Abstracts

Rationale: Social support (physical and emotional comfort given by an intimate partner or from family and close friends) can buffer the negative impact of stressful events and chronic health conditions. Previous studies have found psychosocial factors have the greatest impact on health-related quality of life (HRQOL). To date, no previous population studies have analyzed the association between social support (SS) and epilepsy in the United States. The goal of this study was to examine the effects of SS on HRQOL in persons with a history of epilepsy. Methods: The California Health Interview Survey (CHIS) is geographically stratified, random-digit dialed, two-stage telephone survey conducted on a biennial state-basis of non-institutionalized persons in California, over the age of 18 that tracks the prevalence of chronic disease burden and monitor health risks. In the 2003 CHIS, 550 of 41,494 respondents reported a history of epilepsy. Four social support questions measured the respondent’s level of agreement on a four point scale on availability: of someone to help with daily chores when sick, of someone to get together with for relaxation, of someone to understand your problems and of someone to love you and make you feel wanted. A set of survey weight adjusted logistic regression analyses were conducted with self-reported health status as the outcome. In those regression models, we examined the effect from epilepsy status, social support and their interactions, by controlling for demographics and comorbid health conditions. Results: Demographics, comorbid conditions and good social support were evenly distributed among four questions. Analyses examined the interaction between epilepsy and the SS showed a significant interaction between epilepsy and “availability of someone to love you and make you feel wanted”. Controlling for demographics only and designating persons without epilepsy reporting good SS as the reference group, persons without epilepsy with poor SS had poor self-rated health status (PSRHS) (OR 1.9), persons with epilepsy (PWE) and good SS also reported PSRHS (OR 3.6). PWE and poor SS were, however, the most likely to report PSRHS (OR 11.1). Once demographics and comorbid conditions were both controlled for, persons without epilepsy and poor social support reported PSRHS (OR 2.0), PWE and good SS (OR 3.1). Again, PWE and poor SS were the most likely to report PSRHS (OR 9.0). Conclusions: PWE who report lack support from a close personal relationship, where they feel loved and wanted were significantly more likely to report poor HRQOL. Surveys of knowledge, attitudes and beliefs about epilepsy in the U.S. general population over 30 years ago found 18% reported they objected to their son or daughter marrying a person with epilepsy. Previous epidemiological surveys found PWE are more likely to report never being married than those without epilepsy. Results from this study suggest such public attitudes may continue to negatively impact PWE. PWE need encouragement to actively seek and sustain supportive personal relationships may help improve their HRQOL.