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Neighborhood disadvantage and health-related quality of life in pediatric epilepsy.
Chiang, Jenna A; Tran, Thomas; Swami, Sonya; Shin, Elice; Nussbaum, Nancy; DeLeon, Rosario; Hermann, Bruce P; Clarke, Dave; Schraegle, William A.
Afiliação
  • Chiang JA; Department of Neurology, Dell Medical School, University of Texas at Austin, Austin, TX, USA.
  • Tran T; Comprehensive Pediatric Epilepsy Center, Dell Children's Medical Center, Austin, TX, USA.
  • Swami S; Comprehensive Pediatric Epilepsy Center, Dell Children's Medical Center, Austin, TX, USA.
  • Shin E; Comprehensive Pediatric Epilepsy Center, Dell Children's Medical Center, Austin, TX, USA.
  • Nussbaum N; Department of Neurology, Dell Medical School, University of Texas at Austin, Austin, TX, USA; Comprehensive Pediatric Epilepsy Center, Dell Children's Medical Center, Austin, TX, USA.
  • DeLeon R; Department of Neurology, Dell Medical School, University of Texas at Austin, Austin, TX, USA; Comprehensive Pediatric Epilepsy Center, Dell Children's Medical Center, Austin, TX, USA; Department of Pediatrics, Dell Medical School, University of Texas at Austin, Austin, TX, USA.
  • Hermann BP; Department of Neurology, University of Wisconsin, School of Medicine and Public Health, USA.
  • Clarke D; Department of Neurology, Dell Medical School, University of Texas at Austin, Austin, TX, USA; Comprehensive Pediatric Epilepsy Center, Dell Children's Medical Center, Austin, TX, USA; Department of Pediatrics, Dell Medical School, University of Texas at Austin, Austin, TX, USA; Department of Neurosu
  • Schraegle WA; Department of Neurology, Dell Medical School, University of Texas at Austin, Austin, TX, USA; Comprehensive Pediatric Epilepsy Center, Dell Children's Medical Center, Austin, TX, USA; Department of Pediatrics, Dell Medical School, University of Texas at Austin, Austin, TX, USA. Electronic address: w
Epilepsy Behav ; 142: 109171, 2023 05.
Article em En | MEDLINE | ID: mdl-36989568
ABSTRACT

INTRODUCTION:

While several demographic and epilepsy-specific characteristics are associated with diminished HRQoL in children and adolescents with epilepsy, prior investigations have failed to incorporate and address the influence of broader social contextual factors on functional outcomes. To address this gap, the purpose of the current study was to investigate the role of neighborhood disadvantage on HRQoL, including the extent to which familial and seizure-specific risk factors are impacted.

METHODS:

Data included parental ratings on the Quality of Life in Childhood Epilepsy (QOLCE) questionnaire for 135 children and adolescents with epilepsy, and the Area Deprivation Index (ADI) to measure neighborhood disadvantage. Bivariate correlations were conducted to identify significant associations with neighborhood disadvantage, followed by a three-stage hierarchical multiple regression to predict HRQoL. Follow-up binary logistic regressions were used to determine the risk conferred by neighborhood disadvantage on sociodemographic, seizure-specific, and HRQoL factors.

RESULTS:

Moderate associations between neighborhood disadvantage and familial factors, including parental psychiatric history and Medicaid insurance, were identified, while disadvantage and greater seizure frequency were marginally associated. Neighborhood disadvantage independently predicted HRQoL, and was the sole significant predictor of HRQoL when familial factors were incorporated. Children with epilepsy living in disadvantaged areas were four times more likely to have diminished HRQoL, five times more likely to live with a parent with a significant psychiatric history, and four times more likely to reside with a family receiving Medicaid insurance.

CONCLUSIONS:

These results highlight the importance of identifying high-risk groups, as the cumulative burden of social context, familial factors, and seizure-specific characteristics contribute to lower HRQoL in pediatric epilepsy which disproportionately affects patients from lower-resourced backgrounds. Potentially modifiable factors such as parental psychiatric status exist within the child's environment, emphasizing the importance of a whole-child approach to patient care. Further exploration of disadvantage in this population is needed to better understand these relationships over time.
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Texto completo: 1 Base de dados: MEDLINE Assunto principal: Qualidade de Vida / Epilepsia Tipo de estudo: Prognostic_studies / Risk_factors_studies Limite: Adolescent / Child / Humans Idioma: En Ano de publicação: 2023 Tipo de documento: Article

Texto completo: 1 Base de dados: MEDLINE Assunto principal: Qualidade de Vida / Epilepsia Tipo de estudo: Prognostic_studies / Risk_factors_studies Limite: Adolescent / Child / Humans Idioma: En Ano de publicação: 2023 Tipo de documento: Article