Abstract
Purpose of study Visible disfigurement is associated with a range of psychosocial difficulties; however, the problems encountered by patients with eye conditions are under-researched. This study aimed to establish the extent and type of psychosocial distress in this patient population, and to explore the extent to which patients' needs are currently met.
Method Standardised measures (anxiety, depression, appearance-related distress, and quality of life) and a semistructured interview (exploring individual experiences and satisfaction with care) were administered to 153 consecutive attenders at outpatient eye clinics in three different hospitals. Responses were analysed using descriptive statistics, multiple regression, and cluster analyses.
Results Between 10 and 49% of the patient sample scored unfavourably on standardised measures in comparison with normative values. Cluster analyses revealed that more distressed patients typically exhibited higher levels of anxiety, depression, social anxiety, self-consciousness, and social avoidance. Quality of life scores were also less favourable. Distressed patients felt less well informed, less involved in their treatment, and less well supported in the clinic setting. Variability within the sample was high; however, the effects of the cause and duration of the condition were not significantly related to distress. Clinic staff identified a variety of constraints to meeting patients' need, including patient numbers, the lack of appropriate training, and the lack of referral possibilities.
Conclusions A considerable proportion of patients with disfiguring eye conditions experience high levels of psychosocial distress. Several options exist for ways in which patients' needs might more effectively be met within the constraints currently facing care providers.
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Acknowledgements
This work was carried out in the Out-Patient Departments of the Moorfields Eye Hospital, London; The Bristol Eye Hospital & The Artificial Eye Centre, Bristol. The authors wish to acknowledge the help and support offered by staff at these centres, the contribution made to data collection by Veronica Kish, and the statistical expertise provided by Dr Paul White, Faculty of Computing, Statistics & Mathematics, University of the West of England, Bristol, UK. This research was funded jointly by The Nuffield Trust & The King's Fund.
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Clarke, A., Rumsey, N., Collin, J. et al. Psychosocial distress associated with disfiguring eye conditions. Eye 17, 35–40 (2003). https://doi.org/10.1038/sj.eye.6700234
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DOI: https://doi.org/10.1038/sj.eye.6700234
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