID :
4051
Source :
www.aesnet.org
Presentation date :
12/6/2003 12:00:00 AM
Published date :
Dec 1, 2003, 06:00 AM
Authors :
Mark Sabaz, John Lawson, David Cairns, Michael Duchowny, Trevor Resnick, Patricia Dean, Andrew Bleasel, Ann Bye Psychology, Macquarie University, Sydney, Australia; Women[apos]s and Children[apos]s Health, University of NSW, Sydney, Australia; Neurology,
Few studies have examined the impact of epilepsy surgery on the health-related quality of life (HRQOL) of children. There has not previously been a suitable instrument to assess HRQOL in this population. The Quality of Life in Childhood Epilepsy Questionnaire (QOLCE) is a validated tool developed for this purpose. It is the aim of this study to determine if the QOLCE is responsive to post-operative change in seizure status.
[italic]Patients: [/italic]Nineteen children with intractable epilepsy, who underwent epilepsy surgery, and their parents, were recruited into the study. [italic]Measures:[/italic] Parents completed the QOLCE pre-operatively and again 12 to 24 months after surgery. At both assessment dates parents indicated the severity of their child[apos]s seizures during the last six months and the frequency of their child[apos]s seizures during the past four weeks on likert-type scales. [italic]Statistical Analysis:[/italic] Paired t-tests were conducted to assess group differences in pre- and post- operative QOLCE scores. Post-operative change in quality of life was determined by subtracting pre-operative QOLCE subscale scores from respective post-operative QOLCE scores. Linear regression was conducted to determine if improvement in QOLCE scores were related or [quot]responsive[quot] to post-operative seizure freedom over and above baseline, pre-operative QOLCE scores.
Post-operative scores were significantly higher than pre-operative scores for six of the 16 QOLCE subscales: Social Activities, Stigma, Physical Restrictions, Energy/Fatigue, General Quality of Life Rating and General Health Rating (p[lt]0.05). There was a trend for the post-operative overall QOLCE HRQOL score to be higher than the baseline score (p=0.08). Pre-operative levels of functioning were found to be significantly related to degree of improvement observed post-operatively for six of 16 QOLCE subscales: Social Activities, Stigma, Anxiety, Control/Helplessness, Self-Esteem and General Quality of Life Rating (p[lt]0.05). The relationship between pre-operative levels and degree of post-operative change approached significance for three other subscales (Other Cognition, Depression and General Health Rating) and the Overall QOLCE HRQOL score (p[lt]0.10). After controlling for pre-operative QOLCE scores, the group who were seizure free following surgery continued to show greater gains in Social Activities, Physical Restrictions, General Quality of Life Rating, General Health Rating and Overall QOLCE HRQOL (p[lt]0.05).
The QOLCE is responsive to reduction in seizure frequency following epilepsy surgery and is a potentially suitable instrument to assess clinical change due to treatment intervention. Importantly, pre-operative HRQOL levels must be controlled as they predict degree of change in HRQOL post-surgery.
[Supported by: The National Health and Medical Research Council. Macquarie University Post-Graduate Research Fund.]