Barriers in older adults’ decision-making process to use routine eye examinations in Hong Kong

ABSTRACT

Clinical relevance

The decision to have a routine eye examination involves individual- and service-level judgement. A deeper understanding of patient access barriers and expectations could facilitate the design of better-aligned service models in optometric practice, improving the utilisation rate of an important facet of primary healthcare services.

Background

Routine eye examinations achieve several health objectives, including mitigation of sight-threatening risk factors. However, there are barriers to service uptake. Through the qualitative approach, a deeper understanding of these barriers can be realised and enhanced strategies designed to improve the uptake of the routine eye examination. A qualitative study was conducted to identify the factors influencing the decision-making process of older adults to use the routine eye examination service.

Methods

This study was guided by the grounded theory approach. Participants were purposively recruited from six community elderly centres. Semi-structured interviews were conducted with 25 community-dwelling adults aged 65 years or above in Hong Kong. Data were transcribed and constant comparison techniques were used for data analysis.

Results

Difficulty in prioritising and including the routine eye examination in the existing health service utilisation was the central theme associated with its lower use. Four sub-themes were identified to explain this phenomenon: (1) previous health care service utilisation as a reference for judging primary eye care; (2) low perceived primary eye care service needs; (3) low perceived self-efficacy on routine eye care utilisation; (4) service expectations.

Conclusion

Multiple modifiable factors influence decision-making by older adults, suggesting that their routine eye care seeking behaviour might be altered through behaviour change intervention. The context in which services are delivered requires further study, with a focus on exploring the factors influencing service experience and its subsequent impact on regular eye care seeking behaviour.

KEYWORDS:

• Healthcare-seeking behaviour
• primary eye care
• routine eye examination

Acknowledgements

We thank Tang Shu Po for transcribing part of the interview data. Two anonymous reviewers provided invaluable suggestions and advice.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Supplementary data

Supplemental data for this article can be accessed online at https://doi.org/10.1080/08164622.2023.2237971

Additional information

Funding

WYL is supported by the Hong Kong Polytechnic University Postgraduate Studentship. JL is a recipient of the HKSAR HMRF Research Fellowship Scheme. Both funding bodies have no role in the design of the study and collection, analysis, and data interpretation and in the writing the manuscript.