Factors associated with superior self-management skills among individuals with epilepsy.

PURPOSE: This study aimed to determine whether the self-management skills of patients with epilepsy are associated with certain demographic, clinical, and psychosocial variables. METHODS: A direct survey of 182 patients, including the Epilepsy Self-Management Scale, was conducted. RESULTS: On univariate analysis, higher age, the occurrence of convulsions, and the use of religion as a coping mechanism were associated with higher self-management scores. On multiple linear regression, only age and the presence of convulsions remained independently significant. Older individuals employed more medication management skills. Those who experienced convulsions utilized more information management, seizure management, and lifestyle management skills. However, using binary logistic regression, we found that these subscales were not independently significant. The presence of superior self-management skills did not necessarily translate into decreased seizure frequency. CONCLUSION: Individuals with epilepsy who are older and experience convulsions generally have better self-management skills. This indicates that antecedents influence the development of self-management skills.

The societal integration of individuals with epilepsy: perspectives for the 21st century.

Epilepsy is a common neurologic disorder seen throughout the world. Advances in therapy have made it possible for persons with epilepsy (PWEs) to have improved seizure control and a better quality of life. However, it is not entirely clear whether this has resulted in their successful integration into society. This review examines the societal integration of PWEs, identifying both the progress made and the challenges that continue to hamper further advances. In general, PWEs are more integrated in western-oriented cultures. However, there continue to be ongoing difficulties due to poor education and intellectual functioning, poor social and family support, the undertreatment of coexisting psychiatric conditions, transportation and mobility limitations, and problems obtaining employment. This review also discusses the effects of low socioeconomic status on integration and the persisting prejudices that affect certain racial groups. Most importantly, this review underscores the fact that societal stigma towards PWEs is still very much alive. At the beginning of the 21st century, PWEs still encounter difficulties in their quest for full societal integration. Along with medical advances being made to improve seizure control, much still has to be done to bring about the reforms necessary to help PWEs live more meaningful and productive lives.

Factors associated with increased felt stigma among individuals with epilepsy.

PURPOSE: The aim of the study is to determine whether certain demographic, clinical, and psychosocial traits are associated with higher levels of felt stigma among persons with epilepsy (PWE) patients followed at a level 4 epilepsy center. METHODS: We performed a direct survey of 182 consenting patients that included the Epilepsy Stigma Scale. RESULTS: On univariate analysis, higher levels of perceived stigma were associated with age, marital status, race, driving, work status, seizure etiology, Quality of Life in Epilepsy-10 (QOLIE-10) scores, and health literacy. Among coping reactions, the use of denial, behavioral disengagement and venting were also associated with higher degrees of felt stigma. Using multiple linear regression, being single, poorer QOLIE-10 scores, difficulties understanding written information, and the use of behavioral disengagement were independently associated with poorer scores on the Epilepsy Stigma Scale. CONCLUSION: Our study paints a compelling profile of a PWE who has greater perceived stigma. Programs that increase the level of social support, improve health literacy, and enhance quality of life may also help decrease the amount of felt stigma among PWE.