Psychological and quality-of-life changes after removal of the eye in a sample of adult patients, Egypt, 2013

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Abstract

Background and objectives

Of the five human senses, sight has always been considered the most important. Loss of vision due to diseases or trauma causes major changes in the quality of life. Not only is the patient no longer able to perform all the usual tasks and activities to the same extent as previously, but changes in lifestyle, habits, and roles may also result in a serious psychological adjustment; individuals’ social interaction is also affected. Therefore, the current study aimed to assess some socio-demographic characteristics of patients who had undergone removal of the eye, and to investigate the psychological changes and the quality of life of these patients.

Patients and methods

Sixty-one patients with removed eye were recruited from Al-Hussein University Hospital, Ocular Oncology Unit, in the National Eye Center (Rod Elfarag), and the International Eye Hospital (Alooyon Aldawly) after the intervention of ‘enucleation or evisceration’ to participate in this cross-sectional study. Patients were followed up for 3 months after surgery and then 6 months later to gather data on their socio-demographics, psychological state, and quality of life using three different scales: the General Health Questionnaire, Short Form 36, and Beck’s Depression Inventory. Categorical variables were tested using χ2-test and McNemar test for follow-up variables, at 95% confidence interval (P<0.05).

Results

Sixty-one patients were studied: nearly two-third of them were male, between 20 and 40 years old, and had completed their higher degree education. Around half of the sample was married and belonged to a low social class. Forty percent were employed. The most common cause of eye removal was tumor (36.1%); nearly half of the patients were suffering from infection and glaucoma and 16.4% had trauma. The type of surgical operation was nearly equally distributed between enucleation (45.9%) and evisceration (54.1%). There is a strong relationship between depression and socio-demographic characteristics of the patients. During the follow-up of the patients 3 months after surgery and 6 months later, somatic symptoms and severe depression were still present in 52.9% of the patients. However, 64.1% of anxiety patients had no more symptoms, and more than half of the patients complaining of social dysfunction were relieved. According to Beck’s Depression Inventory, there was obvious improvement in patients’ depressive level. Short Form 36 showed that the affected physical function and bodily pain became better.

Conclusion

The current study demonstrates a strong relationship between eye removal and quality of life and the psychological state of patients, in particular among elderly, female, illiterate, unmarried, and low-social-class patients. These findings raise the possibility that improving the psychological health as part of a comprehensive management plan for these patients may improve the overall long-term outcome.

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