A Proposed Health Information

Leaflet in Waray-Waray Dialect for

the Patient Undergoing Cataract
Extraction at Eastern Visayas
Regional Medical Center of
Tacloban City

RATIONALE:
Sight is a magnificent gift of God. The beauty
of things is well appreciated through ones
sense of sight and losing such endowment
would cause distress among the afflicted that
affects ones attitude.
Cataract is define as clouding of the eye lens
that reduces the amount of incoming light and
results in deteriorating of vision.
Cataract is often described as being similar to
looking through a waterfall or waxed paper.

cataract occurs when proteins of the nucleus

(center) degenerate and darken, causing light
to scatter.
In the Philippines 80% of blindness is caused
by cataract (CMC; 2008)
Locally, cataract surgery is one of the most
common procedures performed in Eastern
Visayas Regional Medical Center (EVRMC).
It is done twice a week and scheduled as an
elective operation during Mondays and
Thursdays.

According to the EVRMC-OR census as of

2011, there were 609 cataract surgeries done.
81.3% of the patients are from 50 to 80 years
old, followed by less than 50 years of age.
60% were indigent.
With the number of patients undergoing
surgery, it is imperative that health teaching
provision is needed.

Other factors which influenced the statistics

is the disproportionate nurse-patient ratio
due to limited number of staff nurses,
illiteracy of patients and unavailability of
IEC materials which will be utilized by the
patients.

Undergoing a surgery is the most anxietyprovoking event in a patients life. The

primary role of the nurse is to explore ways
to provide better patient outcomes and the
most effective way of delivering them is
through health education, to improve the
patients confidence in self-management and
at the same increase the level of
independence of families. (Tan; 2011)

It is essential to conduct pre-operative

education among patients undergoing
surgery since this would prepare the patient
psychologically and physically. This would
also meet the patients needs in terms of what
to expect during and after the surgery and at
the same time patients input of goals and
objectives are also elicited. (Wojahn;2002)

GEOGRAPHICAL LOCATION
Eastern Visayas encompasses the two large
islands of Leyte and Samar,
the province of Biliran and several minor
islands.
This region is the eastern boundary of the
Philippines.
As of August 1, 2007, the total population of
the region was 3,912,936

Eastern Visayas Regional Medical Center

(EVRMC) is a government Teaching
Training Hospital in Region VIII which
accommodates whole region as
its catchment area.
At present, it has two affiliating medical
schools
namely,
Remedios
Trinidad
Romualdez Medical Foundation and the
University of the Philippines- School of
Health Sciences.
There are eight colleges of nursing affiliating
in the hospital.

The Operating Room of Eastern Visayas

Regional Medical Center presently has four
existing O.R. suites but construction of three
additional theatres were initiated last
February, thereby a total of seven suites will
be available soon.

Objectives of the Study

This study aims to provide health

information to the Cataract Patients
Undergoing Cataract Extraction at Eastern
Visayas Regional Medical Center,
utilizing a handy leaflet translated in waraywaray dialect. It is the main purpose of the
research utilization. The value of the leaflet
will be measured its ability to:

Provide comprehensive information

regarding health management to patient who
will be undergoing cataract extraction that
includes:

- Information about cataract, its signs and

symptoms;
- Information regarding who are at risk in
developing cataract;
- Pre-operative preparation; Preparation
during the day of surgery; Post-operative
care;
- Expected signs and symptoms after surgery;
symptoms that need immediate follow up
check-up;
- Prevention of complication and Personal
hygiene.

Ability to be understood completely by the

client.
To reduce the anxiety of the patients who
will undergo cataract surgery and significant
others on the post-op management of
cataract.
Its ability to serves as a useful aide in health
teaching responsibility.

REVIEW OF RELATED LITERATURE

Informed consent for cataract surgery: Patient understanding of

verbal, written, and videotaped information Scanlan D,
Siddiqui F, Perry G, Hutnik CML. J Cataract Refract Surg. 2003;
29:19041912 Vol. 38 Issue 1 pp. 80-84.

Summary:

In an academic setting, a verbal consent alone is difficult to

standardize among residents and patients. The goal of this study was
to explore how current practices of resident verbal consent at the VA
Boston Healthcare System compare with more standardized practices
of educating patients on the surgical procedure, benefits, risks, and
alternatives to surgery. Written brochures at a second-grade and
eighth-grade reading level were created to specifically determine
effects of readability. surgery.

REVIEW OF RELATED LITERATURE

The AAO video was also used to analyze how a
standard video providing audio and visual
information translated into understanding the risks
of, benefits of, and alternatives to cataract.
Dhingra et al. found that patient retention of
verbal and written information on cataract surgery
complications was poor on the day of surgery.

In future studies, it would be beneficial to test patients at the

VA Boston Healthcare System on the preoperative visit and
on the day of surgery to determine how quickly information
is forgotten.
This would highlight the importance of repeating the
informed consent with written and video tools if necessary. It
would also be interesting to determine whether verbal
consent combined with second grade-print and video
presentation further enhance a patients understanding and
retention of the informed-consent process.

Based on our results, we conclude that concise informedconsent information sheets at a second-grade reading level
or videotape presentations optimize patient understanding
of the risks of, benefits of, and treatment alternatives to
cataract surgery in our academic tertiary referral center.

Critique:

Adequate informed consent is imperative to a

patients overall feeling of success of any
procedure. It is anticipated that with increased
focus by the surgeon on the informed consent
process, with simplified written information
sheets or videotape presentation, patients may
be more willing to defer elective cataract
surgery.

In relation to our study, construction of

health information leaflet would also help
the patient overcome fear of such operation
or rather the fear of the unknown. They will
thoroughly understand the preparation, the
procedure and the expected outcome after
cataract extraction.

The

Importance of Leaflets, International Medical

article
reviews the usefulness and importance of
Journal pp. 45-46 Family Practice 1998 vol. 14 no. 5

written information, specifically leaflets being given

to patients. It is well known that patient forget of or
misunderstand, much of what is discussed during a
consultation. One study showed that, on average,
patients had forgotten half of what the health care
provider had told them within 5 minutes after
instruction (moron 471).

The primary role of the nurse is to explore

ways to provide better patient outcomes and
the most effective way of delivering them is
through health education, to improve the
patients confidence in self-management and
at the same increase the level of
independence of families (Tan; 2011).

Critique:

The researcher utilizes the health information leaflet

because it will help the patients understand and learn
how to manage on their own. It will reinforce
communication between institutions health personnel
and the patients. As part of the health team, nurses
have the opportunity and responsibility to educate,
motivate patients and significant others to be involve
in the post-op care of the patient.

CATARACT: CAUSES AND RISK FACTORS

SOURCE:www.nei.nih.gov.health/ cataract facts, asp.

Summary:
A cataract is a clouding of the lens in the eye that affects
vision. Most cataracts are related to aging so they are very
common in older people. It can occur in either or both eyes but
cannot spread from one eye to the other. As the person age,
some of the protein may clump together and start to cloud a
small area of the lens. This is a cataract. Overtime, the cataract
may grow larger and cloud more of the lens, making it harder
to see. Researchers suspect that there are several causes of
cataract, such as smoking and diabetes. Or, it may be that the
protein in the lens just changes from wear and tear it takes
over the eyes.

Critique:

Cataract is the major cause of blindness in the

word and the most prevalent ocular diseases. In the
United States, cataract are the most frequently
cited self-reported cause of visual impairment and
the third leading cause of preventable blindness.

Knowing the causes and other facts about

cataract is necessary in explaining to the client the
nature of the disease. Educations of clients help
them to understand and accept the needed
management and care.

Research Model

Research utilization refers to the use of some

aspect of scientific investigation in a clinical
application unrelated to the original research.
The

ultimate

responsibility

for

research

utilization rests within the entire nursing

community. There is tremendous potential for
the utilization of research throughout the
nursing process (Polit & Hungler, 1999).

The Conduct and Utilization of Research

in Nursing (CURN) project. Developed
in 1975-1980 by the Michigan State
Nurses Association with 34 hospitals
participating.

This model exemplifies a structure,

formal organizational process that
requires organizational commitment,
resources, and research expertise.

Assumptions:

Organization must be committed

Visible, potent, enduring mechanisms vital

Substantial resources necessary

Planned change is essential

Two or more studies are required to support

change

STEPS
Systematic Problem Identification.
Assessment of Research
Conduct of Clinical and Trial Evaluation.
Decision Making: rejection,adoption,
modification.
Plan for diffusion of innovation.
Mechanism for maintenance.
Evaluating and intergrating studies for the
research base.

Systematic problem identification

Assessment of research

Figure 1:CURN
MODEL: CONDUCT &
UTILIZATION OF
RESEARCH IN
NURSING

Conduct of clinical trial and evaluation

Decision Making

Rejection

Adoption

Plan for diffusion of innovation and

Mechanism of maintenance.
Evaluating and integrating studies
for the research base

Modification

Recognized need for Health Information Leaflet in Waray-waray

dialect for Patients undergoing Cataract Extraction in Eastern
Visayas Regional Medical Center in Tacloban City

Assessment of Research
Review the existing practices in cataract surgery.
Related studies and research regarding Cataract Surgery, reliability of health information
leaflet

Adaptation/design of practice innovation

No health Information
leaflet about cataract
surgery in EVRMC

Cataract Extraction done

twice a week on regular
basis and are willing to go
through with the study

Limited time spend for discharge

instruction to patient undergoing
cataract surgery due to lack of
nurse staff.

Conduct of clinical trial and evaluation

Complete a health information leaflet based on the review of literature.
Gets the consensus of the administration regarding the content of the leaflet.
Devise a survey tool for the evaluation of the leaflet.
Conduct a survey tool with the approval letter from the administration

Distribution of Health Information leaflet and evaluation tool among

the 10 nurses and medical personnel, and 15 cataract patients at
Eastern Visayas Regional Medical Center
Decision Making

If the Health Information Leaflet

considered not helpful to the
cataract patients and health
Personnel, then re-assessment will
be applied for its problem.

If the Health Information leaflet will

be beneficial, then it will be adopted
by the OR department for its
utilization as per approval by the
administration.

If certain portion of the

Health Information leaflet
need to be Modified, applied
necessary changes then it will
be adopted by the
administration.

Possibility to extend the utilized health information leaflet

with the Optha-Team through its medical mission on other
municipalities and the entire institution of Eastern Visayas
Regl Medical Center of Tacloban City

Figure 2: RESEARCH FLOW