Purpose: To develop a theoretical framework for assessing knowledge about the possible outcomes of undergoing cataract surgery, and explore the association of knowledge level with psychological status and decision quality among patients with cataract in Southern China.
Methods: The details of the knowledge scale were based on the health education information booklet provided by National Eye Institute, NIH. We used a theory-based approach to assess gist knowledge, which comprises 12 questions related to knowledge of the possible surgical outcomes. The scale was then used in a cross-sectional study to assess the association of knowledge score with psychological status and decision quality among cataract patients.
Results: A total of 489 participants with age-related cataract were included in this study, and 10.2% (50/489) of them had adequate level of knowledge. The knowledge scale was significantly associated to the levels of worry (Odds Ratio (OR) = 0.36, 95%CI: 0.18, 0.70; P = 0.003), anxiety (beta coefficient = - 5.36, 95%CI - 8.88, - 1.84; P = 0.003), inaction regret (OR = 0.49, 95%CI: 0.28, 0.88; P = 0.016) and decision conflict (beta coefficient = - 7.93, 95%CI - 12.81, - 3.04; P = 0.002) in multivariate analyses adjusted for age, sex, education level and literacy level.
Conclusion: Knowledge adequacy with cataract surgery outcomes was negatively associated with cataract worry, anxiety and decisional conflict. Patients with adequate knowledge were more likely to postpone cataract surgery.
Keywords: Cataract; Cataract surgery; Decision quality; Knowledge scale.