青光眼病人視覺功能及健康相關生活品質之相關性探討

A Correlation Study of Visual Function and Health-Related Quality of Life in Glaucoma Patients

林人傑(Jen-Chieh Lin)

指導教授 ： 楊銘欽

國立臺灣大學/公共衛生學院/醫療機構管理研究所/碩士(2006年)

https://doi.org/10.6342/NTU.2006.02847

摘要

青光眼是國人三大失明原因之一，它可以四種方式來影響生活品質，包括視覺功能下降，害怕失明的心理因素，手術或藥物治療產生的副作用，返診治療的經濟負擔。生活品質的改變，是青光眼病患除了眼壓、視神經盤及視野外，所必須測量的；同時，它亦是青光眼治療方式選擇的重要參考因素。
本研究目的在於瞭解與青光眼病患生活品質相關的因素，並評估青光眼病患視覺功能與健康相關生活品質（health related QOL），視覺相關生活品質（vision related QOL）的關係。以台北市某區域醫院94年4月1日至94年9月30日期間診斷為青光眼，共計280位病人為研究對象，進行病人人口學特質、臨床特性及藥物使用情形的資料之蒐集；並以SF-36及NEIVFQ-25中文版問卷調查其健康相關生活品質。
重要研究結果如下:
一、青光眼病人的部分人口學特質與健康相關之生活品質顯著相關
二、青光眼病人的部分臨床特性與健康相關之生活品質顯著相關
三、青光眼病人的部分藥物使用情形與健康相關之生活品質顯著相關
四、視覺功能六個變項與SF-36八個次向度、NEIVFQ-25十二個次向度的結果均呈現負相關。其中，NEIVFQ-25有九個次向度與視覺功能變項達到中度的負相關性(r=-0.4~-0.69)；但SF-36只有兩個次向度與視覺功能變項達到中度的負相關性(r=-0.4~-0.69)。
建議醫師可藉由問卷調查的方法來瞭解青光眼病患自覺視覺功能不良的情形及其生活品質，結果將可以作為調整臨床治療的重要參考依據。

關鍵字

青光眼 ； 視覺功能 ； 健康相關生活品質 ； 視覺相關生活品質

並列摘要

Glaucoma is one of the most prevalent causes of blindness in Taiwan. It may affect quality of life in several ways. These include decreased visual function, psychological effect of fear of blindness, the potential side effects of treatment, financial burden of the cost of visits and therapy. Changes in quality of life are essential measures of glaucoma, in addition to intraocular pressure, optic disc, and visual field; in the meantime, they are also the important guidelines of treatments for glaucoma.
The purposes of this study were to explore the possible factors associated with glaucoma patients’ quality of life, and evaluate the relationship between visual function and patients’ perception of their health related QOL as well as vision related QOL.
The study sample was 280 patients with glaucoma undergoing follow-up in one regional hospital in Taipei from April 1st, 2005 to September 30th, 2005. Demographic data, clinical characteristics and the status of treatment were collected. The questionnaire used contains the Taiwan (Chinese) versions of SF-36, NEIVFQ-25 modules to investigate the health related QOL.
Important results of this study were as follow:
1.Part of demographic characteristics of glaucoma patients were associated with their health related QOL.
2.Part of clinical characteristics of glaucoma patients were associated with their health related QOL.
3.Part of the status of treatment of glaucoma patients were associated with their health related QOL.
4.8 subscales of SF-36 and 12 subscales of NEIVFQ-25 demonstrated a negative correlation with 6 variables of visual function. 9 subscales of NEIVFQ-25 were moderately correlated with variables of visual function(r=-0.4~-0.69). However, only 2 subscales of SF-36 were moderately correlated with variables of visual function(r=-0.4~-0.69).
In conclusion, we suggest that physicians could explore the relationship between patients' perception of visual disability from glaucoma and quality of life by means of questionnaires. The results can be used as a reference when adjusting therapy for glaucoma.

並列關鍵字

glaucoma ； visual function ； health related QOL ； vision related QOL

參考文獻

姚開屏: 健康相關生活品質概念與測量原理簡介。台灣醫學2002; 6(2): 183-192。

陸玓玲: 台灣地區生活品質研究概況。中華衛誌 1998; 17(6) : 442-457。

陳慧雯、李世煌: 視野缺損對青光眼病患視覺功能之影響。中眼醫誌 1998; 37(2): 210-213。

張慈惠、黃秀梨: 生活品質評量之臨床應用。台灣醫學 2000; 4(1): 86-90。

曾旭民、盧瑞芬、蔡益堅: 國人生活品質評量(II): SF-36台灣版的常模與效度檢測。台灣衛誌 2003; 22(6) : 512-518。