Robertson Danielle M, Cavanagh H Dwight
The Department of Ophthalmology, UT Southwestern Medical Center, 5323 Harry Hines Boulevard, Dallas, Texas 75390-9057, USA.
Optom Vis Sci. 2011 Dec;88(12):1402-8. doi: 10.1097/OPX.0b013e3182333cf9.
To compare the effects of existing patient awareness of lens-related complications and underlying risk factors on actual patient behavior during contact lens wear and care practices in two different clinical study populations.
Established contact lens wearers (n = 281) completed an anonymous written questionnaire on presenting to their habitual eye care practitioner in the Dallas-Fort Worth metroplex. Data were analyzed and compared against a second study population, which comprised established contact lens wearers (n = 152) who were sequentially evaluated after their routine contact lens examination at the University of Texas Southwestern Medical Center at Dallas, TX (UTSW). All patients were questioned regarding his or her lens care practices and knowledge of complications and risk factors associated with contact lens wear.
Fifty-eight percent of patients in the general community could identify by name a complication associated with lens wear compared with 91% within the medical center. The most frequent complications reported were related to comfort and handling (72%, Dallas-Fort Worth) and infection (47%, UTSW). The majority of patients could correctly identify risk factors associated with lens-related complications; awareness for topping-off solutions, tap water exposure, and hygiene varied between groups. Overall, 85% of patients perceived themselves as compliant with their lens wear and care practices. Using a standard scoring model to determine actual compliance, 2% of patients demonstrated good compliance; however, only 0.4% of patients were fully compliant with contact lens wear and care practices.
The data reveal some study bias in complication and risk awareness between populations; however, despite this limitation, a significant proportion of patients exhibited actual non-compliant behavior despite acknowledged awareness of risk. Although most patients consider themselves to be complying with standard practitioner guidelines for lens wear and care practices, essentially all contact lens wearing patients exhibit behavioral non-compliance with resulting increased risk for significant complications.
比较在两个不同临床研究人群中，患者对镜片相关并发症及潜在风险因素的既有认知对其在佩戴和护理隐形眼镜期间实际行为的影响。
在达拉斯 - 沃思堡都会区，佩戴隐形眼镜的患者（n = 281）向其惯常的眼科护理从业者提交了一份匿名书面问卷。对数据进行分析，并与第二个研究人群进行比较，第二个研究人群包括在德克萨斯大学西南医学中心（UTSW）达拉斯分校进行常规隐形眼镜检查后依次接受评估的佩戴隐形眼镜的患者（n = 152）。所有患者都被询问了其镜片护理习惯以及与隐形眼镜佩戴相关的并发症和风险因素的知识。
普通社区中58%的患者能够说出与镜片佩戴相关的一种并发症，而在医疗中心这一比例为91%。报告的最常见并发症与舒适度和操作（达拉斯 - 沃思堡为72%）以及感染（UTSW为47%）有关。大多数患者能够正确识别与镜片相关并发症相关的风险因素；不同组之间对补充护理液、接触自来水和卫生方面的认知存在差异。总体而言，85%的患者认为自己遵守了镜片佩戴和护理习惯。使用标准评分模型来确定实际依从性，2%的患者表现出良好的依从性；然而，只有0.4%的患者完全遵守隐形眼镜佩戴和护理习惯。
数据揭示了不同人群在并发症和风险认知方面存在一些研究偏差；然而，尽管存在这一局限性，但相当一部分患者尽管知晓风险，仍表现出实际的不依从行为。尽管大多数患者认为自己遵守了从业者关于镜片佩戴和护理习惯的标准指南，但实际上所有佩戴隐形眼镜的患者都存在行为上的不依从，从而增加了发生严重并发症的风险。
