Table 1.
Summary of the Focus Group Findings Indicating Knowledge Deficits or Erroneous Attitudes (n = 36 Participants)
| Themes | Sample Quotes | Focus Group (Gender of Participant) |
|---|---|---|
| Knowledge | ||
| Lack of understanding of what diabetic retinopathy is/how diabetes affects the eye | “I think is the nerve … they find out the blood flow is not so good, they asked to go check the heart doctor, could be probably one of the nerve is clot so the blood system is not constantly supplying to the eye.” | FG1 (M) |
| “I don't know how blood sugar will affect my eye. All I know is when the doctor tells me. … Even the doctor might not know, they are just guessing” | FG1 (M) | |
| Lack of understanding of what causes diabetic retinopathy/misinformation about causes | “According to the doctor, it is because the diabetes is not controlled so causes the pressure to increase. That is why the thing bleeds.” | FG1 (M) |
| “Maybe because of the computer radiation or whatsoever. I talked to the doctor, the doctor says ‘no … nonsense.’ They say this is caused by your diabetes so I say okay, whatever … but it could be caused by that (computer).” | FG2 (M) | |
| “Partly due to age. … I'd like to assume it is because of old age it deteriorates not because of diabetic.” | FG3 (M) | |
| Lack of understanding of how to stop DR progressing/misinformation about how to stop progression | “Don't see computer so often.” | FG3 (F) |
| “Some people advise to take wolfberries.” | FG3 (F) | |
| Unclear about the HbA1c test | “I heard but I don't know what is that.” | FG1 (M) |
| “Is it the fasting blood test?” | FG1 (M) | |
| “They don't elaborate what is this test about. Everything they will say ‘this’ and your reading is ‘this,’ that's all.” | FG2 (M) | |
| [long pause] “Is that a medicine?” | FG4 (F) | |
| Unclear what the purpose of injections for diabetic macular edema is or how many times they are needed | “Worse come to worse, if doctor finds that there is no clot (in the heart, which will affect the oxygen supply to the eyes) then he will give me this oxygen injection, they just put some oxygen to brighten it. … I don't know what is it, I did not really ask him.” | FG1 (M) |
| Unclear what the purpose of laser is or how many times needed | “The laser job is to go there and burn and seal off the bleeding … for medical I don't know how it helps with the bleeding.” | FG3 (M) |
| Uncertain if DR can be asymptomatic | “I do not have vision problem so I did not notice it.” | FG1 (M) |
| “My vision was okay, no blood, no nothing so I don't know why she said that it's caused by diabetes.” | FG2 (M) | |
| Attitudes | ||
| Conflicting attitudes from traditional/Western medicine relating to managing DR | “So I went to China, I see the Chinese doctor, he gave me Chinese medicine to eat you know, here [Singapore] I ask for medicine to eat, they say no, no medicine to eat … how can it [DR] cure if you keep on drop drop drop [eye drops] there is no internal support, if Chinese can do it, why can't Singapore do it.” | FG2 (M) |
| “I go see Chinese sensei my eyes can get better, then they told me don't go too much on injection. The Chinese sensei say don't go for injection, if they inject you the wrong position you go totally blind. That's why I worry.” | FG2 (M) | |
| Injections are painful and not helpful/worry about side effects from treatments | “I don't know how painful the jab was because I have not done before but when I was outside the room, I heard others shouting in pain so they put fear in me.” | FG1 (M) |
| Getting DR is up to fate/genetics/inevitable when you get old | “I think old people, people who are 60 and above or 65 and above, should not go for injections … because it is very painful as what he [FG2, M] says and it might not work on them also.” | FG2 (F) |
| “Probably … I have this condition [DR] is because I have diabetes and my parents have diabetes also, inherited.” | FG4 (F) | |
| The responsibility to manage DR is up to the person with the disease (self) | “I believe that diabetes is not only because of genetics but also because of habits, way of life, diets.” | FG4 (M) |
| “At the end of the day, I think is still because of self-disciplined.” | FG4 (F) | |
| The responsibility to manage DR is up to the doctor/government (others) | “We don't seem to have a source where we can connect when I have a question or I need to know/find out—local version to describe local experience about diabetes. … I don't have an area, a source to ask my questions and not sure how to get my answer—all through guesswork.” | FG1 (M) |
| “Medical authorities have to play a part … you got to tell me … so if you don't give me any advice, I won't know what to do.” | FG2 (M) |