Centre for Public Health, Queen's University Belfast, Belfast, Northern Island, UK.
The Wellcome-Wolfson Institute for Experimental Medicine, Queen's University, Belfast, Northern Ireland, UK.
Eye (Lond). 2023 Apr;37(6):1155-1159. doi: 10.1038/s41433-022-02050-1. Epub 2022 May 6.
BACKGROUND/OBJECTIVE: To explore acceptability by patients and health care professionals of a new surveillance pathway for people with previously treated and stable diabetic macular oedema (DMO) and/or proliferative diabetic retinopathy (PDR).
SUBJECT/METHODS: Structured discussions in 10 focus groups with patients; two with ophthalmic photographers/graders, and one with ophthalmologists, held across the UK as part of a large diagnostic accuracy study (EMERALD).
The most prominent issues raised by patients concerned (i) expertise of the various professionals within clinic, (ii) quality of interactions with clinic professionals, especially the flow of information from professionals to patients, and (iii) wish to be treated holistically. Ophthalmologists suggested such issues could be best dealt with via a programme of patient education and tended to overlook deeper implications of patient concerns for the organisation of services.
For patients, the clinical service should not only include the identification and treatment of disease but also exchange of information, reassurance, and mitigation of anxiety. Alterations in the standard care pathway need to take account of such concerns and their implications, in addition to any assessments of 'efficiency' that may flow from changes in diagnostic technology, or the division of professional labour.
背景/目的：探索曾接受过治疗且病情稳定的糖尿病性黄斑水肿（DMO）和/或增殖性糖尿病性视网膜病变（PDR）患者及其医护人员对新监测途径的可接受性。
方法/方法：在英国各地进行了一项大型诊断准确性研究（EMERALD），共进行了 10 次以患者为中心的焦点小组讨论，其中 2 次讨论涉及眼科摄影师/分级员，1 次讨论涉及眼科医生。
患者提出的最突出问题包括：（i）诊所内各专业人员的专业知识；（ii）与诊所专业人员互动的质量，尤其是专业人员向患者提供信息的流畅程度；以及（iii）希望得到全面治疗。眼科医生认为，可以通过患者教育计划来解决这些问题，并且往往忽略了患者对服务组织的关注的更深层次影响。
对于患者而言，临床服务不仅应包括疾病的识别和治疗，还应包括信息交流、安抚和减轻焦虑。标准护理途径的改变需要考虑到这些问题及其影响，除了可能因诊断技术的变化或专业劳动分工而产生的任何“效率”评估之外。
