Long-term ophthalmic health care in Usher syndrome type I from an ICF perspective.
OBJECTIVE
The aim was to explore ophthalmic health care in female patients with Usher Syndrome type I (USH I) over 20 years and to evaluate the relationship between the ophthalmic health care and the health state of the patients from a health perspective.


METHODS
A retrospective study of records from ophthalmology departments (OD) and low vision clinics (LVC) from 1985 to 2004. Assessment of the reports was performed based on the International Classification of Functioning, Disability and Health (ICF). Findings were analysed by manifest content analysis with ICF as a framework and using four themes: health care system, procedure examinations, patient's functioning and disability and procedure actions.


RESULTS
The records of nine female patients (aged 25-39 years, 1985) with USH I were selected from the national database of USH. A great number of notes were collected (OD 344 and LVC 566). Procedure examinations were exclusively oriented towards body structure and function. All patients showed aggravated visual impairment over and above the hearing and vestibular impairment. Procedure actions were oriented towards environmental factors. No correlation was found between procedures performed and patient's experience of disability.


CONCLUSIONS
The high degree of resource allocation was not correlated to the patients' impairment. The study indicates that the ophthalmic health care was characterised by inefficiency. This conclusion is very serious because patients very likely face severe disability and emotional difficulties. ICF is ought to be incorporated in ophthalmic health care strategy to improve the health care.
Möller
Kerstin
K
Swedish Institute of Disability Research, School of Health and Medical Science, Orebro University, Orebro, Sweden. kerstin.moller@oru.se
Eriksson
Kristina
K
Sadeghi
André M
AM
Möller
Claes
C
Danermark
Berth
B
D000328:Adult; D006233:Persons with Disabilities / Q000145:classification; D005260:Female; D006304:Health Status; D006801:Humans; D009885:Ophthalmology; D010348:Patient Care Team; D011787:Quality of Health Care; D012189:Retrospective Studies; D052245:Usher Syndromes / Q000145:classification / Q000628:therapy*; D015354:Vision, Low / Q000209:etiology / Q000628:therapy; D014792:Visual Acuity