A qualitative investigation into patients' views on visual field testing for glaucoma monitoring
A qualitative investigation into patients' views on visual field testing for glaucoma monitoring
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DOI：
10.1136/bmjopen-2013-003996
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发表时间：
2014-01-01
期刊：
影响因子：
2.9
通讯作者：
Crabb, David P.
中科院分区：
文献类型：
--
作者：
Glen, Fiona C.;Baker, Helen;Crabb, David P.
目的探讨患者对青光眼随访的看法和体会，特别是对视场（VF）检查的类型和频率。设计一个使用焦点小组的定性调查。小组讨论围绕青光眼随访经验，特别是VF监测经验，在提示指南中提出了广泛的开放性问题。使用手工和计算机辅助方法对所有组进行录音、转录和编码。在英格兰设立三家国民保健服务医院；每家医院都安排了两个焦点小组。参与者28例(平均（SD）年龄：74(9)岁；（54%的女性）被诊断患有青光眼至少2年。每个焦点组3-6例患者。(1)青光眼患者对VF检测的态度和经历。(2)青光眼患者对成功随访的看法。结果这些患者不喜欢VF测试，但他们认识到定期监测对保护视力的重要性。这些患者会同意在临床医生的建议下进行更频繁的VF检测。一些主题在焦点小组中反复出现，代表了对后续护理的感知障碍。测试环境、等待时间、预约效率和到诊所的旅行都被认为影响一般临床体验和评估数据的质量。患者也很关心医患沟通的各个方面，而且往往很少甚至没有收到关于结果的反馈。结论患者信任临床医生对其青光眼随访的最佳决策。然而，患者强调了一些可能影响VF检测有效性的问题。解决患者感知的障碍可能是设计最佳后续护理策略的重要一步。
Objectives To investigate the views and experiences of patients regarding their glaucoma follow-up, particularly towards the type and frequency of visual field (VF) testing.Design A qualitative investigation using focus groups. The group discussion used broad open questions around the topics in a prompt guide relating to experiences of glaucoma follow-up, and in particular, VF monitoring. All the groups were taped, transcribed and coded using manual and computer-aided methods.Setting Three National Health Service (NHS) hospitals in England; two focus groups took place at each hospital.Participants 28 patients (mean (SD) age: 74 (9) years; 54% women) diagnosed with glaucoma for at least 2years. Each focus group consisted of 3-6 patients.Primary and secondary outcomes (1) Attitudes and experiences of patients with glaucoma regarding VF testing. (2) Patients' opinions about successful follow-up in glaucoma.Results These patients did not enjoy the VF test but they recognised the importance of regular monitoring for preserving their vision. These patients would agree to more frequent VF testing on their clinician's recommendation. A number of themes recurred throughout the focus groups representing perceived barriers to follow-up care. The testing environment, waiting times, efficiency of appointment booking and travel to the clinic were all perceived to influence the general clinical experience and the quality of assessment data. Patients were also concerned about aspects of patient-doctor communication, and often received little to no feedback about their results.Conclusions Patients trust the clinician to make the best decisions for their glaucoma follow-up. However, patients highlighted a number of issues that could compromise the effectiveness of VF testing. Addressing patient-perceived barriers could be an important step for devising optimal strategies for follow-up care.