Anxiety and the optometric patient

Doctoral thesis English OPEN
Court, Helen Jane
  • Subject: RE

Although patient anxiety is known to be a problematic feature within many areas of healthcare, the subject has been largely neglected within optometry. Therefore, this thesis addresses the issue of patient anxiety within optometric practice. The initial study reported in Chapter 3 is a comparative study of patient anxiety. Results show that there is a distribution of anxiety levels within optometric practice which overlap with dental and general medical practice. A significant association between patient anxiety with patient satisfaction (rs=-0.19 p<0.001) and compliance (rs=-0.19 p<0.001) is reported. Furthermore, an ordinal regression analysis identifies the predictors of patient anxiety as trait anxiety, expectancy of bad news and non-spectacle wear. The development of a new 10-item questionnaire to identify anxious patients in optometric practice is reported in Chapter 4 (the OPAS). A 4- item contact lens anxiety subscale is also described. The most anxiety-provoking parts of a contact lens fitting examination are reported in Chapter 5, in a study which measured patient anxiety with both questionnaires and physiological methods (skin conductance and pulse rate). Heightened anxiety was identified during periods of communicative interaction and contact lens insertion and removal. The ability of interventions to reduce anxiety is the focus of the final study reported in Chapter 6. There was no significant reduction in OPAS scores between patients who received an information leaflet, listened to music or received neither intervention prior to their eye examination. However, there was a significant association between OPAS scores and post-examination patient satisfaction (rs = -0.32 p<0.001) and compliance (rs = -0.47 p<0.001). The results from these studies increase our understanding about the presence, causes and effects of patient anxiety within optometric practice. This thesis shows, for the first time, that heightened patient anxiety is associated with decreased satisfaction, compliance and is likely to be a contributing factor in determining healthcare outcomes.
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