'Smiling and Talking Slowly': A Qualitative Study on the Ideal Ophthalmologist From the Perspective of Adults With Intellectual Disabilities.

Abstract

Background: Health care accessibility and inequality for people with intellectual disabilities have long been subjects of discussion. Issues related to eye examinations and visits to ophthalmologists are particularly challenging for these people. However, disability studies and healthcare from the perspectives of people with intellectual disabilities remain scarce. The current study aims to explore the experiences and expectations of adults with intellectual disabilities during ophthalmologist visits, with a focus on their subjective viewpoints.

Methods: A qualitative study was conducted between 2021 and 2022 that involved semistructured interviews with 22 adults with intellectual disabilities who were users of day programs or residential services in Taiwan. The interviews, supplemented with pictures, were conducted using purposive sampling. Thematic analysis was used to analyse the data.

Findings: Four themes emerged regarding their experiences with ophthalmologists: 'Because my eyes itched, I went to the doctor;' the need for clear and slow explanations during vision screening; anxiety and discomfort during equipment use and focused examination; and 'The doctor is good. She smiles and is gentle with me.' In addition, two themes related to their expectations were identified:equipment use and pre-examination instructions and ideal characteristics of ophthalmologists: smiling and talking slowly.

Conclusion: For people with intellectual disabilities, an ideal ophthalmologist is patient-centred and provides individualised care-'Smiling and Talking Slowly'; otherwise, fear of visiting eye doctors worsens their health inequalities. Integrating these considerations into ophthalmology training and practice is essential to enhance the quality of care for and the well-being and dignity of people with intellectual disabilities.