Understanding and living with glaucoma and non-communicable diseases like hypertension and diabetes in the Jhaukhel-Duwakot Health Demographic Surveillance Site: a qualitative study from Nepal

Abstract

BackgroundPrimary open-angle glaucoma (POAG) is one of the most common causes of irreversible blindness. A possible association between POAG and non-communicable diseases such as hypertension and diabetes suggests that the incidence of POAG may increase. People with POAG in Nepal usually present late to hospital and have poor knowledge of glaucoma.ObjectivesAnticipating a knowledge gap regarding these diseases, this study aimed to explore the knowledge of POAG, hypertension, and diabetes in the community and barriers to health care.DesignWe conducted this qualitative study in the Jhaukhel-Duwakot Health Demographic Surveillance Site (JD-HDSS), a peri-urban community near Kathmandu, a capital city of Nepal. To study how disease influences knowledge, we conducted focus group discussions separately for men and women with and without pre-existing POAG, hypertension, and diabetes. Data were analyzed using the framework analysis approach.ResultsAlthough people suffering from POAG, hypertension, and/or diabetes exhibited adequate knowledge of hypertension and diabetes, they lacked in-depth knowledge of POAG. People believed mostly in internal health locus of control. Perception of disease consequences and impact of disease on daily life was influenced by pre-existing POAG, hypertension, and/or diabetes but only in men. Gender disparity was observed regarding health literacy, health perception, and health barriers, which put women in a more difficult situation to tackle their health. We also revealed a gap between knowledge, attitude, and practice of health among women and healthy men.ConclusionAlthough people in JD-HDSS exhibited adequate knowledge regarding hypertension and diabetes, they lacked in-depth knowledge about POAG. This study demonstrated gender difference in health literacy and access to health care, making women more vulnerable towards disease. We also demonstrated a gap between knowledge, attitude, and practice of health. However, tailored health literacy programs may bring changes in the health status in the community.

Life experiences of patients before having hypertension: a qualitative study

“…Similarly, participants in the qualitative study, participants understood heredity as a factor that must be considered for having high blood pressure ( 19 , 27 , 31 ), which is consistent with results of our study. The difference is that, in our study, participants blamed their families in the transmission of hereditary blood pressure and claimed that negligence of their families caused them to prevent transmission of their high blood pressure; however, in the above studies ( 19 , 27 , 31 ), participants did not blame their families. This finding in our study could be the lack of knowledge and ways of developing the disease and transmission of blood pressure in which basic planning must be done in order to improve awareness.…”

“…In our study, some participants knew the lack of awareness of healthy lifestyles as their own risk factors of hypertension. The results of a qualitative study in Nepal revealed that the cause of neglect and lack of respect for lifestyle by the participants is limited knowledge and unawareness of its potential effects on blood pressure ( 27 ). In another qualitative study, it has been shown that, due to a lack of awareness of hypertension, its risk factors and healthy lifestyle play important roles in developing hypertension in participants ( 19 ).…”

“…In another qualitative study, it has been shown that, due to a lack of awareness of hypertension, its risk factors and healthy lifestyle play important roles in developing hypertension in participants ( 19 ). Accordingly, people who are already aware of the possible consequences of high blood pressure comply more seriously with preventive behaviors ( 27 ). The remarkable thing in our study is that most participants who believed that are aware obtained more information than their elders and families; their awareness from information sources was not scientifically valid.…”

Awareness and knowledge of glaucoma and associated factors among adults: a cross sectional study in Gondar Town, Northwest Ethiopia

“…Glaucoma is a non - communicable, chronic eye disease which needs the principles of long-term care [10]. …”

Importance of giving health education regarding lifestyle modification and perceived barriers: focus group discussion among community health workers of slum of Kolkata, India

“…Similar results were shown in studies done in healthy individuals also opined that good dietary practices reduce the incidence of NCDs. 9,10 Regarding tobacco quitting, everyone stated that health education through camp, awareness programmes on school, colleges and clubs is the most practical way to approach community. Few other studies had shown that behaviour change communication is the way to break the socio-cultural barriers through locally available clubs and camps.…”