Division of Neuroscience and Experimental Psychology, School of Biological Sciences, Faculty of Biology, Medicine and Health, Manchester Academic Health Science Centre, The University of Manchester, Manchester, UK.
Division of Pharmacy and Optometry, School of Health Sciences, Faculty of Biology, Medicine and Health, Manchester Academic Health Science Centre, The University of Manchester, Manchester, UK.
Ophthalmic Physiol Opt. 2022 Jul;42(4):675-693. doi: 10.1111/opo.12975. Epub 2022 Mar 22.
People with autism face significant barriers when accessing healthcare services. Eye examinations present unique challenges. Accessibility of this healthcare sector for people with autism has not been investigated previously. The aim of this research was to investigate eye examination accessibility for autistic adults and produce recommendations for autism-friendly eyecare.
Two qualitative studies were conducted. In Study 1, 18 autistic adults took part in focus groups to elicit their eye examination experiences. Transcripts of the recorded discussions were thematically analysed. Study 1 findings were used to design autism-friendly eye examinations for autistic adults. These were conducted in Study 2. Twenty-four autistic adults participated in these examinations, during which they were interviewed about their experience and how it might be improved by reasonable modifications. Audio recordings of the interviews were content analysed.
Knowledge of what to expect, in advance of the eye examination, could greatly reduce anxiety. Participants liked the logical structure of the examination, and the interesting instrumentation used. However, the examination and practice environment did include sensory challenges, due to lights, sound and touch. Changes in practice layout, and interacting with multiple staff members, was anxiety provoking. Participants expressed a need for thorough explanations from the optometrist that outlined the significance of each test, and what the patient was expected to do.
A number of accessiblity barriers were identified. These suggested that UK eye examinations are not very accessible for autistic adults. Barriers began at the point of booking the appointment and continued through to the dispensing of spectacles. These caused anxiety and stress for this population, but could be reduced with easy-to-implement adaptations. Based on the findings, recommendations are presented here for the whole eyecare team which suggest how more autism-friendly eye examinations can be provided.
自闭症患者在获得医疗保健服务时面临重大障碍。眼部检查带来了独特的挑战。以前没有研究过自闭症患者获得这一医疗保健领域服务的机会。本研究旨在调查自闭症成人的眼部检查的便利性，并为自闭症患者提供友好的眼科护理提出建议。
进行了两项定性研究。在研究 1 中，18 名自闭症成年人参加了焦点小组，以了解他们的眼部检查体验。记录讨论的文字记录进行了主题分析。研究 1 的结果用于为自闭症成年人设计友好的眼科检查。在研究 2 中进行了这些检查。24 名自闭症成年人参加了这些检查，在此期间，他们接受了有关他们的体验以及如何通过合理的修改来改善体验的访谈。对访谈的音频记录进行了内容分析。
在眼部检查之前，提前了解检查内容可以大大减少焦虑。参与者喜欢检查的逻辑结构，以及使用的有趣仪器。然而，检查和实践环境确实包括灯光、声音和触觉方面的感官挑战。实践布局的改变，以及与多名工作人员互动，会引起焦虑。参与者表示需要验光师进行全面的解释，说明每项测试的意义，以及患者预期的操作。
确定了一些可及性障碍。这表明英国的眼部检查对自闭症成年人来说不是很方便。障碍始于预约阶段，并一直持续到配镜阶段。这些给这一人群带来了焦虑和压力，但通过易于实施的调整可以减少。基于研究结果，为整个眼科护理团队提出了建议，提出了如何提供更友好的眼科检查的建议。
