Patient Perception and Emotional Disturbance in Out-of-Hour Ophthalmic Emergency Care

Abstract

ABSTRACTPurpose: To investigate patient’s perception of the severity of their symptoms, reasons for attending an ophthalmic emergency department (ED) out of hours, and to review the prevalence of anxiety and depression. Methods: We carried out a prospective analysis of the cases presenting out of hours (8:30 PM to 8:30 AM) over a four-month period. We also conducted two questionnaire studies. First, patient’s perception of the severity of their symptoms (graded from 1–10). A score of 7 or above was defined as significant. A second questionnaire study used the Hospital Anxiety and Depression Scale (HADS), with a maximum score of 21. Patients who scored between 7–10 points on either anxiety or depression scales are defined as borderline; above 10 as pathological. Results: A total of 1,531 patients attended the out-of-hours service. The most common diagnoses were trauma (22.8%), infective conjunctivitis (10.2%), and contact-lens-related problems (6.6%). Of 175 completed questionnaires, worry about sight impairment and pain were the most common concerns for attendance. A total of 91% of patients believed their conditions were emergencies that require medical review within 24 hours. 127 HADS questionnaires were completed, showing that 18.9% and 15.0% of patients were suffering from borderline and pathological anxiety, respectively, with a mean HADS-A score of 6.5, SD=3.9. The prevalence of possible and pathological depression was 14.2% and 6.3%, mean=4.9 (SD=3.6). There was no statistical significance difference of score with the time of patient presentation. Conclusion: The prevalence of anxiety and depression is relatively high in patients who attended the ophthalmic ED and awareness of psychological impact should be raised amongst healthcare professionals.