Scott I U, Schein O D, Feuer W J, Folstein M F, Bandeen-Roche K
Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami School of Medicine, Miami, Florida 33101, USA.
Am J Ophthalmol. 2001 May;131(5):584-9. doi: 10.1016/s0002-9394(01)00832-7.
To investigate the prevalence of, and potential risk factors for, emotional distress among patients with retinal disease.
Cross-sectional study.
Cases consisted of 86 consecutive patients at Wilmer Eye Institute Retinal Vascular Center. Fifty-one controls with normal visual acuity and no known ocular disease were frequency-matched to the cases by age, sex, and race. Subjects were interviewed using the Community Disability Scale, a functional status questionnaire, and the General Health Questionnaire, a questionnaire assessing emotional distress.
The prevalence of probable (General Health Questionnaire score 4 or greater and less than 10) or definite (General Health Questionnaire score 10 or greater) emotional distress was 59.3% among ophthalmic patients and 2.0% among controls. There were significant relationships between emotional distress, as assessed by General Health Questionnaire score, and degree of 1) visual impairment, as assessed by weighted bilateral average logarithm of minimal angle of resolution (logMAR), and 2) functional impairment, as assessed by Community Disability Scale score (P =.001). Univariate analyses identified significant predictors of emotional distress: shorter duration of ocular disease (P =.019), worse visual acuity (P =.001), increased systemic comorbidities (P =.001), and increased functional impairment (P <.001). Multiple regression analysis demonstrates that worse visual acuity, increased systemic comorbidities, and shorter duration of ocular disease each explain over 10% of the variability in General Health Questionnaire score (r(2) = 0.15, 0.12, and 0.11, respectively). Addition of Community Disability Scale score to the regression model eliminates the significance of visual acuity and systemic comorbidities; Community Disability Scale score explains nearly 30% of the variability in emotional distress, as assessed by General Health Questionnaire score (r(2) = 0.29).
Emotional distress is prevalent among patients with retinal disease; potential risk factors for emotional distress among such patients include shorter duration of ocular disease, worse visual acuity, increased systemic comorbidities, and increased functional impairment.
调查视网膜疾病患者中情绪困扰的患病率及其潜在危险因素。
横断面研究。
病例包括威尔默眼科研究所视网膜血管中心的86例连续患者。51名视力正常且无已知眼部疾病的对照者按年龄、性别和种族与病例进行频率匹配。使用社区残疾量表（一种功能状态问卷）和一般健康问卷（一种评估情绪困扰的问卷）对受试者进行访谈。
眼科患者中可能（一般健康问卷得分4或更高且小于10）或确定（一般健康问卷得分10或更高）情绪困扰的患病率为59.3%，对照者中为2.0%。根据一般健康问卷得分评估的情绪困扰与1）通过加权双眼平均最小分辨角对数（logMAR）评估的视力损害程度，以及2）通过社区残疾量表得分评估的功能损害程度之间存在显著关系（P = 0.001）。单因素分析确定了情绪困扰的显著预测因素：眼病病程较短（P = 0.019）、视力较差（P = 0.001）、全身合并症增加（P = 0.001）和功能损害增加（P < 0.001）。多元回归分析表明，视力较差、全身合并症增加和眼病病程较短各自解释了一般健康问卷得分变异性的10%以上（r²分别为0.15、0.12和0.11）。将社区残疾量表得分添加到回归模型中消除了视力和全身合并症的显著性；社区残疾量表得分解释了根据一般健康问卷得分评估的情绪困扰变异性的近30%（r² = 0.29）。
情绪困扰在视网膜疾病患者中普遍存在；此类患者情绪困扰的潜在危险因素包括眼病病程较短、视力较差、全身合并症增加和功能损害增加。
