Effects of Discharge Education and Telephone Follow-up on Cataract Patients' Activities According to the Model of Living.

PURPOSE: Assess the impact of planned discharge education and telephone follow-up of patients who underwent cataract surgery on daily living activities. DESIGN: A controlled comparative study. METHODS: This study was carried out on patients who underwent cataract surgery (intervention group = 72, control group = 72). Discharge education designed according to the Model of Living was used in the intervention group. Phone follow up was performed for both groups after surgery and activities were assessed. FINDINGS: Significant differences were found between the two groups in applying eye drops, knowledge on using old eye glasses and protecting the operated eye, conditions requiring a physician call, conditions that may deteriorate the operated eye, personal hygiene, mobilization, and sleeping (P < .05). CONCLUSIONS: Using a Model of Living in discharge education of cataract patients and following up using a structured checklist was an effective intervention. This model can be efficiently used in postoperative education of day surgery patients.

[Comprehensive Assessment and Treatment of Cataracts].

Cataract is a global disease that may cause blindness. Due to the slow pace of disease progression, patients often presume incorrectly that their blurred vision is caused by excessive fatigue or lack of sleep. In addition to their role in causing blindness, cataracts that are diagnosed late into their progression are more difficult to treat with corrective surgery. Furthermore, many older individuals believe incorrectly that declines in vision are part of the natural course of aging and accept these declines as inevitable. Reduced vision has a significant and negative effect on quality of life. Although aging is one of the main causes of cataracts, other major factors include common chronic diseases and the side effects of drugs. In addition, lifestyle factors such as diet, activity, and environmental exposure to ultraviolet rays and radiation are factors in cataract development. Surgery is the only treatment for cataracts currently available. Healthcare professionals not only consider a patient's background but also whether surgery may promote quality of life. While preoperative evaluation requires a holistic and comprehensive approach, postoperative care is also important to the overall success of cataract surgery. For example, instructions in topical-drop application, wound assessment, and symptoms of comorbidities are crucial for patients. Therefore, a critical literature review was used in this article to establish a strategy for the holistic evaluation of and perioperative nursing care and prevention strategies for cataracts. In addition, recommendations for the comprehensive assessment of and nursing care for patients with cataracts are provided to healthcare professionals article in hopes of improving the quality of care provided to patients with cataracts.

Nurses' role in early detection of cataracts.

Cataracts are a common problem but can have a significant negative impact on an person's functional abilities and emotional wellbeing. This article shows how age-related cataracts develop and clarifies which symptoms to look out for when conducting holistic patient assessments. Many symptoms go unnoticed for years but early detection could help patients learn to manage gradual loss of vision, thereby maintaining a good quality of life for as long as possible.

Diabetes and cataract surgery: preoperative risk factors and positive nursing interventions.

PURPOSE: In the United States, approximately three million cataract surgeries are performed annually. Although cataract surgery has been demonstrated to improve vision in up to 95% of patients, those with diabetes may be at increased risk of complications and poor visual outcomes. Preoperative risk factors such as age, retinal diseases, hypoglycemic medications, and hemoglobin A1C (Hgb A1C) levels may play a role in patient outcomes following cataract surgery. Furthermore, intraoperative risk factors such as the use of pupillary expanders, trypan blue staining, and additional procedures such as anterior vitrectomy may also be considered as a challenge for diabetic patients. This article will describe preoperative risk factors associated with visual outcomes for diabetic patients undergoing cataract surgery and appropriate nursing interventions for these patients. METHODS: Literature review of risk factors and cataract surgery outcomes in terms of complications, visual acuity, and visual functioning of diabetic patients was undertaken. Preoperative risk factors (i.e., age, retinal diseases, advanced macular disease [AMD], hypoglycemic medications, and Hgb A1C levels) and postoperative complications, including inflammation and cystoid macular edema (CME), were also examined. To emphasize evidence of best practices, the role of the nurse as educator and advocate was further explored in terms of their impact on diabetes management of the patient to improve visual results. RESULTS: Diabetic patients of advanced age, with a history of diabetic retinopathy who are taking insulin and have elevated Hgb A1C levels, may have an increased risk of intraoperative and postoperative complications and decreased postoperative visual acuity and visual functions that may affect their quality of life. CONCLUSIONS: High-risk factors should be identified in diabetic patients when developing a perioperative patient education plan to help reduce their risk of cataract complications and improve their visual outcomes.

Managing depression in older people with visual impairment.

The author describes the management of depression in older people with visual impairment. The concept of depression is defined, and the main classifications are outlined. The signs and symptoms of depression are presented and approaches to treatment are discussed. The role of the nurse in managing depression in older people with sight loss is discussed.

Supporting patients undergoing cataract extraction surgery.

A cataract is an opacification, or clouding, of the lens of the eye, causing a deterioration in the clarity and brightness of vision, which may reduce quality of life. Surgical removal and artificial replacement of the opacified lens is the only treatment option available. This article discusses the patient's experience of treatment and highlights the role of the nurse in pre and post-operative care. A review of the anatomy of the eye is included and, as nurses have a vital role in supporting patients undergoing surgery, the cataract extraction operation and its potential risks and complications are described briefly.

The effect of nursing intervention on preoperative cataract.

This retrospective study investigated the effect of nursing intervention (NIV) in Chinese patients under preoperative cataract (PC). A total of 70 eligible patients with PC were included. Thirty-five patients in an intervention group received regular clinical treatment and NIV before the surgery, while the other 35 patients received regular clinical treatment only. The NIV was applied 4 sessions, 1 week before the surgery. The primary outcome of satisfaction was measured by 11-points visual analog scale. The secondary outcomes were measured by the functional impairment caused by cataract (the VF-14), cooperativeness during the surgery period, and sleep quality. All the outcome measurements were assessed before and after the surgery. After NIV, patients in the intervention group exerted better outcomes in decreasing anxiety (P < .01), increasing current experience with satisfaction (P < .01), and enhancing the cooperativeness during the surgery period (P < .01), compared to those outcomes in the control group. The results of this study showed that NIV may help increase satisfaction in experience and cooperation, and decrease anxiety in Chinese patients with PC.

Visual impairment in children.

This article examines the paediatric ophthalmic nurse's role in treating and managing several common ocular conditions.

[Continuing Nursing Care of Patients with Senile and Diabetic Cataract].

PURPOSE: To explore the treatment and continuing nursing of patients diagnosed with senile and diabetic cataract. METHODS: In total, 142 patients diagnosed with senile and diabetic cataract admitted to Zhongshan Ophthalmic Center from January to December 2014 were randomly assigned into groups A and B. In group A, patients received conventional instruction after discharge, and those in group B additionally received continuing nursing care after discharge including ocular nursing, use of anti-diabetic drugs, psychological nursing, diet nursing, self-monitoring guidance, re-examination and regular follow-up according to the patients' conditions. RESULTS: After one year of continuing nursing care, visual acuity of patients in group B was increased without complications. Body mass index, the fasting and 2h postprandial plasma glucose, and the systolic and diastolic blood pressure were decreased significantly compared with those in group A (all P < 0.05). CONCLUSION: Continuing nursing care, including knowledge education related to ocular use and diabetes mellitus, targeted psychological nursing, medication nursing and daily life guidance, play a pivotal role in enhancing the compliance rate of the patients, reducing the influence upon work and life and enhancing the quality of life to varying extent.

Glaucoma and cataracts: a nurse-patient simulation for nursing students.

Although no formal data collection was done with the students or instructors, attitudes and opinions were solicited. Students, in general, felt positive toward the experience. The student nurses indicated that they had gained a better understanding of the problems faced by the patient with a visual disorder by actually experiencing a temporary loss of vision. The role-playing situations contributed to the student nurses' understanding of how difficult even the simplest task could become. Additionally, the emotional aspects of a vision loss were graphically highlighted. The students also felt that the experience of practicing nursing interventions with another student nurse role-playing the patient with a vision loss would help them in the clinical setting in the future. Their first real experience with a patient of this type would be somewhat easier than if they had not gone through the simulation. The nursing instructors also felt highly positive toward the role-playing simulation. Their students would probably be better able to work with this type of patient, when the first experience occurred. They agreed with the students' attitudes and planned on including the role-playing simulation in the required curriculum for future classes. Interestingly, other nursing instructors not involved in the development of the simulation, but made aware of it through casual discussion among instructors, have indicated interest in incorporating the activity into their curriculum. The simulation described could be easily replicated by other nursing instructors. Basic cost of the materials required is quite low. The role-playing cards can be developed to include activities that student nurses can accomplish in any particular environment.(ABSTRACT TRUNCATED AT 250 WORDS)

Knowledge deficit in the ophthalmic surgical patient.

This case history illustrates some important aspects of the informational needs of ophthalmic surgery patients. As is true with many ophthalmic patients, this patient had a relatively high level of anxiety regarding his potential loss of vision postoperatively. This concern is magnified in a monocular patient. The nurse must help these patients put this concern in the proper perspective by providing accurate information. The nurse who performs such extensive preoperative teaching takes on a role that entails a great deal of responsibility. A planned program of information with written objectives and an outline of the important information to include will help the nurse provide a high level of care in meeting the knowledge needs of the patient. It is not necessary, or even desirable, to develop a plan for each individual patient. A written outline of important and necessary information for each type of ophthalmic surgical procedure provides a means of assuring that the teaching plan is complete and accurate. The information in the teaching plan should be validated by other physician and nurse colleagues. A written plan can save time once it is developed, because the nurse can follow the standard plan, modifying the presentation to meet each patient's specific needs as necessary. The patient indicated feeling somewhat overwhelmed with information when faced with his ophthalmic surgery. It is very important to ensure that the patient and appropriate significant others get both verbal and written information in these situations. The written information gives the patient and his or her family a reference to use when they return home and begin to assimilate more of the information given to them by the nurse. The patient in this case history and his wife both referred to the written instructions several times before and after the operation to verify certain information. The written materials presented information at an appropriate reading level and had large well-spaced print. Repetition (whether verbal or in written format) is important because it reinforces important aspects of the necessary information. The nurse at the surgical facility repeated the postoperative requirements to the patient and his wife before they left the center and made sure that they had the written instructions as well. The nurse demonstrated the necessary motor skills and gave the patient and his wife the opportunity to return the demonstration.

Nursing care of the cataract patient: today's outpatient approach.

Total cataract patient care encompasses nursing assessment, clinical management, emotional support, and the accessibility of the nurse to the patient. Because ophthalmic nurses develop a close relationship with the cataract patient, they are often the first health care professional the patient calls for advice. Patient education and adequate time to listen and respond are integral components in an outpatient cataract surgical approach. All aspects of the nursing care of the cataract patient provide challenge and satisfaction as the ophthalmic registered nurse experiences surgery with the patient and supervises the return to improved vision and quality of life. The nurse must always remember that there is a whole person attached to the eye. Although ophthalmic nursing is specialized and highly technical, patience, empathy, and encouragement are essential in the care of the patient before, during, and after cataract surgery.

Topical anesthesia--a new approach to cataract surgery.

Patients undergoing cataract surgery with the use of topical anesthesia experience less pain, can return home faster, and avoid the need for an eye patch, which can cause depth perception problems. Patient education performed by the perioperative nurse significantly affects patients' experience and recovery. This article discusses the history of cataract surgery, etiology of cataract formation, and traditional anesthetic choices. The patient selection process relative to topical anesthesia is defined, and the patient's experience throughout the perioperative phases of cataract extraction is described.

An enhanced role for the ophthalmic nurse. A control study on day case cataract surgery.

Day case surgery offers a safe and cost-effective alternative to inpatient care. As well as proving popular with patients who can receive aftercare in the familiar environment of their own home, it also re-employs the skills of the ophthalmic nurse which, in the past, have often been underutilized.

Cataract: the role of nurses in diagnosis, surgery and aftercare.

Cataract is a condition that affects many older people and causes reduced vision, contributing to a reduced quality of life. The whole cataract 'episode', from recognition to surgery and aftercare is described, together with the role that nurses play in the care of patients with cataract.

The nurse's role in helping patients cope with sight loss.

Patients with sight loss often have additional nursing and care needs. Nursing staff should be familiar with the common causes of sight loss and their treatment. To help patients come to terms with the distress of losing their eyesight, nursing staff should be aware of the implications of sight loss for patients and, where appropriate, refer them to the relevant support worker, such as an eye clinic liaison officer.