Department of Ophthalmology, Kim's Eye Hospital, Konyang University, Seoul, Korea.
Graefes Arch Clin Exp Ophthalmol. 2013 Jan;251(1):315-9. doi: 10.1007/s00417-012-2099-0. Epub 2012 Jul 11.
To evaluate the psychosocial distress of part-time occlusion therapy in intermittent exotropia.
A total of 25 children (15 males and 10 females, aged 3 to 7 years, mean age 4.7 years) with intermittent exotropia were enrolled. Behavioral and psychosocial problems were assessed by the Korean Child Behavior Checklist (K-CBCL), which consists of eight categories of withdrawal, somatic problems, depression/anxiety, social problems, thought problems, attention problems, delinquent behavior, and aggressive behavior, and the Amblyopia Treatment Index (ATI). The ATI was designed to evaluate the three factors of compliance, adverse effect, and social stigma. The Parenting Stress Index (PSI) is a parent self-report designed to identify potentially dysfunctional parent-child systems. The K-CBCL was obtained before and after occlusion therapy, and the ATI and PSI were taken from parents only after occlusion therapy. We evaluated the change on the K-CBCL and the correlation between the K-CBCL and ATI.
The attention problem assessed by the K-CBCL significantly decreased after occlusion therapy. On the ATI, the social stigma was relatively lower than compliance and adverse effect factors (Likert scale 2.64, 3.11, and 3.11, respectively). The somatic problem assessed by the K-CBCL and compliance on the ATI were significantly correlated (p = 0.014). There was no significant change in percentile scores of each subscale (parental dominant scale and child dominant scale) of the PSI. Total stress index before and after occlusion therapy was 97.16 ± 8.38 and 97.00 ± 8.16 respectively (p = 0.382).
Occlusion therapy may influence the psychosocial impact on intermittent exotropia patients. Part-time occlusion significantly decreased the attention problem in children with intermittent strabismus. Children with a high somatic problem score on the KCBCL showed poor compliance to the part-time occlusion.
评估间歇性外斜视部分遮盖治疗的心理社会困扰。
共纳入 25 名间歇性外斜视儿童（男 15 名，女 10 名，年龄 3 至 7 岁，平均年龄 4.7 岁）。采用韩国儿童行为检查表（K-CBCL）评估行为和心理社会问题，该检查表由退缩、躯体问题、抑郁/焦虑、社会问题、思维问题、注意问题、违纪行为和攻击行为 8 个类别以及弱视治疗指数（ATI）组成。ATI 旨在评估依从性、不良反应和社会耻辱感 3 个因素。父母压力指数（PSI）是一种家长自评工具，用于识别潜在功能失调的亲子系统。K-CBCL 在遮盖治疗前后获得，ATI 和 PSI 仅在遮盖治疗后由家长获得。我们评估了 K-CBCL 的变化以及 K-CBCL 与 ATI 的相关性。
K-CBCL 评估的注意力问题在遮盖治疗后显著改善。在 ATI 中，社会耻辱感相对低于依从性和不良反应因素（Likert 量表分别为 2.64、3.11 和 3.11）。K-CBCL 评估的躯体问题和 ATI 的依从性显著相关（p=0.014）。PSI 的每个子量表（父母主导量表和儿童主导量表）的百分位分数均无显著变化。遮盖治疗前后的总应激指数分别为 97.16±8.38 和 97.00±8.16（p=0.382）。
遮盖治疗可能会影响间歇性外斜视患者的心理社会影响。部分遮盖治疗显著降低了间歇性斜视儿童的注意力问题。K-CBCL 躯体问题得分较高的儿童对部分遮盖治疗的依从性较差。
