Submission ID 129984
| Issue/Objective | Background: In Uganda, the health-related quality of life (HRQOL) of patients with epilepsy (PWE) remains poor due to clinical, psychological, and social challenges. Epilepsy is increasingly recognised as a public health issue; however, interventions have mainly focused on seizure control, with little attention to psychosocial support and lived experiences that impact HRQOL of PWE. Objective: To assess the prevalence of poor HRQOL, associated factors, and the impact of lived experiences among adult patients with epilepsy at Mulago National Referral Hospital (MNRH). Relevance: This study aligns with the theme of global health equity by exposing critical gaps in epilepsy care in a low-resource setting, where psychosocial needs remain neglected despite a high burden of poor HRQOL. |
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| Methodology/Approach | This cross-sectional study design employed a parallel convergent mixed-methods design to collect data among adult PWE at Mulago National Referral Hospital. Quantitative data were collected from 190 randomly sampled participants using a structured interviewer-administered questionnaire. Data were cleaned in Microsoft Excel, and multivariable Poisson regression analysis was done in Stata 14 to determine factors associated with poor HRQOL. Lived experiences that impact HRQOL of PWE were explored among 12 purposefully selected participants who were interviewed using in-depth interview guides. Data were thematically analysed using ATLAS.ti. |
| Results | The prevalence of poor HRQOL was 50.5%. The factors associated with poor HRQOL were: being married aPR = 1.37(1.02-1.85), primary education aPR = 2.01(1.27-3.16) secondary education aPR = 1.61(1.03-2.53), having 6-10 seizures per year aPR = 1.53(1.08-2.17), borderline depressive symptoms aPR=1.58(1.21-2.05), abnormal depression aPR=1.92(1.38-2.65), moderate stigma aPR=4.07(1.75-9.43) and severe stigma aPR=4.10(1.72-9.81). Social and psychological support from family, friends, and religious communities, self-perception and coping mechanisms and health care support positively influenced HRQOL, while medication side effects, social and economic limitations, psychosocial and cognitive difficulties, stigma and discrimination negatively affected the HRQOL of PWE. |
| Discussion/Conclusion | The prevalence of poor HRQOL among PWE at MNRH was high at 50.53%. The factors associated with poor HRQOL were: being married, experiencing seizures, depression, and stigma. Health care services should prioritise a shift to a holistic, patient-centred care that integrates psychosocial well-being and lived experiences into routine epilepsy care. |
| Presenters and Affiliations | HUMPHREY ATWIJUKIIRE Makerere University, School of Public Health HUMPHREY ATWIJUKIIRE Makerere University, School of Public Health |
