Liu Hua, Chen Chen, Chen Zhuo, Li Qian, Li Quan, Liu Wei
Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, Tianjin, China.
Front Med (Lausanne). 2023 Jul 17;10:1161980. doi: 10.3389/fmed.2023.1161980. eCollection 2023.
Glaucoma has an insidious onset with non-specific early symptoms, often leading patients to delay in seeking help. However, postponing the first ophthalmological consultation can result in delayed diagnosis and treatment, with adverse effects on vision. This study explored the factors associated with delayed first ophthalmological consultation in patients with primary glaucoma, with the overarching aim of informing measures to reduce delayed consultation and avoid the consequent adverse outcomes.
We adopted a phenomenological approach. Semi-structured interviews were conducted with patients admitted to a tertiary eye hospital in Tianjin, China, from January 2021 to April 2021. Data were analyzed by Colaizzi's seven-step method.
We identified 46 patients with primary glaucoma who delayed their first ophthalmological consultation for various reasons. There were four major themes and 16 sub-themes. The major themes were as follows: (1) occult symptoms that are difficult to identify; (2) insufficient knowledge and understanding of glaucoma-related risks and harm; (3) perceived difficulties in accessing medical care; and (4) inadequate support system.
In order to avoid patient delay and consequent irreversible damage to the visual field in patients with primary glaucoma, it is essential that medical staff identify symptoms more effectively, change habitual medical behavior of the patients, adopt a medical union model, and promote the use of a social medical support system to address practical difficulties in delivering adequate care.
青光眼起病隐匿，早期症状不具特异性，常导致患者延迟就医。然而，推迟首次眼科会诊会导致诊断和治疗延误，对视力产生不良影响。本研究探讨了原发性青光眼患者首次眼科会诊延迟的相关因素，其总体目标是为减少会诊延迟及避免由此产生的不良后果提供措施依据。
我们采用了现象学方法。于2021年1月至2021年4月对在中国天津一家三级眼科医院住院的患者进行了半结构式访谈。采用Colaizzi七步法对数据进行分析。
我们确定了46例因各种原因延迟首次眼科会诊的原发性青光眼患者。有四个主要主题和16个子主题。主要主题如下：（1）难以识别的隐匿症状；（2）对青光眼相关风险和危害的知识及理解不足；（3）就医存在感知困难；（4）支持系统不足。
为避免原发性青光眼患者延误就诊及随之而来的视野不可逆损害，医护人员必须更有效地识别症状，改变患者的就医习惯行为，采用医联体模式，并促进利用社会医疗支持系统来解决提供充分医疗服务方面的实际困难。
