Evaluation of barriers to surgical compliance in the treatment of trichiasis
Evaluation of barriers to surgical compliance in the treatment of trichiasis
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DOI：
10.1023/a:1006045824191
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发表时间：
1997-01-01
影响因子：
1.6
通讯作者：
West, SK
中科院分区：
文献类型：
--
作者：
Oliva, MS;Munoz, B;West, SK
目的：眼睑修复术可以预防倒睫引起的视力下降。成本、交通困难和家庭责任已被确定为手术依从性的主要障碍。我们评估了在村里提供倒睫手术是否能有效地提高手术接受率和减少手术的感知障碍。方法：1989年，在坦桑尼亚中部发现了205名倒睫妇女，并提供免费手术沿着免费交通。截至1991年，这些妇女中只有18%接受了手术。我们随访这些妇女7年后，村一级手术介绍。结果：自1991年以来，又有12%的妇女接受了眼睑手术。44%是在村里进行的。自1991年以来的手术病例报告了更短的旅行时间到手术地点，类似的术后问题，以及更少的住院天数。在为患者提供福利的同时，增加乡村眼科服务并没有增加手术接受率。拒绝手术的妇女不知道村里有手术，认为费用和交通困难仍然是障碍。50%的未接受者表示，尽管他们中的3/4报告了干扰其日常活动的眼部症状，但没有任何东西能够使他们接受手术干预。结论：需要对村级眼科服务的成本效益进行评估，并提高对这些服务的认识。
Purpose: Eyelid repair surgery can prevent the effects of trichiasis leading to visual loss. Cost, transportation difficulties, and familial responsibilities have been identified as major barriers to surgical compliance. We evaluated whether offering trichiasis surgery in the village was effective in increasing the rate of surgical acceptance and in decreasing perceived barriers to surgery. Methods: In 1989, 205 women with trichiasis were identified in Central Tanzania and were offered free surgery along with free transport. As of 1991, only 18% of these women had undergone the surgery. We followed-up these women 7 years later after village level surgery was introduced. Results: Since 1991, an additional 12% of the women had undergone eyelid surgery. 44% were conducted in the village. Surgical cases since 1991 reported shorter travel times to the place of surgery, similar post-surgical problems, and fewer days in the hospital. While providing benefits to the patient, increased village eye services did not increase the rate of surgical acceptance. The women who declined surgery did not know surgery in the village was available and the perceived cost and transportation difficulties continued to be barriers. 50% of the non-accepters stated that there was nothing that would enable them to accept surgical intervention despite the fact that 3/4 of them reported eye symptoms that interfered with their daily activities. Conclusions: The cost efficacy of village level eye services needs to be evaluated and the awareness of these services increased.