Phenomenological approach to childhood cataract treatment in New Zealand using semi-structured interviews: how might we improve provision of care

Abstract

PurposeTo understand how we might improve the provision of medical care for children with cataracts.DesignA phenomenological design was employed. Semi-structured interviews were conducted to capture rich descriptions of the phenomena. Our goal in the interview and the analysis was to understand the sources of distress associated with treatment for cataract and deprivation amblyopia which (1) could be addressed by the medical community and (2) related to treatment adherence.SettingInterviews were conducted by a non-clinician researcher in New Zealand (NZ) in a location chosen by informants. In NZ, the red reflex screening test is performed shortly after birth, and surgery to remove paediatric cataracts is publicly funded.ParticipantsFamilies of children who had a history of cataract in Auckland, NZ were posted an invitation to participate. Twenty families were interviewed.ResultsOur analysis illustrated that informants described a wide range of experiences, from declined cataract surgery to full adherence to medical advice including years of patching for more than 4 hours a day. Across these experiences, we identified three relevant themes; timing of diagnosis, communication between the parent and clinician, and parental social support networks.ConclusionThe medical community may be better placed to support families dealing with childhood cataract by improving detection of childhood cataract, building appropriate communication pathways and promoting social support, with an emphasis on empathetic, individualised care.

Clinical Practice of Cataract Special Care Standards in Nonophthalmic Wards

“…e results of active services, service attitude, health education, psychological support, and patients care satisfaction rate in the experimental group were apparently higher than in the control group, demonstrating that medical staff actively and patiently answer all kinds of doubts for patients and assist patients solve various practical problems in the process of implementing the cataract ZhuanBing standards of care in ophthalmology wards. Importantly, health promotion for patients not only strengthens communication between each other but also meets patients' requirements, which helps to reduce medical disputes, improve patients' satisfaction with medical staff and their own image, and increase social benefits [13,14].…”