A qualitative study in the United Kingdom of factors influencing attendance by patients with diabetes at ophthalmic outpatient clinics
A qualitative study in the United Kingdom of factors influencing attendance by patients with diabetes at ophthalmic outpatient clinics
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DOI：
10.1080/09286580701375195
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发表时间：
2007-11-01
影响因子：
1.8
通讯作者：
Charteris, David
中科院分区：
文献类型：
--
作者：
Lewis, Karinya;Patel, Daksha;Charteris, David
简介：许多糖尿病患者没有定期的眼部检查，尽管众所周知，早期诊断和治疗威胁视力的视网膜病变可以降低失明的风险。人们对阻止糖尿病患者去眼科诊所的障碍知之甚少。目的：探讨影响糖尿病患者眼科就诊的因素。研究方法：在农村地区的综合医院和城市三级教学医院的患者和眼科护理提供者进行了定性调查。研究方法包括半结构化访谈、焦点小组和非参与性观察。所有访谈和讨论都被记录和转录。然后对这些记录进行分析，以发现新出现的主题。数据收集一直持续到没有新的主题出现。结果：缺乏认识被视为最大的障碍，由患者和供应商。患者知道糖尿病会影响眼睛，但不知道它会导致失明，也不知道严重的视网膜病变可能没有症状。患者报告说，眼底图像用于筛选是一个有价值的教育资源。恐惧，特别是对激光治疗的恐惧，以及对控制不良导致视网膜病变的内疚，阻止了患者参加。病人和医疗服务提供者都认识到，定期就诊是不方便的;然而，医疗服务提供者低估了病人在获得下班时间去诊所就诊方面所面临的困难。结论：提供更完整的糖尿病视网膜病变信息，使患者更方便地前往眼科诊所就诊，可能会增加定期进行眼科检查的糖尿病患者数量。
Introduction: Many diabetics do not have regular eye examinations, although it is known that early diagnosis and treatment of sight-threatening retinopathy reduces the risk of blindness. The barriers that prevent diabetics from attending eye clinics are poorly understood. Purpose: To determine what factors may influence diabetic patients' attendance at eye clinics. Methods: A qualitative survey of both patients and eye care providers was undertaken in a rural district general hospital and in an urban tertiary teaching hospital. Methods employed included semistructured interviews, focus groups and non-participatory observations. All interviews and discussions were recorded and transcribed. The transcripts were then analyzed to detect emerging themes. Data collection continued until no new themes emerged. Results: Lack of awareness was seen as the greatest barrier by both patients and providers. Patients were aware that diabetes could affect the eye, but not that it could lead to blindness, nor that severe retinopathy could be asymptomatic. Patients reported that fundus images used for screening were a valuable educational resource. Fear, particularly of laser treatment, and guilt, about poor control causing retinopathy, deterred patients from attending. Both patients and providers recognized that regular attendance was inconvenient; however, providers underestimated the difficulties patients faced in obtaining time off work to attend clinics. Conclusion: Providing more complete information about diabetic retinopathy, and making eye clinic attendance more convenient for patients, may increase the number of diabetics who have regular eye examinations.