湿性老年黄斑变性患者治疗期间生存质量及影响因素的纵向研究

Factors affecting the quality of life in patients during treatment for wet age-related macular degeneration: a longitudinal cohort study

目的采用前瞻性的纵向研究设计,探讨人口学和专科资料以及社会心理因素对老年黄斑变性(age-related macular degeneration,AMD)患者不同治疗期生存质量的影响。方法采用方便抽样法选取2016年1月至2017年9月就诊于我院门诊的137例AMD患者作为研究对象,分别在治疗后1、3、6个月3个时间点,采用问卷调查对其生存质量及影响因素进行测评。结果治疗后3个月的生存质量最差,为(54.25±13.37)分,治疗后1个月生存质量最好,为(62.10±15.86)分,且3个不同治疗期的生存质量差异有统计学意义(F=11.518,P=0.000)。对生存质量影响因素的多元逐步回归分析显示:治疗手段(P<0.01)、文化程度(P<0.01)、婚姻状况(P<0.01)、焦虑(P<0.01)、抑郁(P<0.05)、自我效能(P<0.01)、社会支持(P<0.05)和积极应对(P<0.01)是AMD患者生存质量的主要影响因素。结论 AMD患者治疗后6个月中的不同阶段其生存质量及影响因素是动态变化的,为护理人员精准制订多阶段、有针对性的干预措施提供了理论依据。

Objective To survey the quality of life and the factors affecting the quality of life of patients with age-related macular degeneration （AMD） in different phases of treatment. Methods The convenience sampling was used for selecting 137 patients with AMD admitted in our department between January, 2016 and September, 2017. Follow-up survey for quality of life of the patients was conducted at 1, 3 and 6 months during the treatment. Results The mean score for quality of life was the lowest at 3 months （54.25 ± 13.37）, and was the highest at 1 month during the treatment （62.10 ± 15.86）. Multivariate regression analysis identified the type of disease （ P 〈 0.01 ）, education level （ P 〈 0.01 ）, marital status （P 〈 0.01 ）, anxiety （ P 〈 0.01 ）, depression （ P 〈 0.05 ）, self-efficacy （ P 〈 0.01 ）, social support （ P 〈 0.05） and positive coping style （P 〈0.01） as the factors that significantly affected the quality of life in the patients during treatment. Conclusion The factors affecting the quality of life of patients with ADM change with time during the treatment, and multi-staged, targeted interventions of these factors, preferentially within the initial 6 months during treatment, can improve the quality of life among the patients.