Study On Effects Of Psychological Intervention On Cataract Patients' Quality Of Life And Its Correlative Factors

Background:Cataract is the main blinding eye diseases in the world, it's reported that it accounts for 41% of the blinding person total, and the incidence rate of cataract is increasing progressively year by year in the global. According to the statistic, the blind in our country approximately compose 18% of the world blind person total, in which the amount of cataract patients approximately accounts for 1/5 of the total number of the world cataract patients. Literature has reported that cataract occupies the main status of the senior citizen disease spectrum in our country, and it has affected patients'life seriously. Along with our country population aging and advanced age speed quickening, the number of cataract patients will increase unceasingly. Serious damage to the visual function make the patients see things limited, see fuzzily, even see nothing. These make patients create the enormous psychological stress, anxiety, depression and so on. All above seriously take from the patients'self-care ability, and make patients'quality of life obviously be lower than healthy person. The quality of life is an overall target, which produces under the new medical pattern to comprehensively appraise the individual or the community feeling about the body, psychological, the social various aspects good state of health. QOL is more focused on the subjective feeling, and can more fully reflect the health status of patients. At present, the researches about cataract patients'quality of life are rather few, there aren't any related researches and reports about the cataract patients'psychological condition and their quality of life by the method of psychological intervention in domestic and foreign yet. Objectives:1. To investigate cataract patients'psychological status and quality of life situation.2. To investigate correlation factors distributed situation about cataract patients'anxiety and depression.3. To discuss the influence of suitable psychological intervention methods on cataract patients'worse moods and quality of life.4. To initially research the related factors about cataract patients'quality of life.Methods:We used the combined methods of experimental study and questionnaire survey in this study. The selected 100 cataract patients were stochastically divided into the control group and intervention group with each 50 examples. Two groups were given the same conventional treatment and nursing, simultaneously, the intervention group was performed psychological intervention. On the patients'first hospitalized day, all the patients were tested physiological targets, such as temperature, pulse, breath, blood pressure. On the same day, we need collect the patients'common material and Social Support Rating Scale (SSRS), Medical Coping Modes Questionnaire (MCMQ), Self-rating anxiety scale(SAS), Self-rating depression scale (SDS), The Short Form-36 Health Survey (SF-36), and we investigate the anxiety and depression related questionnaire ,which was independently designed by the author , to those patients with anxiety or depression; The cataract patients were performed physiological targets, SAS, SDS before surgery; and the patients need to fulfill SF-36, SDS, SAS before leaving hospital.Results:1 Investigations demonstrated that,①The anxious patients, the depression patients separately account for 62.3% and 60.8% in the investigated populations, patients with both anxiety and depression account for 46.2%;②There're 95.1% patients in the 81 cases anxious patients belong to mild anxious ones, 4.9% patients belong to moderate anxious ones; there're 93.7% patients in the 79 cases depression patients belong to mild depression, 6.3% patients belong to moderate depression ones.③Cataract patients'SAS and SDS scores are higher than the normal crowd in domestic (p<0.001).④The cataract patients'quality of life in other various dimensions are lower than the normal at home except bodily ache (BP) and mental health (MH) and vitality(VT), there are significant differences in statistics (p<0.05).2. The investigation about the unhealthy moods-related factors showed that, firstly, cataract patients worry about the eyesight restoration degree after the operation. Second is their demand for health education. Others are that they don't understand the surgery process, worry about the medical expenses, can't understand disease knowledge, fear pain, be anxious about the inconvenient life after operation during recovery period. The last factor is they worry about cataract recurring again.3. There is no statistical difference in the general condition, physiological target, SAS, SDS, SSRS, MCMQ, SF-36 between two groups (P>0.05).4. After interventions,①The pulse and the blood pressure of the control group are higher than the intervention group before operation, there are significant differences in statistics (p<0.05).②There are obvious differences in statistics between two groups in SAS and SDS( p<0.01).③The respective comparisons both intervention group and control group on their own longitudinal SF-36,which indicate that both groups'quality of life were all higher when the patients leave off hospital, there are significant differences in statistics (p<0.05).④General health perception (GH), mental health (MH), bodily pain (BP) and social functioning (SF) of intervention group are higher than the control group, there are significant differences in statistics (p<0.05).⑤Intervention group anxious patients'GH, BP are much higher when compared to the control group, there are significant differences in statistics (p<0.05); Intervention group depression patients'GH, BP, SF, MH, VT are higher when compared to the control group, there are significant differences in statistics (p<0.05); The GH, BP, VT of intervention group patients, who are with both anxious and depression coexistence, are higher than that of control group, there are significant differences in statistics (p<0.05). 5.①The total score of SAS was obviously negative correlation with SF (p<0.05), the total score of SDS was obviously negative correlation with PF, BP, GH, VT, SF, MH (p<0.05, p<0.01).②The social support total score was obviously positive correlation with PF, BP, GH, VT, SF, RE (p< 0.05, p<0.01), the subjective support was obviously positive correlation with PF, BP, VT, SF (p<0.05, p<0.01), the objective support was obviously positive correlation with PF, VT, RE (p<0.05, p<0.01), the exploitability degree of the social supports was obviously positive correlation with PF, BP, GH, VT, SF, MH (p<0.05, p<0.01);③Confrontation, avoidance were obviously negative correlation with MH (p<0.01), acceptance-resignation was obviously negative correlation with PF, SF, MH (p<0.01, p<0.05).④Age was obviously negative correlation with PF,VT,SF(p<0.01, p<0.05).6. Influencing factor analysis of the quality of life: The VT of cataract patients who are in the marriage is higher than that of widowed cataract patients(p<0.05); When patients can take care of themselves, their PF, GH, SF, VT, MH are higher than those who need to be attended (p<0.01); The PF, BP of cataract patients with convenient hospitalizing conditions are higher than those with inconvenient hospitalizing conditions (p<0.01); Cataract patient's PF in urban is higher than those in non-urban (p<0.01); Cadre's PF, BP and GH, VT are higher than common staff and other occupations'patients (p<0.01, p<0.05); The MH of cataract patients, whose course is less than 1 year, is higher than that of patients whose course is between 1-3 years (p<0.05); Patient's PF and BP, GH, SF, VT are higher at the degree of education in senior high school or above than in the junior middle school or below (p<0.01, p<0.05). When in a family per person's average monthly income is higher than 2000 Yuan, cataract patient's PF, BP, GH, SF, VT are higher than those insufficient 2000 Yuan (p<0.05).Conclusions:1. Cataract patients have unhealthy moods such as anxiety and depression, and mild anxiety and mild depression occupy the overwhelming majority. 2. Cataract patients'the most primary factor of anxiety and depression is that they care about the eyesight restoration degree post-operation.3. The cataract patients'anxiety and depression degree are higher than the normal crowd in domestic.4. Except the bodily pain, the mental health two aspects are close to the normal crowd level in domestic and vitality is higher than the normal crowd level in domestic, other aspects of cataract patients'quality of life are generally lower.5. The psychological intervention may improve the cataract patients'unhealthy moods such as anxiety and depression.6. The psychological intervention may improve cataract patients'quality of life. Especially, they are improved obviously in general health perceptions, bodily pain, role limitations due to emotional problems, social functioning, vitality, mental health.7. Anxiety, depression, the coping style of avoidance and acceptance-resignation and the age are obviously negative correlation with the quality of life, the social support is obviously positive correlation with the quality of life.8. General influencing factors of the quality of life include: marital conditions, types of care, hospitalizing conditions, home addresses, years of education, per person's average monthly income in a family, cataract courses, occupations.