Generic selectors
Exact matches only
Search in title
Search in content
Post Type Selectors
Search in posts
Search in pages
Filter by Categories
Book Review
Brief Report
Case Letter
Case Report
Case Series
Commentary
Current Issue
Editorial
Erratum
Guest Editorial
Images
Images in Neurology
Images in Neuroscience
Images in Neurosciences
Letter to Editor
Letter to the Editor
Letters to Editor
Letters to the Editor
Media and News
None
Notice of Retraction
Obituary
Original Article
Point of View
Position Paper
Review Article
Short Communication
Systematic Review
Systematic Review Article
Technical Note
Techniques in Neurosurgery
Generic selectors
Exact matches only
Search in title
Search in content
Post Type Selectors
Search in posts
Search in pages
Filter by Categories
Book Review
Brief Report
Case Letter
Case Report
Case Series
Commentary
Current Issue
Editorial
Erratum
Guest Editorial
Images
Images in Neurology
Images in Neuroscience
Images in Neurosciences
Letter to Editor
Letter to the Editor
Letters to Editor
Letters to the Editor
Media and News
None
Notice of Retraction
Obituary
Original Article
Point of View
Position Paper
Review Article
Short Communication
Systematic Review
Systematic Review Article
Technical Note
Techniques in Neurosurgery
Generic selectors
Exact matches only
Search in title
Search in content
Post Type Selectors
Search in posts
Search in pages
Filter by Categories
Book Review
Brief Report
Case Letter
Case Report
Case Series
Commentary
Current Issue
Editorial
Erratum
Guest Editorial
Images
Images in Neurology
Images in Neuroscience
Images in Neurosciences
Letter to Editor
Letter to the Editor
Letters to Editor
Letters to the Editor
Media and News
None
Notice of Retraction
Obituary
Original Article
Point of View
Position Paper
Review Article
Short Communication
Systematic Review
Systematic Review Article
Technical Note
Techniques in Neurosurgery
View/Download PDF

Translate this page into:

Commentary
2 (
1
); 38-39

Commentary

Department of Epilepsy and Clinical Neurophysiology, Institute of Mental Health, Belgrade University Medical School, Palmoticeva 37, 11000 Belgrade, Serbia.

Address for correspondence: Dr. Zarko Martinovic, Department of Epilepsy and Clinical Neurophysiology, Institute of Mental Health, Belgrade University Medical School, Palmoticeva 37, 11000 Belgrade, Serbia. E-mail: martinovic@sezampro.rs

Licence

This is an open-access article distributed under the terms of the Creative Commons Attribution-Noncommercial-Share Alike 3.0 Unported, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Disclaimer:
This article was originally published by Medknow Publications and was migrated to Scientific Scholar after the change of Publisher.

The quality of life (QOL) is a very complex concept and it is raised in many different fields from economics and policy to medicine. The World Health Organization (WHO) defines QOL as an individual's “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] In public health and in medicine, the concept of health-related quality of life (HRQOL) refers to a person or group's perceived physical and mental health over time. Over the past three decades, the QOL research gradually contributed a significant new dimension to medical science by entitling the patient to provide data aiming to assess the overall impact of diseases and medical treatments from her/his own point of view. Thus, the patient has become a partner in the treatment and assessment of overall effects of disesae on her/his life.

Assessments of HRQOL may be done either with generic scales (used for comparisons of health status between different diseases and applicable to virtually all people) or with disease-specific scales (used for those individuals with particular diseases or conditions). One of the most widely used generic HRQOL scale is Short Form Health Survey (SF-36).[2] Both approaches have advantages and drawbacks. The use of a generic scale, such as SF-36, can enable direct comparison of HRQOL across various populations, e.g., groups suffering from different diseases with a general reference group of healthy individuals.[3] However, it can miss some disease-specific problems, in particular specific transportation and employment restrictions imposed on daily living of People with epilepsy (PWE). The combination of a disease-specific scale with a generic one can provide the benefits of both instruments.

Contemporary HRQOL studies in people with epilepsy (PWE) should preferably employ scales with known psychometric properties (reliability, validity, and responsiveness), widespread in use (used by more than one author, and used in more than five studies), and assessing epilepsy-specific factors, in particular characterstics of seizures and the effects of antiepileptic treatment. The authors of the study published in this issue[4] of the Journal of Neurosciences in Rural Practice, appropriately choosed the QOLIE-89,[5] which fulfils all requested criteria. Since the QOLIE-89 was originally validated in English language, the authors of the present study[4] performed the cross-cultural validation by translating 89-item questionnaire to Kannada and Marathi, the two most common languages used in their working region, then back-translating and validating the questionnaire by testing it in a pilot study. Subsequently, discriminative validity of the QOLIE-89 questionnaire was demonstrated in a sample of 60 adult PWE wherein the authors found significantly impaired HRQOL in PWE, with increased impairment in those with simple partial seizures, with longer duration of the epilepsy, and with a recent seizure. The relation of simple partial seizures to a worse HRQOL was explained by the fact that patients with localization related epilepsy had more number of seizures than other types of seizure. It is possible that PWE with several seizure types might have a higher seizure severity. In our study, the HRQOL in PWE is significantly correlated with seizure severity.[6]

Regarding the demographic factors, the finding of a lower HRQOL in female patients and married people[4] was not reported in all published studies of HRQOL in various countries.[36] Equally, older age was not correlated with a worse HRQOL,[4] contrary to the studies from other countries.[356] Determinants of HRQOL in PWE are undoubtedly multiple, related not only to epilepsy, but also to many demographic, psychosocial, economic, and cultural factors, as well as to medical and psychiatric comorbidities.[358] As stated in the present study,[4] it seems that demographic factors are culture related. Further studies on HRQOL in larger samples of PWE should should discern the interconnections of various factors influencing on HRQOL. An important area of study is to prove the responsiveness of HRQOL scales to clinical changes, in particular the use of medication with a better efficacy and tolerability or after epilepsy surgery.[8] It is hoped that HRQOL studies should be helpful to attain one of the main treatment goal in PWE, namely to maximize quality of life by using comprehensive treatment that would improve the QOL beyond seizure control.

References

  1. World Health Organisation Quality of Life Group. What quality of life? World Health Organisation quality of life assessment. World Health Forum. 1996;17:354-6.
    [Google Scholar]
  2. SF-36 Health Survey (Original version) Language Recalls. Available from: http://www.qualitymetric.com
    [Google Scholar]
  3. , , , . Determinants of quality of life in people with epilepsy. Neurol Clin. 2009;27:843-63.
    [Google Scholar]
  4. , , , , . Quality of life in patients with epilepsy in India. J Neurosci Rural Pract 2011 in press
    [Google Scholar]
  5. , , , , , , . Development of the quality of life in epilepsy inventory. Epilepsia. 1995;36:1089-104.
    [Google Scholar]
  6. , , , , , , . Psychometric evaluation of the Serbian version of the Quality of Life in Epilepsy Inventory-31. Seizure. 2010;19:517-24.
    [Google Scholar]
  7. , , , , , . Effect of levetiracetam on epilepsy related quality of life: N132 Study Group. Epilepsia. 2000;41:868-74.
    [Google Scholar]
  8. , , , , , , . Long-term outcome and determinants of quality of life after temporal lobe epilepsy surgery in adults. Epilepsy Res. 2009;86:191-9.
    [Google Scholar]

    Fulltext Views
    497

    PDF downloads
    376
    View/Download PDF
    Download Citations
    BibTeX
    RIS
    Show Sections