Effectiveness of An Instructional Program on Adult Cataract Patients ' Knowledge Concerning Prevent Post-Operative Complications At Ibn AL-Haitham Teaching Eye Hospital In Baghdad City

Background: Postoperative complications of cataract are a major health problem because these complications are difficult to heal and lead to permanent vision lost and affect the quality of life which makes the patient dependent on others . Objectives : The study aims to determine the effect of an instructional program on the patients' knowledge to prevent postoperative complications of cataract between patients socio-demographic characteristics of gender , age , educational level , social status , occupation , monthly income , type of residence and residential area and their knowledge related cataract disease. Methodology: a descriptive study has been carried out in Ibn AL-Haitham Teaching Eye Hospital , from December 15 th , 2016 February 20 th , 2017 . A purposive (non-probability) sample of (100) patients suffering from cataract disease are selected . The sample is divided into two groups : 50 patients for the control group and 50 patients for the case study group. Results: the results of the cataract disease and the prevention of post-operative complications show the differences between the patients knowledge about prevention in pretest and their knowledge in posttest periods and a response for case group after the application of the program Conclusion : the researcher concludes that the case group of cataract patients have benefited from the implementation of the instructional program , and their knowledge is effectively enhanced and established , also he has considered that the instructional program van is as an effective mean for improving the cataract patients knowledge . Recommendations: The researcher recommends the importance of increasing awareness among patients about the cataract and the complications of cataract surgery handbooks, explanatory posters, and performing an educational health programs through modern technological means (audio-visual) to follow their health after cataract surgery at home and at work. Keyword: instructional, knowledge, complications, prevention -------------------------------------------------------------------------------------------------------------------------------------Date of Submission: 24-08-2017 Date of acceptance: 17-09-2017 -------------------------------------------------------------------------------------------------------------------------------------I . Introduction A cataract is a clouding or a discoloration of the crystalline lens of the eye which leads to a reduce in vision (1). Cataract is the leading cause of blindness , affecting an estimated 20 million people , because people growth and increased longevity. This is expected to increase to 50 million by the year 2020 if no additional Interventions are Implemented(2). Cataract Blindness is defined by (W.H.O) as having best corrected visual acuity (BCVA) in the better eye worse than 3/60 or (20/400) (3) . It can affect one or both eye , gradually progressing. (4) According to world Health Organization (WHO) Cataract is the leading cause of blindness and visual impairment throughout the world. (5) The prevalence of cataract increases with age , the world's population aging is related to increasing incidence of Cataract induced visual dysfunction and blindness . (6) So it is now a global problem . It is estimated that more than 82.8% of all blindness occurring in individuals aged 50 and older is related to cataract (7) . Cystoids Macular Edema (CME), Iris prolapse , corneal edema , wound leak or rupture , IOL dislocation , Endophthalmitis , Retinal tear , or detachment , persistent iritic , striate keratopathy, hyphema, macular edema and increase (IOP) . In early stages , corneal edema after cataract surgery can be treated by the use of topical hyper osmotic agents , topical corticosteroids ,when decrease visual acuity , recurrent infections keratitis , and symptoms of pain are possible indications for (penetrating or endothial keratoplasty ). Elevated Intraocular Pressure following cataract surgery . depend on the cause if due to Effectiveness of An Instructional Program on Adult Cataract Patients' Knowledge. DOI: 10.9790/1959-0605027984 www.iosrjournals. org 80 | Page endophthalmitis must be treated by antibiotic and use Timolol drops with diamox tablet is given to slow the production of aqueous fluid , and use Mannitole solution to decrease aqueous fluid production is lead to decrease and maintain IOP normal ( normal rang IOP 11-21 mm.Hg) ,If capsular rupture occurs during phaco emulsification and ECCE ,nuclear material may enter the posterior segment . The high fluid flow state in the anterior chamber increases this risk . A small rupture in the posterior capsule during emulsification of the nucleus can be managed by alteration of the surgical technique ,vitreous prolapse through the pupil , resulting from rupture of the anterior vitreous body during surgery , Treatment vitreous prolaps by anterior vitrectomy ,decentration and dislocation the lens one complications of cataract surgery. Decentration can produce unwanted glare and reflecations or multiple image if the edge of the lens is within the papillary margin (space . The surgeon should attempt to rotate the IOL to apposition where clinical evidence shows sufficient capsule and zonular fibers to support the implant , hyphema in the immediate postoperative period usually originate in the incision or the iris . Treat by washing of anterior chamber .retinal detachment occurs intraoperative or within 6 months of cataract surgery following posterior capsulatomy treat by re attachment of retina by surgeon , The acute post-operative endophthalmitis is a sight treating emergency needs rapid assessment and management . Onset is usually 1-7 days after surgery . The most common microorganisms are staphylococcus epidermis , staphylococcus aurous and streptococcus species diagnosis performance AC tap and vitreous biopsy. Posterior capsular opacification is the late complications of cataract surgery these treated by Nd , YAG laser capsullotomy . II .Methodology The Design of the Study : A quasi-experimental study. The Sample of the Study: Total number of (100) patients have cataract disease undergo at Ibn AL-Haitham Teaching Eye Hospital in Baghdad City . In order to attain precise data and illustrative sample , none probability (purposive) sample is carefully chosen which consists of (100) patients ; (50) patients are assigned for case group and (50) are assigned for control group . The Setting of the Study: To obtain a valid and comprehensive data , the study is conducted in the word department and outpatient department in Ibn Al-H Haitham Teaching Eye Hospital in Baghdad City) . The Instrument. : The questionnaire consisted of (3) parts Part I : The Patients' Socio-demographic Characteristics : This part consists of (8) items which includes : age , gender , occupation , level of education , monthly income , social status , type of resident and residential area . Part II : The Patients' Clinical Characteristics : This part consists of (7) items which includes : presence of chronic disease , type chronic disease smoking , years of smoking , family history for cataract disease , having a pervious surgery for cataract , time of admission to the hospital due to the complications of cataract disease . Part III : The Patients' Knowledge Concerning Cataract The Validity of the Questionnaire and Program : The content validity of the instrument is established through a panel of (13) experts (Appendixes D) they are : (7) Faculty members from College of Nursing / University of Baghdad . (6) Faculty member from Ibn AL-Haitham Teaching Eye Hospital . The Reliability of the knowledge Test Test – retest reliability is determined through a complication of Pearson Correlations for the scales . knowledge coefficients for the (5) Parts of anatomy scale : (r = 0.97) for the part of causes and risk factors ; (r= 0.98) for the part of signs and symptoms; (r= 0.89) for the part of complications ; (r= 0.98) part of prevision methods ; (r= 0.98) The Statistical Analysis :The analysis of the data was used through descriptive statistics(Frequencies , Percentage, Mean, Standard Deviation)and statistical Inferential (T-test)in order to find the differences between the case group and control group. III. Results The table(1) the socio-demographic Characteristics for case and control groups of Study Samples (No.=50) Variables classification Case group Control group