眼球摘除后视功能生活质量及容貌负面评价与情绪的关系研究

发布时间：2018-04-27 17:37

本文选题：眼球摘除 + 视功能生活质量　；参考：《浙江大学》2016年博士论文

【摘要】：目的：眼球摘除患者因视功能和容貌均受影响,面临着身心健康的改变。本研究目的是,评估眼球摘除患者的视功能生活质量、容貌负面评价以及焦虑和抑郁情绪,探索患者的人口统计学变量、临床变量和社会心理学变量与焦虑和抑郁情绪之间的相关性。方法：本横断面研究纳入了2014年7月至2016年2月就诊于浙江大学医学院附属第二医院眼科中心的195例眼球摘除患者为病例组,以及同期100例眼科患者的陪同者为对照组。研究采集病例组和对照组的人口统计学资料,病例组的临床资料以及羞愧、悲伤和愤怒的程度。两组研究对象均完成视功能生活质量量表、负面身体自我量表-容貌分量表以及医院焦虑和抑郁量表。比较视功能生活质量、容貌负面评价、以及焦虑和抑郁程度的组间差异。以患者的人口统计学变量、临床变量和社会心理学变量为自变量,以焦虑和抑郁程度为因变量,进行多因素逐步回归分析。结果：与对照组相比,病例组的视功能生活质量较低(中位数(四分位数间距)：91.9(85.6-95.9)vs 71.8(58.1-83。.7),P0.001),容貌评价较负面(1.2(0.5-1.9)vs0.4(0.1-0.8),P0.001)。病例组中,23.1%对自我容貌不满意,比例明显高于对照组。义眼配戴时间和义眼与健眼的相似度,与患者的容貌负面评价有关。病例组中,11.8%存在焦虑情绪,13.8%存在抑郁情绪,比例均明显高于对照组。逐步回归分析发现,病例组的焦虑和抑郁程度与视功能生活质量(焦虑：p=-0.506,P0.001；抑郁：p=-0.346,P0.001)和容貌负面评价(焦虑：p=0.359,P0.001；抑郁：p=0.152,P0.05)相关。年龄越小(p=-0.140,P0.05),焦虑程度越高。受教育程度越低(p=-0.221,P0.001),对眼球摘除感到越愤怒(p=0.217,P=0.001),抑郁程度越高。临床变量与焦虑和抑郁程度无关。结论：眼球摘除患者中存在焦虑情绪和抑郁情绪的比例较高。社会心理学特质,而非临床特质,与患者的焦虑和抑郁程度相关。对于视功能生活质量较低、容貌评价较负面的眼球摘除患者,临床医生可能需要及时提供恰当的心理健康服务,帮助改善患者的情绪状态。在改善措施提出之前,需要进一步的前瞻性研究来明确眼球摘除患者的情绪状态的影响因素。
[Abstract]:Objective: the patients with enucleation are faced with physical and mental health changes due to the influence of visual function and appearance. The aim of this study was to assess the visual function quality of life, negative appearance, anxiety and depression in patients with enucleation, and to explore the demographic variables of the patients. The correlation between clinical variables and social psychological variables and anxiety and depression. Methods: from July 2014 to February 2016, 195 patients with ophthalmectomy and 100 patients accompanying ophthalmectomies from the second affiliated Hospital of Zhejiang University Medical College were included in this cross-sectional study as the control group. The study collected demographic data from case and control groups, clinical data from case groups, and levels of shame, sadness and anger. Both groups completed visual function quality of life scale, negative physical self-scale-appearance scale and hospital anxiety and depression scale. The quality of life of visual function, negative evaluation of facial appearance, and the degree of anxiety and depression were compared between groups. Multivariate stepwise regression analysis was carried out with demographic variables, clinical variables and social psychological variables as independent variables and anxiety and depression degree as dependent variables. Results: compared with the control group, the quality of life of visual function in the case group was lower than that in the control group (median: 91.9% 85.6-95.9) vs 71.8% 58.1-83..7P 0.001g, and the negative evaluation of appearance was 1.2-1.5-1.9vs0.40.1-0.8P0.001. In the case group, 23.1% were not satisfied with self-appearance, and the proportion was significantly higher than that in the control group. The wearing time and the similarity between prosthetic eye and healthy eye were related to the negative evaluation of the patient's appearance. In the case group, 11.8% had anxiety and 13.8% had depression, which was significantly higher than that in the control group. Stepwise regression analysis showed that the degree of anxiety and depression was correlated with the quality of life of visual function (anxiety: pn-0.506U P0.001; depression: p-0.346n P0.001) and negative evaluation of appearance (anxiety: p359 (P0.001); depression: P0. 152 (P0.05). The younger the age was, the higher the anxiety was. The lower the education level was, the higher the degree of depression was. Clinical variables were not associated with anxiety and depression. Conclusion: the proportion of anxiety and depression in patients with enucleation is higher. Social psychological traits, rather than clinical traits, were associated with anxiety and depression. For the patients with lower quality of life and negative evaluation of visual function, the clinician may need to provide appropriate mental health services in time to help improve the emotional state of the patients. Further prospective studies are needed to identify the factors affecting emotional state in patients with enucleation before improvement measures are proposed.
【学位授予单位】：浙江大学
【学位级别】：博士
【学位授予年份】：2016
【分类号】：R779.6

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