Purpose: We report the development of an instrument to assess health-relate
d quality of life (HRQOL) in adolescents with epilepsy.
Methods: A sample of 197 English-speaking adolescents (aged 11-17 years) wi
th epilepsy completed a test questionnaire of 88 items. Also included were
mastery and self-esteem scales to assess external validity. A parent simult
aneously completed an Ii-item questionnaire to evaluate the child's HRQOL.
Both adolescent and parent questionnaires were repeated in 2-4 weeks. Demog
raphic information and information pertaining to seizures were collected at
baseline along with assessment of systemic and neurologic toxicity.
Results: The QOLIE-AD-48 contains 48 items in eight sub scales: epilepsy im
pact (12 items), memory/concentration (10), attitudes toward epilepsy (four
), physical functioning (five), stigma (six), social support (four), school
behavior (four), health perceptions (three), and a total summary score, wi
th higher scores indicating better HRQOL. Internal construct validity was d
emonstrated in a single-factor solution for the eight dimensions. All corre
lations were statistically significant at p < 0.05 level. Internal consiste
ncy reliability estimated by Cronbach's alpha coefficient was 0.74 for the
summary score and ranged from a low of 0.52 (three-item Health Perceptions
Scale) to 0.73-0.94 for the other individual scales. Good test retest relia
bility was found for the overall measure (0.83), Summary score correlations
with the two external validity scales, self-efficacy and self-esteem were
0.65 and 0.54, respectively. Statistically significant differences in summa
ry scores indicating that HRQOL was increasingly better for adolescents as
seizure severity decreases (no seizures = 77 +/- 13, low = 70 +/-. 17, high
= 63 +/- 17) were found among seizure-severity groups.
Conclusions: These data describe the development of a robust instrument to
evaluate HRQOL in adolescents with epilepsy. Empiric analyses provide stron
g evidence that the QOLIE-AD-48 is both a reliable and valid measure for ad
olescents with epilepsy.