Table 5.
Comparison of patients’ and practitioners’ perspectives on the treatment experience
Main theme | Subtheme(s) | Illustrative quotations | Comment | |
Patients (PA) | Practitioners (HP) | |||
Fear of losing eyesight and apprehension on patient adherence to treatment | Fear of the ‘unknown’ and the feeling of suspicion | ‘I mean the fact that I would just have to have a needle in my eyeball is not very good.’ (PA02) | ‘Normally patient says it’s the thought of it you know… they just feel lining something in their eye. They are startle.’ (HP4) | Agreement |
Coping mechanisms to manage apprehension | ‘I'm now going to give you the injection [they say] …they prepare you for it.’ (PA14) ‘They always do it. When you're in a chair, you don't know where to put your hands really. And she would always hold your hand.’ (PA09) |
‘I explain step by step, so they're involved. Most patients, I realise, they like that.’ (HP5) ‘If there is someone who is particularly anxious the healthcare assistant would always make sure they hold their hand, so they got some sort of comfort there.’ (HP1) |
Agreement | |
In adherence to treatment | ‘So relieved to find you could have some treatment that you didn't really mind. It was better than nothing.’ (PA12) ‘Well one of my consultants. And he was very reassuring. And I put my confidence and trust in him.’ (PA05) |
‘…talking to the patients in a nice way, in a gentle way, sometimes you can convince them of the benefits of an injection.’ (HP6) | Agreement | |
Variability of pain perception during injection | Intravitreal injection: expecting versus experiencing | ‘…there’s a sting and a pressure. And that’s the same…that’s the only way they can get it in you know.’ (PA06) ‘…they say, it’s a common practice, you don't experience any pain, but you do. It’s not pleasant.’ (PA07) |
‘There is a lot of anaesthetic used…you should not feel anything from that side of things… What they should really feel is a pressure…’ (HP1) ‘…you can reassure them that this is not going to be painful.’ (HP6) |
Dissonance |
Impact of quality of care delivery on patient experience | ‘She said, I like to wait.’ (PA06) | ‘The time is not a bad thing because you need time for the anaesthetic to work better and for your iodine to clean the eye better. Sometimes working too quickly is not a good idea.’ (HP6) | Agreement | |
‘And she always gets hold of your hand just to reassure you, so she can feel the tension that’s going in there.’ (PA08) ‘…she will lift the corner up [of the drape] and just so I can get fresh air, which is fine.’ (PA08) |
‘If there is someone who is particularly anxious the HCA [healthcare assistant] holds their hand, so there that they have got some sort of comfort there.’ (HP1) ‘If they've got breathing problems…I would probably get my colleague to sort of hold up the corner [of the drape]…so their face is not so covered.’ (HP2) |
Agreement | ||
Post-injection experience and impact on patient recovery | Instructions and provision of patient information leaflets | ‘And before I left the hospital I went to my consultant and told him and he said, don't worry. Blurriness will clear very quickly. And it did.’ (PA05) ‘And I mustn't rub it, you know.’ (PA14) ‘It’s antibiotics. And you have to take them 4 times a day, 16 altogether. And they say you can carry on. Sometimes I do it for 5 days.’ (PA03) |
‘It gives a bit of a blur initially…you have to explain these things to them. If they're not being informed about it, they ring because they're worried about it.’ (HP6) ‘Give them careful instructions not to rub the eye.’ (HP6) ‘And if your eye is dry or gritty, you can use more of that [Chloramphenicol], it won't harm. It just eases the eye, like you know, the grittiness and the dryness of the eye.’ (HP5) |
Agreement |
Home remedies for ocular pain | ‘They just say to take paracetamol if you do [feel pain].’ (PA06) ‘I get a like a compress with hot water to hold of my eye.’ (PA14) |
‘If they felt that they would have any discomfort, I would always advise them to take some paracetamol if they wanted to.’ (HP3) ‘I think most of them will kind of go to bed with a cold compress on their eye afterwards. That is what they generally report.’ (HP1) |
Agreement |