Relationship Between Illness Perception,Social Support And Vision-related Quality Of Life Among Patients With Wet Aged-related Macular Degeneration

ObjectivesTo investigating the general information,illness perception,social support and vision-related quality of life among patients with Wet Aged-related Macular Degeneration(w-AMD);To analyze the related factors of vision-related quality of life among patients with Wet Aged-related Macular Degeneration;To explore the path of illness perception,social support and vision-related quality of life among patients with Wet Aged-related Macular Degeneration.MethodsA cross-sectional,observational study was conducted.The subjects were recruited from Tianjin Medical University Eye Hospital from January 2017 to December 2017.Patient diagnosed with Wet Aged-related Macular Degeneration were recruited.The patients were requested to fulfill the following questionnaires:the general situation questionnaire,Brief Illness Perception Questionnaire(BIPQ),Social Support Rating Scale(SSRS),National Eye Institute-Vision Function Questionnaire(NEI-VFQ-25).All the data collected were analyzed by SPSS 22.0 and AMOS 7.a.Mean standard deviation,frequency,and proportion were used for statistical description,multiple linear regression was used to analyze the assiciated factors of visual-related quality of life in patients with wet age-related macular degeneration,and structural equation model was used to analyze the path of illness perception,social support and vision-related quality of life.Results1 We distributed 224 questionnaires and retrieved 224 effective questionnaires.223 questionnaires were valid,the effective return ratio was 99.55%.There were 119(53.36%)male patients and 104(46.64%)female patients among 223 w-AMD patients.The patients between the age of 47 and 89,with a mean age of 66.44±9.40 years.Education level was low,only 10.31%had college degrees,bachelor degrees or above,the proportion of family income per capita was 3000-5000 accounted for 45.74%,patients lived with family accounted for 95.07%.The visual acuity on average was 0.43±0.21,ranged from 0.03 to 1.03.Patients with medical insurance was 82.96%and binocular involvement was 52.02%.2 Among the 223 w-AMD patients,the average scores of illness perception and its three dimensions including cognize,emotion and Comprehension ability were 47.00(42.00,53.00),31.00(27.00,34.00)?12.00(14.00,16.00)?3.00(2.00,4.00).Among the 223 w-AMD patients,the overall mean score of social Social Support Rating Scale was 36.00(32.00,39.00),three dimensions including objective support,subjective support and social support utilization were 23.00(20.00,26.00)?8.00(6.00,8.00)?5.00(4.00,6.00).Among the 223 w-AMD patients,the average scores of vision-related quality of life and its twelve dimensions including general health,general vision,ocular pain,near activities,distance activities,social functioning,mental health,role difficulties,dependency,driving,color vision and peripheral vision were 69.66(56.29,79.96),50.00(25.00,75.00)?40.00(40.00,60.00)?87.50(75.00,100.00)?58.33(41.67,66.67)?50.00(33.33,66.66)?100.00(87.50,100.00)?62.50(37.50,81.25)?50.00(37.50,75.00)?75.00(50.00,100,00)?83.33(75.00,100.00)?100.00(100.00,100.00).100.00(75.00,100.00).3 Apart from the general health dimension and color vision dimension,There is a negative relationship between emotion and other dimensions of vision-related quality of life total score(P<0.05).Social support utilization was positively correlated with ocular pain,social functioning,role difficulties,peripheral vision and vision-related quality of life total score(P<0.05).Age was negatively correlated with ocular pain and vision-related quality of life total score(P<0.05).Pathogenesis was negatively correlated with mental health and vision-related quality of life total score(P<0.05).4 The structural equation modeling analysis indicated that social support has a negative effect on vision-related quality of life(?=-0.095,P<0.001),social support has a positive effect on illness perception(?=1.146,P<0.001),emotion has a negative effect on vision-related quality of life(?=-0.103,P<0.001).The model can reflect the interrelationships among variables in this group(RMSEA=0.069,NNFI=0.893,CFI=0.915).Conclusions1 The social support and illness perception of the w-AMD patients were in the medium level,the vision-related quality of life was poor.2 Age,course of disease,emotion and social support utilization were associated factors of vision-related quality of life.3 The patients' social support not only can directly influence vision-related quality of life,also can indirectly influence vision-related quality of life via emotion(illness perception).Emotion(illness perception)showed a partial mediating role between social and vision-related quality of life.It suggested that the medical staff should pay attention to the adjustment function of social support,avoid or timely guide patients' negative emotion and improve their vision-related quality of life.