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Ehlers M, Mauschitz MM, Wabbels B. Implementing strabismus-specific psychosocial questionnaires in everyday clinical practice: mental health and quality of life in the context of strabismus surgery. BMJ Open Ophthalmol 2023; 8:e001334. [PMID: 37558407 PMCID: PMC10414054 DOI: 10.1136/bmjophth-2023-001334] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Accepted: 07/21/2023] [Indexed: 08/11/2023] Open
Abstract
BACKGROUND Strabismus can have a great negative impact on the quality of life and the well-being of affected patients. In the past, these aspects were often neglected and, compared with somatic functioning, placed in the background. The aim of our study is to elicit factors influencing satisfaction with strabismus surgery, quality of life and expectations of surgery in order to better predict who will benefit the most and who may need further support. METHODS We made a selection of suitable questionnaires to assess psychosocial aspects of strabismus and decided for Adult Strabismus 20 Questionnaire, Amblyopia and Strabismus Questionnaire, Diplopia Questionnaire, Expectations of Strabismus Surgery Questionnaire and Hospital Anxiety and Depression Scale. We then translated these measures (if not available in German). The patients filled out these forms as part of their preoperative orthoptic and ophthalmological assessment as well as approximately 3 months after strabismus surgery. RESULTS We enrolled 59 patients in this study. Postoperative strabismus-related quality of life was higher after surgery and anxiety and depression levels were lower. Satisfaction with surgery was lower with higher postoperative angle and diplopia; the latter was also a determinant of lower postoperative quality of life. Higher expectations of strabismus surgery were present with higher depression levels and higher preoperative strabismus angle. CONCLUSION Our data indicate that strabismus surgery may cause a significant improvement in several psychosocial domains. There is evidence that psychosocial factors can have significant impact on expectations with surgery. Hence, it is important to consider mental health aspects of this disease in order to treat patients in the best possible way.
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Affiliation(s)
- Maja Ehlers
- Department of Ophthalmology, University Hospital of Bonn, Bonn, Germany
- Department of Psychosomatic Medicine and Psychotherapy, University of Cologne, Cologne, Germany
| | | | - Bettina Wabbels
- Department of Ophthalmology, University Hospital of Bonn, Bonn, Germany
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Kumaran SE, Khadka J, Baker R, Pesudovs K. Patient‐reported outcome measures in amblyopia and strabismus: a systematic review. Clin Exp Optom 2021. [DOI: 10.1111/cxo.12553] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Affiliation(s)
- Sheela E Kumaran
- Discipline of Optometry and Vision Science, Flinders University, Adelaide, South Australia, Australia,
| | - Jyoti Khadka
- Discipline of Optometry and Vision Science, Flinders University, Adelaide, South Australia, Australia,
| | - Rod Baker
- Discipline of Optometry and Vision Science, Flinders University, Adelaide, South Australia, Australia,
| | - Konrad Pesudovs
- Discipline of Optometry and Vision Science, Flinders University, Adelaide, South Australia, Australia,
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Dagi LR, Velez FG, Archer SM, Atalay HT, Campolattaro BN, Holmes JM, Kerr NC, Kushner BJ, Mackinnon SE, Paysse EA, Pihlblad MS, Pineles SL, Strominger MB, Stager DR, Stager D, Capo H. Adult Strabismus Preferred Practice Pattern®. Ophthalmology 2020; 127:P182-P298. [DOI: 10.1016/j.ophtha.2019.09.023] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2019] [Accepted: 09/20/2019] [Indexed: 11/25/2022] Open
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Péntek M, Hajdu O, Rencz F, Beretzky Z, Brodszky V, Baji P, Zrubka Z, Major K, Gulácsi L. Subjective expectations regarding ageing: a cross-sectional online population survey in Hungary. THE EUROPEAN JOURNAL OF HEALTH ECONOMICS : HEPAC : HEALTH ECONOMICS IN PREVENTION AND CARE 2019; 20:17-30. [PMID: 31111403 PMCID: PMC6544751 DOI: 10.1007/s10198-019-01059-w] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/26/2019] [Accepted: 04/14/2019] [Indexed: 05/11/2023]
Abstract
BACKGROUND We aimed to investigate individuals' subjective expectations regarding health and happiness alongside their provisions on life circumstances for older ages. METHODS A cross-sectional online survey was performed involving a representative sample (N = 1000; mean age 50.9, SD = 15.4; female 54.5%) in Hungary. Subjective expectations on health status (EQ-5D-3L/-5L, GALI, WHO-5), happiness (0-10 VAS), employment status, care time, and forms of care for ages 60, 70, 80, and 90 were surveyed. RESULTS Current mean EQ-5D-5L was 0.869 (SD = 0.164) and happiness was 6.7 (SD = 2.4). Subjective life expectancy was 80.9 (SD = 11.1), and median expected retirement age was 65. Mean expected EQ-5D-5L for ages 60/70/80/90 was 0.761/0.684/0.554/0.402, and no activity limitations (GALI) were expected by 64%/40%/18%/14%, respectively. Expected happiness score was 6.8/6.7/6.2/5.7, and a decrease in mental well-being (WHO-5) was provisioned. A substantial increase in drug expenses and care time was anticipated, but only 52% thought to have extra income besides pension. The great majority expected to be helped by the family (77%/72%/53%/40%) if needed. Educational level, GALI, and longevity expectations were significant predictors of EQ-5D-5L expectations using a standard 5% significance level of decision. Current happiness was major determinant of expected future happiness. CONCLUSIONS Individuals expect a significant deterioration of health with age but only a moderate decrease in happiness. Overestimation of future activity limitations suggests a gap between statistical and subjective healthy life expectancy. The majority expects to rely on informal care in the elderly. Raise in retirement age is underestimated. Our results can be used as inputs for economic modelling of labor force participation and ageing.
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Affiliation(s)
- Márta Péntek
- Department of Health Economics, Corvinus University of Budapest, Fővám tér 8., Budapest, 1093, Hungary.
| | - Ottó Hajdu
- Department of Comparative Economics, Institute of Business Economics, Eötvös Loránd University, Szép u. 2, Budapest, 1053, Hungary
| | - Fanni Rencz
- Department of Health Economics, Corvinus University of Budapest, Fővám tér 8., Budapest, 1093, Hungary
- Premium Postdoctoral Research Programme, Hungarian Academy of Sciences, Nádor u. 7, Budapest, 1051, Hungary
| | - Zsuzsanna Beretzky
- Department of Health Economics, Corvinus University of Budapest, Fővám tér 8., Budapest, 1093, Hungary
- Doctoral School of Business and Management, Corvinus University of Budapest, Fővám tér 8., Budapest, 1093, Hungary
| | - Valentin Brodszky
- Department of Health Economics, Corvinus University of Budapest, Fővám tér 8., Budapest, 1093, Hungary
| | - Petra Baji
- Department of Health Economics, Corvinus University of Budapest, Fővám tér 8., Budapest, 1093, Hungary
| | - Zsombor Zrubka
- Department of Health Economics, Corvinus University of Budapest, Fővám tér 8., Budapest, 1093, Hungary
- Doctoral School of Business and Management, Corvinus University of Budapest, Fővám tér 8., Budapest, 1093, Hungary
| | - Klára Major
- Department of Macroeconomics, Corvinus University of Budapest, Fővám tér 8., Budapest, 1093, Hungary
| | - László Gulácsi
- Department of Health Economics, Corvinus University of Budapest, Fővám tér 8., Budapest, 1093, Hungary
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Singh A, Rana V, Patyal S, Kumar S, Mishra SK, Sharma VK. To assess knowledge and attitude of parents toward children suffering from strabismus in Indian subcontinent. Indian J Ophthalmol 2017; 65:603-606. [PMID: 28724818 PMCID: PMC5549413 DOI: 10.4103/ijo.ijo_619_16] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Purpose: Strabismus and anisometropia are the most common causes of amblyopia. It can be easily prevented or treated if detected early. With the changing socio-cultural-economic milieu of the society, the perspectives of strabismus in society are gradually changing but still adequate knowledge, awareness, and attitude of parents toward strabismus will help in preventing amblyopia and aid in the proper psychosocial adaptation of such children. This study aimed to assess knowledge and attitude of parents toward children suffering from strabismus. Methods: A prospective study was carried out from January 1 to February 29, 2016, through a structured questionnaire to assess the level of knowledge and attitude of parents of children suffering from strabismus. Results: One hundred and twenty parents of children with strabismus were interviewed through a questionnaire. Education level of 78 parents was less than graduation (60%) and of 42 parents (40%) was graduation or higher. The majority of the parents, i.e., 116 (96.67%) were bothered due to strabismus. One hundred and one (84.17%) parents felt that their child's strabismus was noticed by others during interaction. Seventy-four (61.67%) parents felt that their children will have difficulty in making friends. Ninety (75%) parents felt uncomfortable if someone asked something about their child's strabismus. One hundred and ten (91.67%) parents considered strabismus as cosmetic stigma. Conclusion: Some parents, especially from the lower educated segment, had poor understanding of strabismus, thus resulting in late presentation and ineffective countermeasures. The key to prevent strabismic amblyopia and its psychosocial impacts is to provide health education regarding strabismus.
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Affiliation(s)
- Anirudh Singh
- Department of Ophthalmology, Army Hospital (R&R) Delhi Cantt, New Delhi, India
| | - Vipin Rana
- Department of Ophthalmology, Army Hospital (R&R) Delhi Cantt, New Delhi, India
| | - Sagarika Patyal
- Department of Ophthalmology, Army Hospital (R&R) Delhi Cantt, New Delhi, India
| | - Santosh Kumar
- Department of Ophthalmology, Army Hospital (R&R) Delhi Cantt, New Delhi, India
| | - Sanjay K Mishra
- Department of Ophthalmology, Army Hospital (R&R) Delhi Cantt, New Delhi, India
| | - Vijay K Sharma
- Department of Ophthalmology, Army Hospital (R&R) Delhi Cantt, New Delhi, India
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Adams GGW, McBain H, MacKenzie K, Hancox J, Ezra DG, Newman SP. Is strabismus the only problem? Psychological issues surrounding strabismus surgery. J AAPOS 2016; 20:383-386. [PMID: 27651232 DOI: 10.1016/j.jaapos.2016.07.221] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2016] [Revised: 07/10/2016] [Accepted: 07/27/2016] [Indexed: 10/21/2022]
Abstract
BACKGROUND Strabismus, which has been estimated to occur in 4% of the adult population, can have a negative psychosocial effect on an individual's quality of life. While correction of strabismus may improve quality of life, this is not always the case, even if realignment surgery is clinically successful. Surgeons need to understand patients' expectations of postsurgical outcomes and the impact surgery has on their psychosocial well-being. METHODS This was a prospective cross-sectional study of 220 adult patients undergoing strabismus surgery at Moorfields Eye Hospital NHS Foundation Trust. Clinical assessments were performed before surgery and again 2 weeks and 3 months after surgery. Standardized psychological questionnaires were completed preoperatively and 3 and 6 months postoperatively. RESULTS Of 220 patients included in the study (mean age, 45 years), 54% were female, 81% were white, and 58.6% had a concomitant deviation. Prior to surgery, 24% of study participants were experiencing clinical levels of anxiety; 11% were suffering clinical levels of depression. Quality of life improved and anxiety and depression were reduced after surgery. Approximately 6% of the sample regretted having undergone surgery either at 3 or 6 months after treatment. CONCLUSIONS It is important to identify patients who are experiencing significant psychosocial distress and to assess their postsurgical expectations in order to improve the outcomes of strabismus surgery. Presurgical psychosocial support should be considered for these patients.
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Astle AT, Foulsham T, Foss AJ, McGraw PV. Is the frequency of adult strabismus surgery increasing? Ophthalmic Physiol Opt 2016; 36:487-93. [DOI: 10.1111/opo.12306] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2016] [Accepted: 05/11/2016] [Indexed: 12/01/2022]
Affiliation(s)
- Andrew T. Astle
- Visual Neuroscience Group; School of Psychology; University of Nottingham; Nottingham UK
| | - Tom Foulsham
- Department of Psychology; University of Essex; Colchester Essex UK
| | - Alexander J. Foss
- Department of Ophthalmology; University Hospital; Queen's Medical Centre; Nottingham UK
| | - Paul V. McGraw
- Visual Neuroscience Group; School of Psychology; University of Nottingham; Nottingham UK
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Does strabismus surgery improve quality and mood, and what factors influence this? Eye (Lond) 2016; 30:656-67. [PMID: 27126298 DOI: 10.1038/eye.2016.70] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2015] [Accepted: 01/29/2016] [Indexed: 11/08/2022] Open
Abstract
AimsTo establish the impact of adult strabismus surgery on clinical and psychosocial well-being and determine who experiences the greatest benefit from surgery and how one could intervene to improve quality of life post-surgery.MethodsA longitudinal study, with measurements taken pre-surgery and at 3 and 6 months post-surgery. All participants completed the AS-20 a disease specific quality of life scale, along with measures of mood, strabismus and appearance-related beliefs and cognitions and perceived social support. Participants also underwent a full orthoptic assessment at their preoperative visit and again 3 months postoperatively. Clinical outcomes of surgery were classified as success, partial success or failure, using the largest angle of deviation, diplopia and requirement for further therapy.Results210 participants took part in the study. Strabismus surgery led to statistically significant improvements in psychosocial and functional quality of life. Those whose surgery was deemed a partial success did however experience a deterioration in quality of life. A combination of clinical variables, high expectations, and negative beliefs about the illness and appearance pre-surgery were significant predictors of change in quality of life from pre- to post-surgery.ConclusionsStrabismus surgery leads to significant improvements in quality of life up to 6 months postoperatively. There are however a group of patients who do not experience these benefits. A series of clinical and psychosocial factors have now been identified, which will enable clinicians to identify patients who may be vulnerable to poorer outcomes post-surgery and allow for the development of interventions to improve quality of life after surgery.
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