目的:癫痫对患者的社会功能产生负面影响。癫痫手术是一种癫痫发作自由率较高的治疗方法。癫痫手术后的心理社会结果取决于几个因素,包括病人的应对方式。重要的是要确定在癫痫手术后有经历心理社会困难风险的患者,并咨询他们进行精神干预。这项研究旨在评估社会适应的变化,感到耻辱,自尊,和癫痫手术后的自我效能,以及应对策略的效果,社会人口统计学和癫痫相关变量,和这些结果的术后癫痫发作结果。
方法:本研究纳入了30例颞叶癫痫成年患者,这些患者均为手术对象(平均年龄:33.07岁,平均发作年龄:17.2岁,平均癫痫持续时间:15.8岁)。采用癫痫自我效能量表对患者进行癫痫手术前和术后6个月,社会适应自我评价量表,罗森博格自尊量表,FeltStigmaScale,以及应对经历问题清单的方向。
结果:患者术后自我效能水平升高(p=0.005)。术后社会适应水平与较高的积极重新解释和增长相关,积极应对,和规划(分别为p=0.016,p=0.005,p=0.002)。术后自我效能水平与积极应对和计划计划呈正相关(分别为p=0.003,p=0.035)。术后自尊(分别为p=0.012,p=0.049,p=0.034)和病耻感(分别为p=0.029,p=0.014,p=0.027)与正的重新解释和成长呈负相关,积极应对,和规划。此外,术前期间被雇用与更好的术后社会适应相关(p=0.004)。
结论:癫痫手术后的心理社会结果不仅取决于癫痫发作的结果。了解癫痫发作自由之外的因素,允许医疗保健专业人员在探索和管理患者的期望方面发挥关键作用,促进关于潜在结果的更全面和现实的对话。考虑到受雇的病人有更好的社会心理结果,我们建议患者家属,医疗保健专业人员,和癫痫支持组织应合作,在提供就业机会方面支持癫痫患者。
OBJECTIVE: Epilepsy negatively affects the social functioning of patients. Epilepsy surgery is a treatment with superior rates of seizure freedom. The psychosocial outcomes after epilepsy surgery depend on several factors, including the patient\'s coping style. It is important to identify the patients who are at risk of experiencing psychosocial difficulties after epilepsy surgery and consult them for psychiatric interventions. This study aimed to assess changes in social adaptation, felt stigma, self-esteem, and self-efficacy after epilepsy surgery, and the effect of coping strategies, sociodemographic and epilepsy-related variables, and post-surgical seizure outcomes on these results.
METHODS: Thirty adult patients with temporal lobe epilepsy who were candidates for surgery were included in the study (mean age: 33.07, mean seizure onset age: 17.2, mean duration of epilepsy: 15.8). The patients were assessed before and 6 months after epilepsy surgery using the Epilepsy Self-Efficacy Scale, Social Adaptation Self-Evaluation Scale, Rosenberg Self-Esteem Scale, Felt Stigma Scale, and Coping Orientation to Problems Experienced Inventory.
RESULTS: The patients\' self-efficacy levels were increased after surgery (p = 0.005). Postsurgical social adaptation levels were associated with higher positive reinterpretation and growth, active coping, and planning (p = 0.016, p = 0.005, p = 0.002, respectively). Postsurgical self-efficacy levels were positively associated with active coping and planning (p = 0.003, p = 0.035, respectively). Postsurgical self-esteem (p = 0.012, p = 0.049, p = 0.034, respectively) and stigma (p = 0.029, p = 0.014, p = 0.027, respectively) were negatively associated with positive reinterpretation and growth, active coping, and planning. Furthermore, being employed presurgical period was associated with better postsurgical social adaptation (p = 0.004).
CONCLUSIONS: The psychosocial outcomes after epilepsy surgery depend not only on seizure outcomes. Understanding the factors beyond seizure freedom, allows healthcare professionals to have a pivotal role in exploring and managing patients\' expectations, fostering a more comprehensive and realistic dialogue about potential outcomes. Considering employed patients had better psychosocial outcomes, we suggest patients\' families, healthcare professionals, and epilepsy support organizations should work collaboratively to support people with epilepsy in terms of providing job opportunities.