The quality of life in epilepsy : a South African study
The present study investigated the relationship between quality of life (QOL) and measures of epilepsy (i.e. seizure frequency, seizure type, duration of epilepsy and perceived seizure control) in a South African sample of adults with epilepsy. A 3I item quality of life inventory (QOLIE-31) which has been cross culturally translated was administered to 72 epilepsy adults ( age range 17-65 years) across three sites (Groote Schuur Hospital, Tygerberg I-Iospitai and South African National Epilepsy League SANEL) in the Western Cape. Forty individuals were classified as "coloured" and 32 were classified as " white". Data was collected and scored using the QOLIE -31 scoring manual and then analysed using the Statistical Package for Social Sciences (SPSS). The ANOVA and Logistic Regression analysis support a significant relationship between the quality of life of the sample and the measure of perceived seizure control (p < 0.0001), although the prediction on that measure is relatively poor, due to the sample size and number in each cell per variable. The explorative analysis, PRINCALS, looking at the relationship between the demographic variables of the sample group, quality of life and significant measures of epilepsy, illustrates a relationship between employment and site as well as between race and the subscale of emotion. In addition, the second analysis yields strong correlations between seizure frequency and seizure control, social and cognitive aspects of epilepsy and less explicit correlations between emotional aspects and quality of life. The results support other research on quality of life in epilepsy. The instrument is comprehensive, easy to score and appears to adequately assess the primary concerns of individuals who are living with epilepsy, except for the concern over autonomy and independence. Limitations of the study include the small sample size as well as the exclusion of other cultural groups in South Africa which would require further translations and validations of the inventory. The findings support the fact that epilepsy is a disorder characterized by a "loss of control" and that perceived seizure frequency serves to reinforce the perception of control. As a diagnosis however it cannot be separated from psychosocial, emotional and physical functioning and well-being. In addition cross-cultural differences in the perception of epilepsy need to he explored more fitlly in terms of the patient who defines his/her own quality of life, in his/her own particular context. When measuring quality of life cross-culturally, an instrument that has been culturally validated and translated to a particular cultural gnoup must be employed. Further investigations involving a broader cultural and linguistic sample group are warranted.
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