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ORIGINAL ARTICLE
Year : 2019  |  Volume : 6  |  Issue : 1  |  Page : 1-5

Knowledge Impact of the Contextual Presbyopia Education on the At-Risk Population of Saham, Oman


Department of Optometry, College of Health Sciences, University of Buraimi, Al Buraimi, Oman

Date of Submission05-Jun-2019
Date of Acceptance14-Apr-2020
Date of Web Publication13-Jul-2020

Correspondence Address:
Dr. Gopi Suresh Vankudre
Department of Optometry, College of Health Sciences, University of Buraimi, Al Buraimi
Oman
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DOI: 10.4103/bijo.bijo_3_19

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  Abstract 


Context: Acts such as regular check-up and choosing appropriate correction methods can help in reducing the uncorrected burden of presbyopia and enhancing the vision-related quality of life. There is a lack of evidence on presbyopia-related awareness and knowledge in Oman. Even, evidence on the efficiency of condition-related health promotional resources is also limited.
Aim: This study aims to evaluate the community's presbyopia related knowledge level and the impact of the developed video-based presbyopia-related health promotional tool on enhancing their condition related knowledge.
Settings and Design: This cross-sectional study was conducted in the population of Saham, Oman.
Subjects and Methods: The knowledge assessment was done through a self-designed questionnaire tool before and after the provision of presbyopic health education.
Statistical Analysis Used: Descriptive statistics, Wilcoxon signed-rank, and Kruskal–Wallis test.
Results: The mean age of participants was (42.100 ± 6.3937 years). The mean percentile knowledge score before the intervention was (25.0909% ±23.75966%). Percentile mean knowledge score after intervention increased to (92.9091% ± 12.43264%). Wilcoxon signed-rank test indicated that the postintervention knowledge score was significantly higher than preintervention z = −8.699, P = 0.00. The Kruskal–Wallis test indicated the change is knowledge score was statistically significant with factors of the medical association of the participant either educationally (P = 0.043) or occupationally (0.009).
Conclusion: Most of the study participants had heard about near vision loss but had lower knowledge about presbyopia. The impact of the provided presbyopia health intervention was statistically significant.

Keywords: Impact of presbyopia education, presbyopia health promotion, presbyopia knowledge and awareness


How to cite this article:
Ali Al-Alshidi AS, Vankudre GS. Knowledge Impact of the Contextual Presbyopia Education on the At-Risk Population of Saham, Oman. Albasar Int J Ophthalmol 2019;6:1-5

How to cite this URL:
Ali Al-Alshidi AS, Vankudre GS. Knowledge Impact of the Contextual Presbyopia Education on the At-Risk Population of Saham, Oman. Albasar Int J Ophthalmol [serial online] 2019 [cited 2020 Oct 21];6:1-5. Available from: https://www.bijojournal.org/text.asp?2019/6/1/1/289605




  Introduction Top


Presbyopia is the most widely recognized public eye health issue impairing the near work around the world. It is characterized as a dynamic decline in the accommodative ability prompting uneasiness and trouble for close work. Loss of adaptability of the ocular lens is considered to be one of the reasons for this issue.[1],[2]

Middle-age and older population, especially the population aged 40 years and above, are at a higher risk of having presbyopia.[2] However, universally, it is concluded that the prevalence magnitude of the uncorrected presbyopia population is definite. It is predicted that 1.04 billion people had a presbyopic condition in the world.[3] It is progressively perceived as a noteworthy issue over the world.[4] With the rise in life expectancy in Oman, presbyopia prevalence is increasing.

Presbyopia causes near visual impairment. It hampers an individual's performance and their quality of life. Uncorrected presbyopia can have a negative effect on everyday living such as reading newspaper and seeing phone numbers. Women are more affected in household work like threading the needle for sewing.[1]

Presbyopia can be corrected by simple means of glasses or contact lens. There are many types of spectacle lenses used for the correction of presbyopia, such as separate single-vision glasses for near work, bifocal, trifocal, and progressive addition lens. It can also be corrected by surgical means using accommodative “intra-ocular lens or laser conventional corrective surgical techniques for refractive modification.”[5]

The World Health Organization has advised ranking the population as a high priority for service delivery if less than one-third of it has a near correction. If one to two-thirds of the population use spectacles, they would be ranked moderate priority, and if more than two-thirds use spectacles, they would be ranked low priority.[3]

Noncorrection of presbyopia is multifactorial. Studies have observed many factors, which may affect the level of perception and attention about the presbyopia. For instance, lack of awareness, difficulty maintaining the spectacles while working, feeling ashamed while using spectacles, and or nonaffordable spectacles. This may further lead to an increased burden of presbyopia within the community.[1] A study done by Gajapati et al. observed that 66.7% of the study participants were unaware of the condition of presbyopia. Further, the study highlighted that out of 96.9% who are corrected by spectacles, 60.2% did not get the spectacles because they have difficulties maintaining the spectacles while working. The author emphasized the need for increased health education regarding presbyopia.[1]

There is a need to have a combined approach by the health system, health professionals such as optometrists or ophthalmologists and the presbyopic population to tackle the condition-related burden. Early approaches to the care of health-care facilities with appropriate ideas are needed to manage refractive errors. Optometrists can detect potential eye problems and lead them to the next-level of care and help increase utilization of eye care services.[6]

Appropriate attention and regular checkup are the two ideal approaches to correct the presbyopia. Hence, optometrists in Oman can also contribute to reducing presbyopia related visual impairments. A further step by the eye health professionals to educate the at-risk community about the condition and its managerial options can be helpful. Unfortunately, the treatment for uncorrected refractive errors received less attention in Oman. It may negatively affect the working efficacy of the individuals and in turn the community development.[6]

In summary, acts such as regular check-up and choosing appropriate correction methods can help in reducing the uncorrected burden of presbyopia. Eventually, it can positively enhance eye health of the Omani community. It can enhance the vision-related and overall quality of life of the affected individuals and in turn the community. From the literature review, it is observed that there is a lack of evidence on presbyopia related awareness and knowledge in Oman. Even, condition-related health promotional resources are also observed to be limited. The previous study stated the higher impact of video-based approach[7] compared to the conventional printing material. Hence, the research aims to evaluate the community's presbyopia related knowledge level and the impact of the developed video-based presbyopia-related health promotional tool on enhancing their condition-related knowledge.


  Subjects and Methods Top


Approval

The study obtained approval by the Research and Ethics committee of the College of Health Sciences, of a university in Oman. It followed the guidelines mentioned in the Declaration of Helsinki.

Knowledge assessment questionnaire

The first component of the questionnaire collected responses on the sociodemographic responses of the participants. The second part of the questionnaire has collected the responses on the type of spectacles participant is wearing, the nature of his near activity and history of previous ocular examination. Moreover, prior knowledge assessment involved the components related to the condition itself, its causes, and available managerial modalities. A self-designed questionnaire through a literature review was used for this study. The questionnaire addressed in both Arabic and English language in the same form. The questionnaire and expected responses validated by the language and subject experts prior to the study used. The content validity approach was used for this validity. 80% of the agreement of the expert is considered as validated. The questionnaire consisted of both categorical and open-ended responses. The open-ended responses were further classified by the field investigator into categorical responses and graded as per the model answers. Each item in the knowledge section was graded and a total score for each participant was calculated in percentages.

Video

A validated presbyopic health promotion video was chosen as an educational intervention for this study. It had a duration of 4 minutes. It was transcribed and validated in both English and Arabic language.

Study setting and design

The study was conducted among native residents of Saham, Oman aged 35 years and above. Participants were provided with the brief study background and advantages of this study before their enrolment into the study. Prior consent was taken from all the eligible participants willing to participate in this study.

Participants

The researchers used Open Source Epidemiologic Statistics for Public Health Version 3.01 (Centers for Disease Control and Prevention, United states) to calculate the sample size. The total population of Saham is 89,327. The global prevalence of presbyopia 25% was hypothesized presbyopic population with a confidence interval of 95%.[8] Considering the nonrespondent rate, the study contacted 100 randomly selected potential participants, of which 89 responses were the minimum requirement.

Inclusion and exclusion criteria

The study included Omani citizens 35 years and above willing to participate in the study. Participants having adequate communication skills needed for the interview was an additional eligibility criterion. It excluded individuals <35 years of age and participants having other ocular pathologies or lack of communication abilities.

Data analysis

The study used descriptive statistics for summarizing sociodemographic information. Participants having a knowledge score of <50% was considered to have inadequate knowledge or otherwise adequate knowledge. Chi-square test was used to analyze the significance of the association between knowledge score and demographic variables. Normality of the percentage knowledge score was assessed using the Shapiro–Wilk test of normality that represented the non-normal distribution of the pre- and post-intervention knowledge scores as well as a change in knowledge scores. Hence, the Kruskal–Wallis test was applied to examine the effect of sociodemographic variables on change in participant's presbyopia-related knowledge score. The impact of the health intervention on the knowledge score was examined using Wilcoxon signed-ranked test as the data was not normally distributed. The statistical analyses were done using IBM Statistical Package for Social Sciences (SPSS) version 21 (International Business Machines Corporation, United States.).


  Results Top


One hundred presbyopic or at-risk individuals residing in Saham and aged 35 years and above were included in this study. [Table 1] indicates the details of sociodemographic of the participants. The mean age of participants was (42.100 ± 6.3937 years). It consisted of 43% males and 57% females. 37% males and 30% females had more than secondary educational level. 59 (41.0%) were from non-medical educational background. Only 7% of the participants were associated with medical field occupationally [Table 1].
Table 1: The demographic profile of the study participants from Saham

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[Table 2] shows history of participation for ocular examination and spectacle. 92% of participants underwent the ocular examination, 75% were prescribed with glasses, and 56% were currently using glasses. Most of the participants were using single vision lenses (37%), followed by progressives (10%) and (7%) bifocals [Table 2].
Table 2: History related to ocular examination and spectacle were

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{Table 2}

During preintervention, only (71%) participants had heard about near vision loss and 29% had not heard about it. [Figure 1] shows the mean percentile knowledge score before the intervention as (25.0909% ±23.75966%) increased up to (92.9091% ±12.43264% years) post intervention [Figure 1].
Figure 1: Percentile mean knowledge score difference pre- and post-intervention

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Based on the negative ranks, the Wilcoxon signed-rank test indicated that the postintervention knowledge score was significantly higher than preintervention z = −8.699, P = 0.00.

The Shapiro–Wilk normality test indicated the nonnormal distribution of the percentage change in knowledge score (P = 0.00). Hence, the Kruskal–Wallis test was applied to identify the association between the percentage change in knowledge score and the socioeconomic variables of the study participants [Table 3]. The change is knowledge score was statistically significant with factors of the medical association of the participant either educationally (P = 0.043) or occupationally (0.009). The association between change in knowledge score and factors of educational level (P = 0.324) and occupation (P = 0.083) was found to be statistically insignificant [Table 3].
Table 3: Association between change in percentage knowledge score with participant's socioeconomic profile

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  Discussion Top


This study evaluated presbyopia-related knowledge level and impact of the developed presbyopia related health promotional tool within the community. The study observed higher presbyopia knowledge scores postintervention. The mean percentile knowledge score increased from 25.0909% to 92.9091%. A similar study done by Al Owaifeer et al. used education video among glaucoma in Saudi Arabia and observed positive knowledge outcomes.[7]

Most of these study participants 71% were aware of presbyopia. In contrast, the study done by Gajapati et al. observed that 66, 7% were not aware of presbyopia.[1] The difference could be because of the inclusion of only female participants in the study. Second, the later study was done among the rural population in the later study. Moreover, the participant's literacy level was higher in our study.

We observed a statistically significant change in percentage knowledge score among participant's with medical background either educationally or occupationally. A study done by Al Owaifeer et al., observed the factor of age, gender, level of education, occupation, and income level as statistically significant.[7] The differences in involved study variables associated with the knowledge impact could be due to the lower sample size in our study.

The use of the spectacles for correction of presbyopia was observed to be associated with education level. This is similar to other study done by Marmamula et al. the study, which observed that (52.0%) were corrected presbyopia.[9] However, a studies done by Laviers et al.,[3] and Mashayo et al.[10] observed low participants corrected with presbyopia 17.6% and 0.42% respectively.

Limitations and future recommendations

This study included only the participants from one region of Oman. Community's condition related attitude and practice can also be explored. Similar studies can be conducted in the other parts of Oman and including and with different socioeconomic profiles. The implementation of presbyopia health interventional programs can be helpful in raising awareness about the condition.


  Conclusion Top


Most of the study participants had heard about near vision loss but had lower knowledge about presbyopia. The impact of the provided presbyopia health intervention was statistically significant. Medical background was the most significant factor responsible for higher presbyopia-related knowledge postintervention. Similar studies can be conducted in the other parts of Oman and including population with different socioeconomic profiles.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
Gajapati CV, Pradeep AV, Kakhandaki A, Praveenchandra RK, Rao S. Awareness of Presbyopia among Rural Female Population in North Karnataka. J Clin Diagn Res 2017;11:NC01-NC05.  Back to cited text no. 1
    
2.
Holden BA, Tahhan N, Jong M, Wilson DA, Fricke TR, Bourne R, et al. Towards better estimates of uncorrected presbyopia. Bull World Health Organ 2015;93:667. Available from: http://www.who.int/entity/bulletin/volumes/93/10/15-156844/en/. [Last accessed on 2019 Jun 5].  Back to cited text no. 2
    
3.
Laviers HR, Omar F, Jecha H, Kassim G, Gilbert C. Presbyopic spectacle coverage, willingness to pay for near correction, and the impact of correcting uncorrected presbyopia in adults in Zanzibar, East Africa. Invest Ophthalmol Vis Sci 2010;51:1234-41.  Back to cited text no. 3
    
4.
Marmamula S, Keeffe JE, Raman U, Rao GN. Population-based cross-sectional study of barriers to utilisation of refraction services in South India: Rapid Assessment of Refractive Errors (RARE) Study. BMJ Open 2011;1:e000172.  Back to cited text no. 4
    
5.
Goertz AD, Stewart WC, Burns WR, Stewart JA, Nelson LA. Review of the impact of presbyopia on quality of life in the developing and developed world. Acta Ophthalmol 2014;92:497-500.  Back to cited text no. 5
    
6.
Thomas JF. A vision for optometry in Oman. Oman J Ophthalmol 2013;6:75-6.  Back to cited text no. 6
[PUBMED]  [Full text]  
7.
Al Owaifeer AM, Alrefaie SM, Alsawah ZM, Al Taisan AA, Mousa A, Ahmad SI. The effect of a short animated educational video on knowledge among glaucoma patients. Clinical Ophthalmology. Clin Ophthalmol 2018;12:805-10. Available from: https://www.dovepress.com/the-effect-of-a-short-animated-educational-video-on-knowledge-among-gl-peer-reviewed-fulltext-article-OPTH. [Last accessed on 2019 Jun 5].  Back to cited text no. 7
    
8.
Fricke TR, Tahhan N, Resnikoff S, Papas E, Burnett A, Ho SM, et al. Global Prevalence of Presbyopia and Vision Impairment from Uncorrected Presbyopia: Systematic Review, Meta-analysis, and Modelling. Ophthalmology 2018;125:1492-9.  Back to cited text no. 8
    
9.
Marmamula S, Madala SR, Rao GN. Prevalence of uncorrected refractive errors, presbyopia and spectacle coverage in marine fishing communities in South India: Rapid Assessment of Visual Impairment (RAVI) project. Ophthalmic Physiol Opt 2012;32:149-55.  Back to cited text no. 9
    
10.
Mashayo ER, Chan VF, Ramson P, Chinanayi F, Naidoo KS. Prevalence of refractive error, presbyopia and spectacle coverage in Kahama District, Tanzania: A rapid assessment of refractive error. Clin Exp Optom 2015;98:58-64.  Back to cited text no. 10
    


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