| The incidence of proliferative diabetic retinopathy(PDR) increases with the rise of people's living standard and life prolongation of diabetes.PDR is a disease of having serious ocular fundus changes,morbility with both eyes and multiplicity for treatment,most patients need to be operated by vitrectomy combined with silicon oil or gas filling which is one of the most complicate operations of ophthalmogy.Its therapeutic efficacy is affected by many factors including blood sugar,the condition of ocular fundus and course of diabetes.Thus,it is difficult for patients with PDR to estimate the efficacy of operation.Because the patients, visual function is seriously damaged by PDR,their means of communication have decreased. Meanwhile,PDR brings the patients unconvenience of living and influence their normal activities,patients with PDR always emerge psychological changes and emotional reaction as anxiety,depress and despair,et.The psychological reactions result in patients, descending of quality of life.To raise quality of life of patients with PDR,besidestherapentic tool should be impoved constantly,psychological support should be thought highly of.Till now, studies on quality of life for patients with PDR only include some overviews and general surveys on influence actors.It is meaningful to research the psychological charactors of patients with PDR in order to raise quality of life.Investigations on influence of mental interventions on quality of life of patients with PDR is have not been reported.The purpose of present study is to explore the effect of mental interventions on quality of life in patients with PDR in hospital receiving vitrectomy combined with silicon oil or gas filling ,eventually to find out effective measures to raise quality of life. Methods:40 patients with PDR who receiving vitrectomy combined with silicon oil or gas filling were divided into two groups according to admission order(odd number patients was added to the control group, even number patients was added to treatment group). Routine nursing care and health education were performed in control group while routine nursing care , health education and mental intervention measures were performed in treatment group. The Hamilton anxiety scale(HAMA) ,quality oflife scale of eye diseases with visual functional lesion and self-designed related factors of anxiety questionnaire were used to assess the patients on the second day after admission,on the first day after operation and before discharge.The results showed that:(1)Anxiety and descending of quality of life existed in both groups when they were recruited. (2)Compared with the two groups, there were no significant differences in the scores of the Hamilton(HAMA) anxiety scale and the quality of life scale (P>0.05) when they were recruited.There were significant differences in the scores of the Hamilton(HAMA) anxiety scale, the quality of life scale, aspect of mind and psychological in the quality of life scale(P<0.01) after mental intervention; there were no differences in the scores of aspects of symptom and vision function,body function and social activities in the quality of life scale (P>0.05). (3)The main related factor of anxiety of patients before operation was fearing forced decumbent position during post-operation; the main related factor of anxiety of patients after operation was phisiological discomforts caused by prone position.The results demonstrated that mental intervention could not only relieve anxiety of patients with PDR in hospital,but promote the patients, vision-related quality of life. Mental interventions of pre-operation and post-operation raised quality of life by improving mental state, but did not influence patients, symptom and vision function,body function and social activity function. Concrete measures of mental interventions in this study were as following:(1)establish satisfactory nurse-patient relationship. (2) give patients supportive psychological nursing:apply explaination,encouragement, comforting, suggestion, changing environments to solve psychological problems existing in patiens.(3)psychological behavior interventions:muscle slacken train,deep breathing to relieve anxiety.(4) family intervention.The measures in this study improved patients, psychological condition with PDR.The measures have certain clinic practical value to raise quality of life of patients with PDR in hospital .
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