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Visual and non-visual factors associated with patient satisfaction and quality of life in LASIK.

ABSTRACT: PURPOSE: The aim of this study was to determine how laser in situ keratomileusis (LASIK) affects quality of life (QOL) and to identify factors that may affect satisfaction after LASIK. METHODS: A total of 104 patients with a mean age of 29±6, treated with LASIK for myopia and astigmatism, were enrolled in a prospective study. High (90%) and low (10%) contrast visual acuity (CVA) were measured under photopic and scotopic conditions before surgery and at 3 months later. A multidimensional QOL scale (Institute for Eye Research multidimensional QOL scale), which assesses psychological characteristics, personality traits, cosmesis, frequency, and tolerance to disturbing visual and ocular symptoms, and overall satisfaction with vision correction, was also used. Paired rank tests were used to compare preoperative and postoperative vision and QOL scores. Correlations and a multiple linear regression were used to describe the relationship between CVA, QOL, and satisfaction after LASIK. RESULTS: Significant postoperative changes included increased satisfaction following LASIK (P<0.001), reduced frequency of visual and ocular symptoms (P<0.001), and change in psychological characteristics (P=0.033). The change in satisfaction with LASIK can be predicted by a combination of preoperative satisfaction, postoperative frequency of disturbing visual and ocular symptoms, postoperative mean spherical equivalent, and postoperative scotopic high CVA (R (2)=0.725, P<0.05). CONCLUSIONS: Satisfaction with LASIK is related to visual function, preoperative expectations, psychological characteristics, and uncorrected CVA achieved. An increased sense of subjective well-being, adaptability, and self-efficacy was evident after LASIK. Patients reported a more optimistic attitude to life and increase perceived QOL after surgery.

SUBMITTER: Lazon de la Jara P

PROVIDER: S-EPMC3178233 | biostudies-other | 2011 Sep

REPOSITORIES: biostudies-other

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Project description:BackgroundImplant survival and implant success (freedom of biologic complications) are important factors in assessing the success of implant therapy. However, these factors are not the only determinants. Patients' satisfaction also plays a very important role in daily practice. Therefore, the aim of this study was to assess patients' satisfaction regarding function (phonetics, chewing comfort, stability, cleanability) and aesthetics in patients treated with XiVE and Frialite implants in a private periodontal practice ten years after implant placement. Furthermore, oral health-related quality of life (OHRQoL) was evaluated.MethodsPatient-reported outcome measures (PROMs) regarding overall satisfaction, phonetics, chewing comfort, stability, cleanability, and aesthetics were examined on a Visual Analog Scale (VAS) 10 years ± 6 months after implant placement in a cross-sectional survey. OHRQoL and psychological impact were assessed via the Oral Health Impact Profile (OHIP) and Psychosocial Impact of Dental Aesthetics Questionnaire (PIDAQ). Potential influence of patient-related factors (age, gender, smoking, peri-implantitis, implant position, type of restoration) on VAS, OHRQoL and PIDAQ were investigated using regression analyses.ResultsHigh satisfaction with implant-supported restorations was seen in all 95 patients ten years after implant placement. Mean VAS-score for general satisfaction with implant-supported restoration was 93.0% (SD ± 9.4, median: 96.3%, range 50.0-100%). Mean OHIP score was 11.3 (SD ± 10.8, median: 9.0, range 0-45), mean PIDAQ score 20.5 (SD ± 11.37, median: 17.0, range 0-52). A slight tendency that presence of a moderate/severe peri-implantitis lowers satisfaction could be detected (overall satisfaction: ordinal, p = 0.012, VAS, p = 0.026). Also, the factors age, implant position and type of restoration might have an impact on patient's satisfaction.ConclusionsPatients restored with mostly fixed implant-supported restorations showed a very high patient satisfaction regarding function and aesthetics 10-year after implant placement. The presence of a moderate/severe peri-implantitis showed a slight tendency for influencing patient satisfaction. Due to the cross-sectional design results have to be interpreted with care.

Project description:PurposeThe aim of this study was to explore and describe quantitatively patient-reported outcome measures (PROMs), ie, health-related quality of life (QoL), visual function and treatment satisfaction, in patients with diabetic macular edema (DME) receiving two different regimens of Ozurdex (intravitreal dexamethasone implant).MethodsIn this multicenter, prospective study, 100 patients with center-involving refractory DME were randomized 1:1 to either five monthly fixed dosing or optical coherence tomography (OCT)-guided pro re nata (PRN) regimen of dexamethasone intravitreal implant therapy. The primary outcome was the difference between arms in change in PROMs and health-related QoL from baseline to 12 months, as measured by the Retinopathy-Dependent Quality of Life (RetDQoL) questionnaire, Visual Function Questionnaire-25 (VFQ-25) and Retinopathy Treatment Satisfaction Questionnaire (RetTSQ).ResultsThere was no statistically significant difference in the RetDQoL score and VFQ-25 score at month 12 compared to those at baseline, whereas the total mean RetTSQ score increased significantly at the exit visit. The two treatment arms did not differ significantly regarding the change in PROMs and health-related QoL questionnaires. Logistic regression analysis showed that visual acuity (VA) of ≥55 letters, central foveal thickness <300 μm and macular volume <9.2 mm3 at the exit visit (month 12) predicted a higher change in RetTSQ.ConclusionThis study showed that there is a statistically significant improvement in treatment satisfaction, as measured by RetTSQ, in patients with DME treated with dexamethasone intravitreal implant, independent of the dose regimen, namely, fixed or PRN. However, it should be noted that the clinically meaningful change could not be assessed accurately, since no thresholds for clinically meaningful change currently exist for the RetTSQ. On the other hand, there was no significant change in health-related QoL, as measured using VFQ-25 and RetDQoL. Factors affecting the patients' treatment satisfaction were the final VA, the central foveal thickness and the macular volume.

Project description:Predicted shortages in the supply of neurologists may limit patients' access to and quality of care for neurological disorders. Retaining neurologists already in practice provides one opportunity to support the overall supply of practicing neurologists. Understanding factors associated with professional life satisfaction (and dissatisfaction) and implementing policies to enhance satisfaction may encourage neurologists to remain in clinical practice. In this paper, we present results from the first study examining factors associated with professional life satisfaction among a large sample of U.S, neurologists.We collaborated with the AAN to survey a sample of U.S. neurologists about their professional life satisfaction. Analyses examined the association of physician and practice characteristics with aspects of professional life satisfaction, including satisfaction with their career in medicine, medical specialty, current position, relationship with colleagues, relationship with patients, work/life balance, and pay.The study population consisted of 625 neurologists. In multivariate regression analyses, no single group or population stratum indicated high (or low) responses to all aspects of satisfaction. Older neurologists reported higher satisfaction with career, specialty, and relationship with patients than younger neurologists. Female neurologists had significantly lower satisfaction with pay than male neurologists. Neurologists who spent more time in research and teaching had greater satisfaction with specialty, relationship with colleagues, and relationship with patients than those spending no time in research. Neurologists who practiced in small cities/rural areas reported lower satisfaction across multiple dimensions than those practicing in large urban areas. Neurologists in solo practice had greater satisfaction with the relationship with their patients, but lower satisfaction with pay.Satisfaction is a multidimensional construct that is associated with physician and practice characteristics. Enhancing professional life satisfaction among neurologists requires multiple strategies, such as promoting comparable wages for men and women, providing collaboration and research opportunities, and providing resources for small and rural practices.

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Visual and non-visual factors associated with patient satisfaction and quality of life in LASIK.

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