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Diabetic Retinopathy Screening in Enugu, South-East Nigeria: A Cross-Sectional Study of Patients' Barriers and Practices
Authors
Authors:
1. Name: Obuezue, Ogochukwu Gladys
Qualifications: MSc. (Medical Surgical Nursing); ROPHTHN; RPON
Institution: Nursing Science Department; Faculty of Health Sciences, University of Nigeria, Enugu State
Address: Nursing Services Department, University of Nigeria Teaching Hospital, Enugu State, Nigeria
E-mail address: obuezueogochukwu@gmail.com
2. Name: Udeh, Nnenma Ndidiamaka
Qualifications: MSc. (Public Health -Bioethics); FMCOph; FWACS
Institution(s): Ophthalmology Department; Faculty of Clinical Sciences, University of Nigeria, Enugu State / Department of Ophthalmology, University of Nigeria Teaching Hospital, Enugu State, Nigeria
E-mail address: nnenma.udeh@unn.edu.ng
3. Name: Anarado, Agnes
Qualifications: PhD; RNE; RM/ RN
Department: Department of Nursing Sciences; Faculty of Health Sciences and Technology, University of Nigeria, Enugu Campus.
E-mail address: agnes.anarado@unn.edu.ng
4.Name: Madu, Obiageli T
Qualifications: MSc; BSc; RNE; RM; RN
Institution: Department of Nursing Sciences; Faculty of Health Sciences and Technology,
University of Nigeria, Enugu Campus.
E-mail address: obiageli.madu@unn.edu.ng
CORRESPONDING AUTHOR
Name: Udeh Nnenma Ndidiamaka
Qualifications: Phone numbers: +234803 547 0772
E-mail address: nnenma.udeh@unn.edu.ng
ONLINE ISSN: 2645-2936
PRINT ISSN: 0795 – 6541
Editor-in-chief
Prof. (Mrs.) Ijeoma O. Ehiemere
University of Nigeria
Editorial Secretary
Dr. Goodluck I. Nshi
Aspen University, Denver, CO, U.S.A.
Assistant Editorial Secretary
Prof. Emmanuel Ejembi Anyebe
University of Ilorin, Nigeria
Institutional Affiliation(s)
Department of Nursing Sciences; Faculty of Health Sciences and Technology, University of Nigeria, Enugu Campus.
Ophthalmology Department; Faculty of Clinical Sciences, University of Nigeria, Enugu State / Department of Ophthalmology, University of Nigeria Teaching Hospital, Enugu State, Nigeria
Citation
Obuezue, O.G., Udeh, N.N., Anarado, A., Madu, O.T. (2026). Diabetic retinopathy screening in Enugu, South-East Nigeria: A cross-sectional study of patients' barriers and practices. The Nursing Scope, 9(1), 22- 40. ISSN: 2645-2936 (Online); 0795–6541 (Print). https://doi.org/10.59073/thenursingscope91/22-40
Keywords
Abstract
Abstract
Background: Diabetic retinopathy (DR) screening is essential for early detection and prevention of vision loss, yet evidence on screening practices and barriers in Nigeria remains limited.
Aim: This study assessed the practices and barriers to the uptake of DR screening among patients with diabetes attending two tertiary hospitals in Enugu State, South-East Nigeria.
Method: A descriptive cross-sectional study was conducted among 400 patients recruited proportionally using stratified and consecutive sampling between September and November 2019. Data were collected using a structured interviewer-administered questionnaire assessing socio-demographic characteristics, clinical variables, screening practices, and perceived barriers. The instrument demonstrated strong reliability (Cohen’s κ = 0.952). Data were analysed using SPSS version 25 with descriptive statistics.
Findings: Uptake of DR screening was very low, with 94.0% of participants reporting no screening since diagnosis, despite many living with diabetes for more than 10 years. Only 3.3% demonstrated good screening practice. Major barriers included lack of awareness of DR screening, limited knowledge of diabetic retinopathy, absence of physician referral, and perception of having no eye problems.
Conclusion: DR screening uptake was markedly low and influenced largely by preventable knowledge- and system-related barriers.
Recommendation: Integrating structured patient education, nurse-led counselling, and standardized referral pathways within diabetes clinics may improve screening adherence and reduce preventable vision loss.