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Tanja C. Gninka, Donald H. Watanabe, Ivan J. Galic, Olga Overbury; Patients' Awareness Of Vision Rehabilitation Services In Private Versus Public Ophthalmology Practices. Invest. Ophthalmol. Vis. Sci. 2012;53(14):4425.
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© ARVO (1962-2015); The Authors (2016-present)
The Montreal Barriers Study investigates the awareness of low vision patients regarding vision rehabilitation services (ARVO 2008, 2010, 2011). Participants are categorized into one of three groups; those who are unaware of rehabilitation services, those who choose not to access services, and those who have received vision rehabilitation. It was found that, of the 702 participants enrolled in the study as of 2010, 54% had received rehabilitation services, 13% knew about them but did not go, and 33% had never heard of low vision rehabilitation. The present study examines the degree of awareness as well as probability of referral by an ophthalmologist as a factor of patient characteristics in a private versus a public clinical setting.
Fifty study participants were recruited in ophthalmologists’ private-practice waiting rooms. These were matched on age, gender, diagnosis and level of impairment severity to 50 public-practice patients who were drawn from the Montreal Barriers Study database. During the structured interview, all 100 participants provided demographic information and answered four standardized questionnaires (Visual Functioning Index 14, Brief COPE Inventory, Center for Epidemiological Studies Depression Scale and Satisfaction with Life Scale). The questions of interest for this study were whether or not the participants had ever been informed of low vision rehabilitation services, who informed them, and if they had chosen to access the available services.
Contrary to expectations that private-practice patients would be better informed, both groups were equally likely to be aware of rehabilitation services and to be referred to them by their ophthalmologist. It was also found that these two groups of patients were equally likely to access vision rehabilitation services. Furthermore, data analysis showed that coping was the only psychosocial variable on which the two groups differed significantly, t(93) = -1.987, p =.05. Specifically, the patients in private clinics had a higher Brief COPE score than those in public clinics (M = 73.06 ± 9.48 and 68.0 ± 14.82, respectively).
Although it is commonly assumed that patients receiving ophthalmological care in a private practice are higher in socio-economic status than those attending public clinics and that they may be better educated, the data do not support this supposition. Furthermore, the assumption that ophthalmologists in a private practice may have more time to talk to their patients and would therefore be more likely to refer them to rehabilitation services was not upheld. The significant difference between the two groups on coping ability is interesting but challenging to explain at this point.
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