| Objective:The purpose of this study is to investigate the self-perceived burden(SPB) of diabetic retinopathy(DR) patients after Diabetic Retinopathy and its influencing factors, and analyze the correlation between the two. In addition, these patients’ depression level and quality of life were investigated and the relationship between SPB and patients’ depression level and quality of life were discussed, which provided critical theory evidences for the effective nursing interventions to perform in clinic. Methods:By convenient sampling method, 178 DR outpatients were selected from the ophthalmology department of the 3-A-grade hospital in Changchun.2014 to Apr. 2015. Self-designed general questionnaire and self-rating questionnaires including self-perceived burden scale, center for epidemiologic studies depression scale(CES-D) and quality of life scale for visual impairment patients, etc were used for the survey. All survey information was imported into Excel database. SPSS18.0 statistical software was used for the descriptive analysis, single-factor analysis, multiple-factor analysis and correlation analysis. Results: 1. Self-perceived burden of patients after diabetic retinopathy surgeryPatients’ SPB after DR surgery was evaluated according to the results acquired from the survey, the average SPB score was 28.22 ± 7.11, which was classified as mild SPB level. SPB was experienced at all levels by a total of 154 out of 178 patients, which counted as 86.52%. Within each survey category of SPB, “Concerns about spending a lot of money” scored the top, which was 3.10 ± 1.27; then the next highest scores were “Concerns about bringing trouble to the caregivers” and “Concerns about putting economic burden on the caregivers”, which were 2.99 ± 1.09 and 2.99 ± 1.10. 2. Single-factor analysis for the influencing factors of patients’ SPB after DR surgerySPB score was a dependent variable. The single-factor analysis was proceeded with 18 influencing factors as independent variables according to the references. The result showed that there were 7 influencing factors of patients’ SPB after DR surgery, including working condition, family income, resident condition, children condition, the time span since diagnosis, whether having complications and whether familiar with vitrectomy(P <0.05 or P <0.01). In this survey, the DR patients who felt the most burdens were the ones that were jobless, with family income <1000 RMB/month, in other resident condition excluding living alone or living with children/spouse, with 6~12 months since diagnosis, having hypertension and coronary heart disease complications, as well as not familiar with vitrectomy. 3. Multiple-factor analysis for the influencing factors of patients’ SPB after DRsurgeryChoosing the 7 influencing factors in the single-factor analysis that had statistical significance as independent variables and SPB score as dependent variable(introducing standard 0.05; rejection standard 0.10), the multiple stepwise regression analysis was proceeded. The result showed that 4 variables went into the regression equation, including working condition, children condition, disease time and whether familiar with vitrectomy. The equation of the above 4 factors with SPB score was: SPB = 14.358 + 0.820×working condition + 1.709×children condition + 2.002×disease time + 1.848×whether familiar with vitrectomy. The regression equation F = 43.22, R2=0.2397,P <0.0001, which meant that the final model of regression analysis had statistical significance. The 4 influencing factors that entered the equation all had positive effects on patients’ SPB. 4. Analysis of the relationship between patients’ SPB after DR surgery and theirdepression symptoms(1) Depression score of the patients after DR surgeryThe depression score of the patients after DR surgery was evaluated according to the center for epidemiologic studies depression scale(CES-D). The result showed that the overall depression level of the patients after DR surgery was in positive depression condition, with the highest depression score 49, lowest score 2, average score 23.13 ± 9.41, which was higher than the normal range bound value(≤15).(2) The relationship between patients’ depression symptoms and different SPBlevels after DR surgeryOn the basis of analyzing the depression scores of the patients in different SPB levels after DR surgery, the result showed that the depression scores varied with patients’ different SPB levels, with statistical significant difference(F = 46.46, P <0.001). The depression score of the patients with no obvious SPB was 10.21 ± 6.95, classified as no depression symptom condition; the depression score of the patients with mild SPB level was 21.99 ± 6.07; the depression score of the patients with moderate SPB level was 27.28 ± 7.69; the depression score of the patients with severe SPB level was 36.30 ± 10.0, which were all classified as positive depression condition. By one-to-one comparison of the depression score in each group, the differences between each two groups all had statistical significance(P <0.001).(3) Correlation analysis of patients’ SPB score with depression score after DRsurgeryThrough the Pearson correlation analysis of patients’ SPB score with depression score after DR surgery, the result indicated positive correlations between the SPB score and depression score, with the correlation coefficient r = 0.689, P = 0.001. 5. Analysis of the relationship between patients’ SPB after DR surgery and theirquality of life(1) Quality of life score of the patients after DR surgeryThe quality of life score of the patients after DR surgery was evaluated according to the quality of life scale designed for visual impairment patients. The result showed that the average quality of life score of the patients after DR surgery was 96.5 ± 19.7, which was classified as moderate level, with the issues in physical function, social activity and psychological aspects standing out.(2) The relationship between patients’ quality of life and different SPB levels afterDR surgeryOn the basis of analyzing the quality of life scores of the patients in different SPB levels after DR surgery, the result showed that the quality of life scores varied with patients’ different SPB levels, with statistical significant difference(F = 7.81, P <0.001). By one-to-one comparison of the quality of life score in each group, there was no statistical difference among the no obvious SPB, mild SPB and moderate SPB groups(P >0.05), however the difference between severe SPB group and other three groups all had statistical significance(P <0.05).(3) Correlation analysis of patients’ SPB score with quality of life score after DRsurgeryThrough the Pearson correlation analysis of patients’ SPB score with quality of life score after DR surgery, the result indicated negative correlations between the SPB score and quality of life score, with the correlation coefficient r =-0.247, P = 0.0009.Conclusions:1. SPB was experienced at all levels by 86.52% of patients after DR surgery, with an overall mild SPB level.2. The SPB of patients after DR surgery was mainly influenced by their working condition, children condition, the time span since diagnosis and the knowledge of vitrectomy, etc.3. The depression levels of the patients after DR surgery varied with their different SPB levels. The patients with no obvious SPB had no depression symptoms. The patients with mild and higher level SPB may appear depression symptoms. There was positive correlation between SPB and depression occurrence.4. Severe SPB of the patients after DR surgery led to the reduced quality of life. There was negative correlation between SPB and quality of life. |
PDF Full Text Request