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仅一眼手术研究 2(OnES 2):“当眼罩取下时,我能看得见吗?”一项关于患者接受高风险仅一眼手术体验的定性研究。

Only eye study 2 (OnES 2): 'Am I going to be able to see when the patch comes off?' A qualitative study of patient experiences of undergoing high-stakes only eye surgery.

机构信息

Division of Optometry and Visual Sciences, School of Health Sciences, City University of London, London, UK

Birmingham Institute for Glaucoma Research, Institute of Translational Medicine, Birmingham, UK.

出版信息

BMJ Open. 2020 Nov 9;10(11):e038916. doi: 10.1136/bmjopen-2020-038916.

Abstract

OBJECTIVES

Ocular surgery is a source of significant concern for many patients, especially in high-stakes circumstances. The purpose of this study was to explore patient experiences of undergoing surgery on their only-seeing eye.

DESIGN

A qualitative investigation using semistructured face-to-face interviews. Transcripts were analysed using thematic analysis.

SETTING

Hospital eye service in the UK.

PARTICIPANTS

Twelve participants with a diagnosis of glaucoma with worse eye visual acuity <3/60± end-stage visual field loss. All participants had experience of undergoing surgery on their better-seeing (ie, 'only') eye.

RESULTS

Data were coded into three key themes relating to (1) emotional impact of surgery, (2) burden of visual loss and (3) coping with surgery. Patients reported depressive symptoms at all stages of their surgical journey; concern about poor visual outcomes was a common feature. Only eye surgery imposes an emotional burden due to the uncertainty regarding individuals' ability to continue daily activities and maintaining social roles. Burden extended to the inconvenience of frequent hospital visits and difficulties with follow-up care. Participants' ability to cope effectively with surgery appeared to be linked to extent of support from healthcare professionals. Key areas in developing trust and support were an open and transparent dialogue between surgeons and patients, continuity of care, patient inclusion in decision-making, and observable empathy.

CONCLUSIONS

The findings indicate a need for an enhanced model of care in only eye surgery to better target patient preferences and allay concerns inherent with these procedures.

摘要

目的

眼部手术令许多患者感到担忧,尤其是在高风险情况下。本研究旨在探讨患者接受单眼手术的体验。

设计

采用半结构式面对面访谈的定性研究。使用主题分析对转录本进行分析。

设置

英国医院眼科服务。

参与者

12 名参与者被诊断为青光眼,患眼视力<3/60±晚期视野丧失。所有参与者均有接受优势眼(即“唯一”眼)手术的经验。

结果

数据编码为三个关键主题,分别为(1)手术的情绪影响,(2)视力丧失的负担,(3)应对手术。患者在手术过程的各个阶段均报告出现抑郁症状;对视力不良结果的担忧是一个常见特征。单眼手术会带来情绪负担,因为患者不确定自己是否能够继续日常活动和维持社会角色。频繁的医院就诊和随访护理困难也增加了负担。患者有效应对手术的能力似乎与医护人员提供的支持程度有关。在发展信任和支持方面的关键领域包括外科医生与患者之间的开放透明对话、护理的连续性、患者参与决策以及可观察到的同理心。

结论

研究结果表明,单眼手术需要改进护理模式,以更好地满足患者的偏好并减轻这些手术带来的固有担忧。

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