Factors Affecting Compliance with Diabetic Retinopathy Screening: A Qualitative Study Comparing English and Spanish Speakers.
Factors Affecting Compliance with Diabetic Retinopathy Screening: A Qualitative Study Comparing English and Spanish Speakers.
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DOI：
10.2147/opth.s342965
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发表时间：
2022
期刊：
影响因子：
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通讯作者：
Fong DS
中科院分区：
文献类型：
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作者：
Hudson SM;Modjtahedi BS;Altman D;Jimenez JJ;Luong TQ;Fong DS
本研究的目的是了解影响糖尿病视网膜病变（DR）评估依从性的个人，社会和系统水平因素，以及这些因素在英语和西班牙语使用者之间的差异。我们采用半结构化访谈进行了定性研究。研究对象包括Kaiser Permanente南加州成员，患有II型糖尿病，年龄至少26岁，讲英语或西班牙语。根据患者对DR评估的依从性将其分组。我们的主要结局指标是患者表达的主要主题，这些主题解释了他们对DR评估的依从性。入组了51名参与者：30名讲英语的人（11名未依从，19名依从）和21名讲西班牙语的人（8名未依从，13名依从）。坚持治疗的患者更有可能有糖尿病的经历，并认为自己对自己的护理负责。更多不遵守规定的患者表明，信仰和态度是人们错过视网膜病变预约的原因。更多讲英语的参与者倾向于自我管理他们的医疗保健，而更多讲西班牙语的人依赖他人的帮助。说英语的人也注意到他们与医生的关系更好。西班牙语发言者概述了保险范围和费用方面的问题，认为这是障碍。这些数据表明，眼科护理提供者可以实施两种特定的干预策略，以提高糖尿病视网膜病变筛查和随访的依从性：将DR相关视力丧失的人纳入提供糖尿病支持计划和沟通活动的工作人员团队，包括特定的信息传递，以解决与视力丧失相关的恐惧。
The purpose of this study was to understand individual-, social-, and system-level factors that affect compliance with recommended diabetic retinopathy (DR)-evaluations, and how these factors vary between English and Spanish speakers. We conducted a qualitative study using semi-structured interviews. Study subjects included Kaiser Permanente Southern California members with type II diabetes mellitus at least aged 26 years who spoke English or Spanish. Patients were divided into groups based on their adherence with DR evaluations. Our main outcome measure was the major themes expressed by patients that explained their compliance with DR evaluation. Fifty-one participants were enrolled: 30 English speakers (11 nonadherent, 19 adherent) and 21 Spanish speakers (8 nonadherent, 13 adherent). Adherent patients were more likely to have had experience with diabetes and identify as being responsible for their own care. Substantially more non-adherent patients suggested that beliefs and attitudes were the reasons people missed retinopathy appointments. More English-speaking participants tended to be self-directed in managing their healthcare, whereas more Spanish speakers relied on others for help. English speakers also noted better relationships with their physicians. Spanish speakers outlined problems with insurance coverage and costs as barriers. These data suggest two specific intervention strategies that eye care providers could implement to improve adherence with diabetic retinopathy screening and follow up: incorporating a person with DR-related visual loss into the team of staff delivering diabetes support programs and communication campaigns including specific messaging to address fears related to vision loss.