白内障手术对活动和时间利用的影响：来自肯尼亚、孟加拉国和菲律宾的纵向研究结果。
The impact of cataract surgery on activities and time-use: results from a longitudinal study in Kenya, Bangladesh and the Philippines.
机构信息
Department of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, United Kingdom.
出版信息
PLoS One. 2010 Jun 1;5(6):e10913. doi: 10.1371/journal.pone.0010913.
BACKGROUND
Cataract is the leading cause of blindness in the world, and blindness from cataract is particularly common in low-income countries. The aim of this study is to explore the impact of cataract surgery on daily activities and time-use in Kenya, Bangladesh and the Philippines.
METHODS/PRINCIPAL FINDINGS: A multi-centre intervention study was conducted in three countries. Time-use data were collected through interview from cases aged >or=50 years with visually impairing cataract (VA <6/24) and age- and gender-matched controls with normal vision (VA>or=6/18). Cases were offered free/subsidized cataract surgery. Approximately one year later participants were re-interviewed about time-use. At baseline across the three countries there were 651 cases and 571 controls. Fifty-five percent of cases accepted surgery. Response rate at follow up was 84% (303 out of 361) for operated cases, and 80% (459 out of 571) for controls. At baseline, cases were less likely to carry out and spent less time on productive activities (paid and non-paid work) and spent more time in "inactivity" compared to controls. Approximately one year after cataract surgery, operated cases were more likely to undertake productive activities compared to baseline (Kenya from 55% to 88%; Bangladesh 60% to 95% and Philippines 81% to 94%, p<0.001) and mean time spent on productive activities increased by one-two hours in each setting (p<0.001). Time spent in "inactivity" in Kenya and Bangladesh decreased by approximately two hours (p<0.001). Frequency of reported assistance with activities was more than halved in each setting (p<0.001).
CONCLUSIONS/SIGNIFICANCE: The empirical evidence provided by this study of increased time spent on productive activities, reduced time in inactivity and reduced assistance following cataract surgery among older adults in low-income settings has positive implications for well-being and inclusion, and supports arguments of economic benefit at the household level from cataract surgery.
背景
白内障是全球致盲的首要原因，而低收入国家的白内障致盲尤为常见。本研究旨在探讨白内障手术对肯尼亚、孟加拉国和菲律宾的日常活动和时间利用的影响。
方法/主要发现：本研究为多中心干预研究，在三个国家开展。通过访谈收集年龄≥50 岁、视力受损白内障（VA<6/24）的病例和年龄及性别匹配的视力正常（VA≥6/18）对照者的时间利用数据。为病例提供免费/补贴白内障手术。大约一年后，对参与者进行时间利用的再访谈。在三个国家的基线期，共有 651 例病例和 571 例对照者。55%的病例接受了手术。手术病例的随访应答率为 84%（361 例中的 303 例），对照者为 80%（571 例中的 459 例）。基线期，病例参与生产活动的可能性较小，花费的时间也较少，且“不活动”时间较多。白内障手术后大约一年，与基线相比，手术病例更有可能从事生产活动（肯尼亚从 55%增至 88%；孟加拉国从 60%增至 95%；菲律宾从 81%增至 94%，p<0.001），且每个环境中生产活动的平均时间增加了一到两个小时（p<0.001）。肯尼亚和孟加拉国的“不活动”时间减少了大约两个小时（p<0.001）。每个环境中活动协助的报告频率减少了一半以上（p<0.001）。
结论/意义：本研究在低收入环境中，老年白内障患者手术后生产活动时间增加、“不活动”时间减少、协助减少，提供了实证证据，这对福祉和包容具有积极意义，并支持了白内障手术对家庭层面经济收益的观点。
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