中国乐清市自行实施家庭视力检查的有效性和可行性：一项横断面研究。
Validity and feasibility of a self-administered home vision examination in Yueqing, China: a cross-sectional study.
机构信息
The Affiliated Eye Hospital, School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, China.
Centre for Public Health, Queen's University Belfast, Belfast, Belfast, UK.
出版信息
BMJ Open. 2020 Apr 16;10(4):e030956. doi: 10.1136/bmjopen-2019-030956.
OBJECTIVE
To investigate the validity and feasibility of a self-administered home vision examination programme in China.
DESIGN
Cross-sectional study.
SETTING
Yueqing, China.
PARTICIPANTS
A two-stage convenience sampling procedure was used to randomly select 600 households from 30 communities participating in the Yueqing Eye Study (YES). The aim of YES is to encourage home-based vision screening, reporting of visual acuity (VA) annually through social media and encouraging people to attend follow-up clinic appointments as a way to improve eye care access for adults with VA ≤+0.5 log of the minimum angle of resolution (logMAR).
INTERVENTIONS
Household screeners (one per household) who tested other family members' VA completed a questionnaire on family structure, demographic information and knowledge about screening procedures. Other family members then underwent confirmatory VA testing by researchers.
OUTCOME MEASURES
The completion rate of home-based VA screening, its sensitivity and specificity were used to evaluate validity. Factors that determined whether families participated in the self-VA screening were used to evaluate feasibility.
RESULTS
345 (66%) of the 523 (87.2%) households with valid data form their home-based vision examinations also were retested by researchers. There was no statistically significant difference in scores on the family-administerd or researcher-administerd VA test (VA≤+0.5 logMAR, p=0.607; VA >+0.5 logMAR, p=0.612). The sensitivity and specificity of home-based vision screening were 80.5% (95% CI 70.2% to 86.9%) and 95.1% (95% CI 92.6% to 96.8%), respectively. 14.7% (77/523) of tested respondents had VA ≤+0.5 logMAR. Predictors of performing home screening for VA remaining in regression models included higher economic status ('fair and above' vs 'poor': OR 1.74; 95% CI 1.08 to 2.76; p=0.022), age (<45 years vs ≥45 years: OR 0.46; 95% CI 0.25 to 0.85; p=0.014) and living in a nuclear (OR 5.17; 95% CI 2.86 to 9.36; p<0.001) or extended family (OR 8.37; 95% CI 4.93 to 14.20; p<0.001).
CONCLUSION
Self-administered home vision screening is reliable and highly accepted by Chinese adults.
目的
在中国研究自我管理家庭视力检查方案的有效性和可行性。
设计
横断面研究。
地点
中国乐清。
参与者
采用两阶段便利抽样程序，从参与乐清眼研究（YES）的 30 个社区中随机抽取 600 户家庭。YES 的目的是鼓励家庭进行视力筛查，通过社交媒体每年报告视力（VA），并鼓励人们参加随访诊所预约，以改善成年人 VA≤+0.5 对数最小角分辨率（logMAR）的眼保健服务获取。
干预措施
对测试其他家庭成员 VA 的家庭筛查员（每户一名）完成了一份关于家庭结构、人口统计学信息和筛查程序知识的问卷。然后，其他家庭成员由研究人员进行确认性 VA 测试。
结果
在 523 个（87.2%）有有效数据的家庭中，有 345 个（66%）家庭进行了基于家庭的 VA 筛查，并且也接受了研究人员的复查。家庭管理或研究人员管理的 VA 测试的得分没有统计学上的显著差异（VA≤+0.5 logMAR，p=0.607；VA >+0.5 logMAR，p=0.612）。家庭视力筛查的敏感性和特异性分别为 80.5%（95%CI 70.2%至 86.9%）和 95.1%（95%CI 92.6%至 96.8%）。在接受测试的受访者中，有 14.7%（77/523）的 VA≤+0.5 logMAR。回归模型中进行 VA 家庭筛查的预测因素包括较高的经济地位（“好”和“很好”与“差”：OR 1.74；95%CI 1.08 至 2.76；p=0.022）、年龄（<45 岁与≥45 岁：OR 0.46；95%CI 0.25 至 0.85；p=0.014）和居住在核心（OR 5.17；95%CI 2.86 至 9.36；p<0.001）或扩展家庭（OR 8.37；95%CI 4.93 至 14.20；p<0.001）。
结论
自我管理的家庭视力筛查是可靠的，并且深受中国成年人的欢迎。
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