The psychological status of patients with delayed intravitreal injection for treatment of diabetic macular edema due to the COVID-19 pandemic.

Autor: Zaini MA; Department of Ophthalmology, National University of Malaysia Medical Centre, Kuala Lumpur, Malaysia., Mohd Zain A; Department of Ophthalmology, National University of Malaysia Medical Centre, Kuala Lumpur, Malaysia., Din NM; Department of Ophthalmology, National University of Malaysia Medical Centre, Kuala Lumpur, Malaysia., Mustapha M; Department of Ophthalmology, National University of Malaysia Medical Centre, Kuala Lumpur, Malaysia., Sidi H; Department of Psychiatry, National University of Malaysia Medical Centre, Kuala Lumpur, Malaysia.
Jazyk: angličtina
Zdroj: PloS one [PLoS One] 2023 Aug 25; Vol. 18 (8), pp. e0290260. Date of Electronic Publication: 2023 Aug 25 (Print Publication: 2023).
DOI: 10.1371/journal.pone.0290260
Abstrakt: Background: Since the enforcement of the Movement Control Order (MCO) to contain the spread of COVID -19 infection in Malaysia, most clinic appointments have been rescheduled and procedures and surgeries postponed to a later date. Clinic appointments including intravitreal endothelial growth factor (anti-VEGF) treatment for patients with diabetic macular edema (DME) were also no exception to the postponement. This measure takes a psychological toll on patients because of the overwhelming concern for their eye condition. This study was conducted to assess the psychological status of DME patients with delayed anti-VEGF treatment during the pandemic.
Methods: A cross-sectional study was conducted from September 2020 to March 2021 in Ophthalmology Clinic Hospital Canselor Tuanku Muhriz Universiti Kebangsaan Malaysia (HCTM UKM). Subjects diagnosed with center-involved DME aged between 20 to 80 years who experienced delayed anti-VEGF injection were recruited. Level of depression, anxiety and stress were assessed using DASS-21 questionnaire. Statistical analysis using non-parametric tests were performed to determine the relationship between the DASS-21 score and duration of last injection, in those whose vision was affected by delayed injection and the relationship to the impact of COVID-19 pandemic. Statistical significance was denoted as p < 0.05.
Results: A total of 86 respondents with median age of 69 years old participated in this study. Most respondents were Malays (n = 47,54.7%) males (n = 51, 59.3%), had education up to secondary level (n = 37, 43%), unemployed (n = 78, 90.7%), married (n = 72, 83.7%) and living with their family (n = 82, 95.3%). The number of intravitreal injections received was at least three times among the respondents (n = 81, 94.2%). More than half of the respondents (n = 46, 53.5%) had been postponed for more than 12 weeks and felt that their vision was affected after delayed intravitreal injection (n = 47, 54.7%). Most of the subjects did not experience depression, anxiety, or stress. However, there was a significant level of stress scores among those with delayed injection of 9 to 12 weeks (p = 0.004), and significant anxiety (p = 0.029) and stress (p = 0.014) scores found in subjects with vision affected due to delayed treatment.
Conclusion: The level of anxiety and stress can be significant in DME patients who experienced delay in intravitreal anti-VEGF treatment. Assessment of psychosocial impacts is important to identify early mental health issues potentially leading to the onset of psychiatry illness, thus early intervention is indispensable.
Competing Interests: The authors have declared that no competing interests exist.
(Copyright: © 2023 Zaini et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)
Databáze: MEDLINE
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