eye care

眼部护理
  • 文章类型: Journal Article
    未经批准:随着澳大利亚人口的增长和年龄的增长,对眼部护理服务的需求,和护士提供服务,预计会增加。这会影响护士,他们是澳大利亚最大的医疗保健提供者团体。了解和绘制护士在眼科护理中的当前作用和使用是未来卫生人力规划和发展的重要第一步。为了绘制他们的订婚地图,我们进行了范围审查,以了解当前澳大利亚护士眼保健劳动力的情况,帮助指导和支持未来的劳动力发展活动。其次,我们评估了该领域的出版物是否在其出版物中纳入或提及了澳大利亚眼科护理协会的国家标准(实践标准).这项审查还为其他国家和眼部护理提供者提供了评估自己的卫生劳动力计划和护士效用的机会。
    未经评估:我们对学术和灰色文献进行了回顾,通过各种搜索引擎,以及纳入和排除标准。
    未经评估:我们发现了11种出版物。其中,五篇是研究扩展和高级护理实践的学术论文,一封是给编辑的信,两个是行业专题评论,两个是行业报告,最后一个是实践标准。贯穿始终的关键主题表明了护士培训和护士参与眼部护理的好处。总的来说,没有足够的信息或数据来描述护士的部署,实践和效用。最后,实践标准没有在任何出版物中引用。
    UNASSIGNED:没有足够的公布信息来计算护士的水平和参与,或者描述他们现有的角色,在澳大利亚眼科护理领域的进步或未来部署。没有明确的信息,澳大利亚无法制定有效的卫生劳动力战略来吸引,火车,保留,并适当部署护士以满足未来的眼部护理需求。
    UNASSIGNED: As the Australian population grows and ages, the demand for eye care services, and nurses to provide the services, is expected to increase. This will impact nurses, who are Australia\'s largest health-care provider group. Understanding and mapping the current role and use of nurses in eye care is an essential first step for future health workforce planning and development. To map their engagement, we undertook a scoping review to gain an understanding of the current Australian nurse eye care workforce landscape, to help guide and support future workforce development activities. Secondly, we evaluated if publications in this field incorporated or mentioned the Australian Ophthalmic Nursing Association\'s National Standards (Practice standards) in their publication. This review also offers other nations and eye care providers the opportunity to evaluate their own health workforce plan and nurse utility.
    UNASSIGNED: We conducted a review of academic and grey literature, via various search engines, and an inclusion and exclusion criteria.
    UNASSIGNED: We uncovered 11 publications. Of those, five were academic papers examining extended and advanced nursing practice, one was a letter to the editor, two were industry feature reviews, two were industry reports and the final was the Practice Standards. Key themes throughout indicated the benefit of nurse training and nurse involvement in eye care. Overall, there was insufficient information or data to describe nurse deployment, practice and utility. Finally, the Practice Standards were not referenced in any publication.
    UNASSIGNED: There is insufficient published information to calculate the level and involvement of nurses, or describe their existing role, advancement or future deployment in eye care in Australia. Without clear information, Australia is unable to develop effective health workforce strategies to attract, train, retain, and appropriately deploy nurses to meet future eye care needs.
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  • 文章类型: Journal Article
    背景:与普通人群相比,养老院居民的眼病和视力障碍患病率要高得多。对于这一弱势群体来说,获得眼部护理服务和治疗的机会可能是可变的。
    目的:本文回顾了为家庭护理居民提供眼部护理服务和干预措施的现有证据。主要的审查问题是:(1)为养老院居民提供眼部护理干预措施或服务(包括服务配置)的现有证据是什么?(2)提供这些干预措施或服务是否可以改善结果?
    方法:自1995年以来,对EMBASE/MEDLINE进行文献搜索。两名审稿人独立审查了摘要/论文。数据提取并使用叙事综合进行评估。
    结果:13篇原始论文符合纳入标准。家庭验光师服务改善了眼部疾病的诊断和管理,一项研究显示,53%的居民受益于直接眼科干预。提供干预措施,比如白内障手术,屈光不正矫正和低视力康复,改善视力和视觉相关的生活质量,但没有改善认知或身体功能,抑郁症或与健康相关的生活质量。几乎没有基于英国的文献来告知眼科服务设计或干预措施以改善跌倒等结果。
    结论:基于家庭护理的眼部评估可改善眼部疾病的管理。干预措施可改善视力和与视觉相关的生活质量。需要进一步的研究来更好地了解当前的英国服务,获取困难或良好做法的例子,以及为这一弱势群体确定和测试具有成本效益的服务模式。
    The prevalence of eye disease and visual impairment in care home residents is disproportionately higher compared to the general population. Access to eye care services and treatment can be variable for this vulnerable population.
    This paper reviews the available evidence of services and interventions for delivering eye care to care home residents. The key review questions are: (1) What is the existing evidence for eye care interventions or services (including service configuration) for care home residents? (2) Does the provision of these interventions or services improve outcomes?
    Literature search of EMBASE/MEDLINE for original papers published since 1995. Two reviewers independently reviewed abstracts/papers. Data were extracted and evaluated using narrative synthesis.
    13 original papers met the inclusion criteria. Domiciliary optometrist services improved diagnosis and management of eye conditions, with one study showing 53% of residents benefited from direct ophthalmology intervention. Provision of interventions, such as cataract surgery, refractive error correction and low-vision rehabilitation, improved visual acuity and vision-related quality of life but did not improve cognitive or physical function, depression or health-related quality of life. There was little UK-based literature to inform eye service design or interventions to improve outcomes such as falls.
    Care home-based eye assessments improve the management of eye conditions. Interventions improve visual acuity and vision-related quality of life. Further research is needed to better understand current UK services, access difficulties or examples of good practice as well as to identify and test cost-effective service models for this vulnerable group.
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  • 文章类型: Systematic Review
    目的:验光师越来越多地采用远程验光作为提供眼部护理的一种方法。2019年冠状病毒病(COVID-19)大流行为验光师创造了更多机会,让他们利用远程医疗创新为遇到接触障碍的个人提供眼部护理。提出了系统的文献综述,详细说明了支持使用远程验光的证据。方法:MEDLINE数据库,全球卫生,搜索了科学网,如果他们报告验光师参与远程医疗的提供,则包括文章。根据用于提供眼部护理的远程医疗模式报告了调查结果,远程医疗协作类型,以及通过远程医疗提供眼部护理的格式和地理区域。结果:确定了27项相关研究。只有11项研究包括视光师作为远程医疗团队成员的角色,该团队的实践范围超出了创建和接受转介的范围,在现场服务中收集临床数据,并在咨询眼科医生后继续进行当面护理。通常使用同步和异步远程医疗服务。验光师最常参与眼科主导的远程医疗合作(n=19)。八项研究报告说,验光师通过远程医疗独立提供初级眼部护理,通常包括视频会议。结论:远程验光术在眼科护理中的应用正在迅速兴起,似乎是提供当面验光服务的可行辅助手段。该评论强调了围绕临床益处的证据的匮乏,安全,和远程验光的结果。在这方面需要进一步的研究。
    Objective: Optometrists are increasingly adopting teleoptometry as an approach to delivering eye care. The coronavirus disease 2019 (COVID-19) pandemic has created further opportunities for optometrists to utilize innovation in telehealth to deliver eye care to individuals who experience access barriers. A systematic literature review is presented detailing the evidence to support the use of teleoptometry. Methods: Databases of MEDLINE, Global Health, and Web of Science were searched, and articles were included if they reported any involvement of optometrists in the delivery of telehealth. Findings were reported according to the mode of telehealth used to deliver eye care, telehealth collaboration type, and the format and geographical areas where eye care via telehealth is being delivered. Results: Twenty-seven relevant studies were identified. Only 11 studies included the role of optometrists as a member of the telehealth team where the scope of practice extended beyond creating and receiving referrals, collecting clinical data at in-person services, and continuing in-person care following consultation with an ophthalmologist. Both synchronous and asynchronous telehealth services were commonly utilized. Optometrists were most commonly involved in ophthalmology-led telehealth collaborations (n = 19). Eight studies reported optometrists independently delivering primary eye care via telehealth, and commonly included videoconferencing. Conclusion: The application of teleoptometry to deliver eye care is rapidly emerging, and appears to be a viable adjunct to the delivery of in-person optometry services. The review highlighted the scarcity of evidence surrounding the clinical benefits, safety, and outcomes of teleoptometry. Further research is required in this area.
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  • 文章类型: Journal Article
    视力障碍(VI)的患病率持续上升,尽管努力减少它。疾病负担对生活质量产生负面影响,教育机会,以及各种社区的其他发展。从今以后,这项研究旨在确定和量化南非VI的主要原因,确保在解决这些问题时采取准确的干预措施,并减轻这种情况下眼部疾病的负担。进行了系统的范围审查,以绘制VI和眼部疾病的证据,使用PRISMA-P指南。在PubMed上搜索英语研究,谷歌学者,和EBSCOhost使用各种搜索词。对符合条件的文章进行了筛选,并最终进行了数据提取,以确定南非VI的主要原因。荟萃分析使用逆方差异质性(IVhet)模型进一步得出了合并患病率估计值(PPE)。在三个级别筛选的13527项研究中,10项研究符合最终审查的纳入标准;然而,9项研究符合由两名独立评审员进行的质量评估的条件。纳入研究的质量指标为71.1%。失明的VI患病率为2%,中度和重度视力障碍(MSVI)的患病率为12%。合并患病率确定为未矫正屈光不正(URE)(43%),白内障(28%),青光眼(7%),和糖尿病视网膜病变(4%)是MSVI的主要原因。失明的主要原因是未经治疗的白内障(54%),青光眼(17%),和糖尿病视网膜病变(57%)。引起VI的眼部疾病是可以避免的,与中低收入国家相似。MSVI是由URE引起的,白内障,青光眼,和糖尿病视网膜病变。失明主要是由白内障引起的,青光眼,和糖尿病视网膜病变。管理这些条件的战略计划将在很大程度上减轻该国VI的负担。早期筛查和干预措施,以最大限度地提高初级保健水平的护理水平,将大大减少该国可避免失明的负担。
    The prevalence of visual impairment (VI) continues to rise, despite efforts to reduce it. The burden of disease negatively impacts the quality of life, education opportunities, and other developments in various communities. Henceforth, this study aimed to determine and quantify the major causes of VI in South Africa, to ensure accurate interventions in addressing them and to reduce the burden of ocular disease in that context. A systematic scoping review was conducted to map evidence on VI and ocular diseases, using the PRISMA-P guidelines. English studies were searched for on PubMed, Google Scholar, and EBSCOhost using various search terms. The eligible articles underwent screening and ultimately data extraction to identify major causes of VI in South Africa. A meta-analysis further resulted in pooled prevalence estimates (PPE) using the Inverse Variance Heterogeneity (IVhet) model. Of the 13,527 studies screened at three levels, 10 studies met the inclusion criteria for the final review; however, 9 studies were eligible for quality assessment performed by two independent reviewers. The quality index for the included studies was 71.1%. The prevalence of VI was 2% for blindness and 12% for moderate and severe visual impairment (MSVI). Pooled prevalence identified uncorrected refractive error (URE) (43%), cataract (28%), glaucoma (7%), and diabetic retinopathy (4%) as major causes of MSVI. The leading causes of blindness were untreated cataracts (54%), glaucoma (17%), and diabetic retinopathy (57%). Ocular diseases causing VI are avoidable and similar to those of low-to-middle income countries. MSVI were caused by URE, cataract, glaucoma, and diabetic retinopathy. Blindness was mainly caused by cataracts, glaucoma, and diabetic retinopathy. A strategic plan to manage these conditions would largely reduce the burden of VI in the country. Early screenings and interventions to maximize care at primary health levels would decrease the burden of avoidable blindness in the country significantly.
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  • 文章类型: Journal Article
    Evidence-based practice is fundamental to providing quality care, patient satisfaction and judicious use of limited healthcare resources. However, variability in evidence-based eye care delivery has been reported. Given the important role of optometrists in delivering primary eye care, a better understanding of the barriers and facilitators to providing optometric care is required. This systematic review aimed to identify determinants (barriers and facilitators) of eye care delivery by optometrists and interventions that may improve eye care delivery.
    PubMed, MEDLINE, EMBASE, CINAHL, SCOPUS, PsychINFO, ProQuest and Web of Science were searched for studies reporting barriers and facilitators to eye care delivery published between 1999 and 2020. The Theoretical Domains Framework (TDF) was used to analyse data (quotations, interpretive summaries, survey result) with barriers and facilitators coded to one or more of the 14 domains, and used to identify the key behavioural domains influencing eye care delivery based on frequency of coding, elaboration and stated importance in the study. Influential domains were mapped to the Behaviour Change Wheel to identify potential interventions to improve eye care delivery. Of the 802 studies retrieved from the search, 30 were included. Frequently identified barriers were time constraints, resources and equipment issues, patient factors, lack of awareness, skill proficiency deficits and negative attitudes and beliefs. Frequently identified facilitators were adequate time, resources and equipment, education, skill proficiency and understanding the relevancy of the eye care provided. The key TDF domains influencing eye care delivery were \'environmental context and resources\' (time, resources, equipment issues, patient factors), \'knowledge\' (awareness issues), \'skills\' (skills proficiency) and \'belief about consequences\' (beliefs and relevancy). Intervention functions that may improve eye care delivery were education, training, restriction, environmental restructuring, enablement, persuasion and modelling.
    The barriers and facilitators identified in this review were diverse and located at both the practitioner and organisational levels. Four TDF domains were found to be influential determinants of eye care practice. Intervention functions identified in this study can be used to improve the appropriateness of primary eye care delivery.
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  • 文章类型: Journal Article
    For many people, settling in a new country is associated with a new identity as an \'ethnic minority\', one that can remain through future generations. People who are culturally distinct from the dominant population group may experience a variety of barriers to accessing healthcare, including linguistic and cultural barriers in communication, navigation of an unfamiliar health system and unconscious or overt discrimination. Here, we outline the protocol of a scoping review to identify, describe and summarise interventions aimed at improving access to eye care for non-Indigenous, non-dominant ethnic groups residing in high-income countries.
    We will search MEDLINE, Embase and Global Health from their inception to July 2019. We will include studies of any design that describe an intervention to promote access to eye care for non-Indigenous, non-dominant ethnic groups. Two authors will independently review titles, abstracts and full-text articles for inclusion. Reference lists from all included articles will also be searched. In cases of disagreement between initial reviewers, a third author will help resolve the conflict. For each included article, we will extract data about the target population, details of the intervention delivered and the effectiveness of or feedback from the intervention. Overall findings will be summarised with descriptive statistics and thematic analysis.
    This review will summarise existing literature and as such ethics approval is not required. We will publish the review in an open-access, peer-reviewed journal, and draft appropriate summaries for dissemination to the wider community. This wider community could include clinicians, policymakers, health service managers and organisations that work with non-dominant ethnic groups. Our findings will also feed into the ongoing Lancet Global Health Commission on Global Eye Health.
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  • 文章类型: Journal Article
    Globally, there are an estimated 370 million Indigenous people across 90 countries. Indigenous people experience worse health compared with non-Indigenous people, including higher rates of avoidable visual impairment. Countries such as Australia and Canada have service delivery models aimed at improving access to eye care for Indigenous people. We will conduct a scoping review to identify and summarise these service delivery models to improve access to eye care for Indigenous people in high-income countries.
    An information specialist will conduct searches on MEDLINE, Embase and Global Health. All databases will be searched from their inception date with no language limits used. We will search the grey literature via websites of relevant government and service provider agencies. Field experts will be contacted to identify additional articles, and reference lists of relevant articles will be searched. All quantitative and qualitative study designs will be eligible if they describe a model of eye care service delivery aimed at Indigenous populations. Two reviewers will independently screen titles, abstracts and full-text articles; and complete data extraction. For each service delivery model, we will extract data on the context, inputs, outputs, Indigenous engagement and enabling health system functions. Where models were evaluated, we will extract details. We will summarise findings using descriptive statistics and thematic analysis.
    Ethical approval is not required, as our review will include published and publicly accessible data. This review is part of a project to improve access to eye care services for Māori in Aotearoa New Zealand. The findings will be useful to policymakers, health service managers and clinicians responsible for eye care services in New Zealand, and other high-income countries with Indigenous populations. We will publish our findings in a peer-reviewed journal and develop an accessible summary of results for website posting and stakeholder meetings.
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  • 文章类型: Journal Article
    痴呆和眼部病理学的患病率随着年龄的增长而增加,并且许多受此类疾病影响的老年人正在被制度化。本系统评价的目的是描述向老年机构个人提供的眼部护理服务的水平,介绍了痴呆症患者视力障碍的患病率,并描述为患有痴呆症的视力受损居民提供的干预措施。
    在四个相关数据库中进行了文献综述,仅限于以英语和法语出版的同行评审期刊,在1984年和2014年之间。该审查针对65岁或以上的个人,居住在长期护理设施/疗养院并受痴呆症影响。本次审查只保留了涉及三个目标中至少一个目标的相关文章。
    文献检索确定了440篇由每位作者阅读的摘要。达成共识后,92篇文章被确定为潜在相关并阅读。最后,发现28个目标至少涉及三个目标之一,并保留供审查。结果表明,老年人的眼科护理服务是次优的,该人群中视力障碍的患病率仍然很高,以及诸如优化眼屈光等干预措施,进行白内障手术,提供低视力康复和适应环境可能对居民有利。
    这项系统评价证明了为长期护理机构/疗养院居民提供定期眼部护理的好处,包括所有级别的痴呆症患者。此外,它记录了各种治疗方式的好处,如白内障手术,员工培训,环境适应和视觉康复,以提高居民生活质量的几个方面。这次审查,然而,强调了一个事实,即需要更多的研究来加强迄今为止报告的发现,而且重要的是,评估本文所述的各种治疗方式,用于痴呆症最晚期的居民。
    The prevalence of dementia and ocular pathology increases with age and many older individuals affected by such diseases are being institutionalised. The objectives of this systematic review are to describe the level of eye care services being offered to older institutionalised individuals, present the prevalence of visual impairment in those with dementia, and describe the interventions offered to visually impaired residents with dementia.
    A literature review was performed in four relevant databases, limited to peer-reviewed journals published in English and French, between the years 1984 and 2014. The review targeted individuals 65 years of age or older, residing in long-term care facilities/nursing homes and affected by dementia. Only relevant articles addressing at least one of the three objectives were retained for this review.
    The literature search identified 440 abstracts that were all read by each of the authors. After consensus, 92 articles were identified as potentially relevant and read. In the end, 28 were found to address at least one of the three objectives and were kept for the review. The results indicated that eye care services for older institutionalised individuals are sub-optimal, that the prevalence of visual impairment remains high in that population, and that interventions such as optimising the ocular refraction, performing cataract surgery, providing low vision rehabilitation and adapting the environment can be beneficial to residents.
    This systematic review demonstrated the benefits of providing regular eye care to long-term care facility/nursing home residents, including those at all levels of dementia. Additionally, it documented the benefits of various treatment modalities such as cataract surgery, staff training, environmental adaptations and visual rehabilitation for improving several aspects of the residents\' quality of life. This review, however, has highlighted the fact that additional studies are required to strengthen the findings reported so far, and importantly, to evaluate the various treatment modalities described herein for residents in the most advanced stages of dementia.
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