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Task sharing: situation analysis about capacity and resources for management of diabetic retinopathy in Pakistan

International Journal of Ophthalmology(English edition) 2019年第5期12卷 809-814页

作者： mufarriq shah Ayesha Noor C Alex Harper Jill Elizabeth Keeffe Pakistan Institute of Community Ophthalmology Hayatabad Medical Complex Vision and Dental Care Clinic Centre for Eye Research Australia Department of OphthalmologyUniversity of Melbourneand Royal Victorian Eye and Ear Hospital LV Prasad Eye Institute

AIM: To assess the capacity and resources of eye care facilities, using the WHO Health Systems Framework, to manage diabetic retinopathy(DR) through task sharing.METHODS: Using purposive sampling, four participants(administrators) from four selected hospitals in two provinces in Pakistan were recruited for this cross-sectional study. A survey, to assess the capacity and resources of the selected eye care facilities for the feasibility to adopt task sharing in management of DR to prevent vision loss, was emailed to participants who were asked to complete. Responses to open-ended questions were entered into a Microsoft Excel spread sheet and inductive approach was applied for analysis.RESULTS: All the surveyed eye care facilities offer eye care services for people with diabetes and DR. All surveyed eye care facilities have a shortage in the number of human resources across all cadres. Optometrists and mid-level eye care workers did not have active roles in DR screening and management in all four hospitals. All the hospitals surveyed did not have a computerized record management system for patients who visit ophthalmologists for eye examinations. Equipment for detection and management of DR were short in number and main users were ophthalmologists. There was no policy for population-based screening program for detection of DR in any of the surveyed hospitals.CONCLUSION: A system-based approach to manage DR is needed. The capacity of eye care facilities and the potential to improve access of people with diabetes to eyecare services can be enhanced through implementation of task sharing.

关键词： task sharing capacity diabetes diabetic retinopathy Pakistan

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Roles of the eye care workforce for task sharing in management of diabetic retinopathy in Cambodia

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International Journal of Ophthalmology(English edition) 2018年第1期11卷 101-107页

作者： mufarriq shah Gail M.Ormsby Ayesha Noor Rahul Chakrabarti Manfred Morchen Fakir MAmirul Islam CAlex Harper Jill E Keeffe Pakistan Institute of Community Ophthalmology Hayatabad Medical Complex Peshawar 25000Pakistan Centre for Eye Research Australia Department of Ophthal-mologyUniversity of MelbourneRoyal Victorian Eye and Ear HospitalMelbourneVIC 302Australia Faculty of Education Science and BusinessLifestyle Research CentreAvondale College of Higher EducationCooranbongNSW 2265Australia Vision and Dental Care Clinic Peshawar 25000Pakistan CARITAS Takeo Eye Hospital Krong Doun Kaev 21151Cambodia Regional office Asia South East CBM International Unit 604 Alabang Business Tower 1216 Acacia AveMuntinlupa City 1799Philippines Statistics Data Science and EpidemiologySwinburne University of TechnologyHawthornVIC 3122Australia LV Prasad Eye Institute Hyderabad 500034India

AIM： To identify the current roles of eye and health care workers in eye care delivery and investigate their potential roles in screening and detection for management of diabetic retinopathy（DR） through task sharing.METHODS： Purposive sampling of 24 participants including health administrators, members from non-government organizations and all available eye care workers in Takeo province were recruited. This cross sectional mixed method study comprised a survey and in-depth interviews. Data were collected from medical records at Caritas Takeo Eye Hospital（CTEH） and Kiri Vong District Referral Hospital Vision Centre, and a survey and interviews with participants were done to explore the potential roles for task sharing in DR management. Qualitative data were transcribed into a text program and then entered into N-Vivo（version 10） software for data management and analysis. RESULTS： From 2009 to 2012, a total of 105 178 patients were examined and 14 030 eye surgeries were performed in CTEH by three ophthalmologists supported by ophthalmic nurses in operating and eye examination for patients. Between January 2011 and September 2012, 151 patients（72 males） with retinal pathology including 125（83%） with DR visited CTEH. In addition 170 patients with diabetes were referred to CTEH for eye examinations from Mo Po Tsyo screening programs for people with diabetes. Factors favouring task sharing included high demand for eye care services and scarcity of ophthalmologists.CONCLUSION： Task sharing and team work for eye care services is functional. Participants favor the potential role of ophthalmic nurses in screening for DR through task sharing.

关键词： task sharing diabetes diabetic retinopathy human resources Cambodia

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助视器对年龄相关性黄斑变性患者视功能恢复和阅读速度的影响

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国际眼科杂志 2021年第1期21卷 9-14页

作者： mufarriq shah Muhammad Tariq Khan Hayatabad医疗中心巴基斯坦社区眼科研究所视光科巴基斯坦白沙瓦25000 Hayatabad医疗中心眼科巴基斯坦白沙瓦25000

目的:评估助视器对年龄相关性黄斑变性(AMD)患者视功能恢复和阅读速度的影响。方法:对低视力门诊44名AMD患者进行评估。收集并分析使用助视器前和使用助视器时裸眼视力、最佳矫正视力、屈光状态、助视器类型(LVAs)以及阅读速度的相关数... 详细信息

目的:评估助视器对年龄相关性黄斑变性(AMD)患者视功能恢复和阅读速度的影响。方法:对低视力门诊44名AMD患者进行评估。收集并分析使用助视器前和使用助视器时裸眼视力、最佳矫正视力、屈光状态、助视器类型(LVAs)以及阅读速度的相关数据。结果:共44例AMD患者,平均年龄为73±10.8岁,男性36例(82%)。其中,29例(67%)受试者视力较好的眼远视力(DVA)为1.0~1.6 LogMAR,而36例(82%)受试者近视力(NVA)小于3.2 m。使用助视器时平均DVA提高0.67±0.27 LogMAR(P=0.000)。使用LVAs时,42例患者NVA达到1 m甚至更佳,仅有2例(4.5%)没有使用LVAs的患者NVA为1 m。在使用一定时间的助视器后,有阅读能力的患者平均阅读速度从每分钟2.9±4.78字提高到每分钟71.31±29.96字(P<0.001)。15名受试者远距离视觉使用单目望远镜,而戴高倍单目镜片眼镜作为最常用的阅读辅助工具。结论:LVAs对AMD患者的视功能恢复和阅读能力的提高有一定的作用。对于AMD患者而言,接受低视力护理服务是有必要的。

关键词：年龄相关性黄斑变性失明视功能恢复助视器

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