Does Life for Children and Families Change after Epilepsy Surgery?
Abstract number :
L.02
Submission category :
Year :
2001
Submission ID :
289
Source :
www.aesnet.org
Presentation date :
12/1/2001 12:00:00 AM
Published date :
Dec 1, 2001, 06:00 AM
Authors :
L.M. Lach, MSW, Division of Neurology, Hospital For Sick Children, Toronto, ON, Canada; I.M. Elliott, RN, MHSc, Division of Neurology, Hospital For Sick Children, Toronto, ON, Canada; M.L. Smith, Ph.D., Division of Neurology, Hospital For Sick Children, T
RATIONALE: Although the stated goal of epilepsy surgery in childhood is to improve seizure control and quality of life, evidence regarding the extent to which quality of life improves after epilepsy surgery is scarce. The purpose of this study was to assess the impact of epilepsy surgery on four domains of quality of life: physical, psychological, social, and family functioning.
METHODS: This paper reports quantitative findings from an exploratory prospective longitudinal multi-method study of children undergoing epilepsy surgery (n=30; mean age 13.3) and a matched cohort who also have intractable epilepsy but did not undergo this procedure (n=21; mean age 13.0). The Child Behaviour Checklist, Family Environment Scale and the Piers-Harris Self-Concept Scales were administered to parents or their children before and one year after surgery in the surgical group and at comparable points in time in the control group. Multiple scales from each of these measures were analyzed. Analyses of covariance using age, gender and time 1 data as the covariates were used to detect between group differences at time 2.
RESULTS: One year after surgery, there were improvements in the surgical group, relative to the control group in the following areas: parental anxiety, independence promotion in the family, and family conflict (p[lt]0.05). However, children in the surgical group perceived themselves as more anxious than those in the control group (p[lt]0.05). For those who scored in the clinically significant range at baseline, there was no association between receiving surgery and improvement in function on any of these measures.
CONCLUSIONS: Practitioners and families often have high expectations for improvements in many aspects of the child[ssquote]s psychological, social and family well-being after surgery. The majority of subscales in this study fail to reveal evidence for such change. Further those children who scored in the problematic clinical range before surgery were likely to continue to score in that range after surgery. Expectations that parents and children have for gains in these areas of functioning in the first year after surgery should be discussed prior to surgery as they may be unrealistic and contribute to a sense of dissatisfaction.
Support: The Ontario Mental Health Foundation.