Valentine Group Health
Nancy C. Sharts-Hopko, PhD, RN, FAAN
Professor and Director, PhD Program
College of Nursing
Villanova University
Background:
Dr. Nancy Sharts-Hopko teaches and directs the PhD Program in the College of Nursing at Villanova University. With a specialty in women’s health, her research over the past 35 years has addressed women’s experiences of health and life transitions including menopause, hysterectomy, childbearing in a foreign country, a diagnosis of HIV, disabilities, and specifically, most recently, vision loss.
At present she is a Co-PI on a Robert Wood Johnson Foundation grant to examine the effect on senior faculty of the Institute of Medicine’s recommendation that the number of doctorally prepared nurses be doubled by the year 2020. She has over 160 publications in journals that include Nursing Research, Advances in Nursing Science, MCN: The American Journal of Maternal Child Nursing, Image, Nursing Education Perspectives, and others.
Dr. Sharts-Hopko began her career as a staff nurse in the neonatal intensive care unit at New York Hospital – Cornell University College of Medicine in New York City. She began her teaching career at Lehman College in the City University of New York, and subsequently taught for several years at the University of Delaware. Prior to joining the faculty at Villanova University, Dr. Sharts-Hopko served as a Visiting Lecturer at St. Luke’s College of Nursing in Tokyo in her capacity as an Overseas Associate of the Presbyterian Church USA. She previously served as a short-term consultant for the World Health Organization in Bangladesh. She served eight years in the U. S. Army Reserve.
Dr. Sharts-Hopko earned her BSN at Indiana University in Indianapolis, where she currently serves as a member of the Dean’s Advisory Committee, and her MA and PhD at New York University. She has served as a member of two advisory committees of the U.S. Food and Drug Administration, and currently serves as Treasurer of Sigma Theta Tau International. She was inducted as a Fellow in the American Academy of Nursing in 1990.
Overview:
Baby boomers are a risk for poor eye health. Research shows that they do not take care of their eyes. They tend to report being unconcerned about their eyes. Most believe they tend not to perceive risk even if they are older than 65 and even if they have a family history. Over 1/3 of adults over 65 fail to have annual eye exams. Among people who don’t wear glasses, must 21% get yearly eye exams. Fewer than 1/3 report consistent wearing of sun glasses. Just 1% have stopped smoking, just 7% have increased intake of eye-protective vegetables, and just 2% have started exercising.
Scope of the problem: Over 21 million non-institutionalized adults live with visual impairment in the US, expected to increase by up to 500,000 per year by 2025. Visual impairment among the 10 most common causes of disability in the US. Visual impairment is associated with diminished life expectancy and quality of life even when the impairment is moderate rather than severe and even if only 1 eye is involved.
Defining low vision; vision in the better-corrected eye of less than 20/40. Blindness: visual acuity of 20/200 in the better-seeing eye. This does not take into account some visual disturbances such as dimming, glare, clouding, partial loss of a visual field, or the presence of a large number of floaters. Biggest causes of vision loss: glaucoma, cataracts, macular degeneration, diabetic retinopathy. In common: Alterations in microcirculation.
Dr. Sharts-Hopko’s research at Villanova targeted on a focus group study of women with low vision or now vision showed that accessing routine health services is harder and clinicians are insensitive. Most educational material is print. People have a difficult time with transportation to health services and negotiation of health care settings. Clinicians and non-clinicians assume that people with sensory deficits are hard of hearing or incapable of taking care of themselves. Clinicians tend to underutilize beneficial referral services. Patients fear that clinicians “cut corners” when they are not watched. Staff may fail to offer assistance – e.g. completing forms. Patients report that isolation and depression are common. Normal health maintenance activities may be skipped – by patients or by providers because they seem too difficult.
Secondary analyses of the large annual Centers for Disease Control data base, the National Health Interview Survey that she conducted have shown that low vision and blind women are less likely to be employed than normal vision women and have more restricted activities of daily living and social activities; they are more likely to report that they cannot afford a prescription or dental care and they are substantially less likely to have had a Pap test in the past 2 years. They are much likelier to report that they have cardiovascular disease, diabetes and obesity. They are more likely to smoke than women with normal vision. They are likelier to report anxiety, depression, hopelessness, sadness, and panic attacks. And finally, they are likelier than women with normal vision to have experienced falls and bone and joint injury. The saddest relationship observed is that women with low vision or no vision are likelier than sighted women to have ever spent time in a homeless shelter.
3 Key Points:
- Eye health assessment is an important component of overall health promotion and disease prevention, particularly as people age.
- Lifestyle changes can reduce the risk of developing major eye diseases and they are largely the same lifestyle changes recommended for prevention of diabetes and heart disease.
- People seeking health care and health care providers need to incorporate visual health promotion and, if needed, vision loss management into a holistic plan of care.
