Psychosocial Well-Being and Quality of Life in Uveitis: A Review

As a potentially sight-threatening disease with ocular, systemic, and treatment-related complications, uveitis diminishes quality of life (QOL) and affects psychosocial well-being. This review summarizes the existing tools for evaluating psychosocial well-being and/or QOL in patients with uveitis, explores the biological and non-biological factors affecting psychosocial well-being and/or QOL, and proposes future directions for incorporating these tools into clinical practice. A systematic search of the MEDLINE, Embase, and Cochrane databases from inception to June 8, 2022 was conducted, screening for articles focused on psychosocial well-being and/or QOL in patients with uveitis. Both quantitative and qualitative analyses were performed. In uveitis research, the most frequently studied patient-reported outcome measures were vision-related QOL (e.g. Visual Function Questionnaire [VFQ-25]) and health-related QOL (e.g. Short Form Survey [SF-36]), followed by mental health indicators including depression and anxiety. Instruments have also been developed specific to the pediatric population (e.g. Effects of Youngsters’ Eyesight on Quality of Life [EYE-Q]). Generally, studies report worse psychosocial outcomes and QOL in patients with uveitis compared to the general population. Contributory factors include both clinical (e.g. visual impairment, ocular comorbidities) and patient-related (e.g. older age, female sex) factors. Given the heterogeneity of instruments used, it is worth considering standardization across large uveitis studies and trials. Beyond research, given the biopsychosocial effects on patients with uveitis, there are benefits to incorporating QOL and psychosocial assessments into clinical practice. Simplification of questionnaires into abridged forms, focusing on the most clinically relevant aspects of patient care, may be considered.

作为一种可能威胁视力、兼具眼部、全身及治疗相关并发症的疾病，葡萄膜炎会降低患者的生活质量（Quality of Life，以下简称QOL）并损害其社会心理健康。本综述总结了当前用于评估葡萄膜炎患者社会心理健康及/或QOL的现有工具，探讨了影响患者社会心理健康与QOL的生物学及非生物学因素，并提出了将这些工具整合入临床实践的未来研究方向。本研究系统检索了MEDLINE、Embase及Cochrane数据库自建库至2022年6月8日的文献，筛选聚焦于葡萄膜炎患者社会心理健康及/或QOL的相关文章，并开展了定量与定性分析。在葡萄膜炎研究领域，最常被研究的患者报告结局指标包括视力相关QOL（如视力功能问卷[Visual Function Questionnaire，简称VFQ-25]）与健康相关QOL（如简明健康调查问卷[Short Form Survey，简称SF-36]），其次是抑郁、焦虑等心理健康指标。此外，还开发了针对儿科人群的专用评估工具（如儿童视力对生活质量的影响量表[Effects of Youngsters’ Eyesight on Quality of Life，简称EYE-Q]）。总体而言，现有研究表明，与普通人群相比，葡萄膜炎患者的社会心理结局与QOL更差。其影响因素包括临床相关因素（如视力损害、眼部合并症）及患者自身相关因素（如高龄、女性性别）。鉴于当前研究所使用的评估工具异质性较强，在大型葡萄膜炎研究与临床试验中推行评估工具标准化具有重要价值。除研究领域外，鉴于葡萄膜炎患者所承受的生物-心理-社会层面影响，将QOL与社会心理健康评估整合入临床实践可使患者获益。未来可考虑将问卷简化为精简版本，聚焦于临床护理中最具相关性的患者评估维度。