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Barriers to cataract surgery from the perspective of elderly patients with cataract blindness in the eastern zone of Peninsular Malaysia: an interpretative phenomenological analysis

Poster Details

First Author: A.Mutalib MALAYSIA

Co Author(s):    N. Mat Zin   A. Hassan                 

Abstract Details

Purpose:

The Malaysian Rapid Assessment of Avoidable Blindness (RAAB) Survey in 2014 revealed cataract as the leading cause of blindness with the prevalence of 1.2 %. The total number of cataract surgery backlog for the whole country was estimated to be more than six hundred thousand. Understanding the barriers to undertake early cataract surgery is warranted to effectively increase the cataract surgical rate and reduce the prevalence of cataract blindness. In this study we explore the barriers to cataract surgery from the perspective of elderly patients with blindness due to cataract.

Setting:

The study involves eleven participants who have been diagnosed with cataract blindness from the eastern zone of Peninsular Malaysia in the state of Kelantan, Terengganu and Pahang. All interviews were carried out in their own home setting.

Methods:

Using interpretative phenomenological analysis (IPA) approach in health psychology, semi-structured interview was tape recorded and transcribed verbatim. The final qualitative data analysis and identification of the related quotes from the transcription was facilitated using the NVivo software version 6.0. Several quotes by the participants are chosen to exemplified the themes developed. Ethical approval was granted by the Universiti Sultan Zainal Abidin human research ethical committee.

Results:

Our study identifies the barriers to cataract surgery at three levels i.e. at the patient�â�€�™s level, primary care level, and specialist care level. Barriers at the patient�â�€�™s level are their belated needs for better sight, feeling of apprehension, general physical status, amount of family support and cost incurred. Most patients emphasize their needs and capability to perform daily living activities in spite of their visual impairment. Barrier at the primary care level is regarding patient-provider related issues and at the specialist care level are concerning healthcare system bureaucracy, waiting time and accessibility.

Conclusions:

Their belated needs for better sight generate delayed awareness and impeded their initial decision to disclose their visual problem to family members or primary healthcare providers for alternative treatment or surgery. However, appropriate approach and advice from healthcare providers may be able to motivate patients to acquire better vision by an earlier cataract surgery. Thus, further improvement in health education, promotion, vision screening and eyecare delivery system can increase the awareness of the community and healthcare provider about cataract and formulate more effective strategy towards earlier and more extensive cataract surgery uptake.

Financial Disclosure:

NONE

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