The Effect of Counseling on Cataract Patient Knowledge, Decisional Conflict, and Satisfaction

Abstract

Purpose Cataract is the leading cause of non-refractive preventable blindness, and comprehensive strategies to increase cataract surgery rates are imperative, including high-quality supportive patient education. We evaluated the effectiveness of non-physician pre-surgical counselors teaching patients about cataract and cataract surgery in improving patient knowledge, decisional conflict, and satisfaction. Methods A survey was given before and after 61 newly-diagnosed cataract patients underwent pre-surgical counseling at the Aravind Eye Hospital, Madurai, India. The survey measured change in cataract knowledge and decisional conflict, a measure of anxiety surrounding the decision to undergo surgery, along with patient satisfaction. Multiple regression was used to identify factors that influenced change in knowledge. Results Both patient knowledge scores and decisional conflict scores improved following counseling (mean difference +2.0, P=0.004 and +8.4, P<0.0001, respectively). Multiple regression analysis identified female sex (β=2.5, P<0.001) and being illiterate (β=1.7, P=0.04) as important predictors of increased knowledge post-counseling. Conclusion Counseling both improved knowledge and reduced decisional conflict about cataract surgery, particularly among patients who had traditionally had more limited access to healthcare such as women and illiterate patients. Increased use of high quality counseling might help to further reduce the global burden of cataract and other forms of blindness.

Knowledge about benefits and risks of undergoing cataract surgery among cataract patients in Southern China

“…In terms of decision quality, adequate knowledge was found negatively associated to decision conflict and inaction regret, implying that patients with increased knowledge might experience greater certainty about their options and feel more supported. It was consistent with previous studies in India 42 , Australia 43 and the United Kingdom 41 that knowledge improvement by decision aids helped in reducing decision conflict and uncertainty. However, there was not statistically significant in decision conflict and regret in Brazell's study for the treatment of pelvic organ prolapse.…”

Fear and Anxiety Associated with Cataract Surgery Under Local Anesthesia in Adults: A Systematic Review

“…The great fear of cataract surgery may be the reason for cancelling the procedure. The importance of preoperative counselling in preventing patients from withdrawing from surgery was shown in the research by Newman-Casey et al 55 According to their study, adequate education increases the number of people who decided to undergo surgery by 14% despite prior fears and the willingness to postpone it indefinitely. As much as 98.9% of the respondents were satisfied or very satisfied with their counselling.…”

Factors limiting the Northeast Indian elderly population from seeking cataract surgical treatment: Evidence from Kolasib district, Mizoram, India

“…The role of counseling in improving uptake of cataract surgeries is well established. [ 26 27 28 ] It is, therefore, recommended that in large-scale community eye camps and community mobilizations should make a mandatory provision for a dedicated full-time counselor to address these otherwise avoidable barriers. The role of digital technology in addressing the knowledge and communication gap is enormous in these setting although the robust scientific investigation into this is warranted.…”