STATEMENT OF THE PROBLEM

A research critique on lived-in experience of patients subjected to cataract surgery at SRH

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OBJECTIVE Elicit the lived-in experiences of patients before cataract surgery Explore the lived-in experiences of patients after cataract surgery PURPOSE Develop appropriate nursing strategies for the pre-operative and post operative needs and problems of the cataract patients

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ASSUMPTION 1. The essential truth about reality can be identified by eliciting the patients lived-in experience 2. The perception of the phenomenon varies with each individual CONCEPTUAL FRAME WORK Conceptual frame work for the study was derived from Peplau's interpersonal relation model

METHODOLOGY
RESEARCH DESIGN: The research design adapted for the study was Qualitative design with phenomenological approach SETTING OF THE STUDY: The study was conducted in Sri Ramachandra Hospital, Porur, Chennai.

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POPULATION: Patients who had been admitted for cataract extraction in SRH SAMPLING TECHNIQUE & SAMPLE SIZE: A convenient sample of 30 patients admitted for cataract surgery were taken as samples

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SAMPLING CRITERIA:
1.Inclusion criteria: Both the male & female patients with in the age group of 40-70 years subjected for cataract surgery Patients who speak & understand Tamil Patients who were admitted on the previous day of surgery & staying in the hospital on 1st postoperative day Patients who were conscious & oriented

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2.Exclution criteria:
Patients who were not willing to participate Patients who did not speak and understand Tamil Patients who had hearing problem Patients who were subjected to day care cataract surgery

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DESCRIPTION OF THE INSTRUMENT:
Section A: The demographic variables used in the study were age, sex, religion, education, occupation, monthly income of the family, marital status, type of family, locality & duration of cataract. Section B: An interview schedule was used to explore the lived in experience of patients subjected to cataract surgery by using open-ended question

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DATA COLLECTION: An unstructured interview schedule was used to explore the lived-in experience of cataract patients. The interview was recorded in tape recorder.

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DATA ANALYSIS: The collected data were analyzed by using modified Colaizzis analysis. Modified Colaizzi analysis framework All interviews were transcribed into verbatim and read in order to get an understanding of the verbatim Significant statement and phrases pertaining to the experience of patients under investigation were extracted Meanings were formulated from these significant statements Significant statement were organized into clusters of themes The themes were used to provide a full description of the experiences

RESULTS
Lived-in experiences of patients subjected to cataract surgery were organized into the clusters of themes and subthemes were extracted from themes

THEMES
Physical dimension
Psychological dimension
Economical dimension Educational dimension Social dimension Vocational dimension Spiritual dimension

Satisfaction of care

Physical dimension
Preoperative period
100% of patients were experienced diminished vision 73%of patients were experienced glaring of eyes 43% of patients were experienced sleep disturbance 40% of patients were expressed there difficult in ADL 20% of patients were experienced giddiness

Postoperative period

93% of patients were having pain in operated eye 27% of patients were experienced giddiness immediately after surgery 60% of patients had inadequate sleep because of pain

Psychological dimension
Preoperative period
60% of patients experienced anxiety about surgery 30% of patients had loss of control over their family members 27% of patients experienced fear about future & there family position 23% of patients were depressed due to there condition & about economical burden 17% of patients were felt guilty for their previous actives

Postoperative period
100% of patients expressed their happiness as they are going to get the vision 67% of patients had fear about the outcome of surgery

Economical dimension
Preoperative period
80% of patients stated that they had economical burden 67% of patients stated that their surgery delay was due to economical burden

Postoperative period
67% of patients were more eager to improve the economical status

Educational dimension
13% of patients had some knowledge about condition 20% of patients had some knowledge about home care measures

Social dimension
Preoperative period
33% of patients were experienced inability to meet others 93% of patients had family support 7% of patients got social support from an orphanage

vocational dimension
Preoperative period
50% of patients were not able to do the work properly because of diminished vision 20% of patients were lost their job due to poor vision 30% of patients were not going for job because of visual problem

Postoperative period
66% of patients were planning to go back to same job 7% of patients were planning to change the job 27% of patients were planning not to go for job

Spiritual dimension
Preoperative period
97% of patients believes god & stated he is the creator of everything 27% of patients expressed their anger towards god 27% of patents were blaming god for given this problem 97% of patients were stated that they are praying god to get back the better vision

Postoperative period
97% of patients said that they are very much thankful to god

Satisfaction of care
80% of patients were much satisfied for the care given by the hospital members 20% of patients expressed that they are not satisfied with the care

CONCLUSION
The study identified that cataract has more influence on the patients quality of life. Due to cataract, the patients physical , psychological, economical, educational, social, spiritual, and vocational aspect has got affected. Nurses & health care professionals need to intensify their involvement in implementing the care to enhance the supportive environment and to reduce the sufferings of cataract patents before and after surgery.