Department of Optometry and Visual Science, College of Science, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana.
Health & Wellbeing, Human and Social Capabilities Division, Human Sciences Research Council, Cape Town, South Africa.
BMC Psychol. 2021 Apr 29;9(1):66. doi: 10.1186/s40359-021-00558-x.
Psychological distress in vision impairments and blindness is a complex issue and a major public health concern. Sudden adjustments in routine lifestyle and career aspirations in such persons culminate in and/or aggravate their level of stress. Yet, psychological distress in persons with visual difficulties and vision loss in South Africa is poorly understood. We investigated the association between psychological distress and self-reported vision difficulties as well as clinician-assessed vision loss using data from the South African National Health and Nutrition Examination Survey (SANHANES-1).
Data was analysed on participants aged ≥ 15 years who participated in the SANHANES-1 clinical examinations and interviews. Data on demographic, socio-economic, and health status variables were gathered using a structured questionnaire. Psychological distress was assessed using the Kessler psychological distress scale (K10). Vision assessment was conducted by clinicians adhering to standard protocols as well as by participants' subjective response to vision-related questions. Vision loss was defined as presenting visual acuity worse than Snellen 6/12 in the better eye. Bivariate and multiple logistic regressions were used to examine the association between vision parameters and psychological distress.
The analytic sample comprised 6859 participants with mean age of 38.4 years (60.8% females). The prevalence of psychological distress was 19.9%. After adjusting for demographics, socioeconomic, health risk and eye care variables, self-reported myopia (mild adjusted odds ratio [AOR] = 1.9, 95% CI 1.3-2.7; moderate AOR = 2.4, 95% CI 1.6-3.7; severe AOR = 3.6, 95% CI 1.8-7.3) and self-reported hyperopia (mild AOR = 1.7, 95% CI 1.2-2.5; moderate AOR = 2.4, 95% CI 1.5-3.8; severe AOR = 3.5, 95% CI 1.8-6.8) were significantly associated with psychological distress. While psychological distress was higher in patients with clinician assessed vision loss than those with normal vision, the association was not statistically significant after adjusting for confounders (AOR: 1.0, 95% CI 0.7-1.4).
Persons who self-reported vision difficulty experienced a higher prevalence of psychological distress. Therefore, comprehensive psychological care is needed for patients with eye disease or vision difficulties as part of a governmental strategy to provide mental health care for all South Africans.
视力障碍和失明人群中的心理困扰是一个复杂的问题，也是一个主要的公共卫生关注点。此类人群的日常生活和职业抱负突然发生变化，导致他们的压力水平达到或超过了他们的承受能力。然而，南非视力障碍人群和视力丧失人群的心理困扰情况却鲜为人知。我们利用南非国家健康和营养调查（SANHANES-1）的数据，研究了心理困扰与自我报告的视力困难以及临床医生评估的视力丧失之间的关系。
对参加 SANHANES-1 临床检查和访谈的年龄≥15 岁的参与者进行了数据分析。使用结构化问卷收集了人口统计学、社会经济和健康状况变量的数据。使用 Kessler 心理困扰量表（K10）评估心理困扰。通过临床医生遵循标准协议以及参与者对与视力相关问题的主观反应进行视力评估。视力丧失定义为较好眼的视力低于 Snellen 6/12。使用双变量和多变量逻辑回归来检查视力参数与心理困扰之间的关系。
分析样本包括 6859 名参与者，平均年龄为 38.4 岁（60.8%为女性）。心理困扰的患病率为 19.9%。在调整人口统计学、社会经济、健康风险和眼部护理变量后，自我报告的近视（轻度调整后的优势比 [AOR] = 1.9，95%CI 1.3-2.7；中度 AOR = 2.4，95%CI 1.6-3.7；重度 AOR = 3.6，95%CI 1.8-7.3）和自我报告的远视（轻度 AOR = 1.7，95%CI 1.2-2.5；中度 AOR = 2.4，95%CI 1.5-3.8；重度 AOR = 3.5，95%CI 1.8-6.8）与心理困扰显著相关。虽然与视力正常的参与者相比，临床评估有视力丧失的参与者的心理困扰程度更高，但在调整混杂因素后，这种关联没有统计学意义（AOR：1.0，95%CI 0.7-1.4）。
自我报告视力困难的人经历更高的心理困扰患病率。因此，需要为眼病或视力障碍患者提供全面的心理护理，这是为所有南非人提供精神卫生保健的政府战略的一部分。
