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Previous issue date: 2017-12-18 / Introduction: Epilepsy is a chronic neurological condition characterized by seizures recurring caused by excessive neuronal activity in the brain, usually self-limited. Several studies have reported impaired quality of life in epilepsy associated with different clinical and psicossocial aspects. However, it is still little studied in adult patients with epilepsy (PWE) the ability to deal with adverse events and whether there is relationship between resilience and aspects of epilepsy.
Objetive: Assess the resilience and its relationship with sociodemographic, clinical and the perception of life in PWE.
Materials and procedures: 80 consecutive adults PWE were included, treated in the clinic Clinical Neurology Hospital Celso Pierro (PUC-Campinas). The PWE were assessed: sociodemographic questionnaire, medical history, economic classification criteria Brazil, Wagnild & Young resilience scale, life orientation test (LOT-R) and Inventory of depression in neurological disorders epilepsy (NDDI-E) . Statistical tests were used with significance level of p <0.05.
Results: The average age of PWE was 45.4 (? 14.4) years, 46 (57.5%) were females; 38 (47.5%) and 42 are unemployed (52.5%) and 41 (51.2%) patients were married. The average age of the first patients seizure was 21.1 (? 17.1) years; 49 (61.2%) were seizure for less than a year and the average duration of epilepsy was 27.7 (? 16.2) years. The seizure type was focal in 67 (83.75%) cases and generalized only in 13 (16.25%). Fifty-one PWE were using one antiepileptic drug (AED), and more than two drugs, 29 (36.2%) cases. The epileptic syndrome was, idiopathic generalized epilepsy in 13 cases (16.25%), symptomatic focal in 45 (56.25%) and probably symptomatic focal in 22 cases (27.50%). In symptomatic epilepsies etiology was temporal lobe epilepsy with hippocampal sclerosis in 27 (33.7%) cases. The average score of the resilience scale was 139.2 (? 15.6). In classification level resilience was observed that 15 (18.7%) patients had low resilience (?125), middle (> 125 and ?145) and high resilience (> 145) were respectively 32 (40%) and 33 (41.2%) patients. The average score TOV-R was 20.5 (? 3.4) and NDDI-E 12.6 (? 2.6). The PWE that used two or more AED had significantly lower scores on scale resilience when compared to those using single drug (142.3 ? 14.7 133.9 ? 16.1 x; t-test, p = 0.025). It was observed that the PWE presenting depressive episode (values above 15) in NDDI-E show significantly lower scores on scale resilience (141.7 ? 14.1 x 119.8 ? 14.2; T-test; p = 0.000) and lower scores on TOV -R (21.0 ? 2.6 x 16.5 ? 6.1, t-test, p = 0.000). There was a significant positive correlation between the scores of resilience scale with the TOV-R. There was a negative correlation between the scores of resilience and range scores NDDI-E.
Discussion and conclusion: Most PWE showed medium and high resilience, suggesting that persons with high resilience can develop skills to overcome challenges and adversity and unpredictability of epilepsy. In screening for depressive episodes in NDDI-E was observed average values do not suggestive of depressive symptoms. Low resilience was significantly associated with the use of more than one AED. There was no association with other clinical and socio-demographic aspects of epilepsy. PWE with greater optimism in the perception of their lives (LOT-R) have more resilience. There was an association between depressive symptoms (NDDI-E) and lower resilience. In conclusion, less resilients PWE use more than one AED, show less optimism to perceive their lives and more depressive symptoms. / Introdu??o: Epilepsia ? uma condi??o neurol?gica cr?nica caracterizada por crises epil?pticas (CE) recorrentes, causada pela atividade neuronal excessiva no c?rebro, usualmente autolimitada. V?rios estudos descrevem comprometimento da qualidade de vida na epilepsia associado a diferentes aspectos cl?nicos e psicossociais. Entretanto, ainda ? pouco estudada em pacientes adultos com epilepsia (PCE) a capacidade de lidar com eventos adversos e se h? rela??o entre resili?ncia e aspectos da epilepsia.
Objetivo: Avaliar a resili?ncia e sua rela??o com aspectos sociodemogr?ficos, cl?nicos e com a percep??o da vida em PCE.
Casu?stica e procedimentos: Foram inclu?dos 80 PCE adultos consecutivos, atendidos no ambulat?rio de Neurologia Cl?nica do Hospital e Maternidade Celso Pierro (PUC-Campinas). Os PCE foram avaliados com: Question?rio sociodemogr?fico, hist?ria cl?nica, crit?rio de classifica??o econ?mica Brasil, Escala de resili?ncia de Wagnild & Young, Teste de orienta??o da vida (TOV-R) e Invent?rio de depress?o em transtornos neurol?gicos para epilepsia (IDTN-E). Foram utilizados testes estat?sticos com n?vel de signific?ncia p< 0,05.
Resultados: A idade m?dia dos PCE foi 45.4 (?14.4) anos, 46 (57.5%) eram do g?nero feminino; 38 (47.5%) estavam desempregados e 42 (52.5%) e 41 (51.2%) pacientes casados. A idade m?dia da primeira crise epil?ptica (CE) foi de 21.1 (?17.1) anos; 49 (61.2%) estavam com CE h? menos de um ano e a dura??o m?dia da epilepsia foi de 27.7 (?16.2) anos. O tipo de CE foi focal em 67 (83.75%) casos e exclusivamente generalizada em 13 (16.25%). Cinquenta e um PCE estavam utilizando uma droga antiepil?ptica (DAE) e, mais que duas drogas, 29 (36.2%). A s?ndrome epil?ptica foi: epilepsia generalizada idiop?tica em 13 casos (16.25%), focal sintom?tica em 45 (56.25%) e focal provavelmente sintom?tica em 22 casos (27.50%). Nas epilepsias sintom?ticas a etiologia foi epilepsia de lobo temporal com esclerose hipocampal em 27 (33.7%). O escore m?dio da escala de resili?ncia foi 139.2 (?15.6). Na classifica??o dos n?veis de resili?ncia foi observado que 15 (18.7%) pacientes tinham baixa resili?ncia (?125) e, m?dia (>125 e ?145) e alta resili?ncia (>145) foram respectivamente, 32 (40%) e 33 (41.2%) pacientes. O escore m?dio do TOV-R foi 20.5 (?3.4) e do IDTN-E, 12.6 (?2.6). Os PCE que utilizavam mais de uma DAE apresentaram de modo significativo menores escores na escala de resili?ncia quando comparados ?queles que utilizavam droga ?nica (142.3?14.7 x 133.9?16.1; Teste T; p=0.025). Foi observado que os PCE em epis?dio depressivo (valores acima de 15) no IDTN-E tiveram de modo significativo menores escores na escala de resili?ncia (141.7?14.1 x 119.8?14.2; Teste T; p=0.000) e menores escores no TOV-R (21.0?2.6 x 16.5?6.1; Teste T; p=0.000). Houve correla??o positiva significativa entre os escores da escala de resili?ncia com o TOV-R. Houve correla??o negativa significativa entre os escores da escala de resili?ncia e os escores do IDTN-E.
Discuss?o e conclus?o: A maioria dos PCE foram classificados em m?dia e alta resili?ncia, o que sugere que indiv?duos com elevada resili?ncia podem desenvolver
habilidades para superar os desafios e adversidades frente a imprevisibilidade da epilepsia. No rastreamento de epis?dios depressivos, no IDTN-E, foi observado valores m?dios n?o sugestivos de sintomas depressivos. Baixa resili?ncia foi associada de modo significativo ? utiliza??o de mais de uma DAE. N?o foi observada associa??o com outros aspectos cl?nicos da epilepsia e sociodemogr?ficos. PCE com maior otimismo na percep??o de suas vidas (TOV-R) apresentam maior resili?ncia. Houve associa??o entre sintomas depressivos (IDTN-E) e menor resili?ncia. Concluindo, PCE com menor resili?ncia utilizam mais de uma DAE, apresentam menor otimismo ao perceberem suas vidas com mais sintomas depressivos.
| Identifer | oai:union.ndltd.org:IBICT/oai:tede.bibliotecadigital.puc-campinas.edu.br:tede/1006 |
| Date | 18 December 2017 |
| Creators | Limongi Junior, Jos? M?rio |
| Contributors | Tedrus, Gloria Maria de Almeida Souza, Cardoso, T?nia Aparecida Marchiori de Oliveira, Pinheiro, Sergio Luis |
| Publisher | Pontif?cia Universidade Cat?lica de Campinas, Programa de P?s-Gradua??o em Ci?ncias da Sa?de, PUC-Campinas, Brasil, CCV ? Centro de Ci?ncias da Vida |
| Source Sets | IBICT Brazilian ETDs |
| Language | Portuguese |
| Detected Language | English |
| Type | info:eu-repo/semantics/publishedVersion, info:eu-repo/semantics/masterThesis |
| Format | application/pdf |
| Source | reponame:Biblioteca Digital de Teses e Dissertações da PUC_CAMPINAS, instname:Pontifícia Universidade Católica de Campinas, instacron:PUC_CAMP |
| Rights | info:eu-repo/semantics/openAccess |
| Relation | 6411916762624721206, 500, 500, -8538742193007695607 |
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