Kendrick, Anna M.; (1995) Repertory grid technique in the assessment of quality of life in patients with epilepsy. Doctoral thesis (Ph.D), UCL (University College London).

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Abstract

A review of currently available measures of quality of life (QOL) highlighted a number of shortcomings which limited their use in assessing the QOL of patients with a heterogenous, chronic disease such as epilepsy. The aim of this study was to develop a method for assessing QOL in patients with epilepsy, but which would also be of value in wider applications. A patient-orientated approach based on repertory grid technique has been developed and tested. A working model of QOL is proposed which makes the following assumptions about the concept: 1) QOL is multi-dimensional, 2) it is an individual phenomena, 3) it is a relational concept and 4) the discrepancy between ability and aspirations is important. Repertory grid technique enables a standardised, objective yet individualised assessment of QOL to be made. Five core areas of functioning are addressed by the method: physical ability, cognitive ability, emotional status, social functioning and economic/employment status. The psychometric properties (temporal stability, sensitivity and validity) of the method were assessed in a group of fifty patients with chronic epilepsy who were studies prospectively over a six month period (baseline, 1 month, 3 months, 6 months). In addition, a number of other questionnaires were completed on these occasions including a non-specific, generic QOL measure, a mood scale, a life events scale and a global rating of life satisfaction. Variables relating to epilepsy such as seizure frequency and change of medication were also closely monitored. A small study in a group of patients undergoing surgery for the relief of severe facial pain (trigeminal neuralgia) was conducted to provide additional evidence relating to the sensitivity of the method. A number of outcome measures were subjected to psychometric assessment including five global scores (ABS, DIR, ABS21, ABS6, DIR6) and five profile scores (PHYS, COG, EMOT, SOC, WORK). The findings suggest that the novel method is a reliable, sensitive and valid procedure. It is hoped that this method will provide a useful tool in evaluations of the effects of epilepsy and its treatment on patient-perceived QOL.

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