Silwal Pushkar Raj, Pirouzi Maryam, Murphy Rinki, Harwood Matire, Grey Corina, Squirrell David, Ramke Jacqueline
School of Optometry and Vision Science, The University of Auckland Faculty of Medical and Health Sciences, Auckland, Auckland, New Zealand.
Department of General Practice and Primary Care, The University of Auckland Faculty of Medical and Health Sciences, Auckland, Auckland, New Zealand.
BMJ Open. 2025 Jan 30;15(1):e087650. doi: 10.1136/bmjopen-2024-087650.
To explore the barriers and enablers to accessing diabetes eye care services among adults in Auckland.
This was a qualitative study that used semistructured interviews. We performed a thematic analysis and described the main barriers and enablers to accessing services using the Theoretical Domains Framework.
The study took place in two of the three public funding and planning agencies that provide primary and secondary health services in Auckland, the largest city in Aotearoa New Zealand.
Thirty people with diabetes in Auckland who had experienced interrupted diabetes eye care, having missed at least one appointment or being discharged back to their general practitioner after missing several appointments.
We identified barriers and enablers experienced by our predominantly Pacific and Māori participants that aligned with 7 (of the 14) domains in the Theoretical Domains Framework. The most reported barriers were transport issues, lack of awareness regarding the importance of retinal screening, time constraints, limited and/or inflexible appointment times and competing family commitments. Enablers included positive interactions with healthcare providers and timely appointment notifications and reminders.
Diabetes eye services could be made more responsive by addressing systemic barriers such as service location and transport links, appointment availability and meaningful information to aid understanding.
探讨奥克兰成年人获得糖尿病眼部护理服务的障碍和促进因素。
这是一项采用半结构化访谈的定性研究。我们进行了主题分析，并使用理论领域框架描述了获得服务的主要障碍和促进因素。
该研究在新西兰奥塔哥最大城市奥克兰提供初级和二级卫生服务的三个公共资助和规划机构中的两个进行。
奥克兰30名患有糖尿病的人，他们的糖尿病眼部护理曾中断，至少错过一次预约，或在错过几次预约后被转回其全科医生处。
我们确定了主要为太平洋岛民和毛利人的参与者所经历的与理论领域框架中14个领域中的7个领域相符的障碍和促进因素。报告最多的障碍是交通问题、对视网膜筛查重要性缺乏认识、时间限制、预约时间有限和/或不灵活以及家庭事务繁忙。促进因素包括与医疗服务提供者的积极互动以及及时的预约通知和提醒。
通过解决诸如服务地点和交通联系、预约可用性以及有助于理解的有意义信息等系统性障碍，可以使糖尿病眼部服务更具响应性。
