本文選題：眼球摘除 + 視功能生活質(zhì)量�。� 參考：《浙江大學(xué)》2016年博士論文

【摘要】：目的：眼球摘除患者因視功能和容貌均受影響,面臨著身心健康的改變。本研究目的是,評(píng)估眼球摘除患者的視功能生活質(zhì)量、容貌負(fù)面評(píng)價(jià)以及焦慮和抑郁情緒,探索患者的人口統(tǒng)計(jì)學(xué)變量、臨床變量和社會(huì)心理學(xué)變量與焦慮和抑郁情緒之間的相關(guān)性。方法：本橫斷面研究納入了2014年7月至2016年2月就診于浙江大學(xué)醫(yī)學(xué)院附屬第二醫(yī)院眼科中心的195例眼球摘除患者為病例組,以及同期100例眼科患者的陪同者為對(duì)照組。研究采集病例組和對(duì)照組的人口統(tǒng)計(jì)學(xué)資料,病例組的臨床資料以及羞愧、悲傷和憤怒的程度。兩組研究對(duì)象均完成視功能生活質(zhì)量量表、負(fù)面身體自我量表-容貌分量表以及醫(yī)院焦慮和抑郁量表。比較視功能生活質(zhì)量、容貌負(fù)面評(píng)價(jià)、以及焦慮和抑郁程度的組間差異。以患者的人口統(tǒng)計(jì)學(xué)變量、臨床變量和社會(huì)心理學(xué)變量為自變量,以焦慮和抑郁程度為因變量,進(jìn)行多因素逐步回歸分析。結(jié)果：與對(duì)照組相比,病例組的視功能生活質(zhì)量較低(中位數(shù)(四分位數(shù)間距)：91.9(85.6-95.9)vs 71.8(58.1-83。.7),P0.001),容貌評(píng)價(jià)較負(fù)面(1.2(0.5-1.9)vs0.4(0.1-0.8),P0.001)。病例組中,23.1%對(duì)自我容貌不滿意,比例明顯高于對(duì)照組。義眼配戴時(shí)間和義眼與健眼的相似度,與患者的容貌負(fù)面評(píng)價(jià)有關(guān)。病例組中,11.8%存在焦慮情緒,13.8%存在抑郁情緒,比例均明顯高于對(duì)照組。逐步回歸分析發(fā)現(xiàn),病例組的焦慮和抑郁程度與視功能生活質(zhì)量(焦慮：p=-0.506,P0.001；抑郁：p=-0.346,P0.001)和容貌負(fù)面評(píng)價(jià)(焦慮：p=0.359,P0.001；抑郁：p=0.152,P0.05)相關(guān)。年齡越小(p=-0.140,P0.05),焦慮程度越高。受教育程度越低(p=-0.221,P0.001),對(duì)眼球摘除感到越憤怒(p=0.217,P=0.001),抑郁程度越高。臨床變量與焦慮和抑郁程度無(wú)關(guān)。結(jié)論：眼球摘除患者中存在焦慮情緒和抑郁情緒的比例較高。社會(huì)心理學(xué)特質(zhì),而非臨床特質(zhì),與患者的焦慮和抑郁程度相關(guān)。對(duì)于視功能生活質(zhì)量較低、容貌評(píng)價(jià)較負(fù)面的眼球摘除患者,臨床醫(yī)生可能需要及時(shí)提供恰當(dāng)?shù)男睦斫】捣⻊?wù),幫助改善患者的情緒狀態(tài)。在改善措施提出之前,需要進(jìn)一步的前瞻性研究來(lái)明確眼球摘除患者的情緒狀態(tài)的影響因素。
[Abstract]:Objective: the patients with enucleation are faced with physical and mental health changes due to the influence of visual function and appearance. The aim of this study was to assess the visual function quality of life, negative appearance, anxiety and depression in patients with enucleation, and to explore the demographic variables of the patients. The correlation between clinical variables and social psychological variables and anxiety and depression. Methods: from July 2014 to February 2016, 195 patients with ophthalmectomy and 100 patients accompanying ophthalmectomies from the second affiliated Hospital of Zhejiang University Medical College were included in this cross-sectional study as the control group. The study collected demographic data from case and control groups, clinical data from case groups, and levels of shame, sadness and anger. Both groups completed visual function quality of life scale, negative physical self-scale-appearance scale and hospital anxiety and depression scale. The quality of life of visual function, negative evaluation of facial appearance, and the degree of anxiety and depression were compared between groups. Multivariate stepwise regression analysis was carried out with demographic variables, clinical variables and social psychological variables as independent variables and anxiety and depression degree as dependent variables. Results: compared with the control group, the quality of life of visual function in the case group was lower than that in the control group (median: 91.9% 85.6-95.9) vs 71.8% 58.1-83..7P 0.001g, and the negative evaluation of appearance was 1.2-1.5-1.9vs0.40.1-0.8P0.001. In the case group, 23.1% were not satisfied with self-appearance, and the proportion was significantly higher than that in the control group. The wearing time and the similarity between prosthetic eye and healthy eye were related to the negative evaluation of the patient's appearance. In the case group, 11.8% had anxiety and 13.8% had depression, which was significantly higher than that in the control group. Stepwise regression analysis showed that the degree of anxiety and depression was correlated with the quality of life of visual function (anxiety: pn-0.506U P0.001; depression: p-0.346n P0.001) and negative evaluation of appearance (anxiety: p359 (P0.001); depression: P0. 152 (P0.05). The younger the age was, the higher the anxiety was. The lower the education level was, the higher the degree of depression was. Clinical variables were not associated with anxiety and depression. Conclusion: the proportion of anxiety and depression in patients with enucleation is higher. Social psychological traits, rather than clinical traits, were associated with anxiety and depression. For the patients with lower quality of life and negative evaluation of visual function, the clinician may need to provide appropriate mental health services in time to help improve the emotional state of the patients. Further prospective studies are needed to identify the factors affecting emotional state in patients with enucleation before improvement measures are proposed.
【學(xué)位授予單位】：浙江大學(xué)
【學(xué)位級(jí)別】：博士
【學(xué)位授予年份】：2016
【分類號(hào)】：R779.6

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本文編號(hào)：1811669