成人癫痫患者病耻感的特点及其与生态学执行功能的相关性研究

Characteristics of stigma in adult epilepsy patients:correlation with ecological executive function

目的研究成人癫痫患者病耻感的特点和可能的影响因素;探讨成人癫痫患者病耻感与生态学执行功能的相关性。方法对83例原发性或可能性症状的成人癫痫患者和58例性别、年龄、婚姻、受教育程度与之匹配的健康成人,通过问卷调查的方法,采用Kilifi癫痫患者病耻感中文版量表、执行功能行为评定量表成人自评问卷(BRIEF-A)评估。结果①癫痫组病耻感获得比例高达97.6%,不同居住地、家庭人均收入、控制情况、服药种类的病耻感获得存在差异。②多元逐步线性回归分析提示:癫痫患者的受教育年限(t=-2.383,P=0.019)、家庭人均收入(t=-4.812,P<0.01)与病耻感得分呈负相关;癫痫患者长期居住地(t=2.329,P<0.05)、癫痫控制与否(t=2.206,P=0.03)、服药种类(t=6.496,P<0.01)与病耻感呈正相关。③BRIEF-A总分、行为管理指数、元认知指数及各因子(抑制、转换、情感调控、自我监控、任务启动、工作记忆、计划、组织、任务监控)得分均明显高于健康对照组,差异有统计学意义(P<0.05)。④Spearman相关性分析提示:病耻感与BRIEF-A总分及行为管理指数、元认知指数等呈显著正相关,差异有统计学意义(P<0.01)。结论成人癫痫患者存在明显的病耻感,病耻感的严重程度与受教育年限、家庭人均收入、长期居住地、癫痫控制与否、服药种类相关;成人癫痫患者存在生态学执行功能损害;成人癫痫患者病耻感与执行功能损害密切相关。

Objective To study the characteristics and possible influencing factors of stigma in adult patients with epilepsy,and to explore the correlation between stigma and ecological executive function in adult patients with epilepsy.Methods Through the questionnaire survey,83 patients with primary or possibly symptomatic adult epilepsy and 58 healthy adults with matching gender,age,marriage and education level were used to use the Chinese version of Kilifi stigma scale for epilepsy,the behavior rating inventory of executive function-adult version(BRIEFA)evaluation.Results①In the epilepsy group,the proportion of stigma obtained was as high as 97.6%,and there were differences in the stigma obtained in different places of residence,family income,control status,and medication types.②Multivariate stepwise linear regression analysis suggested that the number of years of education in patients with epilepsy(t=-2.383,P=0.019),per capita household income(t=-4.812,P<0.01)were negatively related to stigma score;the long-term residence of patients with epilepsy(t=2.329,P<0.05),epilepsy was controlled or not(t=2.206,P=0.03),the type of medication(t=6.496,P<0.01)were positively related to stigma score.③The scores of global executive composite(GEC),behavioral regulation index(BRI)and mmetacognition index(MI)of BRIEF-A and various factors(inhibition,conversion,emotional control,self-monitoring,task initiation,working memory,planning,organization,task monitoring)scores were significantly higher than those of health in the control group,and the difference was statistically significant(P<0.05).④Spearman correlation analysis suggested that stigma was significantly positively correlated with the scores of BRIEF-A(including GEC,BRI,MI and all sub factors)(P<0.01).Conclusion Adult patients with epilepsy have obvious stigma,and the severity of stigma is related to years of education,per capita family income,long-term residence,epilepsy control or not,and type of medication;adult patients with epilepsy have ecological executive function impairment;adult epilepsy stigma of patients is closely related to impairment of executive function.