Caswell Dolores, Caswell William, Carlton Jill
Canadian National Institute for the Blind, Toronto, Ontario, Canada.
Patient author, Vancouver, British Columbia, Canada.
Ophthalmol Ther. 2021 Sep;10(3):367-382. doi: 10.1007/s40123-021-00352-3. Epub 2021 Jun 5.
Quality of life (QoL) is a complex idea without a clear consensus definition. Generally speaking, QoL refers to several subjective measures of wellbeing that vary by individual and circumstance. QoL can decline noticeably as a disease progresses. This is particularly true for geographic atrophy (GA), an advanced form of age-related macular degeneration. GA leads to vision loss for which there is no currently approved pharmacological treatment. There is a lack of qualitative, patient-driven research on QoL in GA. There is also limited information available to both patients and physicians about GA, existing support groups and available assistive technologies. To address this, we have collated the experiences of a person with GA and those of her partner and carer with the current literature on QoL in GA. We have also outlined some of the wide range of developing technologies available to help people with GA carry out daily tasks and hobbies. It is clear that support, whether through informal or structured care, is vital to the wellbeing of people with GA. Despite this, the general public are often unaware of care work, which may result in this integral role being undervalued and under acknowledged. Furthermore, it is apparent that the general public have fundamental misunderstandings around what vision loss entails and are unaware that blindness is a vast spectrum. This feeds into the seemingly paradoxical mix of isolation and dependence on others that often results from GA and vision loss. Through this qualitative examination of a patient's experiences, we hope to inform and educate both patients and physicians about GA as well as precipitate discussion around the frameworks that should be in place to support both newly diagnosed and long-term patients with GA and other retinal diseases. Seeing beyond anatomy: quality of life with geographic atrophy (WMV 29479 kb).
生活质量(QoL)是一个复杂的概念,尚无明确的共识定义。一般来说,生活质量指的是幸福感的几种主观衡量标准,会因个人和具体情况而有所不同。随着疾病的进展,生活质量可能会显著下降。对于地理性萎缩(GA)这种年龄相关性黄斑变性的晚期形式来说尤其如此。GA会导致视力丧失,目前尚无获批的药物治疗方法。关于GA患者生活质量的定性、以患者为导向的研究较为缺乏。患者和医生可获取的有关GA、现有支持小组及可用辅助技术的信息也有限。为解决这一问题,我们整理了一位GA患者及其伴侣和护理者的经历,并结合了当前关于GA患者生活质量的文献。我们还概述了一系列正在开发的广泛技术,这些技术可帮助GA患者完成日常任务和从事爱好活动。显然,无论是通过非正式护理还是结构化护理提供的支持,对GA患者的幸福感都至关重要。尽管如此,公众往往不了解护理工作,这可能导致这一不可或缺的角色被低估和忽视。此外,很明显,公众对视力丧失的含义存在基本误解,并且不知道失明是一个范围很广的概念。这导致了GA和视力丧失常常带来的看似矛盾的孤立与依赖他人的混合状态。通过对患者经历的这种定性研究,我们希望为患者和医生提供有关GA的信息并对其进行教育,同时引发围绕应建立何种框架以支持新诊断和长期患有GA及其他视网膜疾病患者的讨论。超越解剖学视角:地理性萎缩患者的生活质量(WMV 29479 kb)