Nora Fayed1, Aileen M Davis2, David L Streiner2, Peter L Rosenbaum2, Charles E Cunningham2, Lucyna M Lach2, Michael H Boyle2, Gabriel M Ronen2. 1. From Health Care and Outcomes Research (N.F., A.M.D.), University Health Network, Toronto; Departments of Pediatrics (N.F., P.L.R., G.M.R.) and Psychiatry & Behavioural Neurosciences (D.L.S., C.E.C., M.H.B.), CanChild Centre for Childhood Disability Research (N.F., P.L.R., G.M.R.), and Offord Centre for Child Studies (C.E.C., M.H.B.), McMaster University, Hamilton; Institute of Health Policy Management and Evaluation (A.M.D.), Graduate Department of Rehabilitation Science (A.M.D.), and Department of Psychiatry (D.L.S.), University of Toronto; and School of Social Work (L.M.L.) McGill University, Montreal, Canada. fayedn@mcmaster.ca. 2. From Health Care and Outcomes Research (N.F., A.M.D.), University Health Network, Toronto; Departments of Pediatrics (N.F., P.L.R., G.M.R.) and Psychiatry & Behavioural Neurosciences (D.L.S., C.E.C., M.H.B.), CanChild Centre for Childhood Disability Research (N.F., P.L.R., G.M.R.), and Offord Centre for Child Studies (C.E.C., M.H.B.), McMaster University, Hamilton; Institute of Health Policy Management and Evaluation (A.M.D.), Graduate Department of Rehabilitation Science (A.M.D.), and Department of Psychiatry (D.L.S.), University of Toronto; and School of Social Work (L.M.L.) McGill University, Montreal, Canada.
Abstract
OBJECTIVE: To study child mental health, parental support, and social support of children with epilepsy as these relate to quality of life (QOL) using child self-report, seizure-related variables, and estimated verbal intelligence based on receptive vocabulary. METHODS: A cross-sectional structural equation model of baseline data from the QUALITÉ cohort study, which includes 6 Canadian child epilepsy ambulatory programs. A sample of 3,481 children were screened for the following eligibility: 8 to 14 years of age, with active or medication-managed epilepsy. Of 894 eligible children, 506 agreed to participate, of whom 26 were then excluded because of an inability to self-report based on a standard cutoff score of receptive vocabulary lower than 70. The primary outcome of child-reported QOL was measured using the Child Epilepsy QOL Questionnaire. RESULTS: From the child's perspective, epilepsy-specific QOL is strongly related to their mental health and social support but not to their seizures. Specifically, child mental health and peer support exhibit direct associations with QOL; parental support has both direct and indirect associations with QOL (via child mental health); estimated verbal intelligence exerts its strongest association with QOL through mental health; and seizure status exhibits a weak relationship to QOL only through mental health. CONCLUSIONS: Among children with epilepsy aged 8 to 14 years, mental health and social support should be areas of focus in the assessment of QOL. Controlling seizures is insufficient care for influencing the child's perception of their life.
OBJECTIVE: To study child mental health, parental support, and social support of children with epilepsy as these relate to quality of life (QOL) using child self-report, seizure-related variables, and estimated verbal intelligence based on receptive vocabulary. METHODS: A cross-sectional structural equation model of baseline data from the QUALITÉ cohort study, which includes 6 Canadian childepilepsy ambulatory programs. A sample of 3,481 children were screened for the following eligibility: 8 to 14 years of age, with active or medication-managed epilepsy. Of 894 eligible children, 506 agreed to participate, of whom 26 were then excluded because of an inability to self-report based on a standard cutoff score of receptive vocabulary lower than 70. The primary outcome of child-reported QOL was measured using the ChildEpilepsy QOL Questionnaire. RESULTS: From the child's perspective, epilepsy-specific QOL is strongly related to their mental health and social support but not to their seizures. Specifically, child mental health and peer support exhibit direct associations with QOL; parental support has both direct and indirect associations with QOL (via child mental health); estimated verbal intelligence exerts its strongest association with QOL through mental health; and seizure status exhibits a weak relationship to QOL only through mental health. CONCLUSIONS: Among children with epilepsy aged 8 to 14 years, mental health and social support should be areas of focus in the assessment of QOL. Controlling seizures is insufficient care for influencing the child's perception of their life.
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