2 articles
Adult epilepsy generates a burden that extends beyond seizure counts and includes adverse treatment effects, role restriction, emotional distress, and the social devaluation attached to the diagnosis. The methodological problem is not the absence of patient-reported measures, but the heterogeneity with which disease-specific quality-of-life and stigma instruments are selected, interpreted, and combined in adult studies.
A structured narrative methodological review was conducted using PubMed/MEDLINE, Scopus, Web of Science, Embase, Cochrane Library, and the institutional repository of the Nicolae Testemițanu State University of Medicine and Pharmacy. The synthesis focused on the Quality of Life in Epilepsy Inventory family, especially the 89-, 31-, 31-P, and 10-item forms, the adolescent 48-item comparator, and adult epilepsy stigma measures such as the Epilepsy Stigma Scale (ESS) variants, the Stigma Scale of Epilepsy (SSE), and the Epilepsy Self-Stigma Scale (ESSS). Special attention was given to publications from the Republic of Moldova and Romania because regional evidence is sparse but clinically relevant.
QOLIE-31 emerged as the most defensible adult comparative instrument because it balances breadth, feasibility, and international comparability. QOLIE-31-P was particularly useful for patient-centred and real-world designs, while QOLIE-10 served primarily as a screening instrument and QOLIE-89 retained value for comprehensive psychometric work. The 48-item version was methodologically informative but remained adolescent-oriented rather than a primary adult endpoint. Across the stigma literature, ESS, SSE, and ESSS were clearly not interchangeable because they capture overlapping but distinct constructs, including perceived stigma, felt stigma, and internalized self-stigma.
The working hypothesis was supported across international, regional, and Moldovan sources: the greater the clinical and psychosocial severity of epilepsy, the lower the epilepsy-specific quality of life. Seizure frequency, uncontrolled or drug-resistant epilepsy, polytherapy, adverse medication effects, depression, anxiety, and stigma were the most recurrent determinants of lower scores. For adult studies intended for Moldovan settings and the MJHS submission, QOLIE-31 or QOLIE-31-P, combined with one clearly defined stigma scale and a standardized set of severity variables, offers the strongest methodological balance.
Research ethics and integrity are fundamental for safeguarding human participants and ensuring trustworthy scientific practices. Understanding researchers’ knowledge, attitudes, and perceptions regarding ethical standards is important for all health researchers, but particularly relevant for early-career researchers. While several international instruments exist to evaluate specific aspects of research ethics, such as plagiarism, organizational climate, or responsible conduct of research, a multidimensional and contextually relevant tool is required.
A comprehensive questionnaire was developed to assess ethical knowledge, attitudes toward research resources and institutional integrity measures, and self-perceived ethical competencies among doctoral students in the health sciences. Item formulation was guided by international standards, including the Declaration of Helsinki, the European Code of Conduct for Research Integrity, and Good Clinical Practice guidelines. The development process included a content validity assessment by 10 experts and a psychometric evaluation of the collected data from 274 doctoral students. Exploratory factor analysis (EFA) was applied to determine the latent structure of the questionnaire, and internal consistency was assessed using Cronbach’s alpha.
EFA revealed a six-factor structure explaining 64.5% of the total variance. The factors measured: (I) perceived importance of research resources, (II) self-perceived ethical competencies, (III) implemented institutional measures for research integrity, (IV) ethical principles and moral responsibilities, (V) perceived accessibility of research resources, and (VI) importance of institutional integrity measures. Factor loadings were generally high, and internal consistency was good to excellent, with Cronbach’s alpha values ranging from 0.738 to 0.989. These findings indicate that the questionnaire captures multidimensional aspects of research ethics and integrity.
The developed questionnaire represents a robust, valid, and reliable instrument for assessing ethical knowledge and attitudes among researchers in health sciences. It can serve as an internal audit tool to evaluate research integrity climate, researcher satisfaction with available resources, and implementation of institutional policies. Moreover, it provides a foundation for designing targeted training programs and professional development initiatives aimed at improving ethical competencies.