Owsley Cynthia, McGwin Gerald, Scilley Kay, Girkin Christopher A, Phillips Janice M, Searcey Karen
Department of Ophthalmology, School of Medicine, University of Alabama at Birmingham 35294-0009, USA.
Invest Ophthalmol Vis Sci. 2006 Jul;47(7):2797-802. doi: 10.1167/iovs.06-0107.
To identify by using focus group methods the perceived barriers to eye care and attitudes about vision and eye care among older African Americans as well as among ophthalmologists and optometrists serving their communities.
Seventeen focus groups of older African Americans residing in the Birmingham or Montgomery, Alabama, areas were led by an experienced facilitator. Discussion was stimulated by a semistructured script focused on their perceived barriers to eye care and attitudes about vision and eye care. Six focus groups of ophthalmologists and optometrists who practiced in this geographic region addressed the same topics. Discussion was audiotaped and transcribed. Comments were coded using a multistep content analysis protocol.
One hundred nineteen African Americans (age range, 59-97 years) and 35 eye care providers (51% ophthalmologists, 49% optometrists) participated. The barrier-to-care problem most frequently cited by both African Americans and eye care providers was transportation. The next most common problems mentioned by African Americans were trusting the doctor, communicating with the doctor, and the cost of eye care; and for eye care providers, the next most common problems were cost, trust, and insurance. With respect to older African Americans' comments on their attitudes about vision and eye care, these comments were predominantly positive (69%), highlighting the importance of eye care and behavior in their lives and attitudes that facilitated care. However, when eye care providers relayed their impressions of African Americans' attitudes about vision and eye care, their comments were largely negative (74%) centering on concerns and frustrations that older African Americans did not have attitudes or engage in behavior that facilitate eye care.
These results provide some guidance for the design of interventions to increase the use of routine eye care in this population. At a societal level, there is a need for affordable and accessible transportation services for older African Americans seeking eye care. For ophthalmologists, optometrists, and their staffs, there is a need for continuing education that imparts culturally sensitive and age-appropriate communication and trust-building skills for interactions with this population. In addition to reinforcing the generally positive attitudes of older African Americans toward the importance of eye care, community-based educational programs should be focused on strategies for overcoming the common barriers to care.
采用焦点小组方法，确定非裔美国老年人以及为其社区服务的眼科医生和验光师眼中的眼保健障碍以及对视力和眼保健的态度。
由一位经验丰富的主持人主持了17个焦点小组，小组成员为居住在阿拉巴马州伯明翰或蒙哥马利地区的非裔美国老年人。讨论由一个半结构化脚本激发，该脚本聚焦于他们眼中的眼保健障碍以及对视力和眼保健的态度。在该地理区域执业的6个眼科医生和验光师焦点小组讨论了相同的主题。讨论进行了录音和转录。使用多步骤内容分析方案对评论进行编码。
119名非裔美国人（年龄范围59 - 97岁）和35名眼保健提供者（51%为眼科医生，49%为验光师）参与了研究。非裔美国人和眼保健提供者最常提到的保健障碍问题是交通。非裔美国人提到的第二常见问题是信任医生、与医生沟通以及眼保健费用；而对于眼保健提供者来说，第二常见问题是费用、信任和保险。关于非裔美国老年人对视力和眼保健态度的评论，这些评论大多是积极的（69%），强调了眼保健和行为在他们生活中的重要性以及有助于保健的态度。然而，当眼保健提供者转述他们对非裔美国老年人视力和眼保健态度的印象时，他们的评论大多是否定的（74%），集中在对非裔美国老年人没有有助于眼保健的态度或行为的担忧和沮丧上。
这些结果为设计干预措施以增加该人群对常规眼保健的使用提供了一些指导。在社会层面，需要为寻求眼保健的非裔美国老年人提供负担得起且方便的交通服务。对于眼科医生、验光师及其工作人员，需要开展继续教育，传授与该人群互动时具有文化敏感性和适合年龄的沟通及建立信任的技能。除了强化非裔美国老年人对眼保健重要性的普遍积极态度外，基于社区的教育项目应侧重于克服常见保健障碍的策略。
