Incentives and barriers to retinopathy screening among African-Americans with diabetes
Incentives and barriers to retinopathy screening among African-Americans with diabetes
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DOI：
10.1016/s1056-8727(96)00121-3
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发表时间：
1997-09-01
影响因子：
3
通讯作者：
Shamoon, H
中科院分区：
文献类型：
--
作者：
Walker, EA;Basch, CE;Shamoon, H
与糖尿病相关的眼科并发症是成人新诊断失明的主要原因，这些眼部并发症在早期阶段通常无症状，但大多数糖尿病患者并未每年进行筛查。为了制定健康促进干预措施，以提高通过散瞳眼底检查 (DFE) 筛查糖尿病视网膜病变的比率，我们评估了患有糖尿病的非裔美国人样本中与预防糖尿病眼部并发症相关的知识和健康信念。该研究设计是横断面的，通过电话采访收集数据，从 104 名患有糖尿病的非裔美国人中随机抽取样本，完成了 67 名（64%）：其中 54 名女性；平均年龄58岁。电话访谈时间表包含的项目分为感知激励、感知获得 DFE 的障碍、眼部问题的原因、眼部问题的风险和眼部问题的有效治疗等子量表。使用描述性统计分析定量数据。对开放式问题的转录定性回答进行了主题分析，“有眼睛问题”和“医生说去很重要”的激励措施各有 91% 的人回答说这是去 DFE 的激励措施。只有大约三分之一的人同意任何特定项目都会成为获得 DFE 的障碍（例如经济因素）。在眼部问题风险子量表中，“视网膜病变”的感知风险水平最低 (30%)，只有 21% 的样本报告有视网膜病变的有效治疗方法，87% 的样本报告错误地认为“糖尿病眼部问题有症状”。只有 36% 的样本表示他们听说过视网膜病变，其中只有 8% 能够正确描述，一般反应主题包括：恐惧、灵性（信仰）和希望）、优先事项、经济或后勤因素以及外部/内部动机。人们对获得 DFE 的感知激励的认可度远高于感知到的障碍。健康宣传材料必须强调在没有症状的情况下每年进行一次 DFE。对于糖尿病眼部问题有有效的早期治疗方法，这些信息应该用来消除对可怕诊断的恐惧，希望得到治疗和治愈。应对对检查的恐惧的方法应该包括在健康教育中，DFE必须成为每年例行的检查，而不仅仅是对已知问题的反应。健康教育必须满足高危少数人群的具体需求。 (C) 1997 爱思唯尔科学公司。
Diabetes-related ophthalmic complications are the leading cause of newly diagnosed blindness among adults, These eye complications are often asymptomatic in the early stages, yet the majority of diabetes patients are not screened yearly. To develop a health promotion intervention to increase the rate of screening for diabetic retinopathy by dilated fundus exam (DFE), we assessed the knowledge and health beliefs related to preventing diabetic eye complications among a sample of African-Americans with diabetes. The study design was cross-sectional, using a telephone interview to collect data, From a random sample of 104 African-Americans with diabetes, 67 (64%) were completed: 54 women; mean age of 58 years. The telephone interview schedule contained items grouped into subscales for Perceived Incentives, Perceived Barriers to getting a DFE, Causes of Eye Problems, Risk of Eye Problems, and Effective Treatments for Eye Problems. Descriptive statistics were used to analyze the quantitative data. Transcribed qualitative responses to the open-ended questions were analyzed for themes, The incentives ''having eye problems'' and ''doctor said it was important to go'' each had 91% responding it was an incentive to go for a DFE. Only about one-third agreed that any particular item was a barrier to receiving a DFE (e.g., economic factors). In the subscale for Risk of Eye Problems, ''retinopathy'' had the lowest level of perceived risk (30%), Only 21% of the sample reported there were effective treatments for retinopathy, Eighty-seven percent reported the faulty belief that ''diabetic eye problems have symptoms.'' Only 36% of the sample said they had heard of retinopathy and of those, only 8% could describe it correctly, Among general response themes were: fear, spirituality (faith and hope), priorities, economic or logistical factors, and external/internal motivation. Perceived incentives for receiving a DFE were acknowledged at far greater rates than perceived barriers. Having a yearly DFE in the absence of symptoms must be emphasized in health promotion materials. There are effective, early treatments for diabetic Eye problems, and this information should be used to counter the fear of a dreaded diagnosis with the hope of treatment and cure, Ways of coping with fear of having the exam should be included in health education, DFEs must become a routine yearly exam and not just a reaction to recognized problems. Health education must address the specific needs of high-risk minority populations. (C) 1997 Elsevier Science Inc.