Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 147
Filtrar
1.
JAMA Ophthalmol ; 138(8): 907-910, 2020 Aug 01.
Artigo em Inglês | MEDLINE | ID: mdl-32644122

RESUMO

Importance: The influence on the psychology and ocular surface of ophthalmologists and ophthalmic nurses in Wuhan, China, during the coronavirus disease 2019 (COVID-19) pandemic is not yet fully understood. Objective: To characterize mental state and ocular surface state of ophthalmologists and ophthalmic nurses in Wuhan, China, and similar areas during the COVID-19 outbreak. Design, Setting, and Participants: This survey study assessed ophthalmologists and ophthalmic nurses in Wuhan, China, and Jiangxi, China, a province approximately 300 km south of Wuhan. The Hospital Anxiety and Depression Scale, the Van Dream Anxiety Scale, and the Ocular Surface Disease Index were used to conduct questionnaire surveys via a messaging and social media app. Main Outcomes and Measures: Mean scores from the Hospital Anxiety and Depression Scale (0-10 points), the Van Dream Anxiety Scale (0-100 points), and the Ocular Surface Disease Index (0-100 points). Results: Of 126 individuals, there were 42 ophthalmologists (33.3%) and 21 ophthalmic nurses (16.7%) from Wuhan and 42 ophthalmologists (33.3%) and 21 nurses (16.7%) from Jiangxi. The mean (SD) age of ophthalmologists was 36.1 (7.6) years in Wuhan and 41.2 (8.8) years in Jiangxi. For ophthalmic nurses, the mean (SD) age was 35.2 (7.4) years in Wuhan and 33.4 (7.9) years in Jiangxi. The response rate for ophthalmologists was 90.3% (84 of 93) and for nurses was 91.3% (42 of 46). The participation rate of ophthalmologists and nurses in Wuhan was 0.06% (42 of 70 000) and 0.07% (21 of 30 000), respectively; the participation rate in Jiangxi was 0.06% (42 of 70 000; 21 of 35 000) for both groups. In Wuhan, the mean (SD) Hospital Anxiety and Depression Scale (anxiety and depression were counted as separate scores), Van Dream Anxiety Scale, and the Ocular Surface Disease Index scores were 6.90 (2.30), 7.38 (2.19), 24.52 (5.86), and 43.90 (3.74), respectively, in ophthalmologists and 8.67 (3.04), 9.38 (2.64), 21.48 (6.15), and 40.05 (6.67), respectively, in ophthalmic nurses. In Jiangxi, these scores were 5.67 (2.89), 4.90 (3.15), 12.76 (7.27), and 38.79 (7.78), respectively, in ophthalmologists and 4.67 (3.20), 4.33 (3.23), 10.10 (7.62), and 41.52 (5.92), respectively, in ophthalmic nurses. The difference (95% CI) between the 2 regions for these scores in ophthalmologists was 2.48 (95% CI, 1.30-3.65), 11.76 (95% CI, 8.90-14.63), 5.12 (95% CI, 2.45-7.79), and 5.12 (95% CI, 2.47-7.77), respectively, and in ophthalmic nurses was 4.16 (95% CI, 2.05-5.95), 5.05 (95% CI, 3.21-6.89), 11.38 (95% CI, 7.06-15.70), and -1.48 (95% CI, -5.41 to 2.25), respectively. Conclusions and Relevance: These findings suggest that ophthalmologists and ophthalmic nurses in Wuhan experienced more anxiety and depression and reported greater ocular surface abnormalities than counterparts outside of Wuhan, but the wide CIs preclude concluding confidently that there were differences.


Assuntos
Betacoronavirus , Infecções por Coronavirus/epidemiologia , Oftalmopatias/epidemiologia , Oftalmologistas/psicologia , Pandemias , Pneumonia Viral/epidemiologia , Estresse Psicológico/etiologia , COVID-19 , China/epidemiologia , Comorbidade , Infecções por Coronavirus/psicologia , Estudos Transversais , Oftalmopatias/enfermagem , Oftalmopatias/psicologia , Humanos , Pneumonia Viral/psicologia , Prognóstico , SARS-CoV-2 , Estresse Psicológico/psicologia , Inquéritos e Questionários
2.
BMJ Open ; 10(6): e033775, 2020 06 03.
Artigo em Inglês | MEDLINE | ID: mdl-32499258

RESUMO

INTRODUCTION: For many people, settling in a new country is associated with a new identity as an 'ethnic minority', one that can remain through future generations. People who are culturally distinct from the dominant population group may experience a variety of barriers to accessing healthcare, including linguistic and cultural barriers in communication, navigation of an unfamiliar health system and unconscious or overt discrimination. Here, we outline the protocol of a scoping review to identify, describe and summarise interventions aimed at improving access to eye care for non-Indigenous, non-dominant ethnic groups residing in high-income countries. METHODS AND ANALYSIS: We will search MEDLINE, Embase and Global Health from their inception to July 2019. We will include studies of any design that describe an intervention to promote access to eye care for non-Indigenous, non-dominant ethnic groups. Two authors will independently review titles, abstracts and full-text articles for inclusion. Reference lists from all included articles will also be searched. In cases of disagreement between initial reviewers, a third author will help resolve the conflict. For each included article, we will extract data about the target population, details of the intervention delivered and the effectiveness of or feedback from the intervention. Overall findings will be summarised with descriptive statistics and thematic analysis. ETHICS AND DISSEMINATION: This review will summarise existing literature and as such ethics approval is not required. We will publish the review in an open-access, peer-reviewed journal, and draft appropriate summaries for dissemination to the wider community. This wider community could include clinicians, policymakers, health service managers and organisations that work with non-dominant ethnic groups. Our findings will also feed into the ongoing Lancet Global Health Commission on Global Eye Health.


Assuntos
Emigrantes e Imigrantes/psicologia , Oftalmopatias/diagnóstico , Oftalmopatias/terapia , Promoção da Saúde , Acesso aos Serviços de Saúde , Grupos Minoritários , Fatores Socioeconômicos , Atenção à Saúde , Oftalmopatias/psicologia , Conhecimentos, Atitudes e Prática em Saúde , Necessidades e Demandas de Serviços de Saúde , Disparidades em Assistência à Saúde , Humanos , Grupos Minoritários/psicologia , Optometria , Aceitação pelo Paciente de Cuidados de Saúde/psicologia , Resiliência Psicológica
3.
Disabil Health J ; 13(4): 100939, 2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-32417146

RESUMO

BACKGROUND: Vision impairment (VI) is a significant risk factor for depression among older adults. The stigma attached to VI, which has multidimensional aspects consisting of ageism and ableism, may constitute a major impediment to accepting one's VI and engaging in help-seeking behaviors, which could have led to suicide prevention. OBJECTIVE: This study aims to investigate the relative strength of association for VI on suicidal ideation among a nationally representative sample of older adults. METHODS: The study sample was composed of 10,635 adults aged 65 years and over, drawn from the 2015-2017 National Survey on Drug Use and Health. Respondents were asked if they had serious thoughts about suicide in the past year. RESULTS: Of the total sample, 6.85% reported VI (n = 729), defined as being blind or having serious difficulty seeing, even when wearing glasses. In comparison to those without VI, older adults with VI were more likely to report impoverished sociodemographic status and poor health conditions. After adjusting for a comprehensive set of covariates, multivariate logistic regression analyses revealed that older adults with VI were more likely to report suicidal ideation, compared to their counterparts without VI (OR = 3.12, 95% CI [1.24, 7.85]. p < 0. 05). Of the covariates, major depressive episodes presented the strongest positive association with suicidal ideation (OR = 14.11, 95% CI [8.93, 22.29], p < 0. 05). DISCUSSION: This study contributes to the scant body of literature by identifying the relative strength of association between VI and suicide in a nationally representative sample.


Assuntos
Transtorno Depressivo Maior/complicações , Transtorno Depressivo Maior/psicologia , Pessoas com Deficiência/psicologia , Oftalmopatias/complicações , Oftalmopatias/psicologia , Qualidade de Vida/psicologia , Ideação Suicida , Idoso , Idoso de 80 Anos ou mais , Transtorno Depressivo Maior/epidemiologia , Oftalmopatias/epidemiologia , Feminino , Humanos , Modelos Logísticos , Masculino , Análise Multivariada , Fatores de Risco , Inquéritos e Questionários , Estados Unidos/epidemiologia
4.
Health Qual Life Outcomes ; 18(1): 85, 2020 Mar 30.
Artigo em Inglês | MEDLINE | ID: mdl-32228619

RESUMO

BACKGROUND: One-third of adults with diabetes in the United States have chronic kidney disease (CKD), and 19% of them have eye complications (ECs). However, little is known about the Health-related Quality of Life (HRQoL) of adults with both of these diabetes-related complications. Therefore, the purpose of this study is to examine differences in the HRQoL, mental health, and healthcare utilization of adults with diabetes who have CKD, ECs, both or neither. METHODS: A cross-sectional study design was implemented using data from multiple panels (2009-2015) of the Medical Expenditure Panel Survey. HRQoL was measured using the SF-12 Physical and Mental Component Summary (PCS & MCS) scores. The HRQoL, mental health, and healthcare utilization of four mutually exclusive groups: 1) diabetes with both CKD and ECs; 2) diabetes with CKD only; 3) diabetes with ECs only, and 4) diabetes with neither CKD nor ECs were compared. In all analyses, adults with neither CKD nor ECs were the reference group. RESULTS: There were 8415 adults with diabetes who met the inclusion criteria. Approximately, 75% of the study sample had neither CKD nor ECs, 13.3% had ECs only, 5.7% had CKD only, and 5.5% had both CKD and ECs. In the adjusted analyses, adults with both CKD and/or ECs complications exhibited significantly lower HRQoL compared to those with neither CKD nor ECs. Mental illness and psychological distress were higher among adults with both CKD and ECs compared to those with neither CKD nor ECs. Furthermore, adults with CKD and/or ECs had higher polypharmacy, inpatient and emergency services use compared to those with neither CKD nor ECs. CONCLUSIONS: The results indicate that the presence of both CKD and/or ECs was negatively associated with poor HRQoL, poor mental health, higher psychological distress and healthcare utilization in adults with diabetes. The findings emphasize the need for routine assessment and treatment for diabetes-related CKD and/or ECs complications to improve the quality of care for individuals with diabetes.


Assuntos
Complicações do Diabetes/psicologia , Oftalmopatias/psicologia , Qualidade de Vida , Insuficiência Renal Crônica/psicologia , Adulto , Idoso , Estudos de Casos e Controles , Estudos Transversais , Complicações do Diabetes/complicações , Oftalmopatias/complicações , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Aceitação pelo Paciente de Cuidados de Saúde/estatística & dados numéricos , Insuficiência Renal Crônica/complicações , Inquéritos e Questionários , Estados Unidos , Adulto Jovem
5.
Acta Ophthalmol ; 98(6): 618-626, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32189476

RESUMO

BACKGROUND: Patient-reported outcome measures (PROMs) are valuable supplements in regular care to facilitate routine monitoring of quality of life from the patient's perspective. The 25-item National Eye Institute Visual Function Questionnaire (NEI-VFQ-25) is a widely used PROM in ophthalmology. However, the NEI-VFQ-25 is too time-consuming and cumbersome for routine evaluations in regular care. The aim of this study is to construct a 7-item questionnaire of which only 3 items are presented to the patient, by means of routing. This VFQ 3 out of 7 (VFQ-3oo7) should have a minimal loss of information compared with the NEI-VFQ-25. METHODS: An historical database including 3293 administrations of the NEI-VFQ-25 was constructed involving patients with retinal detachment, cataract, corneal diseases, glaucoma, macular degeneration, uveal melanoma and a normal population sample. The data were subjected to Rasch analyses, in particular a generalized partial credit model. Items were sorted on the latent trait and divided into seven categories. From each category, the item with the highest discriminative value was selected. Through routing, only three out of the seven remaining questions are used, where the answers navigate patients to a fitting trait level. RESULTS: A one-dimensional structure was considered fitting. The VFQ-3oo7 showed a small loss of information compared with the total score of the NEI-VFQ-25: correlation 0.927 and a relative precision of 0.868. CONCLUSION: The very short, but valid, VFQ-3oo7 can be applied to evaluate the patient's perceived vision-related health status in routine evaluations of treatments in regular care, with a small burden for patients.


Assuntos
Oftalmologia/normas , Medidas de Resultados Relatados pelo Paciente , Psicometria/métodos , Idoso , Oftalmopatias/psicologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Qualidade de Vida , Reprodutibilidade dos Testes , Acuidade Visual
6.
Eur J Ophthalmol ; 30(2): 253-257, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-30696257

RESUMO

BACKGROUND/AIMS: To compare time tradeoff vision utilities from two developed Western countries to ascertain whether these vision-related, quality-of-life preferences are similar. METHODS: Time tradeoff utilities were acquired from ophthalmology patient populations with ophthalmic pathologic conditions by personal interview in Italy and the United States using a reliable and previously validated, standardized questionnaire. RESULTS: Data from 47 consecutive Italian participants and 325 consecutive American participants were compared. The populations were matched for gender, age, and ophthalmic pathologic conditions. The utilities for the various vision sub-cohort levels, characterized according to vision in the better-seeing eye for the Italian/American cohorts were as follows: (1) 20/20 sub-cohort, Italian/American mean utilities = 0.82/0.91 (p = 0.10); (2) 20/25-20/30 sub-cohort, Italian/American mean utilities = 0.79/0.86, (p = 0.05); (3) 2040-20/100 sub-cohort, Italian/American mean utilities = 0.76/0.74 (p = 0.70); and (4) 20/200 or less sub-cohort, Italian/American mean utilities = 0.66/0.58 (p = 0.58). CONCLUSION: Vision-related quality of life, as measured by time tradeoff utilities, was similar in Italian and American ophthalmic populations. This information is relevant when comparing quality of life and cost-utility analyses across international borders.


Assuntos
Oftalmopatias/psicologia , Qualidade de Vida/psicologia , Visão Binocular/fisiologia , Visão Ocular/fisiologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Estudos Transversais , Feminino , Humanos , Itália , Masculino , Pessoa de Meia-Idade , Inquéritos e Questionários , Estados Unidos , Acuidade Visual/fisiologia
7.
Arch. Soc. Esp. Oftalmol ; 94(12): 575-578, dic. 2019. tab
Artigo em Espanhol | IBECS | ID: ibc-190007

RESUMO

INTRODUCCIÓN: Es reconocida la asociación de algunos síntomas somáticos sin causa orgánica con conflictos psíquicos. En oftalmología existen pocos estudios que evalúen esta asociación, y en los actuales Programas de Formación de Residentes en Oftalmología no se incluye entrenamiento formal en Psicosomática. Esto determina que los fenómenos psicosomáticos en la clínica oftalmológica no sean reconocidos, reduciendo la eficacia terapéutica, la satisfacción de pacientes y médicos, e incrementando los costos en salud. El objetivo de este estudio fue caracterizar a pacientes con síntomas visuales/oculares idiopáticos (SVI) y estimar la prevalencia de indicadores de conflictos psíquicos (CP) en ellos. Materiales y métodos: Se reclutaron pacientes con SVI durante 12 meses en una consulta oftalmológica. Descartando causa orgánica, se pesquisó en la historia clínica indicadores de CP: diagnóstico psiquiátrico, uso de psicofármacos, enfermedades psicosomáticas en otros órganos y presencia de crisis biográficas recientes. Se comparó resultados con grupo control. RESULTADOS: Se registraron 39 pacientes con SVI, con una incidencia aproximada del 3%, siendo el 74% mujeres, y su edad promedio 41,8 años. Los SVI más frecuentes fueron: irritación de la superficie ocular (51%) y trastornos visuales inespecíficos (17%). Todos los pacientes presentaron al menos un criterio de CP, incluyendo 46,2% psicodiagnóstico, 48,7% usuarios psicofármacos, 48,7% crisis biográficas recientes y 64% enfermedades psicosomáticas en otros órganos. La frecuencia de psicodiagnóstico y enfermedades psicosomáticas en otros órganos fue estadísticamente superior (p < 0,05) con relación al grupo control. CONCLUSIONES: Pacientes con SVI presentan una alta frecuencia de indicadores de CP. Aunque no es posible asumir un rol causal de los CP en los SVI, su presencia debe alertar al oftalmólogo de la necesidad de la apropiada evaluación e intervención psicológica


INTRODUCTION: Psychogenic causes for some somatic symptoms have been widely recognised. In Ophthalmology however, there are few studies that address this issue, and current Ophthalmology Training Programs do not include formal teaching in Psychosomatics. Psychosomatic phenomena in ophthalmology are probably under-diagnosed, which may reduce therapeutic effectiveness, decrease patient and physician satisfaction, and increase health costs due to multiple consultations and prescriptions. The aims of this study were to describe patients with unexplained visual/ocular symptoms (UVOS), and to estimate the prevalence of psychological distress (PD) among them. MATERIALS AND METHODS: Consecutive adults with UVOS were recruited over a 12 month period. Complete medical history and ocular examination were performed to rule out organic disease. Psychological Distress was defined by the presence of one or more of the following criteria: psychiatric diagnosis, use of psychotropic medication, psychosomatic disease in other organs, and biographical crisis in the last 6 months. Results were compared with a control group. RESULTS: A total of 39 cases of UVOS were recruited, corresponding approximately to 3% prevalence. The large majority (74%) were female. The mean age was 41.8 years. The most common complaints were ocular surface irritation symptoms (51%) and unspecific visual disturbances (17%). At least 1 of the PD criteria was found in 100%, including 46.2% with psychiatric comorbidity, 48.7% with psychotropic medications, 64% with psychosomatic disease in other organs, and 48.7% with recent life-stressful events. PD indicators were statistically higher compared with control group (P < .05). CONCLUSIONES: There was a high frequency of PD indicators in patients with UVOS. Although the causative role of PD remains unclear, the presence of UVOS should warn the ophthalmologist of an underlying psychic conflict and to make an appropriate psychological intervention


Assuntos
Humanos , Masculino , Feminino , Adulto Jovem , Adulto , Pessoa de Meia-Idade , Idoso , Oftalmopatias/psicologia , Transtornos Psicofisiológicos/epidemiologia , Antipsicóticos/uso terapêutico , Acontecimentos que Mudam a Vida , Transtornos Mentais/tratamento farmacológico , Transtornos Mentais/psicologia , Oftalmologia , Transtornos da Visão/psicologia
8.
Artigo em Inglês | MEDLINE | ID: mdl-31605595

RESUMO

Personality correlates in patients with eye diseases have bidirectional influence. It is possible that personality variables lead to behaviours that may influence the cause of eye problems, but the opposite is also possible, that eye problems could have a direct effect on personality. The aim of this study was to evaluate personality traits in patients with glaucoma, diabetic retinopathy and cataract using the Eysenck Personality Questionnaire. Obtained results showed similar personality profiles in patients with glaucoma, diabetic retinopathy and cataract. However, extraversion and neuroticism were higher in patients with diabetes, while the psychopathic traits are the highest in the group of cataract. Age and gender of patients do not influence the scores obtained on the questionnaire confirmed with one way ANOVA. Not significant difference in parameters (tested with Student t-test) was obtained between groups. It is proposed psychological evaluation to be included in the assessment of more serious eye diseases for helping patients to adjust and adapt to the condition and treatment.


Assuntos
Oftalmopatias/psicologia , Inventário de Personalidade/normas , Personalidade/fisiologia , Adulto , Idoso , Transtorno da Personalidade Antissocial/psicologia , Catarata/psicologia , Retinopatia Diabética/psicologia , Extroversão Psicológica , Feminino , Glaucoma/psicologia , Humanos , Masculino , Pessoa de Meia-Idade , Neuroticismo/fisiologia , Inquéritos e Questionários/estatística & dados numéricos
9.
Arch Soc Esp Oftalmol (Engl Ed) ; 94(12): 575-578, 2019 Dec.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-31615689

RESUMO

INTRODUCTION: Psychogenic causes for some somatic symptoms have been widely recognised. In Ophthalmology however, there are few studies that address this issue, and current Ophthalmology Training Programs do not include formal teaching in Psychosomatics. Psychosomatic phenomena in ophthalmology are probably under-diagnosed, which may reduce therapeutic effectiveness, decrease patient and physician satisfaction, and increase health costs due to multiple consultations and prescriptions. The aims of this study were to describe patients with unexplained visual/ocular symptoms (UVOS), and to estimate the prevalence of psychological distress (PD) among them. MATERIALS AND METHODS: Consecutive adults with UVOS were recruited over a 12 month period. Complete medical history and ocular examination were performed to rule out organic disease. Psychological Distress was defined by the presence of one or more of the following criteria: psychiatric diagnosis, use of psychotropic medication, psychosomatic disease in other organs, and biographical crisis in the last 6 months. Results were compared with a control group. RESULTS: A total of 39 cases of UVOS were recruited, corresponding approximately to 3% prevalence. The large majority (74%) were female. The mean age was 41.8 years. The most common complaints were ocular surface irritation symptoms (51%) and unspecific visual disturbances (17%). At least 1 of the PD criteria was found in 100%, including 46.2% with psychiatric comorbidity, 48.7% with psychotropic medications, 64% with psychosomatic disease in other organs, and 48.7% with recent life-stressful events. PD indicators were statistically higher compared with control group (P<.05). CONCLUSIONES: There was a high frequency of PD indicators in patients with UVOS. Although the causative role of PD remains unclear, the presence of UVOS should warn the ophthalmologist of an underlying psychic conflict and to make an appropriate psychological intervention.


Assuntos
Oftalmopatias/psicologia , Transtornos Psicofisiológicos/epidemiologia , Adulto , Idoso , Antipsicóticos/uso terapêutico , Feminino , Humanos , Acontecimentos que Mudam a Vida , Masculino , Transtornos Mentais/tratamento farmacológico , Transtornos Mentais/psicologia , Pessoa de Meia-Idade , Oftalmologia , Transtornos da Visão/psicologia , Adulto Jovem
10.
Artigo em Inglês | MEDLINE | ID: mdl-31060273

RESUMO

High prevalence of blindness coupled with low public awareness of eye diseases is a severe problem in Pakistan. The objective of this study was to evaluate the awareness, attitude and practices related to common ocular problems and eye care use among general population of Punjab, Pakistan. Data were collected cross-sectionally, using random selection of participants from five districts of Punjab, Pakistan. A pre-tested questionnaire was used to collect the data from January to March 2017. The ordinal data were converted to interval--based data by Rasch analysis, which is termed as "knowledge score" and ranges from -3 to +3. Descriptive statistics, linear regression, binary logistic regression and chi square analysis were performed to evaluate the data. Of the 2073 people contacted, 96.4% (2019) responded the interviewer. The mean (SD) age was 39.9 (11.4) years, majority were males (64.8%) and only 3.1% were illiterate. The majority (68.1%) of respondents were aware that blindness can be prevented and are least aware of age-related macular degradation (31.4%). Multivariate analysis to knowledge scores demonstrated that male gender (ß = 0.53 95%CI = 0.39, 0.66, p < 0.001), higher education (ß = 0.31 95%CI = 0.25, 0.37, p < 0.001) were significantly associated with knowledge score. Eighty-two percent of our respondents had a positive attitude towards health-seeking behavior and those who had adequate income on most of occasions were 1.82 (AOR = 1.82 95%CI = 1.26, 2.62 p = 0.001) times more prone towards health-seeking behavior than those who had insufficient income. Out of all respondents, 21.5% had an eye examination at least once a year and this frequency was significantly higher in lower age, females, high education and high Socio Economic Status level (p < 0.05). Among the general population of Pakistan, awareness about prevention of blindness and refractive error was optimum, while awareness of blindness causing eye conditions, like age-related macular degradation was low. Intensive improvements in the health literacy and public interventions-specifically in old age people, males and respondents with lower education-are urgently needed.


Assuntos
Oftalmopatias/psicologia , Conhecimentos, Atitudes e Prática em Saúde , Adulto , Idoso , Idoso de 80 Anos ou mais , Conscientização , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Paquistão , Classe Social , Adulto Jovem
11.
Malawi Med J ; 31(1): 39-44, 2019 03.
Artigo em Inglês | MEDLINE | ID: mdl-31143395

RESUMO

Background: The family provides support in the care of their ill members and suffers some burden during caregiving. This study assessed the burden of family caregivers and associated factors in an ophthalmic clinic situated in a university teaching hospital in southwest Nigeria. Methods: This was a descriptive cross-sectional study where consenting family caregivers of ophthalmic patients completed a semi-structured questionnaire containing information on their socio-demographic characteristics and caregiving burden using the Zarit burden interview. Descriptive and inferential statistics analyses were done. Results: A total of 273 caregivers completed the study. The caregivers were parents (23.5%), spouses (20.1%), siblings (3.3%), children (35.9%) and other relatives (14.2%) with mean age (SD) of 38.9 (14.9) years (range 8-79 years). Majority (81.2%) experienced caregiver burden with prayer (89%) as a coping strategy. Financial support (56%) was a major caregiver need with majority (59.3%) satisfied with their relatives' hospital care. Neither the patients nor their caregivers were on health insurance scheme. Statistical significant factors associated with caregivers' burden included young age (AOR=4.63, 95%CI=1.55-13.90; p=0.01), higher education (AOR=5.51, 95%CI=2.30-13.2, p=0.01), being employed (AOR=1.72, 95CI=1.30-4.76, p=0.04), longer caregiving (AOR=3.37, 95%CI=1.27-7.02, p=0.02), and having patient on hospital admission (AOR=1.90, 95%CI=1.26-3.09, p=0.02). Conclusion: Family caregivers of ophthalmic patients experienced significant burden. Hence, they need more assistance from the health care institutions and community, including policy makers, so that they can cope with their caregiving activities. Enrollment in the social health insurance scheme will reduce out of pocket payment of hospital bills.


Assuntos
Cuidadores/psicologia , Efeitos Psicossociais da Doença , Oftalmopatias/terapia , Família/psicologia , Adolescente , Adulto , Idoso , Criança , Estudos Transversais , Oftalmopatias/psicologia , Feminino , Hospitais de Ensino , Humanos , Masculino , Pessoa de Meia-Idade , Nigéria , Apoio Social , Inquéritos e Questionários , Adulto Jovem
12.
BMJ Open ; 9(1): e026163, 2019 01 17.
Artigo em Inglês | MEDLINE | ID: mdl-30782756

RESUMO

OBJECTIVE: To identify the risk factors for significant depressive symptoms in people with visual impairment in England and Wales to provide information on who is most at risk and to whom support services could be targeted in future. DESIGN: A cross-sectional study using baseline data from a pragmatic randomised controlled trial. SETTING AND PARTICIPANTS: 990 participants aged 18 or over attending 1 of 14 low-vision rehabilitation primary care optometry-based clinics in South Wales or two hospital clinics in London. OUTCOME MEASURE: A score of ≥6 on the Geriatric Depression Scale-15 was classed as clinically significant depressive symptoms. RESULTS: In a multivariable logistic regression model, significant depressive symptoms were associated with age (adjusted OR (AOR)=0.82, 95% CI: 0.66 to 0.90, p<0.001), ethnicity (AOR non-white compared with white=1.72, 95% CI: 1.05 to 2.81, p=0.031), total number of eye conditions (AOR for two vs one condition=0.98, 95% CI: 0.67 to 1.43; three or more vs one condition=0.34, 95% CI: 0.15 to 0.75, p=0.026), self-reported health (AOR for excellent vs poor=0.01, 95% CI: 0.00 to 0.12; very good vs poor=0.06, 95% CI: 0.03 to 0.13; good vs poor=0.14, 95% CI: 0.08 to 0.24; fair vs poor=0.28, 95% CI: 0.18 to 0.46, p<0.001) and self-reported visual functioning (AOR=1.45, 95% CI: 1.31 to 1.61, p<0.001). CONCLUSION: Younger age, a non-white ethnicity, fewer eye conditions and poorer self-reported health and visual function are risk factors for significant depressive symptoms in this population. TRIAL REGISTRATION NUMBER: ISRCTN46824140; Pre-results.


Assuntos
Depressão/epidemiologia , Oftalmopatias/psicologia , Oftalmopatias/reabilitação , Idoso , Idoso de 80 Anos ou mais , Estudos Transversais , Feminino , Humanos , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Atenção Primária à Saúde , Escalas de Graduação Psiquiátrica , Curva ROC , Fatores de Risco , Autorrelato , Reino Unido/epidemiologia
13.
Am J Ophthalmol ; 200: 201-217, 2019 04.
Artigo em Inglês | MEDLINE | ID: mdl-30653960

RESUMO

PURPOSE: To develop patient-derived Pediatric Eye Questionnaires (PedEyeQ) to separately assess eye-related quality of life (ER-QOL) and functional vision in children with eye conditions. DESIGN: Questionnaire development study. METHODS: A total of 444 children (0 to <18 years old), across 10 diagnostic categories, were enrolled at 2 sites. All parents (n = 444) and 277 children (5 to <18 years old) completed master questionnaires, developed from patient-derived concerns. Factor analysis was performed to identify unidimensional domains (eigenvalue >1.0) and Rasch analyses (differential item functioning, targeting, fit) to reduce items (separate analyses for subjects aged 0-4, 5-11, and 12-17 years and for each factor). RESULTS: The Child 5- to 11-year-old PedEyeQ consisted of 4 unidimensional domains/questionnaires: functional vision, bothered by eyes/vision, social, frustration/worry (10 items each). The Child 12- to 17-year-old PedEyeQ consisted of the same 4 domains (total 39 items). The Proxy 0- to 4-year-old PedEyeQ consisted of 3 questionnaires/domains: functional vision, bothered by eyes/vision, social (total 29 items). The Proxy 5- to 11-year-old PedEyeQ consisted of 5 questionnaires/domains: functional vision, bothered by eyes/vision, social, frustration/worry, eye care (total 39 items), as did the Proxy 12- to 17-year-old PedEyeQ (total 42 items). The Parent PedEyeQ consisted of 4 questionnaires/domains: impact on parent/family, worry regarding child's eye condition, worry regarding child's self-perception and interactions, worry regarding child's visual function (total 35 items). Rasch look-up tables were created for scoring. CONCLUSIONS: By following a rigorous approach, we have developed Pediatric Eye Questionnaires for separately assessing functional vision and ER-QOL domains in children of any age and with any eye condition.


Assuntos
Oftalmopatias/diagnóstico , Qualidade de Vida/psicologia , Perfil de Impacto da Doença , Adolescente , Criança , Pré-Escolar , Oftalmopatias/psicologia , Feminino , Nível de Saúde , Humanos , Lactente , Recém-Nascido , Masculino , Acuidade Visual/fisiologia
14.
Psychiatr Danub ; 30(4): 471-477, 2018 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-30439808

RESUMO

BACKGROUND: The aim of this study was to assess subjective, human aspect of the medical condition, evaluate the quality of life (QOL) and level of depressive symptoms in patients with watery eye and compare it with patients with two most common causes of visual deterioration: cataract and macular region pathology. The results of this study may serve to raise awareness of watery eye impact on a large number of patients and subsequently promote their treatment in order to restore full visual and life quality necessary for normal human functioning. SUBJECTS AND METHODS: In this prospective, randomised, questionnaire-based study, we have surveyed three groups of patients with a total of 210 patients: group with the watery eye of different etiology (n=69), group with one pseudophakic eye and one cataract eye (n=73) and group with the unilateral pathology of the macular region (n=68). All three groups underwent a complete ophthalmologic examination. To examine the overall quality of life we have used a modified vision-related quality of life questionnaire (VR-QOL) and to evaluate depression level "Beck Depression Inventory - 2". The results were analyzed with statistical program STATISTICA 13. RESULTS: Compared to group with unilateral cataract eye and to group with unilateral pathology of the macular region, the results of this study show that patients with watery eye have significantly decreased quality of life in all daily activities, particularly in outdoor activities (F=125.80, df=2/143, p<0.01), during sports (F=36.67, df=2/143, p<0.01) and interpersonal relations (F=18.73, df=2/143, p<0.01). Results between three groups showed that group with watering eye expressed highest depression level and group with one pseudophakic eye and the other cataract eye the lowest (F=25.86, df=2/207, p<0.01). CONCLUSION: Watery eye has a significant impact on vision-related quality of life. Our research showed that patients with watery eye had expressed more depressive symptoms than other groups, but still without statistically significant value. Since it affects a large and heterogenic group of patients it is important to be recognized on time and treated etiologically in attempt to restore full function and life quality. The results of this study may serve to raise awareness of watery eye impact on a large number of patients and subsequently promote their treatment in order to restore full visual and life quality necessary for normal functioning.


Assuntos
Depressão , Oftalmopatias , Qualidade de Vida , Catarata , Oftalmopatias/psicologia , Humanos , Estudos Prospectivos , Inquéritos e Questionários , Acuidade Visual
15.
J AAPOS ; 22(6): 445-448.e22, 2018 12.
Artigo em Inglês | MEDLINE | ID: mdl-30243933

RESUMO

PURPOSE: To identify specific health-related quality of life (HRQOL) and functional vision concerns of children with eye conditions, and create comprehensive lists of potential questionnaire items as a first step in developing patient-reported outcome measures. METHODS: Children experiencing a range of pediatric eye conditions, along with one of their parents, were interviewed to identify specific concerns. Transcribed interviews were reviewed, and specific HRQOL and functional vision concerns were coded independently by two reviewers. Coded concerns were reviewed to formulate questions to address specific child concerns (derived from child and parent interviews) and specific parent concerns. Questions were grouped into bins of like questions. Two comprehensive lists of questions were formulated, one addressing child-related concerns and one addressing parent-related concerns. RESULTS: This study included 180 children and 328 parents. A total of 614 individual child questions were grouped into 36 bins (eg, appearance, coordination, glasses, learning), and 589 parent questions were formulated and grouped into 61 bins (eg, having to assist the child, worry about deterioration, time off work, safety). CONCLUSIONS: Using rigorous methods based on individual interviews, we identified a comprehensive list of patient- and parent-derived questionnaire items that address functional vision and HRQOL concerns of children with eye conditions and of their parents. We plan to use this large pool of potential questionnaire items to develop a formal set of pediatric outcome measures, and this pool of questions may also be a resource for future research.


Assuntos
Oftalmopatias/psicologia , Medidas de Resultados Relatados pelo Paciente , Qualidade de Vida , Acuidade Visual , Adolescente , Criança , Pré-Escolar , Oftalmopatias/epidemiologia , Oftalmopatias/fisiopatologia , Feminino , Humanos , Incidência , Lactente , Recém-Nascido , Masculino , Estudos Retrospectivos , Estados Unidos/epidemiologia
16.
Arch Soc Esp Oftalmol (Engl Ed) ; 93(12): 586-591, 2018 Dec.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-30006104

RESUMO

INTRODUCTION: Advances in medicine have contributed to a higher average life expectancy, as well as an increasing number of chronic diseases patients. This longevity means that the assessment of the quality of life, particularly that related to vision, has become very relevant. OBJECTIVE: The validation of the translation and cross-cultural adaptation into Spanish of one of the most widely used vision-related quality of life questionnaires. It has sought to ensure that the Spanish version of the questionnaire was equivalent in semantic, conceptual, and technical content and criteria level, compared to its already validated English version. METHOD: An analytical observational study was conducted using a cohort of patients, in whom their quality of life related to vision was analysed. The study was developed in two steps; the first was the translation and cross-cultural adaptation to Spanish of the NEI VFQ-25 questionnaire. The second one was the psychometric study of the reliability and validity of the scale of the Spanish version. RESULTS: The analysis of the terms of reliability and validity showed that the translation and cross-cultural adaptation met the expected requirements and was well accepted by users. CONCLUSION: There is now a possibility of having a Spanish validated questionnaire available to assess the quality of life related to vision in patients with chronic diseases, such as age-related macular degeneration.


Assuntos
Oftalmopatias/psicologia , Inquéritos e Questionários , Visão Ocular , Idoso , Idoso de 80 Anos ou mais , Características Culturais , Feminino , Humanos , Degeneração Macular/psicologia , Masculino , Pessoa de Meia-Idade , National Eye Institute (U.S.) , Psicometria , Qualidade de Vida , Reprodutibilidade dos Testes , Tradução , Estados Unidos , Acuidade Visual
18.
Ophthalmic Plast Reconstr Surg ; 34(4): 369-374, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-29194103

RESUMO

PURPOSE: To identify the main concerns of patients experienced in wearing cryolite glass prosthetic eyes and to investigate how these have changed over time. METHODS: One hundred six patients experienced in wearing prosthetic eyes for at least 2 years were asked to complete an anonymous questionnaire regarding prosthetic eye concerns at the time of initial eye loss and at the present time. Main outcome measures included changes in levels of concern over time. RESULTS: Initially, the participants were mainly concerned about their appearance, health of the fellow eye, and coping with monocularity. Over time, there was a significant increase of the level of concern regarding the health of the remaining eye (p < 0.001) and regarding watering, crusting, and discharge (p < 0.001). Loss of balance did not change significantly (p = 0.302). All other concerns decreased significantly over time (p < 0.001), with levels of concern about appearance decreasing the most. The current leading concern was the health of the remaining eye followed by concerns about watering, crusting, and discharge. Length of time since natural eye loss was the most important explanatory variable, with significant impact on the concerns about appearance (p = 0.013), retention of the prosthetic eye (p = 0.002), and eyelid contour (p = 0.004). CONCLUSIONS: Health of the remaining eye is the most common current concern of anophthalmic patients, acknowledging the need of good ophthalmologic follow up after losing an eye. The second most important concern is with watering, crusting, and discharge, suggesting further research for establishing an evidence-based protocol for cryolite glass prosthetic eye maintenance and supportive treatment.


Assuntos
Anoftalmia/psicologia , Olho Artificial/psicologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Anoftalmia/cirurgia , Criança , Estética , Oftalmopatias/psicologia , Feminino , Lateralidade Funcional , Vidro , Humanos , Masculino , Pessoa de Meia-Idade , Satisfação do Paciente , Fluoreto de Sódio , Adulto Jovem
19.
Health Qual Life Outcomes ; 15(1): 156, 2017 Aug 08.
Artigo em Inglês | MEDLINE | ID: mdl-28789656

RESUMO

BACKGROUND: To estimate the burden of diseases, it is important to consider patient-reported outcomes including Quality of Life (QoL). The aim of this study is to provide population-based reference data for the National Eye Institute 25-Item Visual Function Questionnaire (NEI VFQ-25), stratified by sex and age. METHODS: The Gutenberg Health Study (GHS) is a population-based, prospective, observational cohort study in Germany, including 15,010 participants aged between 35 and 74. The baseline examination was conducted between 2007 and 2012. To overcome known shortcomings of the NEI VFQ-25, we calculated the previously proposed visual functioning scale and the socio-emotional scale based on Rasch-transformed person-level data. We present mean values, standard deviations and percentiles for age decades stratified by sex. We used a linear regression model to assess the influence of age, sex, socioeconomic status, distance-corrected visual acuity (better-seeing eye) and the absolute difference in distance-corrected visual acuity of both eyes on vision-related QoL. RESULTS: NEI VFQ-25 data are available from 12,231 participants (82%). Both the long-form visual functioning scale (LFVFS) and the long-form socio-emotional scale (LFSES) showed a clear age dependency, with an average LFVFS score of 92.8 for men and 90.5 for women in the youngest age group and 85.7 and 83.4 in the oldest age group, and a LFSES score of 98.3 for men and 98.1 in women in the youngest and 94.7 and 94.5 in the oldest decade. The largest difference was observed between the youngest age group (35-44 years) and the 45-54 years group. Men tended to have slightly higher scores than women. In the multivariable linear regression analysis, age (per 5 years -0.42), female sex (-1.57), worse distance-corrected visual acuity of the better eye (per 0.1 increase in logMAR -2.92) and the difference between both eyes (per 0.1 increase in logMAR -0.87) were associated with a reduced LFVFS score (all p < 0.001). For the LFSES score, we showed that the influence of sex was minor, and that age (per 5 years -0.22), visual acuity of the better eye (-1.65), and the difference between both eyes (-0.56) were associated with a lower score (all p < 0.001). CONCLUSIONS: We report age- and sex-specific reference data from a large population-based study of mainly Caucasian ethnicity of two unidimensional scores based on Rasch-transformed NEI VFQ-25 data. Vision-related QoL is lower in older and in female individuals. Our results support the association of vision-related QoL not only with the distance-corrected visual acuity of the better eye but also with the difference in visual acuity between each eye. Our findings could be used as a reference for comparison in future studies addressing the influence of eye diseases on vision-related QoL.


Assuntos
Oftalmopatias/psicologia , Qualidade de Vida , Visão Ocular , Acuidade Visual , Fatores Etários , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , National Eye Institute (U.S.) , Medidas de Resultados Relatados pelo Paciente , Estudos Prospectivos , Padrões de Referência , Projetos de Pesquisa , Inquéritos e Questionários , Estados Unidos
20.
J Optom ; 10(2): 104-110, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-27423689

RESUMO

PURPOSE: Most causes of childhood blindness are treatable or preventable. Knowledge of parents' awareness and perception of eye problems is important in helping to understand parents' eye care seeking behavior. This understanding becomes necessary as early detection and intervention can be effective when done at an early age. METHOD: Study was carried out in Benin City, Nigeria. Thirty-five parents aged 38-54 years with a mean age of 43(±2) years were recruited. Twenty six were females and nine males. Ten eye care practitioners aged 30-45 years with a mean age of 40 (±2) were included. Seven were males and three were females. Data was analyzed qualitatively and in percentages. RESULTS: Majority of parents were aware of common eye problems: Blurry vision (85.7%), measles in eye (48.5%), cataract (74.3%), conjunctivitis (48.5%), itching and redness (74.3%), crossed eyes (34.3%), strabismus (57.1%), short sightedness (48.5%) and stye or hordeolum (57.1%). Too much carbohydrate, night reading and too much TV were some of the reasons given for bad eyesight. Self medication and use of local remedies for treatment of conjunctivitis was common practice (94.3%). Chloramphenicol eyedrop was the most common drug used for any eye problem before visiting a doctor (80.0%). CONCLUSION: Parents are aware of common eye diseases in children but have wrong perception of their causes. Programs to increase public awareness of causes of eye problems and harmful effects of self medication are advocated for to expose inherent dangers.


Assuntos
Atitude Frente a Saúde , Oftalmopatias/psicologia , Conhecimentos, Atitudes e Prática em Saúde , Pais/psicologia , Adulto , Criança , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Nigéria
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA
...