Abstracts

Rationale: Caregivers of children with chronic illness are reportedly more vulnerable to increased stress and subsequently, a diminished quality of life. In pediatric epilepsy, regardless of individual clinical variables, maternal caregivers experience parenting stress and would benefit from additional support (Wirrell et al, 2008). Social support has been shown to act as a buffer against the negative impact of stress for pediatric caregivers (Horton et al, 2001). Due to the variable SES representation in an urban population, it is important to understand how social support differs across groups and which groups are more vulnerable to lack of social support (Canning at al, 1996).Methods: Data was obtained from caregivers on a self-report survey collecting sociodemographics and standardized scores on the PROMIS measure as part of the Seizures and Outcomes Study (SOS) conducted in Washington, D.C. A two-step cluster analysis was conducted in SPSS on 181 caregivers (91% female; 81% African American, 16% Caucasian, 3% Other; mean age 36.4 ± 9.2) to determine SES groups based on marital status, level of education completed, current employment status, and annual household income. PROMIS scales for instrumental support (4a) and emotional support (4a) were scored to determine caregiver report on 2 factors of social support. 4 items from the PROMIS Global Health Scale were scored and evaluated on an individual level (general health, quality of life, physical health, and mental health). Group differences on social support were evaluated with a MANOVA and a simple linear regression was used to predict degree of support based on SES. Caregiver reported seizure severity was tested for a moderating effect on SES and social support using a moderated multiple regression. Pearson’s correlation coefficient was determined for factors of social support and individual global health items.Results: The four clusters identified were “low” (n=52), “low-medium” (n=49), “high-medium” (n=40), and “high” (n=40) SES. There was a significant difference in instrumental support and emotional support based on SES group, F(6,322) = 4.07, p≤.001; Wilks’ Λ = .864, partial η2 = .07, such that SES group predicted level of instrumental support (r=.47, p<.001) and emotional support (r=.23, p<.01 ). Seizure severity did not serve as a moderator for either instrumental support (r=.004, p=.48) or emotional support (r=-.08, p=.14). Degree of emotional support was strongly positively correlated with caregiver self-report of health (r=.33, p<.001), quality of life (r=.29, p<.001), physical health (r=.30, p<.001), and mental health (r=.41, p<.001). Instrumental support was only positively correlated with physical health (r=.17, p<.05).Conclusions: Primary caregivers of pediatric epilepsy patients with low SES have less emotional and instrumental support regardless of child seizure severity. Attention to SES and caregiver well being in treatment plans for urban pediatric epilepsy patients could benefit caregivers and positively impact care of the child. The SOS study is supported by the Centers for Disease Control and Prevention.