Barriers;
Diabetes mellitus;
Diabetic retinopathy;
Screening;
Sri Lanka;
D O I:
10.1186/s41182-019-0160-y
中图分类号:
R188.11 [热带医学];
学科分类号:
摘要:
BackgroundBlindness and visual impairment from diabetic retinopathy (DR) are avoidable through early detection and timely treatment. The Western Province of Sri Lanka has the highest prevalence of diabetes mellitus (DM) (18.6%) in the country. A situational analysis identified a significant gap in DR screening services (DRSS) uptake in this region. Barriers that hinder people with DM (PwDM) from attending DRSS are poorly understood. The purpose of this study is to understand the factors which influence the uptake of DRSS and follow-up to inform health promotion strategies and improve the uptake of these services.MethodsEleven focus group discussions (FGDs) were conducted with PwDM who presented to medical, general eye and vitreoretinal services in three public sector institutions (two tertiary and one secondary level) in the Western Province between October 2016 and March 2017. We enrolled six groups (four Sinhala speaking, two Tamil) of women and five groups (three Sinhala and two Tamil) of men representing ethnicity and gender. We performed a thematic analysis and described the main themes and subthemes using the socio-ecological model as a framework.ResultsWe identified lack of knowledge of both the condition and the need for screening as key barriers to access DRSS. Socio-cultural factors in the family environment, economic reasons and institutional factors were also important barriers. Additional reasons include long waiting time at eye clinics and poor referrals exacerbated by the lack of a systematic DRSS. In addition, attitudes to DRSS such as fear of discomfort from the procedure and the need for accompaniment following mydriasis were also deterrents to follow-up screening.ConclusionThis study has shown that there are inter-related user, family, and institutional factors which affect the uptake of DRSS. Understanding how DR is conceptualised by PwDM in this region is essential to refine strategies to improve access to DRSS. Strategies to improve knowledge need to be more culturally acceptable and relevant to PwDM and their families, with increased availability of DRSS at convenient locations may increase timely uptake of screening.
机构:London School of Hygiene and Tropical Medicine,Clinical Research Department, Department of Infectious and Tropical Diseases, International Centre for Eye Health
Mapa Mudiyanselage Prabhath Nishantha Piyasena
Gudlavalleti Venkata S. Murthy
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机构:London School of Hygiene and Tropical Medicine,Clinical Research Department, Department of Infectious and Tropical Diseases, International Centre for Eye Health
Gudlavalleti Venkata S. Murthy
Jennifer L. Y. Yip
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h-index: 0
机构:London School of Hygiene and Tropical Medicine,Clinical Research Department, Department of Infectious and Tropical Diseases, International Centre for Eye Health
Jennifer L. Y. Yip
Clare Gilbert
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机构:London School of Hygiene and Tropical Medicine,Clinical Research Department, Department of Infectious and Tropical Diseases, International Centre for Eye Health
Clare Gilbert
Tunde Peto
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机构:London School of Hygiene and Tropical Medicine,Clinical Research Department, Department of Infectious and Tropical Diseases, International Centre for Eye Health
Tunde Peto
Mahesh Premarathna
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机构:London School of Hygiene and Tropical Medicine,Clinical Research Department, Department of Infectious and Tropical Diseases, International Centre for Eye Health
Mahesh Premarathna
Maria Zuurmond
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机构:London School of Hygiene and Tropical Medicine,Clinical Research Department, Department of Infectious and Tropical Diseases, International Centre for Eye Health
机构:
Cent Engn Consultancy Bur, Colombo, Sri LankaCent Engn Consultancy Bur, Colombo, Sri Lanka
Weerasinghe, Kumari M.
Gehrels, Hans
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机构:
Deltares, Delft, NetherlandsCent Engn Consultancy Bur, Colombo, Sri Lanka
Gehrels, Hans
Arambepola, N. M. S., I
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机构:
Asian Disaster Prevent Ctr, Bangkok, ThailandCent Engn Consultancy Bur, Colombo, Sri Lanka
Arambepola, N. M. S., I
Vajja, Hari Prasad
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Asian Disaster Prevent Ctr, Bangkok, ThailandCent Engn Consultancy Bur, Colombo, Sri Lanka
Vajja, Hari Prasad
Herath, J. M. K.
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h-index: 0
机构:
Cent Engn Consultancy Bur, Colombo, Sri LankaCent Engn Consultancy Bur, Colombo, Sri Lanka
Herath, J. M. K.
Atapattu, K. B.
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h-index: 0
机构:
Cent Engn Consultancy Bur, Colombo, Sri LankaCent Engn Consultancy Bur, Colombo, Sri Lanka
Atapattu, K. B.
7TH INTERNATIONAL CONFERENCE ON BUILDING RESILIENCE: USING SCIENTIFIC KNOWLEDGE TO INFORM POLICY AND PRACTICE IN DISASTER RISK REDUCTION,
2018,
212
: 503
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510
机构:
School of Health Sciences, City University London, LondonSchool of Health Sciences, City University London, London
Graham-Rowe E.
Lorencatto F.
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机构:
School of Health Sciences, City University London, LondonSchool of Health Sciences, City University London, London
Lorencatto F.
Lawrenson J.G.
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机构:
School of Health Sciences, City University London, LondonSchool of Health Sciences, City University London, London
Lawrenson J.G.
Burr J.
论文数: 0引用数: 0
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机构:
School of Medicine, University of St Andrews, FifeSchool of Health Sciences, City University London, London
Burr J.
Grimshaw J.M.
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h-index: 0
机构:
Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, ON
Department of Medicine, University of Ottawa, Ottawa, ONSchool of Health Sciences, City University London, London
Grimshaw J.M.
Ivers N.M.
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h-index: 0
机构:
Women's College Hospital, University of Toronto, Toronto, ONSchool of Health Sciences, City University London, London
Ivers N.M.
Peto T.
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h-index: 0
机构:
NIHR Biomedical Research Centre, Moorfields Eye Hospital NHS Foundation Trust, UCL Institute of Ophthalmology, LondonSchool of Health Sciences, City University London, London
Peto T.
Bunce C.
论文数: 0引用数: 0
h-index: 0
机构:
NIHR Moorfields Biomedical Research Centre, Moorfields Eye Hospital London, LondonSchool of Health Sciences, City University London, London
Bunce C.
Francis J.J.
论文数: 0引用数: 0
h-index: 0
机构:
School of Health Sciences, City University London, LondonSchool of Health Sciences, City University London, London
Francis J.J.
Vale L.
论文数: 0引用数: 0
h-index: 0
机构:
Moorfields Eye Hospital NHS Foundation Trust, LondonSchool of Health Sciences, City University London, London
Vale L.
Presseau J.
论文数: 0引用数: 0
h-index: 0
机构:
Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, ONSchool of Health Sciences, City University London, London
Presseau J.
Quartilho A.
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h-index: 0
机构:School of Health Sciences, City University London, London
Quartilho A.
Rice S.
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机构:
Moorfields Eye Hospital NHS Foundation Trust, LondonSchool of Health Sciences, City University London, London
机构:
Gloucestershire Eye Unit, English NHS Diabet Eye Screening Programme, Cheltenham, Glos, EnglandGloucestershire Eye Unit, English NHS Diabet Eye Screening Programme, Cheltenham, Glos, England