| PurposeOur study is to explore status quo of life quality of the patients who underwent keratoprothesis surgery and its influence factors through prevalence survey. Render visual rehabilitation nursing to those of low-vision and investigate the effects, in order to provide the reference basis of nursing interventions effectively to improve the patients,quality of life.Method1. Questionnaire survey research. There were a total of 99 patients (99eyes) who underwent Keratoprethesis between December, 2005 and December, 2015 at the ophthalmology department of PLA general hospital. The longest follow -up was 10 years. We carried out questionnaire survey involving general condition, NEI-VFQ-25,SAS, SSRS in the manner of face-to-face interview and telephone to investigate the status quo of life quality of the patients and its influence factors.2. Visual rehabilitation nursing for the low-vision. Self-controlled research: render visual rehabilitation nursing to those of low vision after Kpro implantation, involving strictly compliance with the policy of visual aids, wearing the visual aids and providing nursing intervention.The indications of evaluation is to evaluate rehabilita-tion effects 3 months before and after the interventions, including best-corrected visual acuity(BCVA) and improvements of life quality.3. Statistical analysis: Data analysis were performed using SPSS 17.0 software, includ-ing descriptive analysis, t-test, Pearson correlation coefficient, variance analysis,multiple stepwise regression analysis and so on. Differences were considered statistically significant when the p-value was less than 0.05.Result1. 99 patients performed permanent KPro implantation surgery. There were 87 males (87.9%,87/99)and 12 females (12.1%,12/99),whose mean age were 43.72±13.32 years.Other demographic background revealed that 58.5% of patients graduated from middle school, 64.4% got married, the income of 48.5% of the patients were less than 2000 yuan, most patients(83.8%) depended on their families instead of themselves, In terms of payment manner, 64.7% chose full payment. Preoperative diagnosis were categorized as follows: alkaline burn 49.5%, acid burn 11.1%,thermal burn 18.1%, Steven-Johnson syndrome 8.1%, severe dry eye 2.0%, ocular cicatrical pempehigoid 5.1%, corneal keratoplasty failure 6.1%. Mean time of preoperative and postoperative course, respectively, was 5.99±7.01 years and 3.88±3.22years, mean times of postoperative complications were 2.40 ± 2.17.2. QOL: The total score of QOL of patients was 43.52±20.20, Furthermore,the result of classification showed good for 10.10% , medium for30.30% , poor for 59.60%. The level of QOL on patients after KPro implantation was poor. Single factor analysis of variance showed that The total score of patients with vision better than 0.3 were 65.63± 13.35,with low vision were 44.23± 10.61,the total score of blind patients were 20.97± 5.77; the total score of patients with their monthly income less than RMB 2000 Yuan were 32.65? 12.18,with their monthly income less than RMB 4000 and more than 2000 Yuan were 54.59± 18.10, with their monthly income more than RMB 4000 Yuan were 52.64± 18.86 ; the total score of patients with disease course more than three years were 44.17±20.63,less than three years were 42.79± 19.92;the total score of patients with complication more than two times were 34.56± 15.34, with less than two times were 58.51 ± 18.52; the total score of patients with postoperative time more than three years were 42.70±19.56,with less than three years were 44.35±21.0;the total score of patients with anxiety were 28.70 ± 11.29 ,with no anxiety were 61.29±12.77; the total score of patients with high social support were 46.39±17.22,with low social support were 41.72±21.81. The vision, income, preoperative disease course, postoperative period, anxiety, social support showed significant differ-ence in total life quality. Multivariate linear stepwise regression analysis indicated that vision, anxiety, postoperative period were important factors influencing the quali-ty of life.3. Visual rehabilitation results: Seventeen patients were included. The best-corrected visu -al acuity(BCVA); three patients obtained vision(0.1?0.3)with incidence rate of 17.7%, ten patients obtained vision(0.3?0.5)with incidence rate of 58.8%,four patients obtained vision(>0.5)with incidence rate of 23.5%. 82.3% of patients were out of visual disability. 23. 5% patients could attain reading success. The vision were all significantly improved by visual aids; QOL: the total score of patients before visual aids used were 48.59±14.13,with used visual aids were 73.53 ±11.59. the total score of distant vision, adjusting ability, reading and fine work, activity of daily living category in patients before visual aids used were 23.53 ±6.18, 10.76±4.16,7.41 ±4.73,6.88±3.86 with used visual aids were 32.47±5.61,12.53±3.59,16.18±4.46.13.35±3.58.The total quality of life score and every category in rehabilitation training after were significantly higher than those before.Conclusion1. In spite of restoring visual acuity after Kpro survey, but some patients got low-visi on or blind.They need more therapy and nursing intervention.2. Life quality of the patients was limited by financial state, postoperative complicati-ons, follow-up and social support. Most patients suffered lower condition, with only 10.10% had a good standard of life quality.3. Various factors could influence life quality of the patients after Kpro implantation,revealing that nursing interventions should be carried out in terms of physical health, mentality society to improve life quality.4. Vision aids is a useful device for visual disability, which can help patients to make use of residual visual acuity and improve the QOL.5. It is necessary for social communities to pay more attention to those patients who underwent Kpro surgery. Putting pointed interventions into effects on the basis of status quo of life quality to thoroughly improve life quality of patients. |
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