Publication: Evaluation of stress and sleep quality among juvenile open angle glaucoma patients using malay translated perceived stress scale (M-PSS) and pittsburgh sleep quality index (M-PSQI)
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Date
2022
Authors
Chelvaraj, Radtthiga
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Abstract
Introduction Glaucoma is a chronic disease that causes progressive optic neuropathy resulting in irreversible blindness. Juvenile open angle glaucoma (JOAG) is a rare variant of primary open angle glaucoma that is associated with autosomal dominant inheritance, primarily affecting those aged between 3 to 40 years old. As JOAG patients are young and actively contributing towards financial stability of the country, this disease may render them blind and incompetent if they are not managed holistically. Stress and sleep quality were studied among other patients with chronic disease. However there were few literatures about stress and sleep quality among JOAG. Purpose The aim of the study was to evaluate stress and sleep quality among JOAG patients compared to control group. Also, the study aimed to determine the factors associated with stress and sleep quality among JOAG patients in Malaysia Materials and Method A comparison cross sectional study involving 128 participants (64 JOAG patients and 64 control group) was conducted between July 2020 and June 2021 in 4 tertiary centres in Malaysia. The Malay version of Perceived Stress Scale (M-PSS) and Pittsburgh Sleep Quality Index (M-PSQI) questionnaires were administered. Sociodemographic data was documented. The JOAG group was evaluated on their clinical findings as well as latest treatment regime. Linear regression analysis was used to identify the associated factors for stress and sleep quality among JOAG group. Results The mean age of the participants was 31.44±6.38 years with no sexual predilection. The mean M-PSS score among the JOAG group was 13.70±3.87 and 8.72±3.96 in the control group respectively. The mean score for M-PSQI was 7.33± 2.30 in the JOAG group and 4.67± 2.12 in the control group respectively. Significant higher perceived stress and sleep quality scores (p<0.05) were observed among JOAG group. From the univariate and multivariate linear regression analysis, occupational status and glaucoma severity on the worse eye showed significant interaction with the M-PSS and M-PSQI scores. Unemployed subjects had 2.59 higher M-PSS score than self employed (95% CI 0.12- 5.06; p = 0.040) and severe glaucoma showed 3.76 higher M-PSS score than those with mild glaucoma (95% CI 0.65-6.86; p = 0.019). For M-PSQI score, unemployed subjects revealed 1.68 higher score than self employed subjects (95% CI 0.22- 3.14; p = 0.025), while severe glaucoma patients showed 2.28 higher score than those with mild glaucoma (95% CI 0.45-4.11; p = 0.016).There was positive moderate association between M-PSS and M-PSQI scores (P<0.05). Conclusion: The mean score for M-PSS and M-PSQI were significantly higher among JOAG patients. Unemployment and severity of glaucoma were associated with stress and sleep disturbances among JOAG patients. Collaboration between ophthalmologists and psychiatrists is vital in the management of JOAG patients holistically.