Enhancing epilepsy self-management and quality of life for adults with epilepsy with varying social and educational backgrounds using PAUSE to Learn Your Epilepsy

Abstract

People with epilepsy (PWE) come from a wide variety of social backgrounds and educational skillsets, making self-management (SM) education for improving their condition challenging. Here, we evaluated whether a mobile technology-based personalized epilepsy SM education intervention, PAUSE to Learn Your Epilepsy (PAUSE), improves SM measures such as self-efficacy, epilepsy SM behaviors, epilepsy outcome expectations, quality of life (QOL), and personal impact of epilepsy in adults with epilepsy. Methods: Recruitment for the PAUSE study occurred from October 2015 to March 2019. Ninety-one PWE were educated using an Internet-enabled computer tablet application that downloads custom, patient-specific educational programs from Epilepsy.com. Validated self-reported questionnaires were used for outcome measures. Participants were assessed at baseline (T0), the first follow-up at completion of the PWE-paced 8-12-week SM education intervention (T1), and the second follow-up at least 3 months after the first follow-up (T2). Multiple linear regression was used to assess within-subject significant changes in outcome measures between these time points. Results: The study population was diverse and included individuals with a wide variety of SM educational needs and abilities. The median time for the first follow-up assessment (T1) was approximately 4 months following the baseline (T0) and 8 months following baseline for the second follow-up assessment (T2). Participants showed significant improvement in all SM behaviors, self-efficacy, outcome expectancy, QOL, and personal impact of epilepsy measures from T0 to T1. Participants who scored lower at baseline tended to show greater improvement at T1. Similarly, results showed that participant improvement was sustained in the majority of SM measures from T1 to T2. Conclusion: This study demonstrated that a mobile technology-based personalized SM intervention is feasible to implement. The results provide evidence that epilepsy SM behavior and practices, QOL, outcome expectation for epilepsy treatment and management, self-efficacy, and outcome expectation and impact of epilepsy significantly improve following a personalized SM education intervention. This underscores a greater need for a pragmatic trial to test the effectiveness of personalized SM education, such as PAUSE to Learn Your Epilepsy, in broader settings specifically for the unique needs of the hard-to-reach and hard-to-treat population of PWE.

Cross-sectional study of the effects of self-efficacy on fatigue and pain interference in black women with systemic lupus erythematosus: the role of depression, age and education

“…Previous studies have described an association between education and self-efficacy, which in turn can impact self-care and modify how patients function in relation to pain 39. Our data also suggest that individuals with lower educational attainment may be more responsive to interventions designed to enhance self-efficacy, which has been previously emphasised 62…”

“…39 Our data also suggest that individuals with lower educational attainment may be more responsive to interventions designed to enhance self-efficacy, which has been previously emphasised. 62 Our study has some limitations. First, the crosssectional design does not allow to infer causality; longitudinal studies are thought to provide better estimates of change since each subject is his or her own control.…”

“… 39 Our data also suggest that individuals with lower educational attainment may be more responsive to interventions designed to enhance self-efficacy, which has been previously emphasised. 62 …”

Home-Based Transcranial Direct Current Stimulation for the Treatment of Symptoms of Depression and Anxiety in Temporal Lobe Epilepsy: A Randomized, Double-Blind, Sham-Controlled Clinical Trial

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“…MLP is a mature method for dealing with linear objective functions and linear constraints (Faul, Erdfelder, Buchner, & Lang, 2009). It has been widely used in the military (Mauntel et al., 2020), economic (Nasiri et al., 2020), industrial (Mu, Sha, Kang, & Yi, 2020), and educational (Pandey et al., 2020) fields. MLP usually includes linear objective functions, linear constraints, and non‐negative variables (see Equations 6–8 below).…”