Radhakrishnan Muralikrishnan, Venkatesh Rengaraj, Valaguru Vijayakumar, Frick Kevin D
Aravind Eye Hospital and Postgraduate Institute of Ophthalmology, Puducherry, India.
Indian J Ophthalmol. 2015 Jul;63(7):594-9. doi: 10.4103/0301-4738.167116.
Literature investigating barriers to cataract surgery is mostly done from the patient's point of view. However, many medical decisions are jointly taken by household members, especially in developing countries such as India. We investigated from the household head's (or representative's) perspective, households' view on those not willing to undergo cataract surgery along with the economic and social factors associated with it.
A cross-sectional survey of four randomly selected village clusters in rural areas of Theni district, Tamil Nadu, India, was conducted to elicit the willingness to pay for cataract surgery by presenting "scenarios" that included having or not having free surgery available. The presentation of scenarios allowed the identification of respondents who were unwilling to undergo surgery. Logistic regression was used to estimate relationships between economic and social factors and unwillingness to undergo cataract surgery.
Of the 1271 respondents, 49 (3.85%) were not willing to undergo surgery if they or their family members have cataract even if free surgery were available. In the regression results, those with good understanding of cataract and its treatment were less likely to be unwilling to undergo cataract surgery. Those not reporting household income were more likely to be unwilling to undergo cataract surgery.
As a good understanding of cataract was an important predictor of willingness to undergo cataract surgery, health education on cataract and its intervention can improve uptake.
关于白内障手术障碍的文献大多是从患者的角度进行研究的。然而，许多医疗决策是由家庭成员共同做出的，尤其是在印度等发展中国家。我们从户主（或代表）的角度调查了家庭对那些不愿意接受白内障手术的人的看法，以及与之相关的经济和社会因素。
在印度泰米尔纳德邦特尼区农村地区随机选取四个村庄集群进行横断面调查，通过呈现包括有无免费手术在内的“情景”来了解支付白内障手术费用的意愿。情景的呈现使得能够识别出不愿接受手术的受访者。采用逻辑回归来估计经济和社会因素与不愿接受白内障手术之间的关系。
在1271名受访者中，49人（3.85%）表示即使他们或其家庭成员患有白内障且有免费手术，他们也不愿意接受手术。在回归结果中，对白内障及其治疗有良好了解的人不太可能不愿意接受白内障手术。未报告家庭收入的人更有可能不愿意接受白内障手术。
由于对白内障有良好的了解是愿意接受白内障手术的一个重要预测因素，因此关于白内障及其干预措施的健康教育可以提高手术接受率。
