du Toit Rènée, Ramke Jacqueline, Naduvilath Thomas, Brian Garry
Vision Cooperative Research Centre and the International Centre for Eye Care Education, University of New South Wales, Sydney, Australia.
Ophthalmic Epidemiol. 2006 Oct;13(5):309-20. doi: 10.1080/09286580600826629.
To determine the awareness, use, and barriers to use of eye services in Fiji's Central Province.
A cross-sectional survey study design with random clusters of households was used. Semi-structured interviews were conducted (152 females and 22 males). For 267 household members, presenting distance and near visual acuities were measured, and the perception of and satisfaction with their vision were recorded.
Most (86%; 150/174) respondents were aware of at least one conventional eye care service. However, only 66% (121/183) of household members with previous eye problems had consulted one of these; the proportion was even lower for those in the older age groups (p < 0.01). Rural dwellers expressed satisfaction with their vision, despite being more likely to regard it as limiting their activities and being less likely to seek conventional care. A higher proportion of females were reported to have (or have had) eye problems (60:40) and were found to have bilateral visual impairment (60:40). Despite this, females and males attended the hospital eye clinic (47:53) or sought treatment from conventional services (51:49) nearly equally. The reasons given for not seeking conventional care were "fatalistic attitude" ("did not bother", "could manage", or accepted the condition: 57%), expense (12%), and fear (8%).
Central Province Fijians, particularly the old, rural, and female, under-utilise conventional eye care services. As in developing countries elsewhere, fatalistic attitudes to visual impairment are a significant contributor to this. To improve eye health, planning and implementation of eye care services must overcome under-utilisation by addressing local barriers to uptake through community participation in education and affirmative action.
确定斐济中部省份民众对眼科服务的知晓度、使用情况及使用障碍。
采用随机整群抽样的横断面调查研究设计。进行了半结构式访谈（152名女性和22名男性）。对267名家庭成员测量了远视力和近视力，并记录了他们对视力的看法和满意度。
大多数（86%；150/174）受访者知晓至少一种传统眼科护理服务。然而，曾有眼部问题的家庭成员中只有66%（121/183）咨询过其中一项服务；老年人群体的这一比例更低（p<0.01）。农村居民对自己的视力表示满意，尽管他们更有可能认为视力限制了他们的活动，且不太可能寻求传统护理。据报告，女性有（或曾有）眼部问题的比例更高（60:40），且被发现有双侧视力损害的比例也更高（60:40）。尽管如此，女性和男性到医院眼科门诊就诊（47:53）或寻求传统服务治疗（51:49）的比例几乎相同。不寻求传统护理的原因包括“宿命论态度”（“不在意”、“能应付”或接受现状：57%）、费用（12%）和恐惧（8%）。
斐济中部省份的居民，尤其是老年人、农村居民和女性，对传统眼科护理服务利用不足。与其他发展中国家一样，对视力损害的宿命论态度是造成这一现象的重要原因。为改善眼部健康，眼科护理服务的规划和实施必须通过社区参与教育和采取积极行动来解决当地的接受障碍，从而克服利用不足的问题。
