The Effect Of Transitional Care On The Quality Of Life In Children With Epilepsy

Objective: To investigate the influence factors to each dimension in the quality of life in children with epilepsy(QOLCE), and explore the needs of transitional care to children and their caregivers, try to construct the transitional care service model for children with epilepsy, and to verify its effectiveness. Methods: Experimental study and nonsychronous control. Choose 44 children aged 4-11 and diagnosed epilepsy in Jul. to Oct. 2014 as control group with their caregivers by convenient sampling. Caregivers were asked to complete the scale of quality of life in children with epilepsy, questionnaire of basic knowledge about epilepsy and care, scale about needs of transitional care, single factor analysis of variance was made to the factors that may affect the QOLCE, then make the influence factors be independent variables, the score of 5 dimensions in QOLCE were the dependent variable, and a multiple regression analysis was made. Qualitative interview was adopted to pediatric specialists to answer what problems were occurred to parents in family nursing; according to the results of interview, caregivers’ needs of transitional care and the influence factors to QOLCE, then construct the transitional care service model, establish health records, follow-up reminding, attention about drugs, children’s behavior training, activity, psychological and nutrition guidance, build communication platform and answering their problems was included. Make the children who were diagnosed epilepsy in Nov.2014 to Feb. 2015 as experimental group. and provide transitional care to them, while control group was given routine health education before leaving hospital. Evaluation indicators: the score of Quality of Life scale and caregivers’ knowledge about epilepsy and care were the subjective evaluation index, therapeutic effect were the objective evaluation index. Compare each evaluation indicators in experimental group before the transitional care and at the 3th and the 6th month during transitional care, and compare each evaluation indicators and seizure prognosis to the control group when leaving hospital 6th month later. All the data were recorded and analysised by SPSS17.0. Statistical methods: statistical descriptive analysis, multiple stepwise analysis, chi-square test, analysis of variance and t-test, rank sum test. Results:(1)Totally 88 children and their caregivers was included in study, There’s no significant difference between the two groups of children in basic data and QOLCE(P>0.05);(2)Multiple regression analysis shows that seizure frequency, age and caregivers’ knowledge about epilepsy was the major factors to QOLCE, B=-1.668, 0.497 and 0.235 respectively(P<0.05).(3)In the needs of transitional care, about 90% of the caregivers choosed medication guide and knowledge of first aid, nearly 70% of the caregivers wanna get an exercise and diet guidance, more than 90% of them selected a phone calls or send a telephone message to get those information, more than 60% of caregivers chosed home visits and online communication.(4)In experimental group, after transitional care 3 months, children got a highter score in emotional function, social function and behavior function than before(P<0.05), as well as the physical function 6 months later. In control group, children’s score of each dimension in QOLCE but physical function and cognitive ability were highter than before when left hospital 6 months later(P<0.05). The score of caregivers’ knowledge about epilepsy in two groups was higher than before, compared experimental group with the control group after intervented 6 months, significant difference were found in caregivers’ knowledge and QOLCE but cognitive ability(P<0.05 or P<0.01), while the therapeutic effect in control group was poorer than experimental group, difference was approaching significant in two groups(P=0.074). Conclusion: The quality of life in epilepsy children is poor, seizure frequency and caregivers’ knowledge about care have significant influence on their quality of life. Transitional care can help caregivers know more about epilepsy and how to care, and then improve the quality of life in children with epilepsy, individualized service should be provided according to the needs of children and their families. Transitional care model should be further improved and extended.