| Summary: | Cataract is one of the most common causes of visual impairment (VI) and blindness in the elderly population. In Hong Kong, the total population and the number of people over the age of 65 has been increasing over the past 10 years. The number of people suffered from cataract has also increased due to population growth and limited availability of medical resources. The waiting time for cataract surgery is long. Patients’ visual acuity (VA) continues to deteriorate while they are waiting for the surgery. Therefore, it is important for healthcare providers to explore the impact of VI on the quality of life (QOL) of cataract patients, and develop strategies to help patients overcome their difficulties.
Patients who were on the cataract surgery waiting list with no cognitive impairment were recruited from the Department of Ophthalmology, Queen Mary Hospital, Hong Kong. A purposive sampling method was used. 24 patients were recruited based on their age and VA. Each group contained the same number of male and female patients. Informed consent was obtained before the start of the interview. Patients’ demographics and clinical data were extracted from their medical records. A mix of qualitative and quantitative approaches was adopted. Data were collected through semi-structural interviews (qualitative) and the administration of the Chinese version of the 25-Item National Eye Institute Visual Function Questionnaire (CHI-VFQ-25) (quantitative).
Our results suggested that patients had poor knowledge regarding the definition and symptoms of cataract. In-depth interviews revealed that patients were having troubles in various ADLs, including cooking and dining, reading and writing, housekeeping, grooming and watching television (TV). Difficulties with mobility and transportation, together with the inability to recognize faces, were found to affect patients’ social lives. The fear of future deterioration in VA and the loss of abilities resulted in a range of negative feelings, such as sadness, frustration, irritation, insecurity and feeling of burden to others. Strategies used to tackle the difficulties in ADLs and patients’ adjustments to their negative emotions were also described. Certain comorbid diseases, for example stroke, arthritis and hearing impairment, further complicated patients’ QOL.
Quantitative analyses showed that patients had suboptimal scores in all subscales of CHI-VFQ-25, except for ocular pain and peripheral vision. In general, the CHI-VFQ-25 composite scores reflected that patients had little to moderate difficulties in their ADLs. Working status also affected the CHI-VFQ-25 scores. Patients who were working had lower scores in almost all subscales (except general health, ocular pain, colour vision and peripheral vision) than retired patients. Intergroup comparison suggested that patients who were older and had lower VA scored worst in the CHI-VFQ-25.
In conclusion, although our patients have been suffered from cataract for years, they had poor knowledge about this common eye disease. Both qualitative and quantitative analyses showed that patients experienced a lot of difficulties in their ADLs, which eventually led to a variety of negative impacts on their emotional and psychosocial wellbeing. === published_or_final_version === Anatomy === Master === Master of Philosophy
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