How does eye care seeking behaviour change with increasing age and visual impairment? Intersectional analysis of older adults in the Indian Sundarbans
How does eye care seeking behaviour change with increasing age and visual impairment? Intersectional analysis of older adults in the Indian Sundarbans
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DOI：
10.1186/s12877-020-1438-y
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发表时间：
2020-02-18
期刊：
影响因子：
4.1
通讯作者：
Mishra, Manasee
中科院分区：
文献类型：
--
作者：
Barman, Debjani;Mishra, Manasee
背景视力障碍不成比例地影响低收入国家的人们。很大一部分视力障碍是可以预防或治愈的。然而，寻求眼睛健康的护理仅限于妇女和老年人。本文采用交叉性的方法来了解如何在印度的贫困和服务不足的地区，随着年龄和视力障碍的增加，男性和女性寻求眼科护理的行为发生变化。它揭示了不同群体之间的共同点和差异。方法采用定性研究方法。50岁以上的人分为中老年人、中老年人和老年人。从三个年龄组中选出了视力低下/视力严重受损的男性和女性。对24名研究参与者进行了深入访谈。数据已达到饱和。JHPIEGO性别分析框架是这项研究的基础。叙述性数据已在NVivo 10软件中编码。结果各种症状与视力损害有关。低视力的老年人没有报告由于视力障碍而造成的困难。研究参与者有高度的视觉障碍，并在老年组。由于视力障碍而难以完成日常家务的报道很少。随着年龄的增长，视力受损被认为是不可避免的。为了眼睛健康而推迟寻求护理。通常，每个群体的男子和妇女都向附近的保健设施寻求门诊治疗。寻求住院治疗的人数有限，而且主要限于男子。随着年龄的增长和视力障碍，男性寻求眼部护理的行为发生变化。在门诊和住院眼科护理方面，女性始终比男性寻求更少的护理。随着年龄的增长和视力障碍，研究参与者的性别都变得依赖。男子享有的传统父权特权（如流动性和经济独立）随着年龄的增长而减少。妇女的脆弱性随着时间的推移而加剧。结论本文提出了一个颗粒状的理解，在印度的老年人之间的眼睛护理寻求行为。在促进普及保健服务的方案中需要认识到这种差别。需要重新审视关于获得保健的现有概念。
Background Visual impairment disproportionately affects people in the low-income countries. A high proportion of visual impairment can be prevented or cured. Yet, care seeking for eye health is restricted for women and older adults. This article uses the intersectionality approach to understand how eye care seeking behaviour changes in men and women with increase in age and visual impairment in a poor and underserved region of India. It brings forth the commonalities and differences between the various groups. Methods The article is based on qualitative data. Persons aged 50 years and more are categorized into young-old, middle-old and old-old. Men and women with low vision/ high visual impairment have been selected from each of the three age groups. In-depth interviews have been carried out with 24 study participants. Data saturation has been attained. The JHPIEGO Gender Analysis Framework underpins the study. The narrative data has been coded in NVivo 10 software. Results Various symptoms are associated with visual impairment. The young-old with low vision do not report much difficulty due to visual impairment. Study participants with high visual impairment, and in the older age groups do. Difficulty in the discharge of regular chores due to visual impairment is rarely reported. Impaired vision is considered to be inevitable with advancing age. Care seeking is delayed for eye health. Typically, outpatient care from nearby health care facilities has been sought by men and women in every group. Inpatient care is limitedly sought, and mostly restricted to men. Eye care seeking behaviour changes among men with increase in age and visual impairment. Women consistently seek less care than men for both outpatient and inpatient eye care. Study participants of both genders become dependent with increasing age and visual impairment. Traditional patriarchal privileges enjoyed by men (such as mobility and economic independence) decrease with age. The vulnerability of women gets compounded with time. Conclusions The article presents a granulated understanding of eye care seeking behaviour among older adults in India. Such differentials need to be taken cognizance of in programmes promoting universal access to health care. Existing conceptualizations on access to health care need to be revisited.