Barriers to uptake of cataract surgery among elderly patients in rural China: a cross-sectional study
Objective To investigate factors that differentiate elderly adults in rural China who accept free vision screening and cataract surgery from those who could benefit from vision care but refuse it when offered.Design We conducted a population-based, cross-sectional study between October and December...
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BMJ Publishing Group
2024-01-01
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| Series: | BMJ Open |
| Online Access: | https://bmjopen.bmj.com/content/14/1/e076116.full |
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| author | Yue Wan Catherine Jan Nathan Congdon Ningli Wang Scott Rozelle Xiaochen Ma Kai Cao Yaojiang Shi Jie Hao Yuan Xie Chengfang Liu Ailian Hu Zhe Dong |
| author_facet | Yue Wan Catherine Jan Nathan Congdon Ningli Wang Scott Rozelle Xiaochen Ma Kai Cao Yaojiang Shi Jie Hao Yuan Xie Chengfang Liu Ailian Hu Zhe Dong |
| author_sort | Yue Wan |
| collection | DOAJ |
| description | Objective To investigate factors that differentiate elderly adults in rural China who accept free vision screening and cataract surgery from those who could benefit from vision care but refuse it when offered.Design We conducted a population-based, cross-sectional study between October and December 2016. Logistic regression models were used to examine the predictors of accepting free vision screening and cataract surgery.Setting Rural communities in Handan, China.Participants Adults aged 50 years or older, with presenting visual acuity ≤6/18 in the better seeing eye, suspected by examining ophthalmologist to be due to cataract.Results Among 613 persons with cataract identified on a population basis, 596 (97.2%) completed the household survey (mean (SD) age, 71.5 (10.0) years; 79.8% female). A total of 214 persons (35.9%) refused participation, while 382 (64.1%) took part in the vision screening. A total of 193 (50.5%) participants were found eligible for surgery, while 189 (49.5%) were not. Among 99 randomly selected participants who were offered immediate free surgery, surgery was accepted by 77 participants (77.8%) and refused by 22 (22.2%). In the multivariate model, being engaged in income-generating activities (p<0.01), self-reported better physical capacity (p<0.001) and having had a recent physical examination (p=0.01) were significantly associated with acceptance of vision screening. The only variable significantly associated with acceptance of surgery was presenting visual acuity, with better vision inversely associated with acceptance of surgery (p<0.05) models.Conclusion Our results suggest that refusal of basic eye examinations may be at least as important a determinant of low surgical rates in rural China as lack of acceptance of surgery itself. |
| format | Article |
| id | doaj-art-b8201c8e080a4f54be114f9b0279b004 |
| institution | OA Journals |
| issn | 2044-6055 |
| language | English |
| publishDate | 2024-01-01 |
| publisher | BMJ Publishing Group |
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| series | BMJ Open |
| spelling | doaj-art-b8201c8e080a4f54be114f9b0279b0042025-08-20T02:13:27ZengBMJ Publishing GroupBMJ Open2044-60552024-01-0114110.1136/bmjopen-2023-076116Barriers to uptake of cataract surgery among elderly patients in rural China: a cross-sectional studyYue Wan0Catherine Jan1Nathan Congdon2Ningli Wang3Scott Rozelle4Xiaochen Ma5Kai Cao6Yaojiang Shi7Jie Hao8Yuan Xie9Chengfang Liu10Ailian Hu11Zhe Dong12Beijing Tongren Eye Center, Beijing Tongren Hospital CMU, Beijing, ChinaThe University of Melbourne Faculty of Medicine, Dentistry and Health Sciences, Carlton, Victoria, Australia1 State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangzhou, Guangdong, ChinaBeijing Tongren Eye Center, Beijing Tongren Hospital CMU, Beijing, ChinaFreeman Spogli Institute of International Studies, Stanford University, Stanford, California, USAChina Center for Health Development Studies, Peking University, Beijing, ChinaBeijing Tongren Eye Center, Beijing Tongren Hospital CMU, Beijing, ChinaCenter for Experimental Economics in Education (CEEE), Shaanxi Normal University, Xi`an, ChinaBeijing Tongren Eye Center, Beijing Tongren Hospital CMU, Beijing, ChinaBeijing Tongren Eye Center, Beijing Tongren Hospital CMU, Beijing, ChinaChina Center for Agricultural Policy, School of Advanced Agricultural Sciences, Peking University, Beijing, ChinaBeijing Tongren Eye Center, Beijing Tongren Hospital CMU, Beijing, ChinaBeijing Tongren Eye Center, Beijing Tongren Hospital CMU, Beijing, ChinaObjective To investigate factors that differentiate elderly adults in rural China who accept free vision screening and cataract surgery from those who could benefit from vision care but refuse it when offered.Design We conducted a population-based, cross-sectional study between October and December 2016. Logistic regression models were used to examine the predictors of accepting free vision screening and cataract surgery.Setting Rural communities in Handan, China.Participants Adults aged 50 years or older, with presenting visual acuity ≤6/18 in the better seeing eye, suspected by examining ophthalmologist to be due to cataract.Results Among 613 persons with cataract identified on a population basis, 596 (97.2%) completed the household survey (mean (SD) age, 71.5 (10.0) years; 79.8% female). A total of 214 persons (35.9%) refused participation, while 382 (64.1%) took part in the vision screening. A total of 193 (50.5%) participants were found eligible for surgery, while 189 (49.5%) were not. Among 99 randomly selected participants who were offered immediate free surgery, surgery was accepted by 77 participants (77.8%) and refused by 22 (22.2%). In the multivariate model, being engaged in income-generating activities (p<0.01), self-reported better physical capacity (p<0.001) and having had a recent physical examination (p=0.01) were significantly associated with acceptance of vision screening. The only variable significantly associated with acceptance of surgery was presenting visual acuity, with better vision inversely associated with acceptance of surgery (p<0.05) models.Conclusion Our results suggest that refusal of basic eye examinations may be at least as important a determinant of low surgical rates in rural China as lack of acceptance of surgery itself.https://bmjopen.bmj.com/content/14/1/e076116.full |
| spellingShingle | Yue Wan Catherine Jan Nathan Congdon Ningli Wang Scott Rozelle Xiaochen Ma Kai Cao Yaojiang Shi Jie Hao Yuan Xie Chengfang Liu Ailian Hu Zhe Dong Barriers to uptake of cataract surgery among elderly patients in rural China: a cross-sectional study BMJ Open |
| title | Barriers to uptake of cataract surgery among elderly patients in rural China: a cross-sectional study |
| title_full | Barriers to uptake of cataract surgery among elderly patients in rural China: a cross-sectional study |
| title_fullStr | Barriers to uptake of cataract surgery among elderly patients in rural China: a cross-sectional study |
| title_full_unstemmed | Barriers to uptake of cataract surgery among elderly patients in rural China: a cross-sectional study |
| title_short | Barriers to uptake of cataract surgery among elderly patients in rural China: a cross-sectional study |
| title_sort | barriers to uptake of cataract surgery among elderly patients in rural china a cross sectional study |
| url | https://bmjopen.bmj.com/content/14/1/e076116.full |
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