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Nwanna-Nzewunwa O, Agwang E, Carvalho M, Ajiko MM, Oke R, Yoon C, Diab MM, Kirya F, Marseille E, Juillard C, Dicker RA. A cost-effectiveness analysis of surgical care delivery in Eastern Uganda-a societal perspective. BMC Health Serv Res 2023; 23:256. [PMID: 36918844 PMCID: PMC10015833 DOI: 10.1186/s12913-023-09216-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Accepted: 02/24/2023] [Indexed: 03/16/2023] Open
Abstract
BACKGROUND The mismatch between the global burden of surgical disease and global health funding for surgical illness exacerbates disparities in surgical care access worldwide. Amidst competing priorities, governments need to rationally allocate scarce resources to address local needs. To build an investment case for surgery, economic data on surgical care delivery is needed. This study focuses on femur fractures. METHODS This prospective cohort study at Soroti Regional Referral Hospital (SRRH), captured demographic, clinical, and cost data from all surgical inpatients and their caregivers at SRRH from February 2018 through July 2019. We performed descriptive and inferential analyses. We estimated the cost effectiveness of intramedullary nailing relative to traction for femur fractures by using primary data and making extrapolations using regional data. RESULTS Among the 546 patients, 111 (20.3%) had femur fractures and their median [IQR] length of hospitalization was 27 days [14, 36 days]. The total societal cost and Quality Adjusted Life Year (QALY) gained was USD 61,748.10 and 78.81 for femur traction and USD 23,809 and 85.47 for intramedullary nailing. Intramedullary nailing was dominant over traction of femur fractures with an Incremental Cost Effectiveness Ratio of USD 5,681.75 per QALY gained. CONCLUSION Femur fractures are the most prevalent and most expensive surgical condition at SRRH. Relative to intramedullary nailing, the use of femur traction at SRRH is not cost effective. There is a need to explore and adopt more cost-effective approaches like internal fixation.
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Affiliation(s)
- Obieze Nwanna-Nzewunwa
- Department of Surgery, Maine Medical Center, 22 Bramhall Street, Portland, ME, 04102, USA
| | - Esther Agwang
- Department of Surgery, Soroti Regional Referral Hospital, Soroti, Uganda
| | - Melissa Carvalho
- Program for the Advancement of Surgical Equity (PASE), University of California Los Angeles, Los Angeles, CA, USA
| | | | - Rasheedat Oke
- Program for the Advancement of Surgical Equity (PASE), University of California Los Angeles, Los Angeles, CA, USA
| | - Christopher Yoon
- David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA
| | - Mohamed M Diab
- Department of Surgery, Duke University Medical Center, Durham, NC, USA
| | - Fred Kirya
- Department of Surgery, Soroti Regional Referral Hospital, Soroti, Uganda
| | - Elliot Marseille
- Principal, Health Strategies International, 555 59th Street, Oakland, CA, USA
| | - Catherine Juillard
- Program for the Advancement of Surgical Equity (PASE), University of California Los Angeles, Los Angeles, CA, USA
| | - Rochelle A Dicker
- Program for the Advancement of Surgical Equity (PASE), University of California Los Angeles, Los Angeles, CA, USA.
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Shrestha M, Bhandari G, Kamalakannan S, Murthy GVS, Rathi SK, Gudlavalleti AG, Agiwal V, Pant H, Pandey B, Ghimire R, Ale D, Kayastha S, Karki R, Chaudhary DS, Byanju R. Evaluating the Effectiveness of Interventions to Improve the Follow-up Rate for Children With Visual Disabilities in an Eye Hospital in Nepal: Nonrandomized Study. JMIR Pediatr Parent 2023; 6:e43814. [PMID: 36821366 PMCID: PMC9999261 DOI: 10.2196/43814] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2022] [Revised: 01/23/2023] [Accepted: 01/31/2023] [Indexed: 02/04/2023] Open
Abstract
BACKGROUND Monitoring ocular morbidity among pediatric patients requires regular follow-up visits. We found that the follow-up rate was poor among children in our setting. Therefore, we intended to assess the effectiveness of 2 interventions-(1) counseling and (2) SMS text messaging and phone calls-to improve the follow-up rates. OBJECTIVE This study aimed to evaluate the effectiveness of 2 interventions, counseling and SMS and phone calls group, as well as a routine standard care for improving the follow-up rate of pediatric patients. METHODS A Nonrandomized, quasiexperimental design was used. Children (aged 0-16 years) with ocular conditions requiring at least 3 follow-up visits during the study period were included. A total of 264 participants were equally allocated to the 3 intervention groups of (1) counseling, (2) SMS and phone calls, and (3) routine standard care group. A 20-minute counseling session by a trained counselor with the provision of disease-specific leaflets were given to those in the counseling group. For the second intervention group, parents of children received an SMS text 3 days before and a phone call 1 day before their scheduled follow-up visits. Participants allocated for the routine standard care group were provided with the existing services with no additional counseling and reminders. Participants attending 3 follow-ups within 2 days of the scheduled visit date were considered compliant. The difference in and among the proportion of participants completing all 3 follow-up visits in each group was assessed. RESULTS The demographic characteristics of the participants were similar across the study groups. Only 3% (8/264) of participants completed all 3 follow-up visits, but overall compliance with the follow-up, as defined by the investigators, was found to be only 0.76% (2/264). There was no statistically significant difference in the proportion of follow-up between the intervention groups. However, the proportion of participants attending the first and second follow-ups, as well as the overall total number of follow-ups, was more in the SMS and phone-call group followed by the counseling group. CONCLUSIONS We did not find any evidence on the effectiveness of our interventions to improve the follow-up rate. The primary reason could be that this study was conducted during the COVID-19 pandemic. It could also be possible that the intensity of the interventions may have influenced the outcomes. A rigorously designed study during the absence of any lockdown restrictions is warranted to evaluate intervention effectiveness. The study also provides useful insights and highlights the importance of designing and systematically developing interventions for improving the follow-up rate and ensuring a continuum of care to children with visual disabilities in Nepal and similar contexts. TRIAL REGISTRATION ClinicalTrials.gov NCT04837534; https://clinicaltrials.gov/ct2/show/NCT04837534. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) RR2-10.2196/31578.
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Affiliation(s)
- Manisha Shrestha
- Bharatpur Eye Hospital, Bharatpur Metropolitan City, Chitwan, Nepal
| | - Gopal Bhandari
- Bharatpur Eye Hospital, Bharatpur Metropolitan City, Chitwan, Nepal
| | | | | | | | | | - Varun Agiwal
- Indian Institute of Public Health, Hyderabad, India
| | - Hira Pant
- Indian Institute of Public Health, Hyderabad, India
| | - Binod Pandey
- Bharatpur Eye Hospital, Bharatpur Metropolitan City, Chitwan, Nepal
| | - Ramesh Ghimire
- Bharatpur Eye Hospital, Bharatpur Metropolitan City, Chitwan, Nepal
| | - Daman Ale
- Bharatpur Eye Hospital, Bharatpur Metropolitan City, Chitwan, Nepal
| | - Sajani Kayastha
- Bharatpur Eye Hospital, Bharatpur Metropolitan City, Chitwan, Nepal
| | - Rakshya Karki
- Bharatpur Eye Hospital, Bharatpur Metropolitan City, Chitwan, Nepal
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Social, Educational and Medical Aspects after Cataract Surgery of Bilaterally Blind Children in Kinshasa—Perception of Parents and Children. CHILDREN 2022; 9:children9111683. [DOI: 10.3390/children9111683] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Revised: 10/27/2022] [Accepted: 10/31/2022] [Indexed: 11/06/2022]
Abstract
The study investigated the influence of bilateral cataract surgery on the social and educational development of previously bilaterally blind children in Sub-Saharan Africa (SSA), where the prevalence of blindness due to cataract is higher than in high-income countries. The views of both, parents and children, were evaluated with structured interviews based on a newly developed questionnaire related to surgery, follow-up, and family life after surgery. The mean age of the children at interview was 14.4 ± 8.1 years, with 27 females and 26 males. Satisfaction with the outcome of the surgery was reported by 91% of parents. Parents would recommend surgery, because of the children being happy and able to act more independently, with personal, educational and familial factors essentially contributing to the reported satisfaction. The results also showed that 85.0% of children did not wear eyeglasses. Reasons given were mainly cost-related, but also included limited communication between families and health institutions. Providing and maintaining a high-quality and accessible pediatric cataract surgery and healthcare service for follow-up is a major requisite to reduce childhood blindness in SSA. Our study proved the necessity and effectiveness of a community-based rehabilitation program that cares about each individual child, whatever his or her social background.
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May E, Arach P, Kishiki E, Geneau R, Maehara G, Sukhai M, Hamm LM. Learning to see after early and extended blindness: A scoping review. Front Psychol 2022; 13:954328. [PMID: 36389599 PMCID: PMC9648338 DOI: 10.3389/fpsyg.2022.954328] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Accepted: 09/26/2022] [Indexed: 10/03/2023] Open
Abstract
PURPOSE If an individual has been blind since birth due to a treatable eye condition, ocular treatment is urgent. Even a brief period of visual deprivation can alter the development of the visual system. The goal of our structured scoping review was to understand how we might better support children with delayed access to ocular treatment for blinding conditions. METHOD We searched MEDLINE, Embase and Global Health for peer-reviewed publications that described the impact of early (within the first year) and extended (lasting at least 2 years) bilateral visual deprivation. RESULTS Of 551 reports independently screened by two authors, 42 studies met our inclusion criteria. Synthesizing extracted data revealed several trends. The data suggests persistent deficits in visual acuity, contrast sensitivity, global motion, and visual-motor integration, and suspected concerns for understanding complex objects and faces. There is evidence for resilience in color perception, understanding of simple shapes, discriminating between a face and non-face, and the perception of biological motion. There is currently insufficient data about specific (re)habilitation strategies to update low vision services, but there are several insights to guide future research in this domain. CONCLUSION This summary will help guide the research and services provision to help children learn to see after early and extended blindness.
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Affiliation(s)
- Eloise May
- School of Optometry and Vision Science, University of Auckland, Auckland, New Zealand
| | | | | | - Robert Geneau
- Kilimanjaro Centre for Community Ophthalmology, Moshi, Tanzania
- Division of Ophthalmology, University of Cape Town, Cape Town, South Africa
| | - Goro Maehara
- Department of Human Sciences, Kanagawa University, Yokohama, Japan
| | - Mahadeo Sukhai
- Accessibility, Research and International Affairs, Canadian National Institute for the Blind, Toronto, ON, Canada
- Department of Ophthalmology, Faculty of Health Sciences, School of Medicine, Queen's University, Kingston, ON, Canada
| | - Lisa M. Hamm
- School of Optometry and Vision Science, University of Auckland, Auckland, New Zealand
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Muacevic A, Adler JR. Knowledge and Practices of Child Eye Healthcare Among Parents in Aseer Region, Saudi Arabia. Cureus 2022; 14:e30404. [PMID: 36407150 PMCID: PMC9669086 DOI: 10.7759/cureus.30404] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/17/2022] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND The majority of causes of childhood blindness are preventable and treatable. There are an estimated 1.4 million blind children worldwide, with roughly three-quarters of them living in developing countries. In most low-income countries, school-age children account for 20%-30% of the total population. AIM To evaluate parents' knowledge, attitudes, and practices related to pediatric eye medical services in Saudi Arabia's Aseer region. METHODOLOGY A descriptive cross-sectional approach was used targeting all parents in the Aseer region. Data were collected using a structured questionnaire developed by the study investigators. The questionnaire included parents' sociodemographic data and a family history of blindness or visual disability. Parents' awareness regarding pediatric eye care was assessed using relevant items. The parents' practices and attitudes regarding eye care were also assessed within the questionnaire. RESULTS The study included 899 parents who replied to the online questionnaire in its entirety. Some 54% of the responding parents were aged 30-50 years, and 51.2% were males. Of the parents, 46.2% had a university-level education, and 48.5% accompanied their children for eye examinations. About 65% of the parents knew about clinics for eye examinations, and 63.3% of them knew that blind children could learn. In total, more than one-third of the parents were aware of pediatric eye care. CONCLUSIONS AND RECOMMENDATIONS The study found that parents were aware of pediatric eye health and sought eye care for their children. More effort should be put forth through planned awareness programs to educate parents and assist them in overcoming the fears and barriers that keep them from seeking eye care for their children.
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Limitations in cataract surgical services for children in Ethiopia: a nationwide survey of pediatric cataract surgeons. BMC Ophthalmol 2021; 21:437. [PMID: 34923960 PMCID: PMC8684671 DOI: 10.1186/s12886-021-02190-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Accepted: 11/17/2021] [Indexed: 11/28/2022] Open
Abstract
Background Bilateral cataract is a significant cause of blindness in children in Ethiopia. This study aimed to identify the resources available for cataract surgery in children, and to assess current surgical practices, surgical output and factors affecting the outcome of surgery in Ethiopia. Methods A Google Forms mobile phone questionnaire was emailed to nine ophthalmologists known to perform cataract surgery in young children (0–5 years). Results All nine responded. All but one had received either 12- or 3–5-month’s training in pediatric ophthalmology with hands-on surgical training. The other surgeon had received informal training from an experienced colleague and visiting ophthalmologists. The surgeons were based in seven health facilities: five in the capital (Addis Ababa) and eight in six public referral hospitals and one private center. Over 12 months (2017–2018) 508 children (592 eyes) aged 0–18 years (most < 15 years) were operated by these surgeons. 84 (17%) had bilateral cataract, and 424 (83%) had unilateral cataract mainly following trauma. A mean of 66 (range 18–145) eyes were operated per surgeon. Seventy-one additional children aged > 5 years were operated by other surgeons. There were substantially fewer surgeons per million population (nine for 115 million population) than recommended by the World Health Organization and they were unevenly distributed across the country. Methylcellulose and rigid intraocular lenses were generally available but less than 50% of facilities had a sharp vitrectomy cutter and cohesive viscoelastic. Mean travel time outside Addis Ababa to a facility offering pediatric cataract surgery was 10 h. Conclusion Despite the high number of cases per surgeon, the output for bilateral cataracts was far lower than required. More well-equipped pediatric ophthalmology teams are urgently required, with deployment to under-served areas.
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Alrasheed SH. A systemic review of barriers to accessing paediatric eye care services in African countries. Afr Health Sci 2021; 21:1887-1897. [PMID: 35283961 PMCID: PMC8889803 DOI: 10.4314/ahs.v21i4.47] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Background Global estimate reported that 1.4 million children are blind of which three-quarters live in developing countries. Childhood Visual Impairment is a major public health problem globally especially in rural areas of developing countries. Objective To review barriers to accessing paediatric eye care services in African countries. Methods The studies in this review were searched in online databases (PubMed, Web of Sciences, ProQuest, Scopus, Google Scholar, African Index Medicus and Medline) for studies published between January 2000 and April 2020. The articles included in this review, which was conducted in Africa to assess the barriers for accessing paediatric eye care services with regards availability, accessibility, affordability, socio cultural barriers of parents/caregivers and community. Results Of 22 705 articles screened, the study found 29 publications from 10 African countries which met the inclusion criteria. The main barriers were non-availability, non-accessibility, and non-affordability of paediatric eye care services. The studies reviewed revealed that there are other factors affecting the utilization of paediatric eye services which include the primary health system, geographic barriers, health beliefs, perception of parents; lack of knowledge, attitudes and practices about paediatric eye care. Furthermore, environmental, demographic barriers and socio-economic status has negative impact on accessing paediatric eye care services in African counties. Conclusion The main barriers to accessing paediatric eye care services in Africa were affordability, accessibility and availability. There is therefore a need for all relevant stakeholders to play a significant role in addressing barriers to child eye care in African countries.
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Affiliation(s)
- Saif Hassan Alrasheed
- Department of Optometry, College of Applied Medical Sciences, Qassim University, Saudi Arabia
- Faculty of Optometry and Visual Sciences, Department of Binocular vision Al-Neelain University, Khartoum, Sudan
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Shrestha M, Bhandari G, Rathi SK, Gudlavalleti AG, Pandey B, Ghimire R, Ale D, Kayastha S, Chaudhary DS, Byanju R. Improving the Follow-up Rate for Pediatric Patients (0-16 years) of an Eye Hospital in Nepal: Protocol for a Public Health Intervention Study. JMIR Res Protoc 2021; 10:e31578. [PMID: 34521615 PMCID: PMC8538025 DOI: 10.2196/31578] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2021] [Revised: 08/24/2021] [Accepted: 09/13/2021] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND The follow-up of pediatric patients ensures regular ocular morbidity monitoring and better treatment outcome. Hiralal Santudevi Pradhan Institute of Ophthalmic Science (Bharatpur Eye Hospital [BEH]) noticed that the follow-up rate was only 22% among its pediatric patients. Several factors like lack of awareness and forgetfulness among patients may contribute to a lower number of follow-up visits. Therefore, BEH decided to find if counseling and reminders through SMS text messaging and phone calls would improve the follow-up rates. OBJECTIVE This study aims to evaluate the impact of interventions like counseling and reminder SMS text messaging and phone calls in improving the follow-up rate of pediatric patients. METHODS This is a public health intervention study being conducted using quantitative analysis. All children (0-16 years) with ocular conditions requiring at least 3 follow-up visits in the study period will be included. In all, 264 participants will be allocated to 3 groups: routine standard care, counseling, and reminders with SMS text messaging and phone calls. In counseling, patients will take part in 20-minute counseling sessions with trained counselors at each visit, and information leaflets will be provided to them. In the reminder SMS text messaging and phone call group, patients will receive an SMS text message 3 days prior and a phone call 1 day prior to their scheduled visits. Patients attending within 2 days of the scheduled date will be considered compliant to follow-up. The proportion of patients completing all the follow-up visits in each group will be assessed. Informed consent will be taken from parents and children. Univariate and multivariate analyses will be conducted. RESULTS The ethical approval for this study has been obtained from the Ethical Review Board (ERB) of Nepal Health Research Council (ERB protocol registration #761/2020 P). The data collection was initiated on January, 24, 2021, but due to the COVID-19 pandemic, as of September 2021, we have only been able to enroll 154 of the planned 264 participants (58.3% of the sample size). CONCLUSIONS This study will reliably document not only the factors associated with follow-up rate through an intervention package (counseling and reminders through SMS text messaging and phone calls) but also the cost effectiveness of the intervention package, which can be applied in all the departments of the hospital. TRIAL REGISTRATION ClinicalTrials.gov NCT04837534; https://clinicaltrials.gov/ct2/show/NCT04837534. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/31578.
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Affiliation(s)
| | | | | | | | | | | | - Daman Ale
- Bharatpur Eye Hospital, Chitwan, Nepal
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- See Authors' Contributions,
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Chougule P, Kekunnaya R. Intraocular lens implantation in infants and toddlers in 2020. EXPERT REVIEW OF OPHTHALMOLOGY 2020. [DOI: 10.1080/17469899.2020.1794822] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Affiliation(s)
- Pratik Chougule
- The David Brown Children’s Eye Care Center, Child Sight Institute, L V Prasad Eye Institute, Vijayawada, Andhra Pradesh, India
| | - Ramesh Kekunnaya
- Jasti V Ramanamma Children’s Eye Care Centre, Child Sight Institute, L V Prasad Eye Institute, Hyderabad, India
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Riggs J, Chung KC. Postoperative Management of Hand Surgery in the Low- and Middle-Income Countries. Hand Clin 2019; 35:403-410. [PMID: 31585600 DOI: 10.1016/j.hcl.2019.07.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
The prevention and treatment of hand injuries in low- to middle-income countries needs to be a priority. Surgical outreach trips are a primary avenue for patients to receive interventions. Challenges include language and cultural barriers, poor infrastructure, and limitations in a patient's ability to follow-up. Strategies to maximize patient functional outcomes include cultural competence, patient education resources, overcoming communication barriers, and using task-shifting strategies. Local therapists' knowledge and clinical skills can be enhanced. With improvements in data collection, therapists may contribute to gaining knowledge of outcomes in low- to middle-income countries.
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Affiliation(s)
- Jeanne Riggs
- Michigan Medicine Plastic Surgery Clinic, Domino's Farms, Lobby A, rm 1108, 24 Frank Lloyd Wright Drive, Ann Arbor, MI 48105, USA; Department of Physical Medicine and Rehabilitation, Michigan Medicine, 325 East Eisenhower Parkway, Ann Arbor, MI 48108, USA
| | - Kevin C Chung
- Section of Plastic Surgery, University of Michigan Medical School, The University of Michigan Health System, 1500 East Medical Center Drive, 2130 Taubman Center, SPC 5340, Ann Arbor, MI 48109-5340, USA.
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Hamm LM, Boluk KA, Black JM, Dai S, Thompson B. Phenomenological approach to childhood cataract treatment in New Zealand using semi-structured interviews: how might we improve provision of care. BMJ Open 2019; 9:e024869. [PMID: 30782745 PMCID: PMC6352803 DOI: 10.1136/bmjopen-2018-024869] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
PURPOSE To understand how we might improve the provision of medical care for children with cataracts. DESIGN A phenomenological design was employed. Semi-structured interviews were conducted to capture rich descriptions of the phenomena. Our goal in the interview and the analysis was to understand the sources of distress associated with treatment for cataract and deprivation amblyopia which (1) could be addressed by the medical community and (2) related to treatment adherence. SETTING Interviews were conducted by a non-clinician researcher in New Zealand (NZ) in a location chosen by informants. In NZ, the red reflex screening test is performed shortly after birth, and surgery to remove paediatric cataracts is publicly funded. PARTICIPANTS Families of children who had a history of cataract in Auckland, NZ were posted an invitation to participate. Twenty families were interviewed. RESULTS Our analysis illustrated that informants described a wide range of experiences, from declined cataract surgery to full adherence to medical advice including years of patching for more than 4 hours a day. Across these experiences, we identified three relevant themes; timing of diagnosis, communication between the parent and clinician, and parental social support networks. CONCLUSION The medical community may be better placed to support families dealing with childhood cataract by improving detection of childhood cataract, building appropriate communication pathways and promoting social support, with an emphasis on empathetic, individualised care.
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Affiliation(s)
- Lisa M Hamm
- School of Optometry and Vision Science, The University of Auckland, Auckland, New Zealand
| | - Karla A Boluk
- Department of Recreation and Leisure Studies, University of Waterloo, Waterloo, Ontario, Canada
| | - Joanna M Black
- School of Optometry and Vision Science, The University of Auckland, Auckland, New Zealand
| | - Shuan Dai
- Department of Ophthalmology, The University of Auckland, Auckland, New Zealand
| | - Benjamin Thompson
- School of Optometry and Vision Science, The University of Auckland, Auckland, New Zealand
- School of Optometry and Vision Science, University of Waterloo, Ontario, Canada
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Bronsard A, Geneau R, Duke R, Kandeke L, Nsibirwa SG, Ulaikere M, Courtright P. Cataract in children in sub-Saharan Africa: an overview. EXPERT REVIEW OF OPHTHALMOLOGY 2018. [DOI: 10.1080/17469899.2018.1555037] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- Annie Bronsard
- Kilimanjaro Centre for Community Ophthalmology (KCCO), Moshi, Tanzania
- Division of Ophthalmology, University of Cape Town, Cape Town, South Africa
| | - Robert Geneau
- Kilimanjaro Centre for Community Ophthalmology (KCCO), Moshi, Tanzania
- Division of Ophthalmology, University of Cape Town, Cape Town, South Africa
| | - Roseline Duke
- Calabar Children Eye Centre, Department of Ophthalmology, University of Calabar Teaching Hospital, Calabar, Cross River State, Nigeria
| | - Lévi Kandeke
- Department of Ophthalmology, University of Burundi, Bujumbura, Burundi
| | | | | | - Paul Courtright
- Kilimanjaro Centre for Community Ophthalmology (KCCO), Moshi, Tanzania
- Division of Ophthalmology, University of Cape Town, Cape Town, South Africa
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Chougule P, Murat S, Mohamed A, Kekunnaya R. Follow-up patterns and associated risk factors after paediatric cataract surgery: observation over a 5-year period. Br J Ophthalmol 2018; 102:1550-1555. [DOI: 10.1136/bjophthalmol-2017-311294] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2017] [Revised: 01/13/2018] [Accepted: 01/19/2018] [Indexed: 11/04/2022]
Abstract
PurposeTo study the pattern of compliance to follow-up of children less than 5 years of age undergoing surgery for congenital and developmental cataract over a period of 5 years.MethodsIt is a retrospective study of children less than 5 years of age undergoing cataract surgery between January and December 2010 for congenital or developmental cataract and followed up until 31 December 2015. Age, sex, distance from hospital and urban or rural habitat, delay in presentation, socioeconomic status, laterality, morphology and type of cataract, implantation of intraocular lens and interventions done were noted. Compliance to follow-up at postoperative 1 week, 1 month, 3 months, 6 months, 1 year and then once a year until 5 years were recorded.Results169 patients were included in the study. The median follow-up was 22 months. Median age at surgery was 10 months and had a negative correlation with total follow-up. Male-to-female ratio was 1.82. Logarithmic curve of follow-up was noticed with 85%, 61%, 55%, 52%, 39% and 28% patients attending 1 month, 3 months, 6 months, 1 year, 3 years and 5 years of follow-up, respectively. Low socioeconomic group had poor follow-up compared with higher socioeconomic group (P=0.009), but the curve of follow-up was similar in both groups; multiple interventions group had better follow-up (P<0.0001).ConclusionCurve of loss to follow-up is logarithmic in children undergoing paediatric cataract surgery. Age at surgery and low economic status are the most important factors associated with poor follow-up.
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