Beyond monetary benefits of restoring sight in Vietnam: Evaluating well-being gains from cataract surgery

Abstract

A more holistic understanding of the benefits of sight-restoring cataract surgery requires a focus that goes beyond income and employment, to include a wider array of well-being measures. The objective of this study is to examine the monetary and non-monetary benefits of cataract surgery on both patients as well as their caregivers in Vietnam. Participants were randomly recruited from a Ho-Chi-Minh City Hospital. A total of 82 cataract patients and 83 caregivers participated in the survey conducted for this study. Paired t-tests, Wilcoxon Signed Rank tests, and regression analysis are used to detect any statistically significant differences in various measures of well-being for patients and caregivers before and after surgery. There are statistically significant improvements in monetary and non-monetary measures of well-being for both patients and caregivers approximately three months after undergoing cataract surgery, compared with baseline assessments collected prior to surgery. Non-monetary measures of well-being include self-assessments of overall health, mental health, hope, self-efficacy, happiness and life satisfaction. For patients, the benefits included statistically significant improvements in earnings, mobility, self-care, the ability to undertake daily activities, self-assessed health and mental health, life satisfaction, hope, and self-efficacy (p<0.01). For caregivers, attendance at work improved alongside overall health, mental health, hope, self-efficacy, happiness and life satisfaction, three months post-surgery (p<0.01). Restoring sight has positive impacts for those suffering from cataracts and their caregivers. Sometimes the benefits are almost equal in their magnitude. The study has also demonstrated that many of these impacts are non-monetary in nature. It is clear that estimates of the rate of return to restoring sight that focus only on financial gains will underestimate the true returns to society of restoring sight from cataract surgeries.

Cataract and the increased risk of depression in general population: a 16-year nationwide population-based longitudinal study

“…Although some previous studies have evaluated the possible benefit of cataract surgery on depression 13 , 15 – 23 , the results are controversial as some of these studies indicated that the depressive symptoms did not improve after cataract surgery 13 , 21 , 22 . Moreover, most of these studies had follow-up periods of < 1 year 13 , 15 – 23 , and only one was a population based study 16 . Therefore, we conducted this 16-year nationwide cohort study to enhance the reliability and indicated that the risk of depression was reduced by 25% in the cataract surgery group compared with that in the non-surgery group.…”

“…They also have a higher institutionalisation rate 26 and visual hallucination risk, which is known as Charles Bonnet syndrome 27 , 28 . Studies have shown improved quality of life, mental health, and economic state in patients following cataract surgery 15 , 29 . Therefore, future studies are required to develop a multifactor strategy for the prevention and management of depression in patients with cataract or visual impairment.…”

“…However, the impact of cataract surgery on depressive symptoms remains controversial. Some studies have demonstrated the beneficial effects of cataract surgery on depression 15 – 20 , whereas others have suggested no remarkable impact 13 , 21 , 22 .…”

“…Depression in cataract patients is an important issue that lacks sufficient evidence. A majority of previous studies are restricted on account of having a cross-sectional design 12 , 22 , follow-up period less than 3 months 15 , 18 – 21 , sample size less than 100 13 , 15 , 18 , 21 , 22 , and single-institutional bias 15 , 18 – 20 , 22 . In the present study, we performed a nationwide population-based cohort study to examine (1) the long-term association between cataracts and the risk of developing depression and (2) the impact of cataract surgery on the risk of depression.…”

Changes in patient subjective happiness and satisfaction with cataract surgery

“…Considering these findings, we assumed that the patient subjective happiness and sleep quality also may be better postoperatively. Feeny et al showed that in Vietnam cataract surgery provided benefits that included significant improvements in earnings, mobility, self-care, ability to undertake daily activities, self-assessed health and mental health, life satisfaction, hope, and self-efficacy 19 .…”