Self-management of age-related macular degeneration and quality of life - A randomized controlled trial
Self-management of age-related macular degeneration and quality of life - A randomized controlled trial
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DOI：
10.1001/archopht.120.11.1477
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发表时间：
2002-11-01
影响因子：
--
通讯作者：
Brown, SI
中科院分区：
文献类型：
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作者：
Brody, BL;Roch-Levecq, AC;Brown, SI
目的：评估年龄相关性黄斑变性（AMD）自我管理计划的有效性，包括健康教育和提高解决问题的能力，以改善生活质量，如情绪和功能的测量。方法：231名居住在社区的认知功能完整的晚期黄斑变性志愿者（平均年龄80.6岁）被随机分配到12小时的自我管理计划（n = 86），一系列12小时的录音健康讲座（n = 74），或等待名单（n = 72）。主要结果测量：主要结果测量是情绪困扰（情绪状态概况）。次要结果测量包括功能（美国国家眼科研究所视觉功能问卷）、社会支持（杜克社会支持指数）、人生观（修订的生活乐观主义测试）和处理AMD日常生活中特定挑战的自信（AMD自我效能问卷）。根据精神疾病诊断与统计手册第1轴第四版研究版的结构化临床访谈来确定临床抑郁症。结果：与对照组相比，自我管理组在情绪和功能方面表现出显著改善。抑郁症患者的这些变化明显大于非抑郁症患者。情绪困扰的减少与自我效能感的增加有关，而功能的改善与自我效能感和感知到的社会支持的增加有关。结论：这些研究结果表明，AMD自我管理计划是一种有效的干预措施，可以提高由于AMD导致的视力低下的老年人的幸福感，特别是那些最初抑郁的老年人。
Objective: To assess the effectiveness of an age-related macular degeneration (AMD) self-management program, consisting of health education and enhancement of problem-solving skills, to improve quality of life as shown by measures of mood and function.Methods: Two hundred thirty-one community-dwelling cognitively intact volunteers (mean age, 80.6 years) with advanced macular degeneration were randomly assigned to a 12-hour self-management program (n = 86), a series of 12 hours of tape-recorded health lectures (n = 74), or to a waiting list (n = 72).Main Outcome Measures: The primary outcome measure was emotional distress (Profile of Mood States). Secondary outcome measures included function (National Eye Institute Visual Function Questionnaire), social support (Duke Social Support Index), outlook on life (Life Optimism Test-Revised), and self-confidence to handle AMD-specific challenges in daily life (AMD Self-Efficacy Questionnaire). Clinical depression was deter-mined in accord with the Structured Clinical Interview for the Diagnostic and Statistical Manual of Mental Disorders, Axis 1, Fourth Edition, Research Version.Results: The self-management group showed significant improvement in measures of mood and function compared,with controls. These changes were significantly greater for the depressed than for the nondepressed subjects. Decreased emotional distress was associated with increased self-efficacy, while improvements in function were associated with increases in self-efficacy and perceived social support.Conclusions: These findings suggest that the AMD self-management program was an effective intervention to enhance well-being in older persons with poor eyesight due to AMD, particularly in those who were initially depressed.