电话回访应用于边远藏区白内障术后患者的满意度调查分析

摘要

?AIM:To evaluate predictors of patient satisfaction with vision and comfort following cataract surgery in Kandze Prefecture People's Hospital, in Dartsedo, the capital of a Tibetan region of China. ? METHODS: Prospective observational study of all patienst undergoing cataract surgery in Kandze Hospital in 2012.Patients categorized in terms of ocular pathology and/or surgic al complications at discharge, were contacted at 3mo postoperatively by cell -phone to d et ermine satisfaction with vision and presence of d iscomfort. ? RESULTS: In 2012, Kandze Hos pital conducted 888 cataract operations on 678pa tients, 364 ( 54%) women. Most patients ( 93%) presented with severe visual impairment or blindness (<6/60 ) in the better eye. Among the 881 eyes, the main surgical complic ations were corneal edema ( 44 cases ) and vitreous loss ( 19 cases) while the main pathologies we rer et inal disorders (30c ases) and“old ” iritis (11 cases).At 3mo, 508( 75%of 678c ataract patients) were contacted at least once by cell-phone.Of the 588 eyes self-assessed, 485 ( 82%) were reported“better”, 85 (15%) “same”, and 18 (3%)“worse” than the time of discharge for discomfort, visual acuity, or both.Significantly more eyes“with pathology”compared with “neither pathology nor complications” at discharge were reported to have discomfort or poor vision at 3mo (Chi-square=6.575, P=0.037). ?CONCLUSION: The need forcataract surgical patient follow-up advice at 3mo is predictable at discharge and increasingly possible with cell -phone technology. However, the ability to assist patients with complications or ocular pathology depends on improving eye care service s in the region.%目的：通过电话回访评估在四川甘孜藏族自治州人民医院进行白内障手术患者对术后视力及舒适满意度的调查分析。　　方法：对2012年于我院行白内障手术的患者建立档案，根据术前是否伴有其它眼科疾病和（或）在出院时是否伴有手术并发症进行分类，并对他们在术后3 mo进行电话回访，回访评估术后视力恢复情况及是否伴有其它不适。　　结果：我院在2012年总共行888例白内障手术6，78位患者，其中女性364例（54％），大多数患者（93％）术前双眼视力视力严重下降或盲（＜6／60）。在记录的881例手术中，主要的术前伴随眼疾：视网膜疾病30例，慢性虹膜疾病11例；主要术中并发症：角膜水肿44例，玻璃体溢出19例。电话回访结果显示：3 mo后508位患者（75％）被电话回访至少一次，在其中参加回访评估的588例手术中，485（82％）叙述相比较与出院时“变好”的视力和（或）伴有不舒适，85（15％）“一样”的视力和（或）伴有不舒适，18（3％）“变差”的视力和（或）伴有不舒适。回访结果显示：术后3 mo后，伴有术前眼疾和（或）手术并发症患者中叙述视力差和（或）术后不适的比例相比较不伴有术前眼疾和（或）手术并发症患者显著升高（ Chi－square＝6．575， P＝0．037）．　　结论：在出院时那些白内障患者特别需要术后3 mo回访是可预料的，而电话回访增加了回访的可能性。而且需要提高处理患者手术并发症或治疗术前伴随眼疾的能力必须通过提高当地的眼科服务能力来实现。