Page 40 - JCBP-2-3

Journal of Clinical and
Basic Psychosomatics Emotions in anophthalmic patients

may necessitate eyeball removal, which results in not only of monocular enucleation eye socket implant, (iii) able to
physical impairment but also substantial psychological read questionnaire written in Chinese, and (iv) volunteers
distress. 2,3 for this survey, were included in the study. Exclusion
criteria included: (i) individuals who are illiterate or semi-
The loss of an eye leads to functional defects,
facial deformities, and even significant psychological literate that cannot complete the survey independently,
consequences. 1,4-7 Compared to individuals who have (ii) individuals who suffer from serious physical and mental
normal vision, those experiencing blindness often exhibit illness, and (iii) individuals with erroneous or missing
symptoms of anxiety and depression such as mental data. The study was approved by the Ethics Committee of
exhaustion, hypoactivity, and social withdrawal, especially Nanfang Hospital, Southern Medical University, and the
in the first few months after their blindness. Appearance study was conducted in accordance to the Declaration of
issues, temporary hallucinations, or ocular secretions may Helsinki.
be the main reasons. Some other studies suggest that using 2.2. Instruments
ocular prosthesis may alleviate the psychological symptoms
in blind patients. However, the levels of depression and Demographic, psychosocial, and ocular prosthesis-
7-9
anxiety in these patients with ocular prosthesis still remain related data were collected in the survey using structured
high, possibly due to a combination of factors including questionnaire. The demographic data included gender, age,
financial burden, prosthetic materials, and the time of household registration, education level, marital status, and
ocular prosthesis use. 10,11 economic status. Factors associated with ocular prosthesis
included prosthetic material, time of wearing ocular
At present, although several studies have examined prosthesis, cause of anophthalmos, and the satisfaction
depression and anxiety in patients with ocular prosthesis, of ocular prosthesis wearing. The Patient Health
most of these studies were of small sample size and only Questionnaire-9 (PHQ-9) and the Generalized Anxiety
investigated a small number of influencing factors, which Disorder-7 (GAD-7) were used to measure psychological
made their findings limited in scope and inconvincible. symptoms. 12-15
Hence, a more comprehensive and standardized study
of the psychological symptoms and their related factors The PHQ-9 was conducted to assess depressive
in these patients is warranted. This study was conducted symptoms. The total scores were categorized into five
aiming at thoroughly investigating the depression and severity levels: normal (0–4), mild depression (5–9),
anxiety symptoms and the associated factors among moderate depression (10–14), moderate to severe
patients wearing ocular prosthesis. depression (15–19), and severe depression (20–27). Higher
score indicated more severe depressive symptoms. The
2. Methods reliability and validity of the Chinese version of the PHQ-9
have been verified in a previous research. 16
2.1. Participants and procedure
To assess patients’ anxiety level, the GAD-7 was adopted.
This study was conducted from June 2022 to September GAD-7 is a four-point Likert scale, in which higher scores
2022 on a network-based platform among patients with indicate more severe anxiety symptoms. The total scores
monocular enucleation eye socket implantation. Structured were categorized into five severity levels: normal (0–4),
questionnaires were utilized in this survey, which was mild anxiety (5–9), moderate anxiety (10–13), moderate
conducted on the Haodaifu Bulletin Board System (BBS) to severe anxiety (14–18), and severe anxiety (19–21). The
(https://bbs.haodaifu.com/). Haodaifu BBS, founded reliability and effectiveness of the Chinese version of the
in 2006, is one of the Chinese leading Internet medical GAD-7 have been validated to be high. 17
platforms that provide medical consultation, prescription,
and follow-up services. As of October 2022, Haodaifu BBS 2.3. Statistical analysis
has served more than 74 million patients. In univariate analysis, Mann–Whitney U-test and Kruskal–
In the present study, questionnaires were distributed Wallis univariate analysis were used to unravel factors that
and collected by doctors on the platform. The are able to distinguish patients with different levels of
questionnaires included demographic, psychosocial, and psychological symptoms. The factors that were significant
ocular prosthesis-related factors. All participants were in the univariate analysis were fed into further analysis.
requested to give informed consent at the beginning of the The optimal scale regression model was performed to
survey. For the patients under 18, the informed consent analyze the association among psychological symptoms,
from their guardians was obtained. In this study, patients demographic factors, and ocular prosthesis-related factors.
who are as follows: (i) Haodaifu BBS users, (ii) recipients All analyses were two-tailed with an alpha level set at

Volume 2 Issue 3 (2024) 2 doi: 10.36922/jcbp.1761