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书面及图片说明书对白内障手术后患者行为的影响

Impact of written and photographic instruction sheets on patient behavior after cataract surgery.

作者信息

Fayers Tessa, Abdullah Wajda, Walton Vivien, Wilkins Mark R

机构信息

St. Thomas' Hospital, London, United Kingdom.

出版信息

J Cataract Refract Surg. 2009 Oct;35(10):1739-43. doi: 10.1016/j.jcrs.2009.07.003.

Abstract

PURPOSE

To evaluate the extent to which patients unnecessarily restrict activities of daily living after routine cataract surgery and to test interventions to increase activity.

SETTING

Day treatment center, London, United Kingdom.

METHODS

In this nonrandomized interventional clinical study, consecutive patients having routine first-eye sutureless small-incision cataract surgery received 1 of 3 of the following postoperative instructions: standard discharge instructions informing patients that they could continue all activities of daily living (standard group), an additional written sheet specifying 9 activities of daily living that are safe to perform (written group), or an additional sheet with photographs of people performing safe activities of daily living (photo group). Three weeks postoperatively, patients answered a questionnaire on whether they had avoided the activities of daily living and if so, why.

RESULTS

Each group comprised 50 patients. Sixty-four percent in the standard group reported avoiding 1 or more activities of daily living. The percentage was 44% in the written group (P = .07) and 30% in the photo group (P = .0013). In all groups, the decision to avoid activities was self-directed more than 50% of the time; it was based on the advice of a nurse in 17% of cases and of a doctor in 4% of cases.

CONCLUSIONS

Many patients unnecessarily avoided activities of daily living after cataract surgery. Providing an additional written sheet did not significantly improve this, whereas a photograph sheet did. Better awareness of the safety and rapid rehabilitation after modern cataract surgery is needed in hospitals and primary care centers.

摘要

目的

评估患者在常规白内障手术后不必要地限制日常生活活动的程度,并测试增加活动量的干预措施。

地点

英国伦敦日间治疗中心。

方法

在这项非随机干预性临床研究中,接受常规第一眼无缝小切口白内障手术的连续患者接受以下三种术后指导中的一种:标准出院指导,告知患者可以继续所有日常生活活动(标准组);一份附加的书面材料,详细列出9项可安全进行的日常生活活动(书面组);或一份带有人们进行安全日常生活活动照片的附加材料(照片组)。术后三周,患者回答一份关于他们是否避免了日常生活活动以及如果是,原因是什么的问卷。

结果

每组包括50名患者。标准组中有64%的患者报告避免了1项或更多的日常生活活动。书面组的这一比例为44%(P = 0.07),照片组为30%(P = 0.0013)。在所有组中,超过50%的情况下避免活动的决定是患者自己做出的;17%的情况是基于护士的建议,4%的情况是基于医生的建议。

结论

许多患者在白内障手术后不必要地避免了日常生活活动。提供一份附加的书面材料并没有显著改善这种情况,而照片材料则有效果。医院和初级保健中心需要更好地了解现代白内障手术后的安全性和快速康复情况。

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