Date of Award


Document Type

Campus Access Dissertation


Health Services and Policy Management

First Advisor

Janice Probst


Diabetic retinopathy (DR) is one of the leading causes of blindness in the world. Early detection and timely management of DR can reduce vision loss from this disease. The aim of this study is to explore possible factors associated with the receipt of a DR exam within the past two years in patients with diabetes in Taiwan. I developed a survey, guided by the Health Belief Model. Patients who visited the eye clinic of Shin-Kong Memorial Hospital from January to June 2009 were invited to take part in this study and complete the survey. Chi-square and Mann-Whitney U test were used to examine for differences between participants with and without a DR exam during the past two years. Logistic multivariate regression was used to determine significant factors related to reported receipt of DR exam. A total of 313 patients were recruited to participate. Participants with missing responses for more than three questions (38) were excluded. Thus, the final sample size was 275. Sixty percent (165/275) of patients reported that they had a DR exam in the past two years. The most common reason patients provided for not having an exam was that they did not know it was necessary (43.2%). Worry about vision (P = 0.011), having a belief that diabetes could damage vision (P = 0.023), and being a housewife versus working full time (P = 0.041) were significantly associated with having a recent DR exam. The findings confirmed that perception of threat is important to promote DR exams. These factors should be considered when developing and implementing policies to encourage DR screening.


© 2010, Pai-Huei Peng