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Attitudes, access and anguish : a qualitative interview study of staff and patients' experiences of diabetic retinopathy screening
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Hipwell, Alison, Sturt, Jackie, Lindenmeyer, Antje, Stratton, Irene, Gadsby, Roger, O'Hare, J. Paul and Scanlon, Peter H. (2014) Attitudes, access and anguish : a qualitative interview study of staff and patients' experiences of diabetic retinopathy screening. BMJ Open, Volume 4 (Number 12). Article number e005498. doi:10.1136/bmjopen-2014-005498
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Official URL: http://dx.doi.org/10.1136/bmjopen-2014-005498
Abstract
Objective To examine the experiences of patients, health professionals and screeners; their interactions with and understandings of diabetic retinopathy screening (DRS); and how these influence uptake.
Design Purposive, qualitative design using multiperspectival, semistructured interviews and thematic analysis.
Setting Three UK Screening Programme regions with different service-delivery modes, minority ethnic and deprivation levels across rural, urban and inner-city areas, in general practitioner practices and patients’ homes.
Participants 62 including 38 patients (22 regular-screening attenders, 16 non-regular attenders) and 24 professionals (15 primary care professionals and 9 screeners).
Results Antecedents to attendance included knowledge about diabetic retinopathy and screening; antecedents to non-attendance included psychological, pragmatic and social factors. Confusion between photographs taken at routine eye tests and DRS photographs was identified. The differing regional invitation methods and screening locations were discussed, with convenience and transport safety being over-riding considerations for patients. Some patients mentioned significant pain and visual disturbance from mydriasis drops as a deterrent to attendance.
Conclusions In this, the first study to consider multiperspectival experiential accounts, we identified that proactive coordination of care involving patients, primary care and screening programmes, prior to, during and after screening is required. Multiple factors, prior to, during and after screening, are involved in the attendance and non-attendance for DRS. Further research is needed to establish whether patient self-management educational interventions and the pharmacological reformulation of shorter acting mydriasis drops, may improve uptake of DRS. This might, in turn, reduce preventable vision loss and its associated costs to individuals and their families, and to health and social care providers, reducing current inequalities.
| Item Type: | Journal Article | ||||||||
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| Subjects: | R Medicine > RE Ophthalmology | ||||||||
| Divisions: | Faculty of Medicine > Warwick Medical School > ( - July 2016) Health Education Hub Faculty of Medicine > Warwick Medical School > Biomedical Sciences > Translational & Experimental Medicine > Metabolic and Vascular Health (- until July 2016) Faculty of Medicine > Warwick Medical School |
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| Library of Congress Subject Headings (LCSH): | Diabetic retinopathy -- Medical examinations | ||||||||
| Journal or Publication Title: | BMJ Open | ||||||||
| Publisher: | BMJ | ||||||||
| ISSN: | 2044-6055 | ||||||||
| Official Date: | 15 November 2014 | ||||||||
| Dates: |
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| Volume: | Volume 4 | ||||||||
| Number: | Number 12 | ||||||||
| Article Number: | Article number e005498 | ||||||||
| DOI: | 10.1136/bmjopen-2014-005498 | ||||||||
| Status: | Peer Reviewed | ||||||||
| Publication Status: | Published | ||||||||
| Access rights to Published version: | Open Access | ||||||||
| Funder: | National Institute for Health Research (Great Britain) (NIHR), Gloucestershire Hospitals NHS Foundation Trust | ||||||||
| Grant number: | PB-PG-1208-18043 (NIHR) |
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