頑固型癲癇病童生酮飲食治療對主要照顧者生活品質的影響

Impacts of Ketogenic Diet for Children with Intractable Epilepsy on Caregivers’ Quality of Life

陳燕慈(Yen-Tsz Chen) ； 李旺祚(Wang-Tso Lee)

《台灣醫學》 20卷4期 (2016/07) Pp. 335-343

https://doi.org/10.6320/FJM.2016.20(4).1

摘要

照顧頑固型癲癇病童，對主要照顧者的生活品質影響甚巨。本研究目的在探討病童接受生酮飲食治療，對於主要照顧者生活品質之影響。調查採用世界衛生組織生活品質問卷台灣簡明版，施測於台北市某醫學中心，接受生酮飲食治療癲癇病童之主要照顧者。問卷施測共3次，首次於病童住院開始實施生酮飲食，和後續2次在門診追蹤的第3和6個月。結果發現：病童接受飲食治療後，主要照顧者生活品質在環境面向的得分增加，但未達統計上差異。在心理面向中，主要照顧者對自己的滿意度，病童癲癇有改善者顯著優於未改善者。病童飲食治療之前，主要照顧者的教育程度和家庭月收入較高者，其生理面向分數明顯較優，但飲食治療3個月則無差異。結論：頑固型癲癇病童主要照顧者的生活品質，與生酮飲食治療的成效呈正相關，但未達統計上差異，這可能受到患童和照顧者基本屬性等許多因素的影響。建議未來應著重生酮飲食整合性團隊醫療方式，以促進照顧者之生活品質。

關鍵字

生活品質 ； 生酮飲食 ； 照顧者 ； 兒童癲癇 ； 頑固型癲癇 ； 親職壓力

並列摘要

It is well recognized that the quality of life (QOL) in caregivers of children with intractable epilepsy were largely impacted. The goal of this study was to investigate the effect of ketogenic diet (KD) therapy on QOL in caregivers of children with intractable epilepsy. The questionnaire - World Health Organization Quality of Life, brief edition, Taiwan version (WHOQOL-BREF(TW)) was used to assess caregiver QOL at baseline, third, and sixth month after KD intervention. Results show that the caregiver QOL score increases in environmental domain after the children received KD intervention. In psychological aspects, the caregiver satisfaction improves when the seizure in children is well-controlled. The QOL biological score is significantly elevated in caregivers with higher education level and income at baseline. Nevertheless, the significance diminishes at third month of treatment due to large individual variations. In conclusion, there is a positive correlation between caregiver QOL and KD intervention in intractable epilepsy. The future direction should focus on a comprehensive and team-based treatment with KD diet intervention in intractable epilepsy to help improve the caregiver QOL.

並列關鍵字

quality of life ； ketogenic diet ； caregiver ； childhood epilepsy ； intractable epilepsy ； parenting stress

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