Mishel theory-based perioperative nursing after trabeculectomy for primary glaucoma: effects on illness uncertainty, self-management, and quality of life
- 1Ophthalmology, The First Affiliated Hospital of Suzhou University
Abstract
Objective: To evaluate the effects of a perioperative nursing intervention based on Mishel’s Uncertainty in Illness Theory in patients with primary glaucoma undergoing trabeculectomy.
Methods: This single-center, two-arm, parallel-group randomized controlled study enrolled 198 patients undergoing first trabeculectomy at The First Affiliated Hospital of Suzhou University between February 2024 and December 2025. Participants were randomly allocated 1:1 to routine perioperative ophthalmic nursing or routine care plus a structured Mishel theory-based nursing intervention. Assessments were conducted 1 day before surgery (T0), at discharge (T1), and at 1 month (T2) and 3 months (T3) after surgery. The primary outcome was illness uncertainty measured using the Mishel Uncertainty in Illness Scale. Secondary outcomes included psychological status, discharge readiness, self-management, medication adherence, sleep quality, vision-related quality of life, satisfaction with nursing care, postoperative ophthalmic outcomes, and complications. All randomized participants completed follow-up and were analyzed according to their assigned groups.
Results: After Holm adjustment, the intervention group had lower illness-uncertainty scores at T1, T2, and T3; lower anxiety scores at T1 and T3 and lower depression scores at T2 and T3; higher discharge-readiness and satisfaction-with-nursing-care at T1; higher self-management and medication-adherence scores and lower sleep-quality scores at T2 and T3; and lower GQL-15 scores at T3. At T3, the model-estimated between-group differences were -8.13 points for illness uncertainty (95% CI, -10.74 to -5.53), 5.64 points for self-management (95% CI, 4.08-7.19), 6.05 points for medication adherence (95% CI, 2.98-9.12), and -3.71 points for GQL-15 (95% CI, -5.41 to -2.00). At discharge, the between-group difference in discharge readiness was 1.23 points (95% CI, 0.99-1.47). No statistically significant between-group differences were detected in postoperative intraocular-pressure trajectories, visual-acuity recovery, medication-free status, postoperative procedures, or complications within 3 months.
Conclusion: In this single-center randomized study, Mishel theory-based perioperative nursing was associated with greater improvements in illness uncertainty and several psychological, behavioral, and recovery-related patient-reported outcomes after trabeculectomy. No statistically significant differences were detected in short-term objective ophthalmic outcomes or postoperative complications.
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BibTeX
@article{ding2026mishel,
title = {{Mishel theory-based perioperative nursing after trabeculectomy for primary glaucoma: effects on illness uncertainty, self-management, and quality of life}},
author = {Qi-Ying Ding and Chun Li and Xue-Man Yin},
journal = {Frontiers in Psychiatry},
year = {2026},
month = oct,
doi = {10.3389/fpsyt.2026.1884293},
url = {https://www.frontiersin.org/articles/10.3389/fpsyt.2026.1884293/full},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Mishel theory-based perioperative nursing after trabeculectomy for primary glaucoma: effects on illness uncertainty, self-management, and quality of life
AU - Qi-Ying Ding
AU - Chun Li
AU - Xue-Man Yin
PY - 2026
DA - 2026/10/14
JO - Frontiers in Psychiatry
DO - 10.3389/fpsyt.2026.1884293
UR - https://www.frontiersin.org/articles/10.3389/fpsyt.2026.1884293/full
AB - Objective: To evaluate the effects of a perioperative nursing intervention based on Mishel’s Uncertainty in Illness Theory in patients with primary glaucoma undergoing trabeculectomy. Methods: This single-center, two-arm, parallel-group randomized controlled study enrolled 198 patients undergoing first trabeculectomy at The First Affiliated Hospital of Suzhou University between February 2024 and December 2025. Participants were randomly allocated 1:1 to routine perioperative ophthalmic nursing or routine care plus a structured Mishel theory-based nursing intervention. Assessments were conducted 1 day before surgery (T0), at discharge (T1), and at 1 month (T2) and 3 months (T3) after surgery. The primary outcome was illness uncertainty measured using the Mishel Uncertainty in Illness Scale. Secondary outcomes included psychological status, discharge readiness, self-management, medication adherence, sleep quality, vision-related quality of life, satisfaction with nursing care, postoperative ophthalmic outcomes, and complications. All randomized participants completed follow-up and were analyzed according to their assigned groups. Results: After Holm adjustment, the intervention group had lower illness-uncertainty scores at T1, T2, and T3; lower anxiety scores at T1 and T3 and lower depression scores at T2 and T3; higher discharge-readiness and satisfaction-with-nursing-care at T1; higher self-management and medication-adherence scores and lower sleep-quality scores at T2 and T3; and lower GQL-15 scores at T3. At T3, the model-estimated between-group differences were -8.13 points for illness uncertainty (95% CI, -10.74 to -5.53), 5.64 points for self-management (95% CI, 4.08-7.19), 6.05 points for medication adherence (95% CI, 2.98-9.12), and -3.71 points for GQL-15 (95% CI, -5.41 to -2.00). At discharge, the between-group difference in discharge readiness was 1.23 points (95% CI, 0.99-1.47). No statistically significant between-group differences were detected in postoperative intraocular-pressure trajectories, visual-acuity recovery, medication-free status, postoperative procedures, or complications within 3 months. Conclusion: In this single-center randomized study, Mishel theory-based perioperative nursing was associated with greater improvements in illness uncertainty and several psychological, behavioral, and recovery-related patient-reported outcomes after trabeculectomy. No statistically significant differences were detected in short-term objective ophthalmic outcomes or postoperative complications.
SN - 1664-0640
ER -