Pain Perception and Acceptance of Illness in Patients Undergoing Phacoemulsification Cataract Surgery under Drip Anesthesia

Abstract

For many years, cataracts have been the main cause of vision loss and vision impairments in the world (43% and 33%, respectively). Currently, the most common surgical method for treating cataracts is phacoemulsification. The aim of this study was to assess the pain perception and acceptance of illness connected with awaiting phacoemulsification cataract surgery under intravenous drip anesthesia, as well as to determine the effect of selected sociodemographic factors on the above. Methods: The study was conducted in a group of patients of the Department of Ophthalmology, University Clinical Hospital in Białystok, Poland suffering from cataracts, who underwent phacoemulsification surgery under intravenous drip anesthesia. The study group consisted of 151 people. The study used an original short questionnaire and three standardized psychometric scales: The acceptance of illness scale (AIS), the Beliefs about Pain Control Questionnaire (BPCQ), and the Coping Strategies Questionnaire (CSQ). Results: The median overall AIS point value was 24 points, which is considered an average score in terms of disease acceptance. Respondents assessed the influence of individual factors on the level of perceived pain and the impact of individual strategies for coping with pain similarly. The level of perceived pain decreased with the patient’s age. People with a higher education level experienced a greater level of pain; however, this relationship was not statistically significant. The place of residence did not affect the level of pain experienced during the procedure. Women had a greater level of acceptance of illness. The respondents’ education level negligibly differentiated the approach to the disease. The place of residence also did not affect the assessment of illness acceptance as measured by the AIS. Whether the surgery pertained to the first or second eye did not significantly affect the approach to the disease. Conclusions: The level of acceptance of illness and pain perception were at a moderate level among the patients. The acceptance of illness was significantly influenced by the age of patients and the waiting period for phacoemulsification, and this level of acceptance decreased significantly with the increasing age of patients. The longer the waiting period for surgery, the lower the acceptance of illness. Sex significantly differentiated the level of pain experienced during the procedure. Education and place of residence did not significantly affect the acceptance of illness and the feeling of pain.

Subjective Opinions of Patients About Step-by-Step Cataract Surgery Preparation

“…While some previous studies analyzed subjective experiences of patients before and during cataract surgery, most of them focused on preoperative anxiety, pain, or visual sensations during the operation. 2 , 5 , 6 , 9–25 To the best of our knowledge, none of the previous studies aimed to identify the least positive components of the phacoemulsification procedure.…”

“… 7 , 8 In addition, there are papers, which describe the subjective feelings of patients during the phacoemulsification procedure, such as the perception of pain, fear, visual and auditory sensation, and duration of the surgery. 9–19 Comparative analysis of the subjective opinions of patients who underwent cataract surgery for one or both eyes demonstrated that the first procedure was associated with higher levels of stress and anxiety, whereas the second one was accompanied by more severe subjective pain. 6 , 20–25 …”

Disease Acceptance and Eudemonic Well-Being Among Adults With Physical Disabilities: The Mediator Effect of Meaning in Life

“…A low score is considered to be less than 20 points, and values above 30 points indicate a high level of acceptance of one's disease. An average score ranges from 20 to 30 points (Kowalczyk et al, 2019). Therefore, the lower the score, the less the patient tolerates their illness.…”

Phacoemulsification: Proposals for Improvement in Its Application

“…Cataracts are defined as the opacity of the crystalline lens and are one of the most prevalent ocular pathologies today, particularly age-related cataracts. They are the leading cause of vision loss [1] and visual impairment around the world (43% and 33%, respectively) [2].…”

“…Cataract surgery is currently a quick, painless, highly effective, and low-risk procedure [3]. About 90% of operated patients are able to see better after the operation [4], which can be undertaken at any stage of cataract development [2].…”