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白内障手术患者的观点:一项队列研究的方案与基线结果

Patient perspectives of cataract surgery: protocol and baseline findings of a cohort study.

作者信息

Do Vu Quang, McCluskey Peter, Palagyi Anna, White Andrew, Stapleton Fiona J, Carnt Nicole, Keay Lisa

机构信息

The George Institute for Global Health, The University of New South Wales, Sydney, New South Wales, Australia.

School of Optometry and Vision Science, The University of New South Wales, Sydney, New South Wales, Australia.

出版信息

Clin Exp Optom. 2018 Nov;101(6):732-739. doi: 10.1111/cxo.12686. Epub 2018 Apr 19.

Abstract

BACKGROUND

Patient-reported outcome measures (PROMs) are becoming increasingly recognised as a key component in assessing the relative effectiveness of cataract surgery. This manuscript presents the protocol methodology and baseline characteristics of a prospective cohort study investigating patient-centred predictors of cataract surgery outcomes.

METHODS

Patients with bilateral cataract (aged ≥ 50 years) scheduled for their first eye cataract surgery were recruited at four public hospitals and three private ophthalmology clinics in Sydney, Australia. Participants underwent a comprehensive assessment of clinical measures of vision (for example, visual acuity, contrast sensitivity) and PROMs prior to first eye surgery and three months after first and second eye surgery. The PROMs of interest included health-related quality of life, visual disability and satisfaction with vision.

RESULTS

The characteristics of the baseline cohort of 359 participants are reported in this manuscript. Enrolment occurred over a two-year period with the majority recruited from urban public hospitals (96 per cent, n = 345). Health-related quality of life was scored highly (80 out of 100). Self-reported visual disability was considered within normal ranges compared to cataract populations in other high-income countries (-0.94 logits). Three-quarters of participants (n = 263/351) were dissatisfied with their pre-operative vision.

CONCLUSIONS

There is a complex and wide range of patient-centred experiences prior to first eye cataract surgery in the public hospital setting. Gaining further insight into the patient perspective may allow eye health professionals to more appropriately time surgery, better manage patient expectations and provide direction for future prioritisation initiatives of cataract wait lists. Companion papers will follow, detailing results of surgery in terms of PROMs.

摘要

背景

患者报告结局测量(PROMs)越来越被视为评估白内障手术相对有效性的关键组成部分。本手稿介绍了一项前瞻性队列研究的方案方法和基线特征,该研究调查以患者为中心的白内障手术结局预测因素。

方法

在澳大利亚悉尼的四家公立医院和三家私立眼科诊所招募计划进行首次单眼白内障手术的双侧白内障患者(年龄≥50岁)。参与者在首次单眼手术前以及首次和第二次单眼手术后三个月接受了视力临床测量(例如,视力、对比敏感度)和PROMs的全面评估。感兴趣的PROMs包括与健康相关的生活质量、视觉残疾和对视力的满意度。

结果

本手稿报告了359名参与者的基线队列特征。招募工作在两年期间进行,大多数参与者来自城市公立医院(96%,n = 345)。与健康相关的生活质量得分很高(满分100分中的80分)。与其他高收入国家的白内障患者群体相比,自我报告的视觉残疾被认为在正常范围内(-0.94对数单位)。四分之三的参与者(n = 263/351)对术前视力不满意。

结论

在公立医院环境中,首次单眼白内障手术前存在复杂且广泛的以患者为中心的体验。进一步了解患者的观点可能使眼科健康专业人员能够更适当地安排手术时间,更好地管理患者期望,并为未来白内障等候名单优先排序举措提供指导。后续将有配套论文详细介绍手术在PROMs方面的结果。

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