Quality of life among patients with epilepsy in Nigeria: predictors and barriers to routine clinical use of QOLIE-31
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Quality of life among patients with epilepsy in Nigeria: predictors and barriers to routine clinical use of QOLIE‑31 Temitope Ogundare1,2 · Timothy O. Adebowale1 · Obinna A. Okonkwo1 Accepted: 12 September 2020 © Springer Nature Switzerland AG 2020
Abstract Purpose To determine the factors predicting poorer quality of life (QOL) among patients with epilepsy attending an outpatient clinic in a Nigerian tertiary hospital, and reflect on the barriers to successful adoption of a structured QOL instrument into routine clinical practice. Methods Two-hundred and seventy patients with a diagnosis of epilepsy attending the Neuropsychiatric Hospital, Abeokuta, Nigeria were recruited. Sociodemographic and clinical information were collected using a proforma. QOLIE-31 was administered to measure QOL. Results The mean (SD) QOLIE-31 scores were 77.98 (13.32), with 15.2%, 74.1%, and 10.7% of the respondents classified as low, moderate, and high QOL, respectively. Factors associated with poorer QOL include seizure frequency, depression, and family history of epilepsy. Conclusion Quality of life is an important outcome measure for people with epilepsy and it focuses on the individual’s subjective assessment of their well-being. Although useful for clinical management of patients with epilepsy, the uniqueness of the practice settings and the limitations of clinical practice in a developing country pose challenges to successful adoption of structured QOL instrument into routine clinical practice. Keywords Clinical practice · Epilepsy · Nigeria · Quality of life · Seizures
Introduction The concept of quality of life (QOL) began to gain prominence in the 1970s and concerns the overall well-being of individuals within the larger society. It is defined as “individuals’ perception of their position in life in the context of the culture and value systems in which they live and in relation to their goals, expectations, standards, and concerns” [1]. Quality of life in epilepsy encompasses physical health (general health and daily function, seizure frequency and severity and medication side effects), mental health (emotional well-being and self-esteem), and social health (relationships with family and friends, and perceived stigma resulting from the diagnosis of epilepsy) [2]. The traditional approach to * Temitope Ogundare [email protected] 1
Neuropsychiatric Hospital Aro, Abeokuta, Ogun State, Nigeria
Boston University School of Public Health, Boston, MA 02118, USA
2
epilepsy treatment focused on decreasing seizure frequency and reducing medication side effects while neglecting the psychosocial aspects of epilepsy on patients [3]. Patients with epilepsy have problems with social and role functioning, emotional well-being, and cognitive impairment arising both from the medical condition and side effects of medications which often go undetected by clinicians [3, 4]. The use of standardized QOL questionnaires allows the clinician to detect these functional limitations and psychological distress to improve patients’ outcomes [3
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