본문 바로가기
KERD
논문KCI 등재

Correlates of Stigma in People with Epilepsy

2

조회

0

다운로드

1

인용

0

참고문헌

키워드

초록

Background and Purpose Epilepsy is often associated with substantial stigma. This study evaluated clinical correlates of stigma in a sample of people living with epilepsy (PLWE) considered high risk due to frequent seizures or other negative health events. Methods Data were derived from an epilepsy self-management clinical trial. Standardized measures assessed socio-demographics, epilepsy stigma, epilepsy severity, self-efficacy, selfmanagement competency, health literacy, depressive symptoms severity, functional status, social support and quality of life. Results There were 120 individuals, mean age of 41.73 (SD=17.08), 81 men (66.9%), and 79 (65.3%) African-American. Individual factors correlated with worse stigma w ere indicative of more severe or poorly controlled seizures (frequent seizures, worse seizure severity scores, more antiepileptic drugs), mental health comorbidity (worse depression severity, other comorbidities) and factors related to individual functioning and perceived competency in managing their health (health literacy, health functioning, self-efficacy, quality of life). Multivariable linear regression found that worse quality of life, and having a mental condition were associated with more stigma (β=6.4 and 6.8, respectively), while higher self-efficacy, health literacy and social support were associated with less stigma (β=-0.06, -2.1, and -0.3, respectively). These five variables explained 50% of stigma variation. Conclusions Stigma burden can be substantial among PLWE and may vary depending on contextual factors such as mental health comorbidity. Care approaches that screen for psychiatric comorbidities, address low health literacy, institute promising self-management programs, and employ effective health communication strategies about epilepsy misconceptions, may reduce epilepsy related burden.

Abstract

Background and Purpose Epilepsy is often associated with substantial stigma. This study evaluated clinical correlates of stigma in a sample of people living with epilepsy (PLWE) considered high risk due to frequent seizures or other negative health events. Methods Data were derived from an epilepsy self-management clinical trial. Standardized measures assessed socio-demographics, epilepsy stigma, epilepsy severity, self-efficacy, selfmanagement competency, health literacy, depressive symptoms severity, functional status, social support and quality of life. Results There were 120 individuals, mean age of 41.73 (SD=17.08), 81 men (66.9%), and 79 (65.3%) African-American. Individual factors correlated with worse stigma w ere indicative of more severe or poorly controlled seizures (frequent seizures, worse seizure severity scores, more antiepileptic drugs), mental health comorbidity (worse depression severity, other comorbidities) and factors related to individual functioning and perceived competency in managing their health (health literacy, health functioning, self-efficacy, quality of life). Multivariable linear regression found that worse quality of life, and having a mental condition were associated with more stigma (β=6.4 and 6.8, respectively), while higher self-efficacy, health literacy and social support were associated with less stigma (β=-0.06, -2.1, and -0.3, respectively). These five variables explained 50% of stigma variation. Conclusions Stigma burden can be substantial among PLWE and may vary depending on contextual factors such as mental health comorbidity. Care approaches that screen for psychiatric comorbidities, address low health literacy, institute promising self-management programs, and employ effective health communication strategies about epilepsy misconceptions, may reduce epilepsy related burden.

참고문헌 (56)

  1. "Epilepsy" (2019)[URL]
  2. Baker D, "Correlates of stigma in adults with epilepsy: a systematic review of quantitative studies", Epilepsy Behav, 83, pp.67~80 (2018)
  3. "Epilepsy data and statistics" (2019)[URL]
  4. Buck D, "Cross-cultural differences in health-related quality of life of people with epilepsy : findings from a European study", Qual Life Res, 8, pp.675~685 (1999)
  5. Institute of Medicine, "Epilepsy across the spectrum : promoting health and understanding" (2012), National Academies Press
  6. Bleasel AF, "Epilepsy in the new century. Treatment has advanced, but a stigma still surrounds this disorder", Med J Aust, 183, pp.121~122 (2005)
  7. Fisher RS, "Epilepsy from the patient’s perspective : review of results of a community-based survey", Epilepsy Behav, 1, pp.S9~S14 (2000)
  8. Guo W, "The stigma of people with epilepsy is demonstrated at the internalized, interpersonal and institutional levels in a specific sociocultural context : findings from an ethnographic study in rural China", Epilepsy Behav, 25, pp.282~288 (2012)
  9. Bifftu BB, "Perceived stigma and associated factors among people with epilepsy at Gondar University Hospital, Northwest Ethiopia : a cross-sectional institution based study", Afr Health Sci, 15, pp.1211~1219 (2015)
  10. Kumar N, "Clinical correlates of negative health events in a research sample with epilepsy", Epilepsy Behav, 79, pp.225~229 (2018)
  11. Shi Y, "Correlates of perceived stigma for people living with epilepsy : a meta-analysis", Epilepsy Behav, 70, pp.198~203 (2017)
  12. Suljic E, "Whether the presence of depressions increases stigmatization of people with epilepsy?", Mater Sociomed, 30, pp.265~269 (2018)
  13. Wilner AN, "Common comorbidities in women and men with epilepsy and the relationship between number of comorbidities and health plan paid costs in 2010", Epilepsy Behav, 32, pp.15~20 (2014)
  14. Bautista RE, "Factors associated with increased felt stigma among individuals with epilepsy", Seizure, 30, pp.106~112 (2015)
  15. Sajatovic M, "A 6-month prospective randomized controlled trial of remotely delivered group format epilepsy self-management versus waitlist control for high-risk people with epilepsy", Epilepsia, 59, pp.1684~1695 (2018)
  16. DiIorio C, "The association of stigma with self-management and perceptions of health care among adults with epilepsy", Epilepsy Behav, 4, pp.259~267 (2003)
  17. Austin J, "Development of scales to measure psychosocial care needs of children with seizures and their parents. 1", J Neurosci Nurs, 30, pp.155~160 (1998)
  18. Baker GA, "The development of a seizure severity scale as an outcome measure in epilepsy", Epilepsy Res, 8, pp.245~251 (1991)
  19. Chaudhry S, "Use of a self-report-generated Charlson comorbidity index for predicting mortality", Med Care, 43, pp.607~615 (2005)
  20. DiIorio C, "Epilepsy self-management : a test of a theoretical model", Nurs Res, 45, pp.211~217 (1996)
  21. DiIorio C, "Project EASE : a study to test a psychosocial model of epilepsy medication managment", Epilepsy Behav, 5, pp.926~936 (2004)
  22. Bass PF 3rd, "A shortened instrument for literacy screening", J Gen Intern Med, 18, pp.1036~1038 (2003)
  23. Kroenke K, "The PHQ-9 : validity of a brief depression severity measure", J Gen Intern Med, 16, pp.606~613 (2001)
  24. Fantino B, "The self-reported Montgomery-Asberg Depression Rating Scale is a useful evaluative tool in major depressive disorder", BMC Psychiatry, 9, pp.26~ (2009)
  25. Ruta D, "The SF 36health survey questionnaire. A valid measure of health status", BMJ, 307, pp.448~449 (1993)
  26. Cramer JA, "A brief questionnaire to screen for quality of life in epilepsy : the QOLIE-10", Epilepsia, 37, pp.577~582 (1996)
  27. Cramer JA, "Comparison between the QOLIE-31 and derived QOLIE-10 in a clinical trial of levetiracetam", Epilepsy Res, 41, pp.29~38 (2000)
  28. Zimet GD, "The Multidimensional Scale of Perceived Social Support", J Pers Assess, 52, pp.30~41 (1988)
  29. Chong J, "Social and family characteristics of Hispanics with epilepsy", Seizure, 21, pp.12~16 (2012)
  30. Reisinger EL, "Individual, seizure-related, and psychosocial predictors of depressive symptoms among people with epilepsy over six months", Epilepsy Behav, 15, pp.196~201 (2009)
  31. Tellez-Zenteno JF, "Psychiatric comorbidity in epilepsy : a population-based analysis", Epilepsia, 48, pp.2336~2344 (2007)
  32. Jones JE, "Rates and risk factors for suicide, suicidal ideation, and suicide attempts in chronic epilepsy", Epilepsy Behav, 4(Suppl 3), pp.S31~S38 (2003)
  33. Kessler RC, "Accounting for comorbidity in assessing the burden of epilepsy among US adults: results from the National Comorbidity Survey Replication (NCS-R)", Mol Psychiatry, 17, pp.748~758 (2012)
  34. Rai D, "Epilepsy and psychiatric comorbidity : a nationally representative popu-lation-based study", Epilepsia, 53, pp.1095~1103 (2012)
  35. Ribot R, "Neurobiologic properties of mood disorders may have an impact on epilepsy : should this motivate neurologists to screen for this psychiatric comorbidity in these patients?", Epilepsy Behav, 98, pp.298~301 (2019)
  36. Gilliam FG, "Rapid detection of major depression in epilepsy : a multicentre study", Lancet Neurol, 5, pp.399~405 (2006)
  37. "epilepsy.com" (2019)[URL]
  38. "nami.org" (2019)[URL]
  39. Bonfils KA, "Self-stigma in PTSD : prevalence and correlates", Psychiatry Res, 265, pp.7~12 (2018)
  40. Chen YH, "Risk of epilepsy in individuals with posttraumatic stress disorder : a nationwide longitudinal study", Psychosom Med, 79, pp.664~669 (2017)
  41. Lancaster CL, "Posttraumatic stress disorder : overview of evidence-based assessment and treatment", J Clin Med, 5, pp.105~ (2016)
  42. 권오영, "Depression and Anxiety in People with Epilepsy", Journal of Clinical Neurology, 10(3), pp.175~188 (2014), 대한신경과학회[DOI]
  43. Spitzer RL, "A brief measure for assessing generalized anxiety disorder : the GAD-7", Arch Intern Med, 166, pp.1092~1097 (2006)
  44. Brandt C, "Prevalence of anxiety disorders in patients with refractory focal epilepsy--a prospective clinic based survey", Epilepsy Behav, 17, pp.259~263 (2010)
  45. Mula M, "Treatment of anxiety disorders in epilepsy : an evidencebased approach", Epilepsia, 54(Suppl 1), pp.13~18 (2013)
  46. Margolis SA, "Anxiety disorders in predominantly African American and Caribbean American adults with intractable epilepsy : the role of perceived epilepsy stigma", Epilepsy Behav, 99, pp.106450~ (2019)
  47. Berkman ND, "Low health literacy and health outcomes : an updated systematic review", Ann Intern Med, 155, pp.97~107 (2011)
  48. Parker RM, "Health literacy: a policy challenge for advancing high-quality health care", Health Aff (Millwood), 22, pp.147~153 (2003)
  49. King MM, "Assessing the readability of mental health internet brochures for children and adolescents", J Child Fam Stud, 12, pp.91~99 (2003)
  50. Institute of Medicine, "Health literacy : a prescription to end confusion" (2004), National Academies Press
  51. Elliott JO, "A health literacy assessment of the epilepsy. com website", Seizure, 18, pp.434~439 (2009)
  52. Akbarbegloo M, "The relationship between self-efficacy and psychosocial care in adolescents with epilepsy", Epilepsy Res Treat, 2015, pp.756849~ (2015)
  53. DiIorio CK, "The prevention research centers’ managing epilepsy well network", Epilepsy Behav, 19, pp.218~224 (2010)
  54. Sajatovic M, "Targeted Self-Management of Epilepsy and Mental Illness for individuals with epilepsy and psychiatric comorbidity", Epilepsy Behav, 64, pp.152~159 (2016)
  55. Herrmann LK, "Epilepsy misconceptions and stigma reduction : current status in Western countries", Epilepsy Behav, 60, pp.165~173 (2016)
  56. Sajatovic M, "A randomized prospective pilot trial of web-delivered epilepsy stigma reduction communications in young adults", Epilepsia, 58, pp.1946~1954 (2017)

관련 논문AI추천

이 간행물의 다른 논문 (25건)