Epilepsy self-management practices enhance a patient’s competence and confidence in managing their chronic condition, which is assumed to lead to an improved quality of life (QoL). We analyzed the relationship between the Epilepsy Self-Management Scale (ESMS) responses and the Quality of Life in Epilepsy (QOLIE-31) scores. Baseline questionnaires from HOBSCOTCH, a self-management program for cognitive problems, were administered in four New England epilepsy centers on adults (n = 100) with epilepsy and subjective memory complaints. There was no correlation between overall self-management scores and overall quality-of-life scores; however, subscale analyses indicated that certain self-management practices were strongly correlated with the overall QOLIE-31 score. Specifically, improved ESMS lifestyle management was associated with an increased quality-of-life score (adjusted p < 0.01), while enhanced ESMS safety management practices were associated with a decreased overall quality-of-life score (adjusted p < 0.01). Our item-level analysis highlighted specific items within the ESMS safety management, ESMS lifestyle management, and ESMS information management subdomains that were significant predictors for QoL. Depression was also shown to be significantly correlated with the QOLIE-31 (p < 0.01). Our study suggests that an overemphasis on safety practices may negatively affect quality of life, while enhanced lifestyle management has positive effects. Furthermore, our finding that quality of life is greatly dependent on depressive symptoms underscores the importance of treating depression in epilepsy.
Epilepsy Self-management Quality of life Depression Determinants
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This project was funded by the Centers for Disease Control and Prevention (CDC) and was supported by special interest project SIP 14-006, Cooperative Agreement Number: 1U48DP005018. We are grateful to the patients who participated in this study, and for our colleagues involved with HOBSCOTCH . Funding was also provided by the NIH Quantitative Biomedical Sciences at Dartmouth training grant: 05-T32LM012204-03.
Compliance with ethical standards
Conflicts of interest
On behalf of all authors, the corresponding author states that there is no conflict of interest.
The Committee for the Protection of Human Subjects (CPHS) at Dartmouth College has approved this study (CPHS#: 23708). Approval by CPHS was based on the study’s appropriate balance of risk and benefit to subjects and a study design in which risks to subjects are minimized. The review was also performed by the Institutional Review Board (IRB), which oversaw that the study satisfied the human subjects protection requirements of the Federal-wide Assurance (FWA) for the Relying Entity (FWA#: 00003095). Thus, all human studies were performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments. Specific national laws were also observed. Informed consent was obtained for all subjects prior to their inclusion in the study, and all details that might disclose the identity of the subjects under study were omitted.
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