Abstracts

Our previous work demonstrated that one year after epilepsy surgery, youth who undergo epilepsy surgery and their mothers experience unique improvements in family life relative to those who do not undergo this procedure. This research addresses two questions pertaining to family life 2 to 4 years after epilepsy surgery: Are the reported changes in family life sustained? Does seizure outcome 2-4 years after surgery predict changes in family life?
Analysis emerges from data collected prospectively at baseline (t[sub]1[/sub]), one (t[sub]2[/sub]) and 2-4 years (t[sub]3[/sub]) after surgery. Data were available for 21 children who received surgery (mean age=13.47; SD=2.63) and 13 children who did not undergo this procedure but who had intractable epilepsy (mean age =14.47; SD=2.79). Two subscales from the parent rated Family Environment Scale (FES; independence promotion and active recreation) and the State Trait Anxiety Inventory (STAI; state and trait anxiety) were used to measure family adjustment. The total score from the Family APGAR (FAPGAR) was used as the child rated measure of family adjustment. Repeated measures analysis was conducted to examine whether the pattern in the surgical group differed from the non-surgical group over time. Regression analysis was conducted using baseline scores and seizure outcome as predictors of change in family adjustment between t[sub]3[/sub] and t[sub]1[/sub].
The two groups did not differ with respect to age, proportion of life with seizures, number of medications and IQ. Repeated measures analyses indicated one significant group x time interaction for FES independence promotion ([underline]F[/underline](2, 56)=3.81; [underline]p[/underline]=0.028). The pattern of change over time observed in the two groups for FES active orientation was similar as both groups initially improved and then sustained those changes ([underline]F[/underline](2,56)=3.574; p=0.035). Of the two predictors examined, only baseline scores predicted significant variance regarding change (t[sub]3[/sub] [ndash] t[sub]1[/sub]) in FES independence promotion (adj R²= 0.182; p=0.024), FES active orientation (adj R²=0.185; p=0.023), and state anxiety (adj R²=0.429; p=0.001). Neither baseline scores nor seizure outcome predicted variance in trait anxiety nor FAPGAR change scores.
The pattern of change in the surgical group related to independence promotion in the family continued to differ from that of the non-surgical group 2-4 years after epilepsy surgery. Independence promotion in the surgical group initially improved (t[sub]1[/sub] to t[sub]2[/sub]) but then returned to baseline functioning at t[sub]3[/sub]. The reverse occurred in the non-surgical group. Between group differences initially observed regarding child satisfaction with family life at t[sub]2[/sub] were not sustained. Seizure outcome in the surgical group did not predict change in indicator of family life. The findings suggest that family intervention should not be postponed until after surgery as seizure outcome continues to be of minimal significance in the surgical group.
[Supported by: Ontario Mental Health Foundation]