| ObjectiveEpilepsy patients with anxiety,depression and life quality problem were included in this study.These patients are professionals or non-professionals with psychological problems.Results provide a reference for the clinical management of the quality of life,as well as promotion of mental and physical treatment for epilepsy patients.MethodsThe sample size was determined by the percentage of patients with occupation in the epilepsy population and statistic standards.There are 33 neurological departments(or epilepsy centers)in Beijing,of which 24 are tertiary grade 3 hospitals,6 second-level grade hospitals and 3 community hospitals.By stratified sampling method(1/3),11 hospitals were selected randomly.According to the inclusion and exclusion criteria,demographic information(gender,nationality,age,occupation,marital status,educational level,living conditions,family income,and medical treatment),the disease information(the age of onset,course,seizure,nearly one-year medication compliance)were collected and filled in the Quality of Life in adult patients with Epilepsy-31items(QOLIE-31)questionnaire,Patient Health Questionnaire-9(PHQ-9)and Generalized Anxiety Disorder scale-7(GAD-7).SPSS23.0 was used for statistical analysis.Data of paired samples were examined by t-test.If meeting the normality and homogeneity of variance,the results of which were measured by means±SD(x ±s).If the data did not accord to the normal distribution,Wilcoxon rank sum test was adopted and the results were measured by Median(M).Three sets of the collected data was compared by using analysis of variance,If the data did not accord to the normal distribution,Kruskal-Wallis rank sum test was adopted.Comparison was made using LSD test,and the significance level was 0.05(two-sided test).ResultsAdult epilepsy patients conformed to the requirements of the epidemiological investigation.For quality of Life in adult patients with Epilepsy-31 items(QOLIE-31)questionnaire,the reliability and validity were 0.93 and 0.93 respectively.Analysis of the reliability of each dimension showed that the scale had high internal consistency.The reliability and validity of Patient Health Questionnaire-9 were 0.87 and 0.87 respectively.The reliability and validity of Generalized Anxiety Disorder Scale-7 were 0.94 and 0.90 respectively.Quality of life of adult epilepsy patients with occupations was(63.31±14.73),higher than groups without occupations(53.43±16.55),and their differences in factor was varied;Quality of life of adult epilepsy patients with fixed occupations was(62.23 ± 14.67)and freelance adult epilepsy patients was(63.33 ± 15.86),showing no statistically significant difference(p>0.05),Depression degree of adult patients with occupations was(8.00),less than the adult epilepsy patients without occupations significantly(p< 0.05);Anxiety degree of adult patients with fixed occupations was(2.00),not statistically significant different from the freelance(2.00).Depression degree of adult patients with fixed occupations was(4.00)and freelance(5.00),showing statistically significant difference(p<0.05);Farmers' anxiety degree was(4.00)significantly(p<0.05)different from students(2.00)and workers(2.00);Farmers' depression was(7.00),students(4.00)and workers(3.00),significantly different from each other(p<0.05).With the increase of frequency of epileptic seizures,has a professional and non-professional adult epilepsy patient's quality of life scores showed a trend of decline.Seizure frequency in 1 time/year to >1 time/year-?1 time/week,the professional and non-professional adult epilepsy patients quality of life score difference is large,but the seizure frequency in >1 time/week-?1 time/day and>1 time/day,the professional and non-professional adult epilepsy patients quality of life score difference is no big.For the factors affecting the quality of life of adult students with epilepsy,the higher depression degree,the higher frequency of seizures in recent years;increasing medical costs would reduce their quality of life;living with family or friends would improve their quality of life.For the factors of quality of life in adult epilepsy workers,the higher score of depression,the higher score of anxiety;the lower the level of diagnosis and treatment,the older age;high frequency of nearly one-year seizures would reduce their quality of life;higher level of education would improve their quality of life.For adult farmer epilepsy patients,the higher score of anxiety,the higher score of depression;the longer the duration,the higher frequency of nearly one-year seizure which would reduce their quality of life;for factors in unemployed adults with epilepsy,the higher score of anxiety,the higher score of depression;high frequency of nearly one year seizures would reduce their quality of life;family could promote their quality of life;for freelance with epilepsy,high depression score would reduce their quality of life.For the factors which affect all adult epilepsy patients,the higher anxiety score,the higher depression score;the more nearly one year seizure frequency,the lower the level of diagnosis and treatment,the longer course of disease,and the more medical expenses;the younger for the first seizure,the lower quality of life.Patients with occupations and with higher level education had higher quality of life;Occupation was an independent factors affecting adult epilepsy patients.ConclusionsThe reliability and validity of the Quality of Life in adult patients with Epilepsy-31items(QOLIE-31)questionnaire,Patient Health Questionnaire-9(PHQ-9)and Generalized Anxiety Disorder Scale-7(GAD-7)were good,the measurement index of the research variables has high internal consistency and reliability.Occupations might be an important factor affecting epilepsy patients' quality of life.Varied effects on anxiety,depression and quality of life were observed for epilepsy patients with different professional status.Non-professional people with epilepsy,anxiety,depression,and psychological problems were under more psychological pressure than professional patients with epilepsy.Occupational factors might affect the frequency of seizures in adults with epilepsy.There were differences between kinds of factors that affect the quality of vocational adult life in patients with epilepsy.Different professional adult epilepsy patients' life quality and the factors are different and occupational status of adult epilepsy patients should take different interventions and psychological treatment to improve the quality of life.Thus,adult patients with epilepsy should not give up looking for work because of the disease.They should seek employment to improve their quality of life. |
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