Impact of Non-Physician Cataract Counselors on Patients’ Surgical Knowledge and Satisfaction
Narrative Responses:
Purpose
Patient education is an important aspect of delivering high-quality care, though not all education programs for cataract patients have been successful. Our objective was to evaluate the efficacy of non-physician pre-surgical educators in 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 who underwent pre-surgical cataract counseling at the Aravind Eye Hospital, Madurai, India. The survey measured the change in knowledge about cataract and cataract surgery and change in decisional conflict score, a measure of anxiety surrounding the decision to undergo surgery, along with patient satisfaction. Multiple regression was used to identify factors that influenced patient knowledge change. We also evaluated each counselor's knowledge.
Results
Both patient knowledge scores and decisional conflict scores substantially improved following counseling. Multiple regression identified female gender (Beta=2.5, p<0.001) and being illiterate (Beta=1.7, p=0.04) as important factors in how the counseling increased patient knowledge.99% of patients reported that they were satisfied with the counseling system, and counselor knowledge score was significantly correlated to the patient satisfaction score (Pearson correlation coefficient 0.49, p<0.001). There was a significant correlation between the patient satisfaction score and the change in patient knowledge score.
Conclusion
Counseling improved knowledge and reduced anxiety about cataract surgery. We found counseling to be important in educating patients who have 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 blindness.