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LETTER TO THE EDITOR |
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Year : 2021 | Volume
: 69
| Issue : 4 | Page : 1019-1020 |
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Comments: Pendleton's Ideas, Concerns and Expectations model for improving outcomes through eye donation counseling
Imogen Milner1, Naveed Hussain1, Princess Imoru1, Haroon Shah2
1 3rd Year Medical Student, Clinical Medical Students, University of Birmingham, Birmingham, UK 2 5th Year Medical Student, Clinical Medical Students, University of Birmingham, Birmingham, UK
Date of Web Publication | 16-Mar-2021 |
Correspondence Address: Miss Imogen Milner 153 Heeley Road, Birmingham, B29 6EJ UK
Source of Support: None, Conflict of Interest: None | Check |
DOI: 10.4103/ijo.IJO_3184_20
How to cite this article: Milner I, Hussain N, Imoru P, Shah H. Comments: Pendleton's Ideas, Concerns and Expectations model for improving outcomes through eye donation counseling. Indian J Ophthalmol 2021;69:1019-20 |
Dear Editor,
We enjoyed reading the work by Thulasiraj et al.[1] focusing on eye donation in India which clearly showed education and counseling of the loved ones of potential donors is fundamental to improving donor numbers. However, we felt that the study did not fully explore barriers to donation that are unrelated to lack of knowledge. Reluctance may not stem from absence of understanding, but instead from personal worries not raised by the questionnaire or considered by counselors. This includes apprehension over lack of transparency relating to misuse of corneas[2]; in a country where organ trafficking is rife[3] this is not an unreasonable basis for refusal. Additionally, as a prominent feature of one's visage, eyes are 'intrinsically associated with […] identity'[4] and removal can be seen to destroy an individual's 'self' cosmetically and spiritually.
These specific concerns could be successfully addressed through the addition of the 'Ideas, Concerns & Expectations' (ICE) Healthcare Consultation Model[5] to counseling sessions. The ICE model, taught in UK medical schools as a template for patient-centered primary care, allows patients to be involved with their healthcare plans and increases compliance. Patients are given a voice to express understanding of their presenting complaint ('ideas'), worries they may have ('concerns') and outcomes they hope to achieve from the consulting ('expectations'). This model can give clinicians greater insight into a patient's condition and treatment plans. Shaping this template for use in eye donation counseling may allow barriers preventing consent to be discussed and dispelled in a manner that is sensitive in its approach toward grieving family members.
COVID-19 has only widened the already gaping mismatch between the availability and demand for donor corneas meaning communicating effectively with relatives for a common goal has never been more important.
Financial support and sponsorship
Nil.
Conflicts of interest
There are no conflicts of interest.
References | | |
1. | Thulasiraj R, Subburaman G, Kempen J, Durairaj S, Balakrishnan V, Valaguru V, et al. Making the decision to donate eyes: Perspectives from the families of the deceased in Madurai, India. Indian J Ophthalmol 2020;68:2094-8. [ PUBMED] [Full text] |
2. | Acharya M, Farooqui J, Dave A, Chaku D, Ganguly K, Das A, et al. Eye donation in north India: Trends, awareness, influences and barriers. Indian J Ophthalmol 2019;67:1570-4. [ PUBMED] [Full text] |
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4. | Lawlor M, Kerridge I. Understanding selective refusal of eye donation. J Bioethical Inquiry 2013;11:57-64. |
5. | Matthys J, Elwyn G, Van Nuland M, Van Maele G, De Sutter A, De Meyere M, et al. Patients' ideas, concerns, and expectations (ICE) in general practice: Impact on prescribing. Br J Gen Pract 2009;59:29-36. |
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