接受白內障手術之病患生活品質及其相關因子探討

Abstract

白內障 (Cataract) 是隨著老化過程所產生的眼科疾病之一，其主要治療方式為手術，本研究之目的為探討白內障病患接受手術治療前後的視覺相關生活品質探討、病患焦慮及憂鬱與疲憊之相關性。研究採橫斷性描述相關性設計，以立意取樣 (purposive sampling) 使用結構式問卷進行資料收集，包括：「視覺功能生活品質量表」、「SF-12一般生活品質量表」、「醫院焦慮及憂鬱量表」、「簡易疲憊中文量表疲憊程度」、「基本資料表」，收案場所於台北某醫學中心之眼科病房及眼科門診，於97年5月至97年10月共收案78人，研究結果顯示一般生活品質、視覺功能生活品質、焦慮、憂鬱及疲憊於白內障手術後皆有顯著差異 (p<0.01)；在視覺品質次項目中，與一般生理生活品質 (PCS) 相關的為心理健康、依賴、遠距離視力、整體健康、整體視力、角色限制 (p<0.01)；與一般心理生活品質 (MCS) 相關的為心理健康、整體視力、依賴、整體健康 (p<0.01)；接受手術後視覺生活品質的改變，與手術後焦慮、憂鬱及疲憊的改變呈正相關 (p<0.01)；本研究有助於臨床護理人員對於白內障手術前後生活品質改變、情緒症狀監測（焦慮憂鬱）及疲憊相關問題更深入瞭解，並早期提供病患諮詢與衛教，可提供學術及臨床照護上具體參考依據。

Cataract is one of the most common age-related ophthalmic diseases. The main treatment is surgery. The purposes of this study were to examine the changes of visual quality of life (QOL) and its relationship with the changes of general quality of life (physical and psychological function), depression, anxiety and fatigue status in cataract patients before and after surgery. A cross-sectional correlational study was applied to recruit subjects from a medical center in Northern Taiwan. We used a set of questionnaires: National Eye Institute Visual Functioning Questionnaire (NEI VFQ- 25), the Short-Form Health Survey (SF-12), the Hospital Anxiety and Depression Scale (HADS), the Brief Fatigue Inventory (BFI) and the general information, to assess variables listed in this study. A total of 78 subjects were recruited by purposive sampling. The results show a significant improvement in the general QOL, visual functioning QOL and a reduction in the degree of anxiety, depression and fatigue after the surgery (p<0.01). Within the subcategories of visual quality (NEI VFQ-25), general health, general vision, role limitation, distance vision, mental health, and dependency are associated with the Physical Component Summary (PCS) (p<0.01). In addition, general health, general vision, mental health and dependency are associated with the Mental Component Summary (MCS) (p<0.01). The change of the visual function before and after surgery are positively correlated with the changes of that of levels of anxiety, depression and fatigue (p<0.01). In conclusion, patients with cataract surgery have major improvement in their vision, visual related QOL and the general QOL. It also has positive improvement in fatigue, depression and anxiety.