Wpływ piętna opiekuna na pacjenta: badanie roli depresji u chorych na epilepsję
The spillover effect of caregiver stigma: A study on the mediating role of depression in patients with epilepsy
W skrócie
Badania pokazują, że gdy opiekunowie pacjentów z epilepsją odczuwają wstyd i stygmatyzację, wpływa to negatywnie na jakość życia samych pacjentów. Depresja u pacjenta jest pośrednim mechanizmem - opiekunowie pełni wstydu powodują u pacjentów depresję, a depresja pogarsza jakość ich życia. Lekarze powinni pracować zarówno z pacjentami jak i ich opiekunami, by zmniejszyć poczucie wstydu i wstydliwości związane z chorobą, co może poprawić wyniki leczenia.
Oryginalny abstract (angielski)
OBJECTIVE: Caregiver stigma of patients with epilepsy (PWEs) is an overlooked factor in epilepsy management. This preliminary study aims to explore whether caregiver stigma affects patient quality of life (QoL) by mediating patient depression. METHODS: This study employed a cross-sectional design and included 90 patient-primary caregiver dyads from an epilepsy specialty clinic. The Stigma Scale for Epilepsy (SSE), the Neurological Disorders Depression Inventory for Epilepsy (NDDI-E), and the Quality of Life in Epilepsy Inventory-31 (QoLIE-31) were used for assessment. Structural equation modeling and the Bootstrap method were applied to test the mediating effect. RESULTS: Caregiver stigma was associated with higher levels of patient depression and poorer patient QoL, and patient depression was in turn associated with lower QoL. Mediation analysis indicated that patient depression partially mediated the relationship between caregiver stigma and patient QoL (indirect effect β = - 0.128, 95% bootstrap CI [-0.255, -0.012]), accounting for 31.2% of the total effect. CONCLUSIONS: Caregiver stigma is associated with poorer patient QoL, partially through its association with increased patient depression. Clinical interventions should focus on the "patient-caregiver" dyadic system, and mitigating caregiver stigma may represent a novel approach to improving patient outcomes.