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.

• Cataract surgical rate
• counseling
• education
• epidemiology of blindness
• international ophthalmology
• workforce

DECLARATION OF INTEREST

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.

This study was supported by the Aravind Eye Care System (SR, AH, VP, MP, VB), Menakkah and Essel Bailey Graduate Fellowship (PANC), the Heed Foundation (PANC); and the National Eye Institute Michigan Vision Clinician-Scientist Development Program (PANC: K12EY022299).

Financial disclosures: PANC: none; SR: none; AH: none; VP: none; MP: none; VB: none; ALR: Merck, Alcon, Glaukos, Aerie Pharmaceuticals, and Aravind Eye Foundation.

Supplemental Material

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Notes

* This work was presented, in part, at the Association for Vision Research in Ophthalmology Annual Meeting, May 7, 2013 and at the American Ophthalmological Society Annual Meeting, May 18, 2013.