Report

4. Impact of Cataract Surgery on Quality of Life (six months’ post-surgery)

This section includes the changes in respondents' quality of life after cataract surgeries from the base hospital. Quality of Life interviews done at two points of time:


1. When patients visit the hospital for surgery

2. Six months after the surgery at their homes


These interviews are done to assess the changes in QoL of the patient’s post-surgery in areas of – Overall eye health, Daily Living, Mobility, Livelihood and Psycho-Social aspects.


A total of 30 questions have been administered on QoL. Patients were interviewed before surgeries at the hospital with a five points rating scale like very good, good, moderate, bad and very bad. In some of the questions, we used the scale as none, mild, moderate, severe and extreme. While in psychosocial aspects, we used the scale as never, rarely, sometimes, often and very often. The same questionnaire was administered after six months of surgeries at their residence address to understand the changes and impact of cataract surgery of their life in their daily life, mobility, psychosocial and their economic aspects of life. There were 30 validated questions to assess the impact of their quality of life after cataract surgery.



a. Self-rating of Overall Eye Health

During the period October to March 2021, a total of 82 patients were interviewed at the doorsteps to complete the follow-up interviews. Respondents were scored on their overall eye health questions, and the compared findings observed as 57% of respondents said very well after surgery in comparison to their before surgery response to 41%.


During the period April 2021 to September 2021, a total of 126 patients were interviewed at the doorsteps to complete the follow-up interviews. Respondents scored on their overall eye health questions, and the compared findings observed as 56% of respondents said very well after surgery in comparison to their before surgery response to 0%.


Percentage of Patients
Very Good Good Moderate Bad Very Bad
Before Surgery 40.63 39.06 18.75 1.56 0.00
After Surgery 57.32 34.15 8.54 0.00 0.00
Percentage of Patients
Very Good Good Moderate Bad Very Bad
Before Surgery 0.00 14.51 38.82 29.41 17.25
After Surgery 56.35 29.37 12.70 1.59 0.00
b. Difficulty in doing Daily Activities:
Difficulty in recognizing people, face, locking door, doing personal activities, finding something, going out in bright light, making out difference in color, findings objects in room etc.

During the period October to March 2021, a total of 82 patients were interviewed at the doorsteps to complete the follow-up interviews. Respondents scored on their difficulties in doing daily activities questions. They compared, findings observed as 71% of respondents said none after surgery in comparison to their before surgery response to 0.84%. During the period April 2021 to September 2021, a total of 126 patients were interviewed at the doorsteps to complete the follow-up interviews. Respondents scored on their difficulties in doing daily activities questions. They compared, findings observed as 74% of respondents said none after surgery in comparison to their before surgery response to 3%.


Percentage of Patients
None Mild Moderate Severe Extreme
Before Surgery 0.84 30.65 40.87 23.92 3.73
After Surgery 70.92 22.98 5.25 0.84 0.00
Percentage of Patients
None Mild Moderate Severe Extreme
Before Surgery 2.75 22.47 31.29 24.82 18.67
After Surgery 73.81 17.54 7.86 0.71 0.08
c. Difficulty in doing Mobility:
Difficulty in climbing stairs, seeing the path, noticing obstacles, finding the way, attending functions, moving out at night and moving within house etc

During the period October to March 2021, a total of 82 patients were interviewed at the doorsteps to complete the follow-up interviews. Respondents scored on their difficulty on mobility-related questions, and the compared findings were observed as 71% of respondents said none after surgery in comparison to their before surgery response to 0.45%.


During the period April 2021 to September 2021, a total of 126 patients were interviewed at the doorsteps to complete the follow-up interviews. Respondents were scored on their difficulty on mobility-related questions, and the compared findings were observed as 77% of respondents said none after surgery in comparison to their before surgery response to 1.18%.


Percentage of Patients
None Mild Moderate Severe Extreme
Before Surgery 0.45 30.80 46.88 19.64 2.23
After Surgery 71.08 23.17 5.40 0.35 0.00
Percentage of Patients
None Mild Moderate Severe Extreme
Before Surgery 1.18 23.33 31.57 24.90 19.02
After Surgery 76.98 15.28 7.54 0.20 0.00
d.Impact on Psychosocial aspects:
Hesitation in socializing, feeling ashamed/embarrassed, feeling of being a burden on others, worrying about losing other eye vision, worrying about falling/injuring oneself etc.

During the period October to March 2021, a total of 82 patients were interviewed at the doorsteps to complete the follow-up interviews. Respondents were scored on their impact of psychosocial aspects related questions, and the compared findings were observed as 74% of respondents said never after surgery in comparison to their before surgery response to 1.30%.


During the period April 2021 to September 2021, a total of 126 patients was interviewed at the doorsteps to complete the follow-up interviews. Respondents were scored on their impact of psychosocial aspects related questions, and the compared findings were observed as 80% of respondents said never after surgery in comparison to their before surgery response to 3%.


Percentage of Patients
Never Rarely Sometimes Often Very Often
Before Surgery 1.30 34.38 41.67 19.27 3.39
After Surgery 73.98 20.73 4.67 0.61 0.00
5. Patient Satisfaction Study

This section highlights the findings of the patient's satisfaction survey. The objective of this study is to assess the patients' level of satisfaction with hospital facilities and services during their stay in the hospital. The methodology used to conduct the study is as- Patients interviewed at the time of discharge by the Field Supervisor. The response was sought on a 5-point scale regarding satisfaction: Extremely Satisfied, Satisfied, Neither Satisfied nor dissatisfied, dissatisfied (Reason asked), Extremely Dissatisfied (Reason asked). In general, there are three aspects of the tools that are used to conduct the exercise, these are quality of services, hospital facilities and counselling services. In quality of services, this exercise aimed to understand the following points like Reason for selection of hospital, Behavior of staff towards the patient, Explanation of process etc., Waiting Time at the hospital. In hospital facilities related this exercise aimed to understand the Bed and bedding, Washroom, privacy during treatment etc., Food – Quantity, Quality and Timing, Water – Accessibility. In the area of counselling services, this exercise aimed to identify Information regarding discharge kits, Usage of medicines, Post-surgery care, and the Counselling process.


PART A: BASIC INFORMATION

From October 2020 to March 2021, 51 patients were interviewed. The major findings are mentioned as 29% male; 71% female patients. 55% of patients said this was their first visit to this hospital. 51% of patients said they approached this hospital because of referral by the community health workers. 45% of respondents said very well about the information shared by the hospital team. 63% of respondents said they have partially understood the printed information.


From April 2021 to September 2021, 60 patients were interviewed. The major findings are mentioned as 40% male; 60% female patients. 55% of patients said this was their first visit to this hospital. 35% of patients said they approached this hospital because of a referral by the CHW. 42% of respondents said very well about the information shared by the hospital team. 100% of respondents said they have partially understood the printed information.


a. Respondents
Number Percentage Number Percentage
Male 15 29 24 40
Female 36 71 36 60
Total 51 100 60 100
b. Is this your first visit to this hospital?
Number Percentage Number Percentage
Yes 28 55 43 72
No 23 45 17 28
Total 51 100 60 100
c. One reason for seeking treatment in this hospital
Number Percentage Number Percentage
Convenient location 0 0 0 0
Convenient hours 0 0 0 0
This facility is free 0 0 2 3
Seeing a doctor is inexpensive 0 0 0 0
Medicines are inexpensive 0 0 0 0
The good reputation of medical staff 0 0 0 0
Referred from eye camp 0 0 0 0
Advised by the community health worker 26 51 21 35
Advised by family or friends to come here 6 12 18 30
It is the only facility available 18 35 0 0
Other 1 2 19 32
Don’t know 0 0 0 0
Total 51 100 60 100
d. How well is your UNDERSTANDING of the information given to you by the hospital staff?
Number Percentage Number Percentage
Very good 23 45 25 42
Good 21 41 28 47
Moderate 7 14 7 12
Bad 0 0 0 0
Very bad 0 0 0 0
Can’t say 0 0 0 0
Refused to answer 0 0 0 0
Total 51 100 60 100
e. Was the information given to you in different ways understood by you? (*Write NA if not applicable)
AUDIO % VIDEO % PRINT % AUDIO % VIDEO % PRINT %
Yes, fully understood NA NA 25 0 0 100
Yes, partially understood 0 0 63 100 100 0
No, not at all understood 0 0 12 0 0 0

PART – B: QUALITY OF HOSPITAL FACILITIES

During the period October 2020 to March 2021, 96% of respondents said they were extremely satisfied with bed bedding facilities provided by the hospital during their stay at the hospital. Related to their toilet facilities 88% responded extremely satisfied. 84% of respondents said extremely satisfied with the quality and quantity of food served by the hospital during their stay at the hospital. Regarding the timing of food, 88% were extremely satisfied.


During the period April 2021 to September 2021, 95% of respondents said they were extremely satisfied with the bed and bedding facilities provided by the hospital during their stay at the hospital. Related to their toilet facilities 73% responded extremely satisfied. 88% of respondents said extremely satisfied with the quality of food and 85% of respondents said extremely satisfied with the quantity of food served by the hospital during their stay at the hospital. Regarding the timing of food, 73% were extremely satisfied.



a. Are you satisfied with the following aspects at the hospital?
BED & BEDDING % TOILET facility % BED & BEDDING % TOILET facility %
Extremely satisfied 96 88 95 73
Satisfied 4 9 3 22
Neither satisfied nor dissatisfied 0 13 2 3
Dissatisfied 0 0 0 2
Extremely dissatisfied 0 0 0 0
Total 100 100 100 100

• Toilet Facility - Don't have tring for cloth dry or open. (Please check with FI)
QUALITY of food % QUANTITY of food % QUALITY of food % QUANTITY of food %
Extremely satisfied 84 84 88 85
Satisfied 16 16 12 15
Neither satisfied nor dissatisfied 0 0 0 0
Dissatisfied 0 0 0 0
Extremely dissatisfied 0 0 0 0
Total 100 100 100 100
TIMING of food % Easy ACCESSIBILITY to drinking water % TIMING of food % Easy ACCESSIBILITY to drinking water %
Extremely satisfied 88 88 78 87
Satisfied 10 10 22 13
Neither satisfied nor dissatisfied 2 2 0 0
Dissatisfied 0 0 0 0
Extremely dissatisfied 0 0 0 0
Total 100 100 100 100
Respect of PRIVACY (during physical examination) % Respect of PRIVACY (during stay) % Respect of PRIVACY (during physical examination) % Respect of PRIVACY (during stay) %
Extremely satisfied 84 88 82 83
Satisfied 16 12 18 17
Neither satisfied nor dissatisfied 0 0 0 0
Dissatisfied 0 0 0 0
Extremely dissatisfied 0 0 0 0
Total 100 100 100 100

PART – C: COUNSELING AND DISCHARGE SERVICES

From October 2020 to March 2021, Related to the patients counselling on the information given regarding the Discharge kit 74% reported being extremely satisfied. Information provided regarding Usage medicines 75% of respondents said they were extremely satisfied. Information regarding Cleaning of Eyes 72% said extremely satisfied. Counselling process by the hospital team responded said 70% said extremely satisfied. 16% of respondents tried to ask for some additional information during counselling. 100% of respondents said they were seated comfortably at their return journey from camp to hospital.


From April 2021 to September 2021, Related to the patients counselling on the information given regarding the Discharge kit 67% reported being extremely satisfied. Information provided regarding Usage medicines 68% of respondents said they were extremely satisfied. Information regarding Cleaning of Eyes 67% said extremely satisfied. Counselling process by the hospital team responded said 61% said extremely satisfied. 10% of respondents tried to ask for some additional information during counselling. 100% of respondents said they were seated comfortably at their return journey from camp to hospital.


a. Are you satisfied with the following aspects at the hospital?
Information is given to you regarding the Discharge kit % Information provided regarding Usage medicines % Information is given to you regarding the Discharge kit % Information provided regarding Usage medicines %
Extremely satisfied 74 75 67 68
Satisfied 16 11 28 27
Neither satisfied nor dissatisfied 10 14 5 3
Dissatisfied 0 0 0 2
Extremely dissatisfied 0 0 0 0
Total 100 100 100 100
• The information provided regarding Usage of medicine – cannot understand
Information regarding Cleaning of Eyes % Counselling process by the hospital team % Information regarding Cleaning of Eyes % Counselling process by the hospital team %
Extremely satisfied 72 70 67 63
Satisfied 12 8 28 32
Neither satisfied nor dissatisfied 16 22 5 5
Dissatisfied 0 0 0 2
Extremely dissatisfied 0 0 0 0
Total 100 100 100 100

b. Is there something that you wanted to know additionally and it was not discussed by the hospital staff?
Yes No Yes No
16 84 10 90
c. Did you get a seat THROUGHOUT THE JOURNEY in the vehicle arranged by the hospital?
CAMP TO HOSPITAL % HOSPITAL TO CAMP % CAMP TO HOSPITAL % HOSPITAL TO CAMP %
Yes, I was sitting throughout the journey 100 100 100 100
No, I was standing 0 0 0 0
throughout the journey 0 0 0 0
No, I was partly sitting and partly standing 0 0 0 0
Total 100 100 100 100

6. One-month visual acuity

This section highlights the personal information of patients. During the period October 2020 to March 2021, a total of 191 patients were interviewed for 1- month visual acuity survey. Out of which 38% were male and 62% were male. 51% of respondents were illiterate, whereas 26% of patients have completed their primary schooling. We also found that 73% of respondents were currently married. In terms of their religion, we found mostly 87% were Hindu. 73% of patients were living together with their children and spouse.


During the period April 2021 to September 2021, a total of 83 patients were interviewed for 1- month visual acuity survey. Out of which 35% were male and 65% were male. 35% of respondents were illiterate, whereas 27% of patients have completed their primary schooling. We also found that 66% of respondents were currently married. In terms of their religion, we found mostly 95% were Hindu. 64% of patients were living together with their children and spouse.


Number % Number %
No. of Patients 191 NA 83 NA
Male 73 38 29 35
Female 118 62 54 65
Total 191 100 83 100
Education Number % Number %
Illiterate 98 51 29 35
Primary schooling 49 26 22 27
Secondary schooling 42 22 32 39
Senior secondary schooling 2 1 0 0
Others 0 0 0 0
Total 191 100 83 100
Marital status Number % Number %
Never Married 5 3 0 0
Currently Married 140 73 55 66
Divorced or separated 0 0 0 0
Widowed / Widower 46 24 28 34
Refused to answer 0 0 0 0
Total 191 100 83 100
What religion do you belong to? Number % Number %
Hindu 166 87 79 95
Muslim 25 13 4 5
Christian 0 0 0 0 0 0 0 0
Sikh 0 0 0 0
Others 0 0 0 0
Refused to answer 0 0 0 0
Total 191 100 83 100
Which of the following best describes the people you live with? Number % Number %
Living with children and spouse 140 73 53 64
Living with children without a spouse 44 23 29 35
Living with spouse only 1 1 0 0
Alone 6 13/td> 0 0
Living with relatives 0 0 1 1
Total 191 100 83 100