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.

作为一种具有潜在致盲风险、伴随眼部、全身及治疗相关并发症的疾病，葡萄膜炎（uveitis）会降低患者的生活质量（Quality of Life, QOL），并对其社会心理健康造成负面影响。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/或生活质量的现有工具，探讨了影响患者社会心理健康及/或生活质量的生物学与非生物学因素，并提出了将此类工具融入临床实践的未来发展方向。本研究系统性检索了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/或生活质量的相关研究文献，并同时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（patient-reported outcome measures）包括视力相关生活质量（如视力功能问卷[Visual Function Questionnaire, VFQ-25]）与健康相关生活质量（如简明健康调查问卷[Short Form Survey, SF-36]），其次是涵盖抑郁与焦虑的心理健康指标。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影响量表[Effects of Youngsters’ Eyesight on Quality of Life, 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健康结局与生活质量更差。相关影响因素包括临床相关因素（如视力损害、眼部合并症）与患者自身相关因素（如高龄、女性性别）。鉴于所使用的评估工具存在异质性，在大型葡萄膜炎研究与临床试验中推行统一标准化评估值得考虑。除研究场景外，考虑到葡萄膜炎患者所受的生物-心理-社会影响，将生活质量与社会心理健康评估纳入临床实践具有诸多益处。可考虑将问卷简化为精简版本，聚焦于患者护理中最具临床相关性的维度。