The George Institute for Global Health, The University of New South Wales, Sydney, Australia.
Ophthalmology Department, Westmead Hospital, Sydney, Australia.
Clin Exp Optom. 2020 Jul;103(4):484-489. doi: 10.1111/cxo.12955. Epub 2019 Aug 26.
This study aims to explore patient perspectives regarding their journey to glaucoma care and sought to understand the determinants that guide their access to tertiary glaucoma care.
Twenty-nine patients who are glaucoma suspects or had definitive diagnosis of glaucoma were recruited from a large public glaucoma clinic and a private ophthalmology clinic in Sydney. Face-to-face, in-depth semi-structured interviews were conducted between April and December 2017. Interviews were recorded and transcribed verbatim. A framework method was used for thematic analysis of the data.
Thematic analysis resulted in the emergence of eight main themes. There was limited patient participation in decision making in their journey to glaucoma care. Consequently, there was great trust placed in the referring clinician. Patients valued their vision and therefore expressed a desire for high-quality care. They placed considerable trust in their specialist but were often unsure how to evaluate the quality of care received. Patients lacked an understanding of the cost of glaucoma care and for some, cost remained a barrier to the access of private care. There were variable experiences with waiting times and the journey to clinic, with many patients making concessions and requiring support to access care.
This study is the first qualitative study exploring the perspectives of glaucoma patients in Australia and the determinants of access to care. These findings support and can inform development of patient-centred models of care furthering patient trust and empowerment.
本研究旨在探讨患者在青光眼治疗过程中的体验，并试图了解影响他们获得三级青光眼治疗的决定因素。
2017 年 4 月至 12 月，从悉尼一家大型公立青光眼诊所和一家私人眼科诊所招募了 29 名青光眼疑似患者或确诊为青光眼的患者。采用面对面、深入的半结构式访谈方法收集资料。访谈进行了录音，并逐字记录。采用框架方法对数据进行主题分析。
主题分析得出了 8 个主要主题。患者在青光眼治疗过程中的决策参与度有限。因此，他们非常信任转诊医生。患者重视自己的视力，因此渴望获得高质量的护理。他们对专科医生非常信任，但往往不知道如何评估所接受的护理质量。患者对青光眼治疗费用缺乏了解，对一些人来说，费用仍是获得私人护理的障碍。在等待时间和就诊过程方面，患者的体验各不相同，许多患者需要做出让步并寻求支持才能获得护理。
本研究是首个探讨澳大利亚青光眼患者观点及其获得护理决定因素的定性研究。这些发现支持并为以患者为中心的护理模式的进一步发展提供了信息，以增强患者的信任和赋权。
