Abateneh Aemero, Tesfaye Markos, Bekele Sisay, Gelaw Yeshigeta
Department of Ophthalmology, College of Public Health and Medical Sciences, Jimma University, Jimma, Ethiopia.
PLoS One. 2013 Oct 25;8(10):e78335. doi: 10.1371/journal.pone.0078335. eCollection 2013.
Vision loss causes major changes in lifestyle and habits that may result in psychological distress and further reduction in the quality of life. Little is known about the magnitude of psychological distress in patients with vision loss and its variation with the normal. The aim of this study is, therefore, to investigate the psychological effects of vision loss and its determinants among Ethiopians.
A comparative cross-sectional study was conducted on adults attending the Eye clinic of Jimma University Hospital. One hundred fifteen consecutive adults with visual loss at least in one eye and 115 age-and sex-matched controls with normal vision were studied. The psychological distress was measured using standardized Self-Reporting Questionnaire (SRQ-20). Chi-square test and logistic regression were carried out and associations were considered significant at P<0.05.
The overall prevalence of psychological distress was 33.4%. While psychological distress was found in 49.8% of patients who had loss of vision at least in one eye, only 18.3% of the controls had it. In the adjusted analysis, patients with vision loss had 4.6 times higher risk of suffering from psychological distress compared to patients with normal vision (AOR 4.56; 95% CI 2.16-9.62). Moreover, patients with vision loss in both eyes (AOR 4.00; 95% CI 1.453-11.015) and with worse visual acuity in the better eye (AOR 3.66; 95% CI 1.27-10.54) were significantly more likely to have psychological distress than those patients with vision loss in one eye only and good visual acuity in the better eye respectively. The cause of visual loss, pattern of visual loss, duration of visual loss and sociodemographic variables did not influence the likelihood of having psychological distress.
Prevalence of psychological distress was significantly higher in patients with visual loss compared to patients with normal vision. There is a need for integration of psychosocial care into the current medical and surgical treatment of patients with vision loss.
视力丧失会导致生活方式和习惯发生重大变化，这可能会引发心理困扰，并进一步降低生活质量。关于视力丧失患者心理困扰的程度及其与正常人的差异，人们了解甚少。因此，本研究的目的是调查埃塞俄比亚人视力丧失的心理影响及其决定因素。
对前往吉姆马大学医院眼科门诊就诊的成年人进行了一项比较横断面研究。研究了115名至少一只眼睛视力丧失的连续成年患者以及115名年龄和性别匹配的视力正常的对照者。使用标准化的自评问卷（SRQ-20）测量心理困扰。进行了卡方检验和逻辑回归分析，P<0.05时的关联被认为具有统计学意义。
心理困扰的总体患病率为33.4%。至少一只眼睛视力丧失的患者中有49.8%存在心理困扰，而对照组中只有18.3%存在心理困扰。在调整分析中，视力丧失患者患心理困扰的风险是视力正常患者的4.6倍（调整后比值比4.56；95%置信区间2.16-9.62）。此外，双眼视力丧失的患者（调整后比值比4.00；95%置信区间1.453-11.015）和较好眼睛视力较差的患者（调整后比值比3.66；95%置信区间1.27-10.54）分别比仅一只眼睛视力丧失且较好眼睛视力良好的患者更易出现心理困扰。视力丧失的原因、视力丧失模式、视力丧失持续时间和社会人口统计学变量均不影响出现心理困扰的可能性。
与视力正常的患者相比，视力丧失患者心理困扰的患病率显著更高。有必要将心理社会护理纳入当前视力丧失患者的医疗和手术治疗中。
