Analysis Of Influencing Factors On The Health Utility Evaluation And Visual Aids Abandoning Of Visually Impaired Adolescents

ObjectiveThe study aims to provide scientific basis and effective recommendations for guiding the rehabilitation of visually impaired adolescents.The time trade-off(TTO)method is used to measure the health utility value of visually impaired adolescents.And the influencing factors of the TTO value of adolescents is analyzed.Investigate the use of visual aids by visually impaired adolescents,and analyze related factors that affecting the abandonment of visual aids among visually impaired adolescents.MethodsIn this study,a telephone follow-up survey was used from June 2020 to February2021 in the context of the normalization of the COVID-19 epidemic.The subjects were derived from the low vision(LV)patient registered by Province Disabled Persons’Federation and the LV patient received the rehabilitation from our team.186 visually impaired adolescents aged 8 to 27 who met the selection criteria were followed up by using a questionnaire designed by our team through telephone.The content of the survey included visual impaired adolescents’basic information,visual acuity,use of visual aids and the health utility questions based on TTO method.165 cases of visually impaired adolescents aged greater or equal to10 years old and understanding health utility were evaluated on the health utility.The independent sample Mann-Whitney U test and Kruskal-Wallis test were used to compare the differences of TTO utility value of visually impaired adolescents among different genders,ages,school conditions,use of visual aids,etiologies of visual impairment and degree of visual impairment.The multiple linear regression was used to define the independent influencing factors of the TTO utility value of visually impaired adolescents.At the same time,a descriptive statistical analysis of 186 cases of visually impaired adolescents’visual aids types,frequency of use,satisfaction,and reasons for abandonment of visual aids was carried out.And the factors related to the visual aids abandoning of visually impaired adolescents were analyzed through the chi-square test.Results1.The average age of 186 visually impaired adolescents who met the selection criteria was(14.6±4.5)years old,117 were males and 69 were females.The three main causes of visual impairment were cataract(27.4%),refractive error or high myopia(15.1%),and optic neuropathy(11.8%).2.The average expected survival years of the 165 visually impaired adolescents who received the evaluation of health utility was 80.5 years.The TTO utility value of visually impaired adolescents with different characteristics was compared between groups.The results of independent sample Mann-Whitney U test and Kruskal-Wallis test showed that the TTO utility value of visually impaired adolescents was different in different school conditions,use of visual aids,and degree of visual impairment,and the differences were statistically significant(P=0.04,P=0.02,P<0.01),but there were no statistically significant differences among different genders,ages,and etiologies of visual impairment(all P>0.05).Multiple linear regression found that the age,use of visual aids,and degree of visual impairment were independent influencing factors of the TTO utility value of visually impaired adolescents(P=0.03,P=0.04,P<0.01),and the gender,school conditions and etiology of visual impairment had no effect on the TTO utility value(all P>0.05).3.In this study,the hand-held electronic visual aids had the highest fitting rate(55.9%),followed by smart phones(48.9%)and listening devices(37.6%).Among all visual aids,smartphones were used most frequently,about 63.2%of users used it almost every day.Hand-held electronic visual aids and smartphones had the highest satisfaction rate with 92.3%and 76.9%.95 interviewee had abandoned visual aids(51.1%).Among all visual aids,smartphones had the lowest abandonment rate(4.2%),followed by desk lamps(10.0%).The abandonment rate of optical vision aids(59.8%)was higher than non-optical visual aids(52.2%)and electronic visual aids(30.8%).The main reasons why visually impaired adolescents abandoned their visual aids were the better alternatives(16.8%),the improvement of personal skills(15.8%),and the damage of visual aids(15.8%).4.In this study,the probability of visually impaired adolescents abandoning visual aids due to cataracts,uncorrected refractive errors(including aphakia),glaucoma,and other etiologies was 41.2%,71.4%,26.7%,and 54.4%,the difference is statistically significant(χ~2=10.61,P=0.01).While the probability of visually impaired adolescents abandoning visual aids was not statistically significant among different genders,ages,school conditions,and degree of visual impairment(Chi-square test,all P>0.05).ConclusionsThe TTO utility value is one of the scientific basis for the rehabilitation of visually impaired adolescents.It is affected by age,use of visual aids,and degree of visual impairment.In this study,visually impaired adolescents abandoned visual aids mainly because of the better alternatives,improved personal skills,and damage to the visual aids.And the probability of abandoning visual aids is mainly related to the etiology of visual impairment.The age,etiology,degree of visual impairment,and use of visual aids should be fully considered in the visual impaired rehabilitation,to meet rehabilitation needs of visually impaired adolescents.