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Knowledge, Attitudes, Beliefs, and Eye-Screening Practices Regarding Diabetic Retinopathy among Adults with Diabetes in Palestine: A Cross-Sectional Study

Year: 2026

Type: preprint

Abstract: Background Diabetic retinopathy (DR) is a major cause of preventable vision loss among adults with diabetes. Despite the importance of early detection, evidence regarding patients’ knowledge, attitudes, and eye-care practices in Palestine remains limited. This study aimed to assess these factors and identify factors associated with an eye examination within the previous year among adults with diabetes in the West Bank. Methods A cross-sectional study was conducted between March and August 2026 among 389 adults with diabetes recruited through convenience sampling in the West Bank, Palestine. Data were collected using a structured questionnaire assessing sociodemographic characteristics, DR knowledge, attitudes, and eye-care practices. Multivariable regression analyses were performed to identify factors associated with knowledge scores and self-reported eye examination within the previous year. Results The mean knowledge score was 7.96 ± 3.06 out of 12. Although 88.4% of participants recognized that diabetes could affect the retina, only 38.8% knew that DR could develop without symptoms. Most participants (94.1%) recognized the importance of regular eye examinations; however, only 51.7% reported undergoing an eye examination within the previous year, while 20.8% had never undergone one. Higher knowledge scores (adjusted odds ratio [aOR] 1.117, 95% CI 1.029–1.212) and physician referral (aOR 2.947, 95% CI 1.807–4.807) were independently associated with reporting an eye examination within the previous year. Men (aOR 0.530, 95% CI 0.305–0.922) and village residents (aOR 0.529, 95% CI 0.323–0.866) had lower adjusted odds of reporting an eye examination within the previous year. Attitudes and beliefs were not independently associated with recent eye examination after adjustment. Conclusion Despite widespread recognition of the importance of preventive eye care, substantial gaps in disease-specific knowledge and eye-examination practices persist among adults with diabetes in the West Bank. The observed associations between knowledge, physician referral, and recent eye examination, together with differences by sex and place of residence, support further investigation of strategies combining targeted education, consistent referral and follow-up and improved access to retinal assessment. Trial registration Not applicable

Source: Research Square

DOI: 10.21203/rs.3.rs-11203145/v1