中老年白内障患者对手术认知及视觉功能改善的调查研究

目的　横断面调查研究中老年白内障患者对手术的认知现况及视觉功能改善的评价或预期，为白内障手术教育、预期引导及提升手术意愿提供指导。方法　研究类型为横断面调查研究。采用济南市第二人民医院眼科设计的《白内障手术认知调查表》调查患者对手术的认知情况；采用《白内障患者对视觉功能改善的评价或预期调查表》调查白内障患者对视觉功能改善的评价或预期，调查时间为2021年4月至8月，调查地点为济南市第二人民医院。计数资料采用χ²检验，计量资料采用独立样本t检验。结果　共531例白内障患者纳入分析，根据是否接受手术分为已接受手术组（169例）与未接受手术组（362例）。已接受手术组患者年龄50～60岁14例，≥60～70岁52例，≥70～80岁67例，≥80岁36例；男67例，女102例；双眼最大视力≤0.3 22例，双眼最大视力>0.3 147例。未接受手术组患者年龄50～60岁42例，≥60～70岁91例，≥70～80岁132例，≥80岁97例；男138例，女224例；双眼最大视力≤0.3 94例，双眼最大视力>0.3 268例。已接受手术白内障患者对“手术是治疗老年性白内障的主要方式”［93.49%（158/169）比44.48%（161/362）］“白内障手术通常可在0.5 h内完成”［94.67%（160/169）比39.23%（142/362）］“白内障手术已纳入我国医保报销范围”［91.12%（154/169）比66.57%（241/362）］正确认知的认同率均显著高于未接受手术组；对“佩戴眼镜就能纠正白内障视力低下”［4.73%（8/169）比26.24%（95/362）］“双眼完全看不清才考虑手术”［8.88%（15/169）比58.31%（193/362）］“白内障成熟才可开展手术”［2.96%（5/169）比29.56%（107/362）］错误认知的认同率均显著低于未接受手术组，差异均有统计学意义（均P<0.05）。已接受手术的白内障患者对术后能看清面孔［87.57%（148/169）比77.96%（282/362）］、能使用电子产品［89.94%（152/169）比75.97%（275/362）］、能增强室内休闲活动［78.11%（132/169）比61.05%（221/362）］的术后视觉改善体验方面的预期均显著高于未接受手术白内障患者，差异均有统计学意义（均P<0.05）。结论　已接受手术的白内障患者对手术认知优于未接受手术的白内障患者，已接受手术的白内障患者在视觉改善方面的体验高于未接受手术的白内障患者的预期。

Investigation on the operative cognition and improvement of visual function in middle-aged and elderly cataract patients

Objective　To investigate the evaluation or expectation of the operative cognition status and visual function improvement in middle-aged and elderly cataract patients in order to provide guidances for cataract surgery education, expectation guidance, and improvement of the willingness of surgery. Methods　This was a cross-sectional investigation study. The Cataract Surgery Cognition Questionnaire designed by Department of Ophthalmology, The Second People's Hospital of Jinan City was used to investigate the patients' operative cognition, the Evaluation or Expectation Questionnaire of Cataract Patients on the Improvement of Visual Function was used to investigate the cataract patients' evaluation or expectation on the improvement of visual function. The investigation time was from April to August 2021, and the investigation site was The Second People's Hospital of Jinan City. χ² test was used for the count data and independent sample t test was used for the measurement data. Results　A total of 531 cataract patients were included in the analysis. According to whether they had undergone surgery, they were divided into a surgery group (169 cases) and a non-surgery group (362 cases). In the surgery group, there were 14 patients aged 50 to 60 years, 52 patients aged ≥60 to 70 years, 67 patients aged ≥70 to 80 years, and 36 patients aged ≥80 years, including 67 males and 102 females; the maximum binocular visual acuity was less than or equal to 0.3 in 22 cases and greater than 0.3 in 147 cases. In the non-surgery, there were 42 patients aged 50 to 60 years old, 91 patients aged ≥60 to 70 years old, 132 patients aged ≥70 to 80 years old, and 97 patients aged ≥80 years old, including 138 males and 224 females; the maximum binocular visual acuity was less than or equal to 0.3 in 94 cases and greater than 0.3 in 268 cases. The correct recognition rates of "surgery is the main way to treat senile cataract" 93.49% (158/169) vs. 44.48% (161/362)], "cataract surgery is usually finished within 0.5 h" 94.67% (160/169) vs. 39.23% (142/362)], and "cataract surgery has been covered by China's medical insurance" 91.12% (154/169) vs. 66.57% (241/362)] in the cataract patients who had undergone surgery were significantly higher than those in the cataract patients who did not undergo surgery, and the false recognition rate of "poor eyesight can be corrected by wearing glasses" 4.73% (8/169) vs. 26.24% (95/362)], "surgery should be considered only when the eyes are completely blurred" 8.88% (15/169) vs. 58.31% (193/362)], and "cataract surgery should be carried out only when the cataract is mature"2.96% (5/169) vs. 29.56% (107/362)] in the cataract patients who had undergone surgery were significantly lower than those in the cataract patients who did not undergo surgery, with statistically significant differences (all P<0.05). The cataract patients who had undergone surgery were able to see clearly their faces after surgery 87.57% (148/169) vs. 77.96% (282/362)], use electronic products 89.94% (152/169) vs. 75.97% (275/362)], and enhance indoor leisure activities 78.11% (132/169) vs. 61.05% (221/362)], the postoperative visual improvement experience was significantly higher than the expectation of the cataract patients who did not undergo surgery, with statistically significant differences (all P<0.05). Conclusions　Cataract patients who have undergone surgery have a better cognition on surgery than those who do not undergo surgery. Cataract patients who have undergone surgery have a higher experience of visual improvement than those who do not undergo surgery expect.