'I don`t need an eye check-up'. A qualitative study using a behavioural model to understand treatment-seeking behaviour of patients with sight threatening diabetic retinopathy (STDR) in India

被引：2

作者：

Kumar, Shuba ^{[1
]}

Mohanraj, Rani ^{[1
]}

Raman, Rajiv ^{[2
]}

Kumar, Geetha ^{[2
]}

Luvies, Sanjay ^{[3
]}

Machhi, Shivani Sunil ^{[4
]}

Chakrabarty, Subhratanu ^{[5
]}

Surya, Janani ^{[2
]}

Ramakrishnan, Radha ^{[6
]}

Conroy, Dolores ^{[6
]}

Sivaprasad, Sobha ^{[6
]}

机构：

[1] Samarth, Social Sci Dept, Chennai, Tamil Nadu, India

[2] Sankara Nethralaya, Dept Ophthalmol, Chennai, Tamil Nadu, India

[3] Giridhar Eye Inst, Dept Ophthalmol, Cochin, Kerala, India

[4] Aditya Jyot Fdn Twinkling Little Eyes, Dept Ophthalmol, Mumbai, Maharashtra, India

[5] VMA Netra Niramay Niketan, Dept Ophthalmol, Haldia, W Bengal, India

[6] Moorfields Eye Hosp NHS Fdn Trust, NIHR Biomed Res Ctr, Dept Ophthalmol, London, England

来源：

PLOS ONE | 2023年 / 18卷 / 06期

基金：

英国科研创新办公室;

关键词：

GLOBAL PREVALENCE; POPULATION; AWARENESS; GLAUCOMA; STATE; CARE;

D O I：

10.1371/journal.pone.0270562

中图分类号：

O [数理科学和化学]; P [天文学、地球科学]; Q [生物科学]; N [自然科学总论];

学科分类号：

07 ; 0710 ; 09 ;

摘要：

Diabetic Retinopathy (DR) affects about 27% of patients with diabetes globally. According to the World Health Organization (WHO), DR is responsible for37 million cases of blindness worldwide. The SMART India study (October 2020-August 2021) documented the prevalence of diabetes, and DR in people40 years and above across ten Indian states and one Union Territory by conducting community screening. About 90% of people with sight threatening diabetic retinopathy (STDR) were referred from this screening study to eye hospitals for management, but failed to attend. This qualitative study, a component of the SMART India study, explored perceptions of referred patients regarding their susceptibility to eye related problems in diabetes and the benefits/barriers to seeking care. Perceived barriers from the viewpoint of ophthalmologists were also explored. Guided by the Health Beliefs Model (HBM), 20 semi structured interviews were carried out with consenting patients diagnosed with STDR. They included nine patients who had sought care recruited from eight eye hospitals across different states in India and eleven patients who did not seek care. Eleven ophthalmologists also participated. Four themes of analysis based on the HBM were, understanding of DR and its treatment, perceptions about susceptibility and severity, perceived barriers, perceived benefits and cues to action. Findings revealed poor understanding of the effects of diabetes on the eye contributing to low risk perception. Prohibitive costs of treatment, difficulties in accessing care services and poor social support were major barriers to seeking care. Ophthalmologists acknowledged that the absence of symptoms and the slow progressive nature of the disease deluded patients into thinking that they were fine. The study attests to the need for greater health literacy around diabetes, DR and STDR; for making treatment more affordable and accessible and for the development of effective patient education and communication strategies towards increasing compliance.

引用

页数：23