Screening for diabetic retinopathy is well received by patients and may improve self‐management intentions

Abstract
Aims To investigate patients' views of screening for diabetic retinopathy and the effects of the screening process on health beliefs and behavioural intentions. Setting A retinal screening clinic at a GP surgery in SW England. Methods Questionnaires administered before and immediately after screening by retinal photography. Results One hundred patients attended (94% of those invited); 12 had Type 1 and 88 Type 2 diabetes. Over 90% found the information, and seeing their retinal photograph, helpful. Sixty-three were found to have no problem and 37 had some type of eye problem detected. Overall, patients rated the news given at screening as better than expected (P < 0.001) and even those found to have problems mostly rated the news as good (P < 0.001). Detection of problems led patients to rate their recent eye health more negatively, but to be less pessimistic about future deterioration (P < 0.01). Patients with diabetes-related eye problems were more likely (P < 0.05) to say that they both should and would make changes to their self-management, but only after controlling for duration of diabetes. Those who had had diabetes longest declared least intention to change. Conclusions Screening by retinal photography is acceptable to patients. Results suggest that screening modified health beliefs but had limited effect on behavioural intentions, with patients of longer disease duration being more reluctant to change their self-management. Opportunities during retinal screening for advice on self-management could be more effectively exploited. Diabet. Med. 18, 835–841 (2001)