AWARENESS AND KNOWLEDGE OF GLAUCOMA

AMONG ADULT PATIENTS AT THE EYE CLINIC OF

MADONNA UNIVERSITY TEACHING HOSPITAL

OKONKWO FAUSTINA CHIZARAM

NSC/19/1611

Faculty of Nursing Science

Madonna University elele campus
Rivers state, Nigeria

23rd JANUARY, 2023

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 AWARENESS AND KNOWLEDGE OF GLAUCOMA
AMONG ADULT PATIENTS AT THE EYE CLINIC OF
MADONNA UNIVERSITY TEACHING HOSPITAL

BY

OKONKWO FAUSTINA CHIZARAM

NSC/19/1611

FACULTY OF NURSING SCIENCE

MADONNA UNIVERSITY, ELELE CAMPUS
RIVERS STATE

IN PARTIAL FULFILLMENT OF NURSING AND

MIDWIFERY COUNCIL OF NIGERIA FOR THE AWARD
OF “REGISTERED NURSE” CERTIFICATE

23rd JANUARY, 2023

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 DECLARATION
This is to declare that this research project titled “AWARENESS AND KNOWLEDGE OF

GLAUCOMA AMONG ADULT PATIENTS AT THE EYE CLINIC OF MADONNA

UNIVERSITY TEACHING HOSPITAL” was carried out by FAUSTINA is solely the result

of my work except where acknowledged as being derived from other person(s) or resources.

Examination Number: _______________________________

In the Department of Nursing Science, Madonna University, Elele Campus, Rivers State

Signature ____________________________ Date ____________________________

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 CERTIFICATION / APPROVAL
This is to certify that this research project by FAUSTINA, with Registration number

____________ has been examined and approved for the award of “Bachelor of Nursing Science”

____________________________________ ___________________
Signature Date
Mrs. Felicia Onuoha
(Project Supervisor)

____________________________________ ___________________
Signature Date
Gemma Galoa, RN, MAN
(Head of the Department)

____________________________________ ___________________
Signature Date
(External Examiner)

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 TABLE OF CONTENT

Title Page i
Certificate Page ii
Declaration iii
Certification iv
Table of Contents viii

CHAPTER ONE: INTRODUCTION

Background to the Study 1
Statement of Problem 3
Objectives of the Study 4
Research Questions 4
Significance of the Study 5
Scope of Study 5
Operational Definition of Terms 6

CHAPTER TWO: LITERATURE REVIEW

Conceptual Review 7
Theoretical Framework 11
Empirical Review 12
Summary of Related Literature 15

CHAPTER THREE: METHODOLOGY

Research Design 17
Research Setting 17
Target Population 18
Sample Size 18

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Sampling Technique 19
Instruments for Data Collection 19
Validity of Instrument 20
Reliability of Instrument 20
Method of Data Collection 20
Method of Data Analysis 21
Ethical Consideration 21
REFERENCES 23
APPENCICES 27

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 CHAPTER ONE
Introduction

Background to the Study

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 (Waisberg & Micieli, 2021). Such peripheral loss of

vision is a unique feature of glaucoma and it occurs silently, leading to irreversible optic

neuropathy (Waisberg & Micieli, 2021). In adults, glaucoma is classified into primary openangle

(OAG) and angle-closure (ACG), and secondary OAG and ACG according to the morphology of

the anterior chamber (Allison, Patel, & Alabi, 2020).

Glaucoma has been adopted as the most common cause of irreversible blindness globally,

affecting approximately 60 million individuals (Alqahtani, Bakarman, Almanjoumi, &

Alzahrani, 2021). However, it ranked fourth as the leading cause of moderate or severe vision

impairment in 2015 following uncorrected refractive error, cataract and macular degeneration,

where the number of blind individuals attributable to glaucoma was estimated as 4.0 million

(80% uncertainty interval 0.6 million to 13.3 million) (Zhang, Wang, Li, & Jiang, 2021).

Regionally, glaucoma remains a significant cause of visual impairment, where surgical rates due

to the condition ranged between 30 to 68.6 surgeries/million/year in the North Africa and the

Middle East region (Kahloun et al., 2019). It accounted for 6.94% and 1.62% of total cases of

blindness and moderate- to-severe visual impairment in 2015 and these numbers are projected to

increase significantly in 2020 (Alqahtani et al., 2021).

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In Nigeria, to the best of the researcher’s knowledge, no available nationwide prevalence studies

have been conducted. Evidence from distinct regions indicated that primary OAG was the most

prevalent type in 60% and 30.5% of patients in the eastern and western regions, respectively

(Ologele & Sulaiman, 2022). However, other studies have shown that primary ACG was the

predominant type (Olawoye et al., 2022), as such, more epidemiological studies are needed

across the country to address the typical prevalence patterns as well as the distribution of

different glaucoma subtypes. The most significant risk factors of glaucoma include older age,

increased intraocular pressure (IOP) in relation to the pressure sensitivity of the optic nerve head,

family history, and ethnicity (Geyer & Levo, 2020). IOP-lowering medications, such as beta-

blockers, prostaglandin analogs, and carbonic anhydrase inhibitors, are usually given for patient

management. In some instances, the efficacy of these drugs to arrest glaucomatous progression is

questionable (Geyer & Levo, 2020).

However, early detection of the disease is paramount to accomplish good therapeutic outcomes,

yet it is often difficult to achieve, particularly in line with the lack of reliable screening tools. It

has been shown that more than half of patients with glaucoma remain undiagnosed and the

majority of them are frequently detected at late stages (Ologele & Sulaiman, 2022). One of the

significant factors that contribute to late presentation is the lack of awareness about disease

nature and risk factors and subsequently failure to seek for medical care and treatment (Uche et

al., 2020). Lack of awareness about the disease may not only affect the timing of diagnosis, but

also using healthcare services. In rural parts of Nigeria, little is known about the levels of

awareness about glaucoma. Moreover, in the light of the researcher’s observation and

experience, several glaucomatous patients failed to perceive the relevance of starting medications

8
until a visual defect takes place. Hence, the need for this study to assess the awareness and

knowledge of glaucoma.

Statement of Problem

Glaucoma is a leading cause of irreversible blindness worldwide, and it is estimated that over 64

million people are affected by this disease. In Nigeria, it is the second leading cause of blindness,

and it has been reported that about 1.1 million people are affected by glaucoma. The awareness

and knowledge of glaucoma among adult patients in Nigeria are crucial to the prevention and

management of this condition. However, it is unclear how much awareness and knowledge about

glaucoma exist among adult patients attending eye clinics in Nigeria. Despite the significant

impact of glaucoma on the Nigerian population, studies on awareness and knowledge of the

disease among adult patients in eye clinics in Nigeria are limited. The lack of awareness and

knowledge of glaucoma may lead to delayed diagnosis, poor treatment adherence, and increased

risk of blindness. Hence, it is essential to understand the level of awareness and knowledge of

glaucoma among adult patients in Nigeria. Therefore, this study aims to investigate the level of

awareness and knowledge of glaucoma among adult patients attending eye clinic in Madonna

University Teaching Hospital, Elele, Rivers State.

Objectives of the Study

The broad objective of the study is to investigate the level of awareness and knowledge of

glaucoma among adult patients attending eye clinic in Madonna University Teaching Hospital,

Elele, Rivers State. To achieve this, the specific objectives are;

1. To determine the level of awareness of glaucoma among adult patients attending eye

clinic in Madonna University Teaching Hospital

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 2. To ascertain the level of knowledge about glaucoma among adult patients attending eye

clinic in Madonna University Teaching Hospital

3. To identify the factors that influence the awareness and knowledge of glaucoma among

adult patients attending eye clinic in Madonna University Teaching Hospital

Research Questions

Specifically, this study seeks to answer the following research questions:

1. What is the level of awareness of glaucoma among adult patients attending eye clinic in

Madonna University Teaching Hospital?

2. What is the level of knowledge about glaucoma among adult patients attending eye clinic

in Madonna University Teaching Hospital?

3. What are the factors that influence the awareness and knowledge of glaucoma among

adult patients attending eye clinic in Madonna University Teaching Hospital?

Significance of the Study

The significance of this study lies in its potential to contribute to the prevention and management

of glaucoma in Nigeria. Specifically, the study's findings would increase awareness and

knowledge of glaucoma among adult patients attending eye clinics in Nigeria. This increased

awareness may lead to early detection and prompt treatment of the disease, which can prevent

irreversible blindness. Secondly, the study's findings may identify specific knowledge gaps

among adult patients about glaucoma, which can be targeted through education and awareness

programs. This targeted education may help to address misconceptions about the disease and

improve patient understanding of the importance of regular eye examinations.

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Furthermore, the study's findings may inform public health policies related to glaucoma

prevention and management in Nigeria. This information may be used to develop policies and

interventions aimed at increasing awareness and knowledge of the disease and improving access

to eye care services. Finally, the study's findings may contribute to existing literature on

glaucoma awareness and knowledge in Nigeria. This may be useful for researchers and

policymakers interested in understanding the factors that influence glaucoma prevention and

management in Nigeria and other countries with similar healthcare challenges.

Scope of Study

This study will be carried out in Madonna University Teaching Hospital, Elele, Rivers State and

will focus on adult patients attending eye clinic the health facility. The instrument that will be

used for the study will be delimited to the use of self-designed questionnaire, and the variables

will measure awareness, knowledge and the factors that influence the awareness and knowledge

of glaucoma.

Operational Definition of Terms

For the purpose of this study, the key terms have been defined as follows:

Adult Patients: refers to individuals receiving treatment at the eye clinic of Madonna University

Teaching Hospital who are above the age of 18 years.

Awareness: refers to the ability to recognize, perceive, or understand the existence, nature, and

significance of glaucoma among adult patients.

Glaucoma: is a group of eye diseases that cause damage to the optic nerve, which is responsible

for transmitting visual information from the eye to the brain.

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Knowledge: refers to information or understanding about glaucoma acquired through adult

patients’ experience, or familiarity with facts, concepts, principles, and procedures related to the

disease condition.

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 CHAPTER TWO

Literature Review

This chapter covers the reviews of different authors concerning the research topic “Biomedical

waste management”. This includes the conceptual review, theoretical framework and empirical

review.

Conceptual Review

Awareness of Glaucoma

Glaucoma is a progressive eye disease that can cause irreversible vision loss if left untreated. It is

estimated that over 3 million Americans have glaucoma, but about half of them are unaware of it

(Ocansey et al., 2021). One in every 20 Nigerians aged 40 years and above has glaucoma, and

one in five being blind. There are approximately 8500 people aged 40 years and above with

glaucoma per million population. Glaucoma is often referred to as the "silent thief of sight"

because it usually has no symptoms until the vision loss becomes noticeable, which is usually

irreversible. Awareness of glaucoma indicates whether or not an individual has heard of the

disease or has any kind of correct understanding of the disease (Ocansey et al., 2021). The

knowledge aspect deals with the level of understanding of the eye disease called glaucoma.

Previous studies from Africa have reported low levels of awareness and knowledge of glaucoma

among Nigerians (Enock et al., 2020). Among Caucasians, the rates ranged between 22.9% and

93% for awareness of glaucoma with a low level of knowledge varying between 2.3% and 35%

for knowledge (Ooms et al., 2021).

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There are several types of glaucoma, but the most common type is primary open-angle

glaucoma, which occurs when the drainage canals in the eye become clogged over time, leading

to increased pressure in the eye (Schuster et al., 2021). Other types of glaucoma include angle-

closure glaucoma, normal-tension glaucoma, and congenital glaucoma. Risk factors for

glaucoma include age, family history of glaucoma, race (African Americans, Hispanics/Latinos,

and Asians are at higher risk), high eye pressure, thin corneas, and certain medical conditions

such as diabetes and high blood pressure (Ooms et al., 2021). Regular eye exams, including

measurement of eye pressure and evaluation of the optic nerve, are essential for early detection

and treatment of glaucoma (Schuster et al., 2021).

Awareness of glaucoma is essential for early detection and treatment because it is important for

individuals to understand the risk factors and symptoms of glaucoma and to schedule regular eye

exams with their eye doctor (Marmamula et al., 2022). Public education campaigns, community

outreach programs, and media campaigns can play a crucial role in raising awareness of

glaucoma and the importance of regular eye exams. Additionally, healthcare providers, including

primary care physicians and ophthalmologists, should ensure that patients receive education on

the importance of regular eye exams and the risk factors and symptoms of glaucoma (Olawoye et

al., 2022).

Knowledge of Glaucoma

Knowledge of glaucoma refers to an individual's understanding of the risk factors, symptoms,

and treatment options for glaucoma. According to Chen et al. (2022), adequate knowledge of

glaucoma is essential for individuals to take preventative measures and seek early treatment if

they develop the condition. Studies have shown that there is a lack of knowledge about glaucoma

14
among the general population (Thapa et al., 2021). Many individuals are not aware of the risk

factors or symptoms of glaucoma, which can delay diagnosis and treatment. This lack of

knowledge may be due to a lack of public education and awareness campaigns on glaucoma

(Thapa et al., 2021).

In addition to the general population, healthcare providers, including primary care physicians and

ophthalmologists, may also have gaps in their knowledge of glaucoma (Tan et al., 2020). A study

by Stein et al. (2021) found that many primary care physicians were not aware of the current

guidelines for glaucoma screening and management, which can lead to missed or delayed

diagnosis. Efforts to improve knowledge of glaucoma can include public education campaigns,

community outreach programs, and continuing education for healthcare providers (Ologele &

Sulaiman, 2022). These efforts can help to increase awareness of the risk factors and symptoms

of glaucoma and promote early detection and treatment. Additionally, healthcare providers can

take an active role in educating their patients about glaucoma and the importance of regular eye

exams (Ologele & Sulaiman, 2022).

Factors that influence the awareness and knowledge of Glaucoma

Several factors can influence the awareness and knowledge of glaucoma, including individual-

level factors, sociocultural factors, and healthcare system factors.

Individual-level factors that can influence awareness and knowledge of glaucoma include age,

education level, and access to healthcare (Ocansey et al., 2021). Older individuals may be more

aware of glaucoma and its potential consequences, as they are at higher risk for developing the

condition. Education level can also play a role in awareness and knowledge, as individuals with

higher education levels may have greater access to information on glaucoma and other health-

15
related topics. Access to healthcare, including regular eye exams, is also critical for awareness

and knowledge of glaucoma, as individuals who do not have regular access to healthcare may not

receive information on glaucoma or have their eyes checked for signs of the condition (Ocansey

et al., 2021).

Sociocultural factors can also play a role in awareness and knowledge of glaucoma. For example,

Tsegaye et al. (2020) reported that race and ethnicity can influence the likelihood of being aware

of glaucoma, as African Americans, Hispanics/Latinos, and Asians are at higher risk for

developing the condition. However, these groups may also experience lower levels of awareness

and knowledge of glaucoma due to language barriers, lack of culturally sensitive educational

materials, or mistrust of the healthcare system (Tsegaye et al., 2020).

Healthcare system factors can also affect awareness and knowledge of glaucoma. For example,

Chen et al. (2022) revealed that a lack of access to eye care specialists or limited insurance

coverage for eye exams can result in lower levels of awareness and knowledge of glaucoma.

Healthcare providers may also play a role in shaping awareness and knowledge of glaucoma, as

they are responsible for educating patients on the importance of regular eye exams and

identifying individuals at high risk for the condition (Chen et al., 2022). However, studies like

Ocansey et al. (2021) have shown that many healthcare providers may lack knowledge of current

glaucoma screening and management guidelines, which can lead to missed or delayed diagnosis.

Overall, awareness and knowledge of glaucoma are influenced by a complex interplay of

individual-level factors, sociocultural factors, and healthcare system factors. Addressing these

factors through public education campaigns, community outreach programs, and improvements

in healthcare access and delivery can help to increase awareness and knowledge of glaucoma and

promote early detection and treatment.

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Theoretical Review

This study is anchored on the Theory of Planned Behavior (TPB), which is a theoretical

framework that explains and predicts human behavior by considering the role of an individual's

attitudes, subjective norms, and perceived behavioral control. TPB was first proposed by

psychologist Icek Ajzen in 1985 as an extension of his earlier work on the Theory of Reasoned

Action (TRA). According to TPB, an individual's intention to engage in a particular behavior is a

key predictor of that behavior. Intention is influenced by three factors: attitudes, subjective

norms, and perceived behavioral control. Attitudes refer to an individual's positive or negative

evaluation of a particular behavior. Subjective norms refer to the perceived social pressure to

engage in or avoid a behavior, based on the individual's beliefs about what others think or do.

Perceived behavioral control refers to an individual's perceived ability to engage in a behavior,

taking into account internal and external constraints.

TPB has been applied to a wide range of health-related behaviors, including physical activity,

healthy eating, medication adherence, and healthcare utilization. In healthcare settings, TPB has

been used to understand and predict patients' intentions to engage in preventive health behaviors,

such as cancer screening, immunization, and regular check-ups. TPB has also been used to

identify and address barriers to patient adherence to medication regimens and lifestyle

modifications. Overall, TPB provides a comprehensive framework for understanding the

complex interplay of individual, social, and environmental factors that influence health-related

behaviors. By considering the interrelatedness of attitudes, subjective norms, and perceived

behavioral control, TPB offers a practical approach to designing and evaluating interventions

aimed at promoting positive health behaviors.

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Application of Model to the Study

The Theory of Planned Behavior (TPB) could be applied to this study. TPB suggests that

individuals' intention to engage in a particular behavior is influenced by their attitudes toward the

behavior, their subjective norms (perceived social pressure to engage in the behavior), and their

perceived behavioral control (perceived ability to engage in the behavior). In the context of

glaucoma, TPB could be used to assess patients' attitudes toward regular eye examinations and

treatment, as well as their perceptions of social norms related to seeking eye care. TPB could

also be used to explore patients' perceived barriers to accessing eye care services and identify

ways to increase their perceived control over accessing such services.

Empirical Review

Chen et al. (2022) sought to investigate the level of knowledge, attitude, and practices about

glaucoma and associated factors among primary glaucoma patients in Kunming, China. A

hospital-based study was conducted on 93 patients from the First Affiliated Hospital of Kunming

Medical University. Interviewer-administered questionnaires were used to collect data after

written informed consent. Among 93 patients, 55 (59.14%) were aware of glaucoma, 48

(51.61%) had good knowledge of glaucoma, while 45 (48.39%) had poor knowledge. Younger

age and duration of glaucoma were associated positively with knowledge of glaucoma. 87

(93.54%) patients got knowledge of their disease from doctors. 79.17% of respondents could use

all the anti-glaucoma medications on time, out of which 54.17% had good knowledge of

glaucoma while 25.00% had poor knowledge of glaucoma. 30.56% of respondents used to stop

anti-glaucoma medications on their own out of which only 9.72% had good knowledge of

18
glaucoma while 20.83% had poor knowledge of glaucoma. Patients with good knowledge of

glaucoma had lower scores on the Glaucoma Quality of Life-15 questionnaire. Thus, the

compliance to anti-glaucoma medications and glaucoma-related quality of life were better in

patients with good knowledge. The authors concluded that Improving knowledge with suitable

content for patients through effective multiple means such as the mass media rather than relying

only on ophthalmologists may be a veritable first step in combating blindness from glaucoma

and enhancing patients' quality of life.

Alqahtani et al. (2021) explored levels and determinants of awareness and knowledge about

glaucoma among patients through a cross-sectional study that included adult patients from

October to the end of December 2018. From the findings, 6.3% and 23.2% reported personal and

family history of glaucoma, respectively. The most frequently reported source of information

about glaucoma was another person with glaucoma (28.2%), followed by physicians (24.8%) and

TV (19.6%). Knowledge by item ranged from 3.1% to 82.5% correctness rate, while KS showed

mean=5.91 and median=5; and reliability testing of the knowledge scale showed Cronbach’s

alpha=0.782. Higher KS were found among respondents with higher educational level (P=0.036),

diabetes history (P=0.025), and personal (P<0.001) and family (P<0.001) history of glaucoma.

The study revealed low awareness and knowledge levels about glaucoma among the attendees of

a local eye care hospital, where several misconceptions about disease risk factors, clinical

features, and management were identified.

Otabor-Olubor and Okafor (2021) carried out a descriptive cross-sectional study of awareness

and knowledge of glaucoma among adults in Ikpoba-Okha Local Government Area, Edo State.

A total of 430 respondents participated in the study. One hundred and sixty-three (38%) of the

respondents had heard of glaucoma (awareness). Among these, 20.9% of the respondents knew

19
that glaucoma was damage to the nerve of the eye due to high pressure in the eye; 23.3% knew

glaucoma to be high pressure in the eye. Respondents in the age group of 30-39 years (p< 0.001)

and those with tertiary level of education (p< 0.001) had higher awareness of glaucoma. Those

with tertiary education had the most knowledge about glaucoma (p= 0.058). Logistic regression

showed that younger subjects (adjusted odds ratio = 2.566; 95% CI = 1.636, 4.023; p = 0.001)

and those with formal education (adjusted odds ratio = 3.579; 95% CI = 1.290, 9.901; p = 0.014)

were more likely to be aware of glaucoma. The results showed that health education and formal

education among the adults in this local government area would be important in prevention of

blindness from glaucoma.

Ogba et al. (2020) carried out a study to determine the level of glaucoma knowledge among

undergraduates of University of Calabar, Cross River state, Nigeria. Four hundred (400)

respondents were involved. The instrument for data collection was a questionnaire and data were

analyzed using Microsoft Excel 2016 and Statistical Package for Social Sciences (SPSS) version

20. The results showed that 66.25% of the respondents had heard of glaucoma, 45% of them had

poor knowledge of glaucoma, and only 29.6% had good knowledge. Common sources of

information about glaucoma were from health care personnel (22.8%), mass media (16.8%) and

from relations and friends (13%). Age and gender of participants were not statistically significant

when compared to their knowledge level of glaucoma (p=0.651 and p= 0.967 respectively.

However, there was a statistically significant relationship between knowledge score and faculty

of study of undergraduates (p=0.002). With the poor knowledge of glaucoma among

undergraduates, the study recommends a stronger collaborative effort in providing quality

glaucoma education by all eye care stakeholders at all levels.

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Hassan et al. (2020) sought to evaluate the level of awareness and knowledge about glaucoma

among Jordanians and determine the relationship between glaucoma knowledge and selected

variables via a descriptive and cross-sectional study conducted at a central hospital. From the

findings, 81.6% of participants had heard of glaucoma. Only 34.2% of participants defined

glaucoma correctly. 52.4% of participants had a low level of knowledge about glaucoma. The

main source of information was from family members, relatives, and friends (66.6%); however,

this source inversely influenced the level of knowledge. The results of the study indicated a high

level of awareness of glaucoma among Jordanians but low-to-average knowledge about it.

Health education programs should be activated at all levels of health- and eye-care services to

increase knowledge about glaucoma and prevent the irreversible loss of vision due to the second

main cause of blindness worldwide.

Durowade et al. (2019) sought to assess and compare the awareness and risk burden of glaucoma

among adults in selected rural and urban communities of Kwara State, Nigeria. This study was a

cross-sectional comparative study. Less than a quarter, 109 (24.2%), of the rural respondents are

aware of glaucoma compared with almost half, 212 (46.1%) of the urban respondents (p<0.001).

More than three-quarters, 187 (88.2%), of the urban respondents in the age group 40-59 years

had awareness of glaucoma compared with older respondents (p<0.05). Inadequate awareness

and high-risk burden of glaucoma have been demonstrated among the respondents in both rural

and urban communities in the study.

Summary of Related Literature

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This chapter reviewed the conceptual issues related to this study. Specifically, the conceptual

review discussed the awareness of glaucoma, knowledge of glaucoma, and the factors that

influence the awareness and knowledge of glaucoma. The model that underpinned this work is

the Theory of Planned Behavior (TPB) which could be used to assess patients' attitudes toward

regular eye examinations and treatment, as well as their perceptions of social norms related to

seeking eye care. TPB could also be used to explore patients' perceived barriers to accessing eye

care services and identify ways to increase their perceived control over accessing such services.

The empirical reviewed compared findings of other authors on similar topics and identified that

no study had been carried out in Madonna University Teaching Hospital, Elele, hence the current

study sought to fill that gap and provide baseline data for decision making and further studies.

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 CHAPTER THREE

Methodology

This chapter deals with the methods adopted in carrying out the research work and comprises of

Research design, Research setting, Target population, Sampling technique, Instrument for data

collection, Method of data analysis, Ethical consideration, Validity of instrument, Method of data

collection and Problems encountered in the field.

Research Design

The research design adopted for this study is a descriptive survey design which is aimed at

assessing awareness and knowledge of glaucoma among adult patients attending eye clinic in

Madonna University Teaching Hospital, Elele, Rivers State. Descriptive research involves

gathering data that talks about events and then organizes, tabulates, depicts and describes the

data collection.

Research Setting

The research setting for this study is Madonna University Teaching Hospital, Elele (MUTH), a

private, faith-based hospital located in Elele, Rivers State, Nigeria. The hospital is owned and

operated by the Catholic Church's Madonna University Nigeria, which is a private Catholic

University in Nigeria. MUTH is a 100-bed hospital that provides a wide range of medical

services, including emergency care, surgery, obstetrics and gynecology, pediatrics, internal

medicine, radiology, laboratory services, and more. The hospital also has a modern intensive

care unit (ICU) and a neonatal unit for premature babies.

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The hospital is staffed with qualified medical professionals and is equipped with state-of-the-art

medical equipment and facilities to ensure patients receive high-quality healthcare services.

MUTH is committed to providing affordable healthcare services to the surrounding communities

and is open to patients of all faiths and backgrounds. MUTH is also involved in medical research

and training, and it offers training and clinical experience to medical students and residents from

Madonna University Nigeria and other medical schools in Nigeria. The hospital has a mission to

provide compassionate and holistic care to patients while promoting the values of excellence,

integrity, and social responsibility.

Target Population

The target population for this study will comprise of adult patients attending eye clinic in

Madonna University Teaching Hospital, Elele, Rivers State. From the hospital records, the

population was put at about 100 patients at the time of the hospital; these are adopted as the

target population.

Sample Size

The sample size is determined using the Taro Yamane’s formula for calculating sample size.

Taro Yamane, a mathematical statistician developed a statistical formula for calculating or

determination of sample size in relation to the population under study so that inferences and

conclusions reached after the survey can be generalized to the entire population from which the

sample was gotten. The Taro Yamane’s statistical formula is stated as follows;

n = N / (1 + Ne2)

n= corrected sample size,

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N = population size (N = 100)

e = Margin of error, e = 0.05 based on the research condition.

Therefore,

n = 100 / 1 + (100 x 0.052)

n = 100 / (1 + 0.25)

n = 100 / 1.25

n = 80

Therefore, the sample size for this study will be 80 adult patients.

Sampling Technique

The sampling technique used was the Convenience sampling technique Convenience sampling is

a non-probability sampling technique where participants are selected based on their availability

and willingness to participate in a study. This sampling method involves selecting individuals or

groups who are easily accessible and convenient for the researcher to reach. Convenience

sampling is often used in research studies that have time or resource constraints, or when the

population of interest is difficult to access. In this study only adult patients attending eye clinic in

MUTH were used, rather than conducting a more extensive search for a representative sample of

patients diagnosed with glaucoma. Only adult patients that are available at the time of the study

and consent to participate in the study will be used for the study.

Instruments for Data Collection

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The primary instrument for data collection used for the study is a self-designed questionnaire

designed using a Likert scale with a 4-point rating: strongly agree (SA), agree (A), disagree (D)

and strongly disagree (SD). The questionnaire consists of four (A, B, C & D) sections. Section A

consists of the demographic data of the respondent, section B, C, and D comprises of data

relating to the objectives of study in terms of awareness of glaucoma among adult patients,

knowledge about glaucoma among adult patients, and factors that influence the awareness and

knowledge of glaucoma among adult patients.

Validity of Instrument

In order to ensure face, construct and content validity instrument will be established by

examining the questionnaire critically. The questionnaire was reviewed by the project supervisor,

project coordinator and research lecturer and necessary adjustments will be made before being

approved.

Reliability of Instrument

The researcher will give samples of the instrument for pilot testing to respondents in Madonna

University Teaching Hospital, Elele who will not be included in the study. After completion, the

questionnaires will be collected and analyzed by the researcher and their responses will be

evaluated in terms of their ability to answer the research questions, and comparing the coefficient

of reliability index which will prove the instrument’s reliability.

Method of Data Collection

The data will be collected using questionnaires with choices for socio-demographic data and

statements on Likert’s scale for research questions. Copies of the questionnaire will be

26
distributed by the research within a week’s period and all questionnaires will be retrieved on the

spot to ensure complete responses. The researcher will distribute the copies of the questionnaire

to the adult patients on days of the week during their visits to the eye clinic and will offer the

necessary assistance needed to complete the instrument. Two research assistants will assist in the

questionnaire distribution procedure.

Method of Data Analysis

Data collected will be analyzed using statistical techniques, such as frequency distribution tables

and percentages and a 4-point Likert’s scale rating was manually used in analyzing the result of

the response, where a mean of 2.5 is considered neutral, above it was accepted and below it was

rejected.

Ethical Consideration

During the course of this study, the following ethical considerations will be ensured.

Informed consent: Participants will be fully informed about the nature and purpose of the study

and they will be required to give their informed consent to participate. Participants will be free to

withdraw from the study at any time.

Confidentiality: The researcher will protect the confidentiality of the participants and ensure

that their personal information will be kept secure.

Anonymity: Participants will be given the option of remaining anonymous, and their responses

will be kept confidential.

27
Avoidance of harm: The researcher will take steps to avoid harming participants, both

physically and psychologically. Participants will not be subjected to undue stress, discomfort, or

harm as a result of their participation in the study.

Respect for autonomy: Participants will be treated with respect and dignity, and their autonomy

and privacy will be respected.

28
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Enock, M. E., Malachi, E. E., Kanoba, O., Omoti, A., Fuh, U. C., Alikah, A. A., & Eguaoje, I. E.

(2020). Knowledge of glaucoma blindness among students of Ambrose Alli University,

Edo State, Nigeria. Annals of Medical and Surgical Practice, 5(2), 94-103.

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32
 APPENDIX A

INFORMED CONSENT

Madonna University,
Nursing Science Department,
Elele Campus
Rivers State.

Dear respondents,

I am a student of the above-named institution carrying out a research study on

“AWARENESS AND KNOWLEDGE OF GLAUCOMA AMONG ADULT PATIENTS AT

THE EYE CLINIC OF MADONNA UNIVERSITY TEACHING HOSPITAL”. The

questionnaire is strictly for collection of data for academic purposes. Please supply the

information as frankly as possible to make this study a success.

Rest assured that all the information given by you will be treated with strict

confidentiality. Your names and personal identifiers are not required.

Thank you for your acceptance and co-operation.

Yours faithfully

Okonkwo Faustina

33
 APPENDIX B

QUESTIONNAIRE

SECTION A: Socio-demographic data of respondents

1. Age
20-30 [ ] 31-40 [ ]
41-50 [ ] 51 years and above [ ]
2. Gender
Male [ ] Female [ ]
3. Educational Qualification
FSLC [ ] SSCE/WAEC [ ] HND/OND [ ]
BSc/MSc [ ] None [ ]
4. Marital Status
Married [ ] Single [ ] Others [ ]
5. Religion
Christian [ ] Muslim [ ] Others [ ]

SECTION B: Awareness of Glaucoma among adult patients

S/N Variables T F
6. Have you ever heard of glaucoma before today's visit?
7. Do you know what the symptoms of glaucoma are?
8. Have you or anyone in your family been diagnosed
with glaucoma?
9. Have you ever had an eye exam that included screening
for glaucoma?
10. Do you know that glaucoma can lead to permanent
vision loss if left untreated?
11. Have you ever received education about glaucoma
from your healthcare provider?
12. Have you ever discussed your risk for glaucoma with
your healthcare provider?
13. Do you know if there are any lifestyle modifications
that can reduce your risk of developing glaucoma?

34
INSTRUCTION: The following KEY will guide the responses to the following questions:
Strongly Agree (SA), Agree (A), Disagree (D), and Strongly Disagree (SD).
SECTION C: Knowledge of Glaucoma among adult patients

S/N Variables SA A D SD
14. Risk of glaucoma increases with age
15. Blindness from glaucoma can be prevented
16. Anyone can have glaucoma
17. Treatment of glaucoma is possible
18. Vision is affected in the early stages of glaucoma
19. Glaucoma has familial predisposition (hereditary)
20. Most times, glaucoma produces or shows no symptoms.
21. Consequence of untreated glaucoma involves slow,
irreversible loss of vision

SECTION D: Factors that influence the awareness and knowledge of glaucoma

S/N Variables SA A D SD
22. Education level and literacy
23. Age of individual
24. Ethnicity and race
25. Family history of glaucoma
26. Socioeconomic status
27. Access to healthcare
28. Availability of information and resources
29. Cultural beliefs and attitudes towards eye health
30. Language barriers and communication difficulties

35