Barriers, motivators and enablers for dispensing multifocal contact lenses in Mumbai, India.

PURPOSE: To understand the potential barriers, motivators and enablers in dispensing multifocal contact lenses (MFCL). METHOD: Two focus group discussions were conducted to design questionnaires regarding the prescribing habits for multifocal contact lenses (MFCL). Questions on potential barriers and motivators were included. The questionnaires were distributed among 133 eye care practitioners across Mumbai, India. Practitioners fitting one or less patient per month with MFCL completed the survey describing potential barriers, while those who prescribed more MFCL's per month completed the survey describing enablers and motivators. RESULTS: Responses from 102 practitioners were received. Most common potential barriers in prescribing MFCL were increased chair time (75%), lack of readily available trials (69%) and limitation in power range (63%). Lack of awareness among patients (90%) was the most common barrier from patients' outlook. Professional satisfaction (88%) and better business proposition (82%) were observed as main motivators while availability of the trials (84%) and correct patient selection (82%) were the major enablers. Graduate Optometrists felt dispensing MFCL did not offer a good business proposition (p=0.02). Experienced practitioners were observed to be least motivated (p=0.01) and believed that their patients found these lenses expensive (p=0.02). CONCLUSION: To enhance the MFCL practice, barriers like lack of awareness and limitations in power range must be addressed. Trial lens availability may motivate practitioners to prescribe MFCL. Further probing is required to understand lack of motivation among experienced practitioners.

Cambio terapéutico en el tratamiento de los trastornos alimentarios: Contenidos, factores facilitadores y obstaculizadores / Therapeutic change in the treatment of eating disorders: Contents, facilitating and hindering factors

Objetivo: Identificar factores facilitadores y obstaculizadores del cambio terapéutico en el tratamiento de pacientes con trastornos alimentarios (TA). Método: Estudio cualitativo-exploratorio, basado en la Grounded Theory. Se realizó un muestreo intencionado y entrevistas en profundidad a una muestra conformada en Chile por 20 pacientes de sexo femenino y 8 terapeutas y en Argentina por 4 pacientes y 6 terapeutas. Resultados: El cambio se presenta como punto de inflexión, en tanto las pacientes describen un momento en que logran reconocer la necesidad de cambiar. Posteriormente son capaces de verbalizar los contenidos de éste a diferentes niveles y en relación al TA. Conclusiones: Al conjugar aspectos facilitadores y obstaculizadores, y en la medida que los primeros sean preponderantes, irán surgiendo cambios que podrían articularse como componentes de la identidad.

Aim: To identify facilitating and hindering factors in the therapeutic change within the treatment of ED patients. Method: Qualitative-exploratory research, based on Grounded Theory. Purposive sampling and in-depth interviews were carried out in a sample of 20 patients and 8 therapists in Chile and 4 patients and 6 therapists in Argentina. Results: Therapeutic change occurred as a turning point in patients, which they described as a moment when they recognized the need for change. Subsequently, they were able to articulate the change as they experienced it in different areas of functioning. Conclusions: When combining facilitating and hindering aspects and the former overcome the latest, there will be changes that ultimately may be articulated in components of personal identity.