Barriers to cataract surgery at the primary healthcare level in the eastern zone of peninsular Malaysia

Asma', Hassan and Abdul Mutalib, Othman and Nurulain, Mat Zin and Ahmad, Shahir (2018) Barriers to cataract surgery at the primary healthcare level in the eastern zone of peninsular Malaysia. In: 33rd Malaysia-Singapore Joint Ophthalmic Congress, 16 Mac 2018, Melaka.

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Abstract

Objective: The Second Malaysia National Eye Survey in 2014 revealed cataract as the main cause of blindness with a distressing majority believes they did not require surgery. We need to understand the barriers to cataract surgery at the primary healthcare level from the perspective of patients who has allowed themselves to become severely blind due to cataract. Method: We studied 11 participants in the Eastern zone utilising the interpretative phenomenological analysis of a qualitative approach more renowned in health psychology research. An in-depth interviews were performed at their homes were recorded and transcribed verbatim. The use of NVivo software version 8.0 facilitated the analysis process. Result: The first main barrier identified was nondisclosure of their visual problems due to belated needs for better sight, delayed awareness of their visual status and social stigma. The second main barrier was concerning the patient-provider-related issues due to miscommunication and delayed referral. The first issue has led to their delayed awareness and belief for not requiring cataract surgery which delayed the disclosure of their visual problems to primary healthcare providers. The patient-provider-related issues further delayed their cataract detection and referral process necessary for an immediate cataract surgery. Conclusion: Thus, addressing these barriers at primary healthcare level can improve our strategies for earlier cataract detection, and to motivate and assist them for the timely surgical intervention. This could prevent severe cataract blindness and the other related complications in the community.

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