Michael Endermann1. 1. von Bodelschwinghsche Stiftungen Bethel, Psychosozialer Dienst im Stiftungsbereich Behindertenhilfe, Remterweg 58, 33617 Bielefeld, Germany. michael.endermann@bethel.de
Abstract
INTRODUCTION: This study examined the effects of a time-limited residential unit for young adults with epilepsy and mild cognitive impairment in a German epilepsy centre. Residents spend approximately 3 years in this unit to gain more independence and better seizure control. METHODS: Fifty-two individuals were interviewed about 4 weeks after admission (T1) and again at discharge (T2) using the PESOS scales on health-related quality of life (HRQOL), the depression scale D-S', the Symptom Checklist 90-R, an item on overall quality of life (QOL), and scales on activities of daily living (ADL), life satisfaction and work related problems. Changes in these self-rating scales were computed and related to changes in seizure frequency and to later support needs following rehabilitation in the residential unit. RESULTS: The frequency of epileptic seizures had declined at the time of discharge. Twenty-nine individuals could move to supported housing, 23 moved to long-term residential units. Some self-rating scales reflected changes of seizure frequency, but a main effect was not detected. Residents assigned to supported housing and those assigned to longer residential care differed significantly in changes of HRQOL, overall QOL, ADL and clinical ratings, controlling for effects of seizure status. Improvements were only found in residents moving to supported housing. However, both groups could not be selected by available information at T1. DISCUSSION: The time-limited residential unit yields positive effects in about half of their clients with epilepsy and mild cognitive impairment. Effects have to be related to a group with well-known difficulties in many aspects of living before admission. Improvements of subjective health status do not seem to be solely attributable to reduction of seizure frequency. Other determining factors for good or poor rehabilitation outcome remain to be identified. (c) 2010 British Epilepsy Association. Published by Elsevier Ltd. All rights reserved.
INTRODUCTION: This study examined the effects of a time-limited residential unit for young adults with epilepsy and mild cognitive impairment in a German epilepsy centre. Residents spend approximately 3 years in this unit to gain more independence and better seizure control. METHODS: Fifty-two individuals were interviewed about 4 weeks after admission (T1) and again at discharge (T2) using the PESOS scales on health-related quality of life (HRQOL), the depression scale D-S', the Symptom Checklist 90-R, an item on overall quality of life (QOL), and scales on activities of daily living (ADL), life satisfaction and work related problems. Changes in these self-rating scales were computed and related to changes in seizure frequency and to later support needs following rehabilitation in the residential unit. RESULTS: The frequency of epilepticseizures had declined at the time of discharge. Twenty-nine individuals could move to supported housing, 23 moved to long-term residential units. Some self-rating scales reflected changes of seizure frequency, but a main effect was not detected. Residents assigned to supported housing and those assigned to longer residential care differed significantly in changes of HRQOL, overall QOL, ADL and clinical ratings, controlling for effects of seizure status. Improvements were only found in residents moving to supported housing. However, both groups could not be selected by available information at T1. DISCUSSION: The time-limited residential unit yields positive effects in about half of their clients with epilepsy and mild cognitive impairment. Effects have to be related to a group with well-known difficulties in many aspects of living before admission. Improvements of subjective health status do not seem to be solely attributable to reduction of seizure frequency. Other determining factors for good or poor rehabilitation outcome remain to be identified. (c) 2010 British Epilepsy Association. Published by Elsevier Ltd. All rights reserved.