Assessing the Effectiveness of the Epilepsy Support Model on Functional and Psychological Dimensions of Quality of Life among Patients with Epilepsy Referred to the Khorramabad Epilepsy Association

Jouzi, Mina; Moballeghi, Tooba; Salmani, Fatemeh

doi:10.22118/jsmj.2026.570023.4130

Assessing the Effectiveness of the Epilepsy Support Model on Functional and Psychological Dimensions of Quality of Life among Patients with Epilepsy Referred to the Khorramabad Epilepsy Association

Document Type : Original Article

Authors

Mina Jouzi ¹

Tooba Moballeghi ²

Fatemeh Salmani ¹

¹ Associate Professor of Nursing, Department of Nursing, Nursing and Midwifery Sciences Development Research Center, Na.C., Islamic Azad University, Najafabad, Iran.

² Department of Nursing, Nursing and Midwifery Sciences Development Research Center, Na.C., Islamic Azad University, Najafabad, Iran.

10.22118/jsmj.2026.570023.4130

Abstract

Introduction: Epilepsy is a chronic neurological condition that profoundly impacts patients' quality of life (QoL) across multiple domains, extending well beyond mere seizure control. While supportive interventions are pivotal in managing chronic illnesses, there is limited evidence regarding whether current support frameworks adequately address all QoL dimensions, particularly psychological well-being. This study evaluated the impact of the Iranian Comprehensive Epilepsy Support Model on various QoL dimensions among patients attending the Khorramabad Epilepsy Association.

Methods: A quasi-experimental design with two groups (intervention and control) was employed in 2024. Sixty-four participants were recruited via convenience sampling and randomly allocated to either group. The intervention group underwent six one-hour sessions focusing on psychotherapeutic techniques, psychological support, and structural modifications to care delivery. Data were collected using standardized epilepsy-specific QoL questionnaires and demographic surveys. Statistical analysis was performed using SPSS version 21, utilizing paired and independent t-tests.

Results: Implementation of the Epilepsy Support Model led to significant improvements in overall QoL (P<0.001) and specific subscales, including seizure concern (p=0.017), energy/fatigue levels (p=0.018), cognitive function (P<0.001), medication side effects (P=0.002), and social functioning (P=0.008). However, no statistically significant difference was observed in mental health scores between the groups (P=0.293).

Conclusion: The educational-psychological support model effectively enhances functional, cognitive, and seizure-related aspects of QoL in patients with epilepsy. Nevertheless, substantial improvements in psychological well-being appear to require more intensive and prolonged psychotherapeutic interventions.

Keywords

Epilepsy

Quality of Life

Support Model

Mental Health

Subjects

Medical

1. Moghaddasi R, Ghotbeddin Z, Moazedi AA, Akhond MR. Study of anticonvulsant effects of carbamazepine during epileptic process by unilateral kindling of ca1 dorsal hippocampus in adult male rrats. Med Sci. 2021;13(3):95–101. [10.52547/nkums.13.3.95]

2. Feigin VL. Global regional and national burden of epilepsy 1990–2016: a systematic analysis for the global burden of disease study 2016. Lancet Neurol. 2021;20(7):532-48. [10.1016/S1474-4422(18)30454-X] [PMID]

3. World Health Organization. Epilepsy [Internet]. Geneva: World Health Organization; 2024 [updated 2024 Feb 15; cited 2026 Sep 15]. [Link]

4. Mousavi SK, Kamali M, Azizkhani H. The effect of patient education and nurse-led telephone follow-up (tele nursing) on quality of life in patients with epilepsy. JNE. 2020;9(4):62–71. [Link]

5. Klein P, Tyrlikova I. No prevention or cure of epilepsy as yet. Neuropharmacology. 2020;168:107762. [10.1016/j. neuropharm.2019.107762] [PMID]

6. Kazmi SMA, Chattha AH, Afzal H, Karim, R, Akhtar H. Living with epilepsy: psychosocial and clinical determinants of quality of life in patients with epilepsy: psychosocial and clinical determinants in e pilepsy. Paki J Health Sci. 2023:175–9. [Link]

7. WHOQOL Group. The World Health Organization Quality of Life Assessment (WHOQOL): position paper from the World Health Organization. Soc Sci Med. 1995;41(10):1403–9. [10.1016/0277-9536(95)00112-k] [PMID]

8. Yogarajah M, Mula M. Social cognition, psychiatric comorbidities, and quality of life in adults with epilepsy. Epilepsy Behav. 2019;100:106321. [10.1016/j. yebeh. 2019.05.017] [PMID]

9. Lagogianni C, Gatzonis S, Patrikelis P. Fatigue and cognitive functions in epilepsy: a review of the literature. Epilepsy Behav. 2021;114:107541. [10.1016/ j.yebeh.2020.107541] [PMID]

10. Fontaine S, Gautier L, Diependaele AS, Hamieh M, Morello R, Guillouët S, et al. Impact of educational actions on the quality of life of patients with epilepsy: a randomised controlled trial. Epilepsy Res. 2023;192:107128. [10.1016/j.eplepsyres.2023.107128] [PMID]

11. Huang Y, Zhang M, Liu T. Effects of self-management education on quality of life in patients with epilepsy: A systematic review and meta-analysis. Epilepsy Behav. 2025 Jul;168:110393. [10.1016/j.yebeh.2025.110393] [PMID]

12. 12. Jannah AH, Devianca N, Andrajati R, Octaviana F, Wiratman W, Indrawati LA, Harsono AR, Hakim M, Safri AY, Fadli N, Budikayanti A. Medication adherence in epilepsy: the role of adverse drug reactions and patient knowledge-attitude-behavior. Acta Epileptol. 2026 Jan 4;8(1):1. doi: [10.1186/s42494-025-00237-z] [PMID]

13. Patterson GM, McLean S, Millingen KS. A randomised trial of strategies to improve patient compliance with anticonvulsant therapy. Epilepsia. 2019;25(4):412–7. [10.1111/j.1528-1157.1984.tb03436.x] [PMID]

14. Hosseini N, Sharif F, Ahmadi F, Zare M. Determining the disease management process for epileptic patients: a qualitative study. Iran J Nurs Midwifery Res. 2016; 21(1):54–62. [10.4103/1735-9066.174748] [PMID]

15. Hosseini N, Sharif F, Ahmadi F, Zare M. Patients’ perception of epilepsy and threat to self-identity: a qualitative approach. Epilepsy Behav. 2013;29(1):228–33. [10.1016/j.yebeh.2013.06.003] [PMID]

16. Haji A, Mahmoud F. Relationship of social support and self-management with quality of life in patients with epilepsy. J Health Care. 2015;17(3):240–7. [Link]

17. Montazeri A, Thoghae M, Vahdaninia M, Ebrahimi F. Psychometric properties of the Iranian version of quality of life in epilepsy inventory 31-Item. Payesh. 2010;9(4):417-24. [Link]

18. Mehrabi F. The effectiveness of mindfulness intervention based on stress reduction on quality of life and the number of seizure attacks in patients with epilepsy. Shenakht J Psychol Psychiatry. 2020; 6(1): 152–9. [Link]

19. DiIorio C, Escoffery C, McCarty F, Yeager KA, Henry TR, Koganti A, et al. Evaluation of webEase: an epilepsy self-management website. Health Educ Res. 2008; 23(2):185–97. [10.1093/her/cyn012] [PMID]

20. Abdel-Aziz R, Al-Aqeel S, Baz S. The impact of a pharmacist-led educational interview on medication adherence of Saudi patients with epilepsy. Patient Pref Adherence. 2017;11:959–64. [10.2147/PPA.S124028] [PMID]

21. de la Torre-Luque A, Gambara H, López E, Cruzado JA. Psychological treatments to improve quality of life in cancer contexts: A meta-analysis. Int J Clin Health Psychol. 2016 May-Aug;16(2):211-219. [10.1016/j. ijchp.2015.07.005] [PMID]

22. Zanjani F, Mohammad Khan Kermanshahi S, Gholami Fesharaki M. The effect of health promotion Support program on quality of life in patients with type 2 diabetes. Qom Univ Med Sci J. 2021;15(4):296–305. [10.32598/qums.15.4.296]

23. England MJ, Liverman CT, Schultz AM, Strawbridge LM. Epilepsy across the spectrum: promoting health and understanding: a summary of the Institute of Medicine report. Epilepsy Behav. 2012;25(2):266–76. [10.1016/ j.yebeh.2012.06.016] [PMID]

24. Murthy MKS, Govindappa L, Marimuthu P, Dasgupta M. Exploring knowledge, attitude, and practices in relation to epilepsy among undergraduates for effective health promotion: Initial evaluation. J Educ Health Promot. 2019;8(1):122. [10.4103/jehp.jehp_435_18] [PMID]

25. Ghaffari M, Sadeghi B, Dadipoor S, Safari-Moradabadi A. Enhancing physical activity participation among female employees: evaluating the effectiveness of an educational intervention. Health Educ Res. 2024; 39(3):262–71. [10.1093/her/cyae016] [PMID]

26. Ahmadi M, Shariati A, Jahani S, Poormansouri S. Self-efficacy following the self-management training program in patients with sickle cell disease (24 weeks of follow-up). Avicenna J Nurs Midwifery Care. 2021; 22(4):12-22. [Link]

27. Fallatah AM, Albadrani MR, Alsalman SA, Almasuad WK, Hamhom AM, Almarshedy SM, Alsallom FA, Bamogaddam FA, Alhameed MH, Aldosari MM. Beyond Seizures: The hidden burden of fatigue in epilepsy. Neurosciences (Riyadh). 2025 Oct;30(4):278-285. [10.17712/nsj.2025.4.20250011] [PMID]

28. ME D, M Z. The mediating role of social support in the relationship between psychosocial problems and sleep patterns of adolescents with epilepsy. Epilepsy Behav. 2024;152:109656. [10.1016/j.yebeh.2024.109656] [PMID]

29. Hajilou M, Ahadi H, Seirafi M, Shahbeigi S, Poor AR. The effectiveness of stress management training based on cognitive-behavioral model on quality of life in patients with MS. J Psychol Sci. 2022;17(72):893–7. [Link]

30. Salehzadeh M. Effectiveness of cognitive–behavioral group therapy with focusing on dysfunctional attitudes in epilepsy on quality of life in intractable Epileptic patients. Int J Behav Sci. 2022;4(4):255–60. [LINK]

31. Hajiafsar S, Mahmoud Fakhe H, Nouri F. Relationship of social support and self-management with quality of life in patients with epilepsy. J Health Care. 2018;17(3): 240–7. [LINK]

32. Al-Ajmi R, Al-Aqeel S, Baz S. The impact of a pharmacist-led educational interview on medication adherence of Saudi patients with epilepsy. Patient Prefer Adherence. 2017;11:959–64. [10.2147/PPA.S124028] [PMID]

33. Li J, Si Y, Hu J, Liu L, Deng Y, He J, et al. Enhancing medical compliance of patients with convulsive epilepsy in rural community: a randomized intervention trial. Epilepsia. 2018;54(11):1988–96. [10.1111/epi.12382] [PMID]

34. Dash D, Sebastian TM, Aggarwal M, Tripathi M. Impact of health education on drug adherence and self-care in people with epilepsy with low education. Epilepsy Behav. 2019;44:213–7. [10.1016/j.yebeh.2014.12.030] [PMID]

35. Gabr WM, Shams ME. Adherence to medication among outpatient adolescents with epilepsy. Saudi Pharm J. 2015 Jan;23(1):33-40. 10.1016/j.jsps.2014.05.003 [PMID]

36. Honari B, Homam SM, Nabipour M, Mostafavian Z, Farajpour A, Sahbaie N. Epilepsy and quality of life in Iranian epileptic patients. J Patient Rep Outcomes. 2021 Jan 28;5(1):16. [10.1186/s41687-021-00292-3] [PMID]

37. Ridsdale L, Philpott SJ, Krooupa AM, Morgan M. People with epilepsy obtain added value from education in groups: results of a qualitative study. Eur J Neurol. 2017 Apr;24(4):609-616. [10.1111/ene.13253] [PMID]

38. Hosseini N, Mokhtari S, Momeni E, Vossoughi M, Barekatian M. Effect of motivational interviewing on quality of life in patients with epilepsy. Epilepsy Behav. 2016 Feb;55:70-4. doi: [10.1016/j.yebeh.2015.10.012] [PMID]

39. Rezaee N, Poyamoghadam S, Navidian A, Ghaljeh M. Comparing quality of life therapy and a psychoeducational intervention on burden of family caregivers of patients with severe mental illness. Payesh 2021; 20 (1):71-80 [LINK]

40. Bujan Kovač A, Petelin Gadže Ž, Tudor KI, Nanković S, Šulentić V, Poljaković Z, Mrak G, Mudrovčić M, Brezak I, Mijatović D, Đerke F, Desnica A, Nemir J, Čajić I, Nimac Kozina P, Đapić Ivančić B, Radić B, Hajnšek S. Quality of life in patients with epilepsy single centre experience. Acta Clin Croat. 2021 Dec;60(Suppl 3):16-24. [10.20471/ acc.2021.60.s3.02] [PMID]

41. Rahimpour Moradi, Adeleh,1400, Quality of life in children with epilepsy,18th International Epilepsy Congress, Tehran. [LINK]

42. mousavi K, Kamali M, azizkhani H. The Effect of Patient Education and Nurse- led Telephone Follow-up (Tele nursing) on Quality of Life in Patients with Epilepsy. 3 JNE 2020; 9 (4) :62-71 [LINK]

43. Safi, F., Areshtanab, H.N., Ghafourifard, M. et al. The association between self-efficacy, perceived social support, and family resilience in patients undergoing hemodialysis: a cross-sectional study. BMC Nephrol 25, 207 (2024). [10.1186/s12882-024-03629-4]