Objective: Medical factors that put adolescents and young adults (AYA) with epilepsy at risk for poor health-related quality of life (HRQOL) are well-established. Less known is whether medical risk is associated with decreases in global psychological well-being and how self-management self-efficacy might contribute to resilience. The current study seeks to (a) examine the relationship between medical risk and both HRQOL and psychological well-being in AYA with epilepsy and (b) investigate the potential moderating role of self-management self-efficacy. Methods: A sample of 180 AYA with epilepsy, aged 13-24 years, was recruited from clinic and community settings and completed questionnaires. A medical risk gradient composed of seizure frequency, antiepileptic drugs, and other health problems was created. HRQOL, psychological well-being, and self-management self-efficacy were assessed. Results: Medical risk was negatively associated with HRQOL, such that youth with greater risk scores reported lower HRQOL (r = -0.35, p <. 01). However, there was no significant relationship between medical risk and psychological well-being (r = -0.08, p =. 31). Self-efficacy was positively correlated with HRQOL and well-being (r = 0.50, p <. 01; r = 0.48, p <. 01). A moderation effect was detected, such that the positive effect of self-efficacy on HRQOL differed across medical risk levels. Implications: Cultivating psychological strengths, as opposed to solely addressing medical problems, may be a promising intervention target when treating AYA with epilepsy, including those navigating healthcare transitions. Self-efficacy predicted HRQOL at most levels of risk, suggesting an important modifiable intrinsic factor that may promote resilience.
Bibliographical noteFunding Information:
This work was supported by the Centers for Disease Control and Prevention as part of the Managing Epilepsy Well Network (special interest project 14-007, cooperative agreement number 1U48DP005022). The findings and conclusions in this study are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention.