HEALTH SEEKING BEHAVIOURS, KNOWLEDGE AND PERCEPTION OF CATARACT AMONG PATIENTS AWAITING SURGERY AT THE AJEROMI GENERAL HOSPITAL, LAGOS, NIGERIA

Abstract

Cataract is a problem of public health importance worldwide, which accounts for most of the causes of blindness among persons aged 50 years and above in Nigeria. People’s perceptions of cataract and their cataract related health-seeking practices have not been fully studied in Nigeria. The study was aimed at assessing the knowledge, perceptions and health-seeking behaviors relating to cataract surgery among patients aged 50-70 years who were awaiting surgery in Ajeromi General Hospital, Lagos. Systematic random sampling technique was used to select 500 participants out of the 590 cataract patients awaiting surgery at the hospital from 27th June to10th August, 2009. A questionnaire which included a 15-point knowledge scale and questions on sociodemographic characteristic, knowledge, perceptions and treatments seeking-behaviours were used for data collection. Scores ranging from 1-6, 7-8 and 9-15 points were categorized as poor, fair and good respectively. Scores 0-8 and 9-15 were described as low and high respectively. Data were analysed using descriptive satistics, such as student’s t-test and ANOVA. Respondents’ mean age was 59.4±5.1 years and 55.4% were males. All the respondents had at least primary school education. Forty-three percent of respondents had heard about cataract before diagnosis and their sources of information were friends (33.2%), family members (29.0%), mass media (24.2%) and health workers (13.6%). Only 12.8% were able to state correctly that it is a white object which blocks the eye thereby preventing it from seeing. Perceived causes of cataract included old age (9.4%) and witchcraft (8.4%). Respondents’ mean knowledge score was 4.0±3.2. Mean score for males was 4.2±3.3 while that of females was 3.8±3.1. Mean knowledge scores by age group were 4.0±3.3 (50-54 years), 4.6±3.1(55- 59 years), 4.1±3.2 (60-64 years) and 3.4±2.9(65-70 years) (p<0.05). Respondents with poor, fair and good knowledge scores were (74.6%) (17.2%) and (8.2%) respectively. The risks associated with cataract surgery were perceived by 8.4% to be worth taking, 32.7% not worth taking, while 46.9% were of the perceptions that the risks were inevitable. Perceived benefits of cataract surgery included restoration of vision (81.3%), better well-being (8.6%) and protection of second eye from cataract in future (5.2%). Ninety percent of the respondents delayed surgery and the reasons given included lack of knowledge of its benefits (37.8%), high cost of surgery (20.2%), fear of surgery (18.4%) and fear of loosing the eye (13.4%). When symptoms of cataract were first noticed, 21.6% did nothing. The health seeking behaviors of the others included visit to a health centre (37.8 %,) patronized herbalists (6.8%), and request for help from family members (3.0%). Twenty- nine percent of respondents had previously visited several other eye clinics before accepting surgical intervention. Suggestions on how to improve eye-care services included subsidizing the cost of eye surgery (12.4%), provision of good quality equipment (21.6%) and training of more eye-care specialists (33.8%). Respondents’ knowledge was low and misconceptions as well as risky health seeking behaviors were common among them. Public enlightenment and preoperative counseling services are needed to address these concerns.