Tjiam A M, Asjes-Tydeman W L, Holtslag G, Vukovic E, Sinoo M M, Loudon S E, Passchier J, de Koning H J, Simonsz H J
a Department of Ophthalmology , Erasmus MC, University Medical Center Rotterdam , Rotterdam , the Netherlands.
b Department of Ophthalmology , Rotterdam Eye Hospital , Rotterdam , the Netherlands.
Strabismus. 2016 Sep;24(3):120-35. doi: 10.1080/09273972.2016.1205101. Epub 2016 Aug 2.
This implementation study evaluated orthoptists' use of an educational cartoon ("the Patchbook") and other measures to improve compliance with occlusion therapy for amblyopia.
Participating orthoptists provided standard orthoptic care for one year, adding the Patchbook in the second year. They attended courses on compliance and intercultural communication by communication skills training. Many other compliance-enhancing measures were initiated. Orthoptists' awareness, attitude, and activities regarding noncompliance were assessed through interviews, questionnaires, and observations. Their use of the Patchbook was measured. The study was performed in low socio-economic status (SES) areas and in other areas in the Netherlands. It was attempted to integrate education on compliance into basic and continuing orthoptic training.
The Patchbook was used by all 9 orthoptists who participated in low-SES areas and 17 of 23 orthoptists in other areas. Courses changed awareness and attitude about compliance, but this was not sustained. Although orthoptists estimated compliance during patching at 70%, three-quarters never suspected noncompliance during a full day of observation in any of their patients. Explanations to parents who spoke Dutch poorly were short. In the second year, explanations to children were longer. Implementation of all 7 additional compliance-enhancing measures failed. Education on compliance was not integrated into orthoptists' training.
Almost all orthoptists used the Patchbook and, as another study demonstrated, it proved to be very effective, especially in low-SES areas. Duration of explanation was inversely proportional to parents' fluency in Dutch. Noncompliance was rarely suspected by orthoptists. Although 7 additional compliance-enhancing measures had been conceived and planned with the best intentions, they were not realized. These required extra, unpaid time from the orthoptists, which is especially scarce in hospitals in low-SES areas where the educational cartoon is most needed.
本实施性研究评估了视光师对一部教育动画片（“眼罩治疗手册”）的使用情况以及其他旨在提高弱视遮盖治疗依从性的措施。
参与研究的视光师在第一年提供标准的视光护理，第二年增加使用眼罩治疗手册。他们通过沟通技能培训参加了关于依从性和跨文化交流的课程。还启动了许多其他提高依从性的措施。通过访谈、问卷调查和观察对视光师关于不依从的认知、态度和行为进行评估。测量他们对眼罩治疗手册的使用情况。该研究在荷兰社会经济地位较低（SES）的地区和其他地区进行。试图将依从性教育纳入基础视光培训和继续视光培训。
在社会经济地位较低地区参与研究的所有9位视光师以及其他地区23位视光师中的17位使用了眼罩治疗手册。课程改变了对视光依从性的认知和态度，但这种改变未能持续。尽管视光师估计遮盖治疗期间的依从率为70%，但在对任何一位患者进行一整天的观察中，四分之三的视光师从未怀疑过不依从情况。对荷兰语说得不好的家长的解释很简短。在第二年，对孩子的解释变长了。另外7项提高依从性的措施全部实施失败。依从性教育未纳入视光师的培训中。
几乎所有视光师都使用了眼罩治疗手册，并且正如另一项研究所表明的，它被证明非常有效，尤其是在社会经济地位较低的地区。解释的时长与家长荷兰语的流利程度成反比。视光师很少怀疑不依从情况。尽管另外7项提高依从性的措施是出于善意构思和规划的，但并未实现。这些措施需要视光师额外的、无报酬的时间，而在最需要这部教育动画片的社会经济地位较低地区的医院，这种时间尤其稀缺。
