الفهرس 
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Abstract
SUMMARY
Glaucoma comprises a set of heterogeneous diseases which differ in their causes, risk factors, symptoms, and treatment. Glaucoma is referred to as a progressive loss of vision due to acquired loss of retinal axons and ganglion cells within the optic nerve with a subsequent development of the peculiar optic nerve head appearance. Such peripheral loss of vision is a unique feature of glaucoma. It occurs silently, leading to irreversible optic neuropathy (Alqahtani et al., 2021).
Glaucoma not only causes permanent visual disability, but also has a negative influence on mental and psychological health, which is subjective and individual specific. Individuals with glaucoma tend to develop negative emotions such as anxiety or depression, which are detrimental in the daily functioning and wellbeing. With the number of glaucoma cases projected to rise, the psychosocial aspect of glaucoma is now becoming a global concern for clinicians all over (Dayal, 2021).
Nurses play a significant role in providing care to glaucoma patients. Nurses are responsible for providing patients with the necessary information and meeting their physical, educational, social, and psychological needs. Also, the nurse should emphasize minimizing the patient’s pain and discomfort, involving the patient and his family in care, preventing complications as soon as possible, and providing complete instructions for glaucoma patients (Gad, Hala Abdel Sabour et al., 2023).
This study aimed to assess the biopsychosocial and educational needs of patients with glaucoma through: -
• Assess the educational needs of patients with glaucoma.
• Assess the physical needs of patients with glaucoma.
• Assess the psychological needs of patients with glaucoma.
• Assess the social needs of patients with glaucoma.
Research Questions
This study answered the following questions:
• What are the educational needs of patients with glaucoma?
• What are the physical needs of patients with glaucoma?
• What are the psychological needs of patients with glaucoma?
• What are the social needs of patients with glaucoma?
Subjects and Methods
Research design
A descriptive exploratory design was utilized to meet the aim of this study. A descriptive exploratory research design helps the investigator describe and document a situation’s aspects as it naturally occur. This design helps to establish a database for future research.
Research setting
This study was conducted at the outpatient clinic of Damanhour Ophthalmology Hospital in Al-Bahira, affiliated with the Ministry of Health.
Research subjects
A convenient sample of all available adult patients with glaucoma (90 patients) who visited the ophthalmology outpatient clinic through a consecutive six-month duration of data collection.
Tools for data collection: The following tools were used for data collection: -
• Category (1): Tool I: Patient`s interviewing questionnaire
• Category (2): Patient’s Biopsychosocial needs questionnaire
Category (1), Tool I: Patient`s interviewing questionnaire
The investigator developed it in a simple Arabic language based on the extensive review of relevant and recent literature to assess the educational needs of patients with glaucoma.
It was consists of three parts:
● The first part was concerned with sociodemographic characteristics of the studied patients as the following (age, gender, marital status, level of education, occupation, residence, treatment cost, income, house condition, light in the housing, and presence of primary caregiver in the home and daily habits ).
● The second Part was concerned with patients’ medical history data; this part assessed patients’ present medical history as affected eye, how long the symptoms started, and glaucoma symptoms. Also, patients’ past medical history (including other chronic diseases, previous eye surgeries, and previous eye problems) and Family medical history.
● The third Part concerned the Educational needs assessment interview questionnaire, which assessed patients’ educational needs regarding glaucoma.
Category (2): Patient’s Biopsychosocial needs questionnaire It was to assess the physical, psychological, and social needs of patients with glaucoma, and it included the following tools:
Tool II: Lawton instrumental activities of Daily Living (IADL): It is used to assess the Patient’s physical ability to perform activities of Daily Living
Tool III: Feelings of depression, Anxiety and Stress Scale-21 Items (DASS-21): It is used to assess feelings of depression, Anxiety, and Stress for patients with glaucoma.
Tool IV: Social dysfunction rating scale: It was written in Arabic and used to assess social needs.
Results:
The current study results Clarified that (52.3%) of the studied patients had an age group of 30-50 years, with a mean age was (47.86±19.5), (55.6 %) of them were male, and (72.2%) were Single. Concerning educational level, it was found that (61.1% were illiterate, while (46.7%) did not work, and (82.2%) of them lived in rural areas. Regarding treatment cost, it was found (90%) of the studied patients had health insurance, (60%) of them reported that their monthly income was insufficient for treatment. (78.9%) of the studied patients lived on the ground floor, with (55.6 %) of them did not have enough light at home, and (71.1%) took a primary caregiver from one of the households.
It illustrated that (71.1%) of the studied patients had one eye affected, and (76.7%) of them had symptoms from ≥ one year. Regarding associated signs and symptoms, (31.1% 26.7%) suffered from severe eye pain and severe headache, respectively, and (25.6%) suffered from eye redness.
Regarding Past medical history (90%) of the studied patients had a history of chronic disease. (27.8%, 21.1%) had a history of previous eye surgeries and previous eye problems, respectively. Regarding the family history of glaucoma, among the studied patients, it was found that (26%) had a positive family history.
It clarified that (62.2%) of the studied patients had unsatisfactory educational needs, and (37.8%) had satisfactory educational needs about glaucoma.
It demonstrated that (77.8%) of the studied patients were independent, (16.6%) of them were partially dependent, and only (5.6%) of them were dependent regarding daily living activities.
It clarified that (83.3%) had a mild level of total psychological needs, 14.4% had a moderate level of total psychological needs, and only 2.3% had a severe level of total psychological needs.
It clarified that (96.7%) of the studied patients had a mild level of social dysfunction, and only 3.3% had a moderate level of social dysfunction.
It illustrated no correlation between educational needs and living activities, stress level, anxiety level, depression level, and social dysfunction.
Conclusion:
In the light of the current study findings, it can be concluded that,
Less than two-thirds of the studied patients had unsatisfactory knowledge. More than three-quarters of the studied patients were independent. Moreover, more than four-fifths had a mild level of total psychological needs. Also, more than half of the studied patients had a mild level of total social dysfunction.
Recommendations
Based on the current study finding the following recommendations were proposed:
• Health education for patients with glaucoma should be started from the first day of diagnosis. Also, awareness of high-risk groups and the family to know the early symptoms of glaucoma.
• A simplified, illustrated, and comprehensive booklet should be available for glaucoma patients, including the most information regarding disease, treatment, and self-care.
• Multidisciplinary team approach is necessary for managing glaucoma patients to meet the studied biopsychosocial and educational needs.
• Replication of this study on a large sample of patients in different hospitals is recommended to generalize the study results.