An Interventional Study to assess the effectiveness of a Nurse Led Intervention on adherence of treatment and quality of life among patients having Glaucoma attending Glaucoma Clinic, AEC, PGIMER, Chandigarh, 2020-22

Glaucoma is a chronic, progressive and most often asymptomatic disease.It is the second most leading cause of irreversible blindness worldwide as perWorld Health Organisation. It is the leading cause of preventable blindness. Glaucomais often called the ‘silent thief of sight’ as patients do not experience thesymptoms until it reaches the late stage. In India, Glaucoma is the leadingcause of treatable non reversible blindness [1]. An estimated 60.5 millionpeople suffered from Glaucoma in 2010 and by 2020 this will reach 79.6 million. Prevalence of Glaucoma is increasing at a rapidspeed so it is very important to keep a check on it so as to avoid blindness inlater stage as its one of the major complication. To avoid this furtherdeterioration and complication in disease condition, Medication Adherence andregular follow-up plays an important role. Due to lack of time and busy schedule andinadequate knowledge, the routine medication  management and regular follow- up required forGlaucoma is fully underestimated which leads to poor prognosis and onset ofirreversible complications. It is noticed that due to one or more abovereasons most of the people does not follow the proper medication schedule aswell as does not show up for routine follow-up. Due to easy availability and direct contact withpatient at all health care delivery system, nurses are the HCP which arethought to fit in place for educating and promoting awareness among people regardingGlaucoma through various Nurse-led Interventions. Therefore, Nurse Led Intervention andproper communication will lead to increase in medication- adherence amongpatients diagnosed with Glaucoma. Further increase in medication adherence,also improves the Quality of Life of these people. This study will also help us to statethe need and benefits of monitoring Intra-Ocular Pressure, its complicationsand correct way of eye drop installation as well as digital IOPself-monitoring. Keeping all the above factors in mind present study is plannedto access the effectiveness of Nurse-Led Intervention Programme for patientsdiagnosed with Glaucoma. 

RESEARCHSTATEMENT:

ARandomized Control Trial to assess the effectiveness of a ‘Nurse LedIntervention’ on adherence of treatment and quality of life among patientshaving Glaucoma attending Glaucoma clinic, AEC, PGIMER, Chandigarh, 2020-22

OBJECTIVES:

•       To develop and implement protocolof a ‘Nurse- led Intervention’ Programme on adherence of treatment amongpatients having Glaucoma attending Glaucoma clinic, AEC, PGIMER, Chandigarh

•       To assess the effectiveness of a‘Nurse- led Intervention’ Programme on adherence of treatment and quality oflife among patients having Glaucoma attending Glaucoma clinic, AEC, PGIMER,Chandigarh

NULLHYPOTHESES (Ho):

Therewill be no significant effect of Nurse- Led Intervention on treatment adherenceamong patients having Glaucoma at 0.05 level of significance.

Therewill be no significant effect of Nurse- Led Intervention on Quality of lifeamong patients having Glaucoma at 0.05 level of significance.

Therewill be no significant effect of Nurse- Led Intervention on Prevention ofcomplication among patients having Glaucoma at 0.05 level of significance.

ALTERNATEHYPOTHESES (H1):

Therewill be significant effect of Nurse- Led Intervention on improving treatmentadherence among patients having Glaucoma at 0.05 level of significance.

Therewill be significant effect of Nurse- Led Intervention on improving Quality oflife among patients having Glaucoma at 0.05 level of significance.

Therewill be significant effect of Nurse- Led Intervention on enhancing Complicationprevention among patients having Glaucoma at 0.05 level of significance. 

Quantitative approach will be used to conduct this study using Experimental two Group Pre-test Post-test research design on Glaucoma patients of sample size 200. Interventional protocol includes the Nurse-led intervention Programme details which will be conductedduring the study in the Interventional phase. It will contain all theinformation regarding Glaucoma which will be given to patients and planning ofhow these procedures will be conducted. Protocol will be prepared in the formof booklet ‘Know about Glaucoma’ and flash book.  

1)    BOOKLET and FLASH BOOK ‘KNOW ABOUT GLAUCOMA’: Thisbooklet and flash book will be developed by the researcher which will serve asready reference for the subjects. It will include detailed information regarding Glaucoma, its causes,risk factors, sign and symptoms associated with Glaucoma, its management,importance and its advantages of treatment adherence and preventive causeswhich should be taken to reduce the risk factors of further deterioration indisease condition. It will also contain protocol to perform different eye exercises, IOPmonitoring and Eye drop instillation which will be practiced by the patientsdaily as these exercises will help in maintain the Intra-Ocular Pressure.

2)    DIARY MAINTAINENCE: Patientwill be asked to maintain a daily dairy to note down the timings when they aretaking medications and how many times they forget to take medications. Theywill also be asked to note how many times they are doing exercises in a day andhow many times they are checking their IOP in a week.  This dairy will be used for data analysis onfollow-up regarding medication adherence and performing eye exercises on dailybasis.