随着年龄的增长和视力障碍的加重，眼部保健寻求行为如何变化？印度孙德尔本斯老年人的交叉分析。
How does eye care seeking behaviour change with increasing age and visual impairment? Intersectional analysis of older adults in the Indian Sundarbans.
机构信息
IIHMR University, Jaipur, India.
出版信息
BMC Geriatr. 2020 Feb 18;20(1):71. doi: 10.1186/s12877-020-1438-y.
BACKGROUND
Visual impairment disproportionately affects people in the low-income countries. A high proportion of visual impairment can be prevented or cured. Yet, care seeking for eye health is restricted for women and older adults. This article uses the intersectionality approach to understand how eye care seeking behaviour changes in men and women with increase in age and visual impairment in a poor and underserved region of India. It brings forth the commonalities and differences between the various groups.
METHODS
The article is based on qualitative data. Persons aged 50 years and more are categorized into young-old, middle-old and old-old. Men and women with low vision/ high visual impairment have been selected from each of the three age groups. In-depth interviews have been carried out with 24 study participants. Data saturation has been attained. The JHPIEGO Gender Analysis Framework underpins the study. The narrative data has been coded in NVivo 10 software.
RESULTS
Various symptoms are associated with visual impairment. The young-old with low vision do not report much difficulty due to visual impairment. Study participants with high visual impairment, and in the older age groups do. Difficulty in the discharge of regular chores due to visual impairment is rarely reported. Impaired vision is considered to be inevitable with advancing age. Care seeking is delayed for eye health. Typically, outpatient care from nearby health care facilities has been sought by men and women in every group. Inpatient care is limitedly sought, and mostly restricted to men. Eye care seeking behaviour changes among men with increase in age and visual impairment. Women consistently seek less care than men for both outpatient and inpatient eye care. Study participants of both genders become dependent with increasing age and visual impairment. Traditional patriarchal privileges enjoyed by men (such as mobility and economic independence) decrease with age. The vulnerability of women gets compounded with time.
CONCLUSIONS
The article presents a granulated understanding of eye care seeking behaviour among older adults in India. Such differentials need to be taken cognizance of in programmes promoting universal access to health care. Existing conceptualizations on access to health care need to be revisited.
背景
视觉障碍在低收入国家的人群中不成比例地存在。很大一部分视觉障碍是可以预防或治愈的。然而，妇女和老年人的眼部健康护理寻求受到限制。本文使用交叉性方法来了解在印度一个贫穷和服务不足的地区，随着年龄的增长和视力障碍的增加，男性和女性的眼部保健寻求行为如何发生变化。它揭示了不同群体之间的共性和差异。
方法
本文基于定性数据。50 岁及以上的人被分为年轻老年人、中年老年人和老年老年人。从每个年龄组中选择了低视力/高视力障碍的男性和女性。对 24 名研究参与者进行了深入访谈。已达到数据饱和。该研究以 JHPIEGO 性别分析框架为基础。叙述性数据在 NVivo 10 软件中进行编码。
结果
各种症状与视力障碍有关。年轻老年人的低视力不会因视力障碍而导致太多困难。高视力障碍和年龄较大的组中的研究参与者会遇到困难。由于视力障碍而难以完成日常家务的情况很少有报道。视力受损被认为是随着年龄增长不可避免的。眼部健康护理的寻求被延迟。通常，每个组的男性和女性都寻求附近医疗机构的门诊护理。住院护理的需求有限，主要限于男性。随着年龄的增长和视力障碍的增加，男性的眼部保健寻求行为发生变化。女性在门诊和住院眼部保健方面的护理需求都比男性少。随着年龄的增长和视力障碍的增加，男女研究参与者都变得依赖。随着年龄的增长，男性享有的传统家长制特权（如流动性和经济独立性）会减少。女性的脆弱性会随着时间的推移而加剧。
结论
本文对印度老年人口的眼部保健寻求行为进行了详细的了解。在促进全民获得医疗保健的方案中，需要注意到这些差异。需要重新审视现有的医疗保健获取概念。
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