Barriers To Cataract Surgery At Primary Healthcare Level In The Eastern Zone Of Peninsular Malaysia: An Interpretative Phenomenological Analysis

Abdul Mutalib, Othman and Asma', Hassan and Ahmad Shahir, Abdul Mutalib and Nurulain, M.Z (2017) Barriers To Cataract Surgery At Primary Healthcare Level In The Eastern Zone Of Peninsular Malaysia: An Interpretative Phenomenological Analysis. In: 1ST INTERNATIONAL COMMUNITY HEALTH CONFERENCE 2017, 7 October 2017, UNISZA.

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Abstract

Background: 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 especially at primary care level 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. Method: 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. 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 8.0. 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 primary care level with two main themes namely refusal to disclose vision problem and patient-provider related issues. These are the identified barriers that seem to have prevented them from revealing their visual problems and delay the decision for cataract surgery uptake earlier. 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. 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.

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