Severity of eye injury and treatment-seeking behavior among adult patients in an eye hospital, Napal

Abstract

This study was conducted in Shree Rana Ambika Shah Eye hospital in February 2006. The objective was to determine severity of eye injury and factors affecting treatment-seeking behaviors of adult patients. Hundred and eighty-nine samples were interviewed using a structured questionnaire, to elicit socio-demographics, knowledge/information, and perceptions, source of information, accessibility, and treatment-seeking behaviors. Clinical examinations were performed to assess severity of eye injury About half (49.0%) cases were in the younger (15-29), and 21% in the older age group (>-50). Age was associated with severity of eye injury; younger patients mostly had mild and moderate injuries, while older patients had severe injuries (p-value < 0.05). The male/female ratio was 3:1. Sex was related to time interval for treatment seeking, with more males visiting hospital within one day and more female after one day (p-value < 0.05). Indian cases (58.2%) outnumbered Nepali cases (41.8%); nationality was associated with severity of eye injury (p-value < 0.05). The largest caste/ethnic group was Terai (47.1%) and the smallest indigenous (9.0%); caste/ethnicity was associated with treatment seeking behavior (p-value < 0.05). Less than half 43.0% of cases never attended school while 13.8% had higher education. No association was found for educational status. Most cases were farmers (37.6%) and farm/factory worker (22.8%). Occupation was related to severity of eye injury (p-value < 0.05). Less than half 40.7% of patients had moderate knowledge, 76.7% had high information and 51.9% had moderate perception levels of eye injury. No association was found between knowledge, information or perception level and severity of eye injury. There was relationship between knowledge and treatment seeking time interval; more patients with moderate knowledge visited hospital within one day (p-value < 0.05). The treatment seeking behavior of most patients (43.9%) in terms of first place to seek treatment was eye hospital and for (50.8%) the time interval for seeking treatment after injury was within one day. First time treatment seeking at the eye hospital was associated with severity of eye injury. Most patients (63.0%) arrived to the hospital by bus. Most patients (48.9%) had to travel 21-160 km, and paid (49.7%) travel costs of 46-200 NRS. An association was found between mode of transport, distance, and cost of travel, with severity of eye injury (p-value < 0.05). The study found that older patients, farmers, housewives were more vulnerable to severe injuries. Therefore, specific programs, including extensive counseling, proper referral system, and priority based-hospital care, are required for these groups. More health education and training programs should also be delivered to the younger and occupational groups.