Lingam Sneha, Rani Padmaja K, Sheeladevi Sethu, Kotapati Vimala, Das Taraprasad
Massachusetts Institute of Technology, Cambridge, MA, USA
International Center for Advancement of Rural Eye Care and Smt. Kanuri Santhamma Retina Vitreous Centre, L V Prasad Eye Institute, Road No 2, Banjara Hills, Hyderabad, Telengana, India
Rural Remote Health. 2018 Feb;18(1):4304. doi: 10.22605/RRH4304. Epub 2018 Feb 19.
To report the results of a knowledge, attitude and practice (KAP) study related to diabetes mellitus (DM), hypertension and diabetic retinopathy (DR) of patient populations in India at different levels (Tertiary (T), Secondary (S) and Primary (P)) of a pyramidal model of eye health care.
In total, 202 participants, composed of equal numbers of diabetic and non-diabetic patients at a Tertiary urban facility (T), a Secondary rural facility (S) and a Primary (P) community-screening program, were surveyed on their knowledge, knowledge sources, attitudes, practices and factors that motivate use of eye health services.
People with diabetes had a higher mean knowledge and attitude score about DM, hypertension and DR (67.3% T, 59.4% S, 47.0% P) than non-diabetics (41.8% T, 29.0% S, 23.5% P; p<0.001). Awareness of DR was more 65.3% among diabetics compared with 22.0% among non-diabetics at all locations. Most participants in all locations were aware of hypertension (84.0% T, 65.3% S, 52.9% P), but few knew it could affect the eyes (30.0% T, 12.2% S, 13.7% P) or be associated with diabetic complications (30.0% T, 32.7% S, 21.8% P). Many participants had never previously had a dilated eye examination (2% T, 40% S, 50% P). Participants were motivated to visit an eye facility for a routine checkup (70.6%), poor vision (22.6%) or a glucose/blood pressure test (17.7%) at a Primary-level facility and for follow-up or poor vision at the other facilities (28% and 42% Tertiary, 50% and 30% Secondary).
Practice-oriented education and advertising of facilities tailored for the relevant populations at each level of an eye health pyramid and continuation of fundus, glucose and blood pressure screening programs can help in creating awareness about diabetes, hypertension and diabetic retinopathy.
报告一项关于印度不同层级（三级（T）、二级（S）和一级（P））眼保健金字塔模型中患者群体糖尿病（DM）、高血压及糖尿病视网膜病变（DR）的知识、态度和实践（KAP）研究结果。
在一家三级城市医疗机构（T）、一家二级农村医疗机构（S）和一个一级（P）社区筛查项目中，对总共202名参与者进行了调查，这些参与者由数量相等的糖尿病患者和非糖尿病患者组成，调查内容包括他们的知识、知识来源、态度、实践以及促使他们使用眼保健服务的因素。
糖尿病患者对DM、高血压和DR的平均知识和态度得分（T级为67.3%，S级为59.4%，P级为47.0%）高于非糖尿病患者（T级为41.8%，S级为29.0%，P级为23.5%；p<0.001）。在所有地点，糖尿病患者中DR的知晓率为65.3%，而非糖尿病患者中为22.0%。所有地点的大多数参与者知晓高血压（T级为84.0%，S级为65.3%，P级为52.9%），但很少有人知道高血压会影响眼睛（T级为30.0%，S级为12.2%，P级为13.7%）或与糖尿病并发症有关（T级为30.0%，S级为32.7%，P级为21.8%）。许多参与者此前从未进行过散瞳眼部检查（T级为2%，S级为40%，P级为50%）。在一级医疗机构，参与者因常规检查（70.6%）、视力差（22.6%）或血糖/血压检测（17.7%）而有动力前往眼科机构，在其他机构则是因随访或视力差（三级医疗机构分别为28%和42%，二级医疗机构分别为50%和30%）。
在眼保健金字塔的每个层级针对相关人群开展以实践为导向的教育和设施宣传，并持续开展眼底、血糖和血压筛查项目，有助于提高对糖尿病、高血压和糖尿病视网膜病变的认识。
