視覺功能缺損病患生活品質之調查研究──以臺中市教學醫院為例

Quality of Life (QOL) Investigation for Patients with Visual Dysfunction: An Example of Teaching Hospitals in Central Taiwan

研究背景與研究目的：因為老年化社會的來臨，視覺缺損的人口比例也隨之增加；視覺缺損所帶來的個人、家庭、社區、就學與就業等生活品質問題，需要從病患的角度切入來進行探討，因此本研究的目的在於以自編問卷探討視覺功能缺損病患之生活品質現況，同時分析不同變項在病患生活品質上的差異。方法：本研究以自編之「臺灣視覺功能缺損病患生活品質量表」為研究工具，以視覺功能缺損病患為研究對象，取得正式有效樣本151份。採描述統計、獨立樣本t考驗、單因子變異數分析、與卡方檢定進行統計分析。結果：視覺功能缺損病患在「家庭與社區」向度中，以自主交通工具使用、陌生環境適應、生育子女考量、以及家庭整體收入的得分較低；在「就業」向度中，選擇「無法回答」或「因困難而放棄」的比例高達六至七成。背景變項分析中，年齡在「家庭與社區」向度中達顯著差異；而「就業」向度則受到所有的背景變項（性別、年齡、與發病年齡）的影響。生理變項分析中，慣用視力與眼球疾病的影響最顯著，視野缺損雖未達統計上的顯著意義，但多數題項得分偏低值得注意；而眼睛症狀則以明暗適應困難的影響最為嚴重。結論：視覺功能的缺損將導致病患在家庭事務、婚姻、生育、獨立行動、就業選擇、職業表現、與經濟收入等生活品質的降低。不同背景變項與不同生理變項對視覺功能缺損病患的生活品質均造成不同程度的影響，在後端重建時建議將上述變項與題項列入考量。

Purpose: The purpose of this study was to investigate the QOL for patients with visual dysfunction. Methods: Participants were asked to fill out the questionnaire with good validity and reliability which was adopted in this study. 151 patients aged from 18 to 91 were referred from ophthalmology clinics or low vision center. Data were then analyzed with descriptive statistics, k statistic, Cronbach α, spearman correlation, independent t test, one-way ANOVA, post Hoc, and Chi-square test by using SPSS 22 package. Results: In the ''Family and Community'' dimension, QOL score was low in vehicles use, unfamiliar environment mobility, child bearing, family income and other factors. In the ''Job'' dimension, about 60~70% chose “unable to answer” or “give up” might indicate the laborer policy had room for improvement. According to statistical analysis, ages and certification variances were significant different in both dimensions; in addition, genders, ages, age of eye disease onset, all were significant different in “ Job” dimensions. Habitual visual acuity was significantly different in family and job dimensions, although visual field did not show significant differences, low tally between every subgroup was worthy of more attentiveness; furthermore, eye disease and light adaption had significant influence on “job” dimensions. Conclusion: Patients with visual dysfunction got lower QOL scores, most patients would give up working after visual function degeneration. The background and the physiological variance were highly correlated with Patients' QOL.