Titre du document / Document title

Postoperative cataract surgery satisfaction in a rural Kenyan clinic

Auteur(s) / Author(s)

RESHEF D. S. ; RESHEF S. H. ;

Affiliation(s) du ou des auteurs / Author(s) Affiliation(s)

Nakuru Eye Unit, Rift Valley Provincial General Hospital, Nakuru, KENYA
Johns Hopkins School of Public Health, Department of International Health, Baltimore, Maryland, ETATS-UNIS

Résumé / Abstract

Purpose: To assess prospectively the factors influencing patient satisfaction following intracapsular cataract extraction (ICCE) surgery in a rural eye unit in Kenya. Setting: Nakuru Eye Unit, Rift Valley Provincial General Hospital, Nakuru, Kenya, and Johns Hopkins School of Public Health, Department of International Health, Baltimore, Maryland, USA. Methods: Starting in November 1992, 232 consecutive blind or visually impaired rural patients, over age 40, with simple senile cataract were offered free standard ICCE. Only 70% agreed to surgery. An interviewer-administered questionnaire and a brief interview were performed postoperatively on day 2, completing an extensive preoperative analysis that was part of the Kenya Rural Cataract Project. A satisfaction level indicator composed from the most important factors, applying a logistic regression model, is suggested as a predictive index for a patient to become a motivator in his or her community. Results: Most patients were happy with their decision to have cataract surgery, even though 92% of the operations were done by clinical officers. Patients were overwhelmingly willing to have their fellow eye operated on or to recommend the operation to another blind friend (83.4%). The proposed model correctly classified 87.1 % of operated patients, with high sensitivity (88.2%) and specificity (81.5%). Conclusions: Cultural differences are paramount in determining health behavior priorities and satisfaction. The post ICCE satisfaction in developing countries must be better evaluated to achieve higher self-referral of cataract-blind patients for surgery in Africa. Hospital conditions, although appreciated, did not play a major role in patients' satisfaction. The immediate surgical outcome was the key factor.

Revue / Journal Title

Journal of cataract and refractive surgery   ISSN 0886-3350   CODEN JCSUEV 

Source / Source

1997, vol. 23, n^o4, pp. 575-580 (12 ref.)

Langue / Language

Anglais

Editeur / Publisher

Elsevier, New York, NY, ETATS-UNIS  (1986) (Revue)

Mots-clés anglais / English Keywords

Cataract ; Extraction ; Extracapsular ; Lens ; Rural area ; Kenya ; Treatment ; Human ; Questionnaire ; Satisfaction ; Africa ; Eye disease ; Lens disease ; Anterior segment disease ; Surgery ;

Mots-clés français / French Keywords

Cataracte ; Extraction ; Extracapsulaire ; Cristallin ; Zone rurale ; Kenya ; Traitement ; Homme ; Questionnaire ; Satisfaction ; Afrique ; Oeil pathologie ; Cristallin pathologie ; Segment antérieur pathologie ; Chirurgie ;

Mots-clés espagnols / Spanish Keywords

Catarata ; Extracción ; Extracapsular ; Cristalino ; Zona rural ; Kenya ; Tratamiento ; Hombre ; Cuestionario ; Satisfacción ; Africa ; Ojo patología ; Cristalino patología ; Segmento anterior patología ; Cirugía ;

Localisation / Location

INIST-CNRS, Cote INIST : 20937, 35400006204672.0170