| Research BackgroundEpilepsy(EP)is the most common chronic brain disease in children,with more than 70 million epileptics worldwide,mostly in developing countries[1-3]Domestic epidemiology shows that there are more than 9 million people have epilepsy with 6.5 million active cases in China,which is increasing yearly with 450,000 new cases and a prevalence rate of 4‰-7‰.60%of the patients originate in childhood[4],and neurobehavioural and psychiatric comorbidities occur in up to 50%of children and are frequently under-recognized[2].Epilepsy is a disease with complex etiology and diverse seizure types,and there are many treatment methods,including drug treatment,surgical treatment,ketogenic diet,etc.Currently,the main treatment is long-term oral AEDs.70-80%of epilepsy patients after a reasonable standard of drug treatment can control the seizure,and even can stop the drug.However,more than 60%of patients with active epilepsy remain untreated[1].Modern medical model is the unity of physiology,psychology and society.It should not only pay attention to the physical health of children,but also pay attention to the integrity of psychological and social adaptation.The core of epilepsy treatment is to control seizures,but due to the long-term process of the disease,the unpredictability of seizures,long-term oral AEDs,AEDs side effects,social discrimination,the economic burden in the diagnosis and treatment process,serious negative impact on children and their families can not be ignored.Some studies have suggested that epilepsy in childhood is more dangerous than epilepsy in adults,and the majority of epilepsy patients with mental disorders originated in childhood,childhood personalities and perceptions of society also influence adulthood[9].Therefore,epilepsy treatment should not only emphasize the control of seizures,but also make the overall improvement of the health of children,improve their quality of life.Effective treatment and reasonable management of children with epilepsy is not only related to the health of the children themselves,but also to the happiness of their families,and related to stability and harmony of the society.Therefore,it is necessary to fully understand the survival status of children with epilepsy and understand the main factors affecting the quality of life of children with epilepsy.In recent years,the research on the quality of life of epileptic patients has become a hot topic,but it is mostly focused on adults,and there are few investigations on the quality of life in children with epilepsy[12].Children are the future of the families and countries,and their quality of life should be valued.Therefore,this study investigates the survival status of children with epilepsy from the aspects of epilepsy diagnosis and treatment,family status,education status and social security,evaluates their quality of life,analyzes the important factors influencing the quality of life,improves the understanding of the medical industry and the public,and provides reference for the rational management of children with epilepsy.Research ObjectiveThe purpose of this study is to understand the survival status of children with epilepsy from the aspects of diagnosis and treatment,family,education,social support and immunization,and analyze the factors affecting their quality of life,in order to facilitate the reasonable management of children with epilepsy.Materials and MethodsThis was an observational,cross-sectional epidemiology study conducted at the Third Affiliated Hospital of Zhengzhou University from January 2019 to June 2019.A total of 506 children who met the epilepsy diagnosis in the pediatric outpatient department were brought into study.The clinical data questionnaire was used to investigate the disease-related factors,family factors,educational status,medical security and social support,and immunization status.Children who are older than 2 years from the above epileptic children were investigated by the Pediatric Quality of Life Inventory(PedsQL).Meanwhile,150 healthy children of the same age in the same area were selected as the control group to compare their quality of life.And the factors that may affect the quality of life in the clinical data of epileptic children were statistically analyzed.SPSS 22.0 software was used for statistical analysis.Counting data were expressed as an example(%).Since the quality of life(QOL)scores were not normally distributed,the rank sum test was used for univariable regression analyses.After univariable regression analyses,significant influencing factors were taken as independent variables,and scores of each dimension of quality of life were taken as dependent variables.Multivariate analyses were conducted with multiple linear regression.The test level was ?=0.05,and the difference of P<0.05 was considered to be significant.Result1.A total of 506 patients were included in this study,the majority(n=310;61.3%)of patients were male.The majority(n=284;56.0%)age was over 5 years old,a total of 203(40.1%)the age at onset was before 2 years,the majority(n=348;68.7%)course of illness is longer than 1 year.A total of 438(86.6%)patients have active epilepsy,monotherapy was used in 50.1%of patients.39.9%of patients have different degrees of development delay.0.8%of patients' outpatient medicine can be partially reimbursed.1.0%of patients after the onset can get the help from society.46%of patients were not immunized after onset.2.Children with epilepsy had diminished scores in total score and all subdomains of PedsQL as compared to healthy children.(P<0.05).Univariable regression analyses revealed that child sex,age,age at onset,course of illness,number of antiepileptic drugs,seizure,developmental delay,whether the one-child,parents' educational level,the impact of the family economy,parental anxiety,family emotional support,education,immunization were significantly associated with QOL(P<0.05).Multivariable regression analysis showed that developmental delay(t=7.123,P=0.000),education(t=4.16,P=0.000),the impact of the family economy(t=3.582,P=0.000),immunization(t=2.497,P=0.013),seizure(t=2.401,P=0.017)were significantly associated with QOL in physical field;seizure(t=3.279,P=0.001),course of illness(t=-2.948,P=0.003),whether the one-child(t=-3.253,P=0.001),the impact of the family economy(t=2.016,P=0.045),family rearing style(t=-1.975,P=0.049)were significantly associated with QOL in psychological field;developmental delay(t=10.139,P=0.000),the impact of the family economy(t=3.341,P=0.001),number of antiepileptic drugs(t=2.842,P=0.005),education(t=3.043,P=0.003),family emotional support(t=2.826,P=0.005),course of illness(t=-2.446,P=0.015)were significantly associated with QOL in social field;developmental delay(t=7.747,P=0.000),number of antiepileptic drugs(t=3.691,P=0.000),the impact of the family economy(t=2.799,P=0.006),parents' educational level(t=2.295,P=0.023),age(-2.106,P=0.036)were significantly associated with QOL in the role field;developmental delay(t=9.495,P=0.000),the impact of the family economy(t=4.364,P=0.000),number of antiepileptic drugs(t=2.394,P=0.017),seizure(t=3.247,P=0.001),course of illness(t=-2.817,P=0.005)were significantly associated with QOL in the comprehensive field.ConclusionChildren with epilepsy live in poor survival present situation.Education,health care,social support and immunization are all lacking to some extent.All dimensions of quality of life are low.Factors affecting the quality of life include the developmental delay,seizure,number of antiepileptic drugs,course,age,education,family economic impact,whether the one-child,parents' educational level,family emotional support,family rearing style,immunization.It should be highly concerned by all sectors of society and given corresponding intervention to improve the quality of life of children with epilepsy. |
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