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英国视光师对近视和近视管理的看法和态度。

Eyecare practitioner perspectives and attitudes towards myopia and myopia management in the UK.

机构信息

School of Optometry and Vision Science, University of Bradford, Bradford, UK.

School of Optometry and Vision Science, University of Bradford, Bradford, UK

出版信息

BMJ Open Ophthalmol. 2024 Jan 11;9(1):e001527. doi: 10.1136/bmjophth-2023-001527.

Abstract

OBJECTIVE

Many children with progressive myopia are still prescribed single-vision correction. An investigation into UK eyecare practitioners' (ECPs) perceptions of myopia management was carried out to ascertain factors which may be limiting its implementation and uptake within clinical practice.

METHODS AND ANALYSIS

Online focus groups were held with UK ECPs. Participants were encouraged to discuss their knowledge of the available myopia management options, their perception of how myopia management is being delivered in the UK and any barriers limiting ECPs' prescribing of these management options in practice. The discussions were transcribed and analysed thematically.

RESULTS

Focus groups were held with 41 ECPs from primary and secondary eyecare. ECPs felt that provision of myopia management in the UK is variable. Most ECPs believe they have sufficient knowledge, but felt a lack of confidence in decision-making and practical experience. Less experienced ECPs sought more definitive guidance to support their decision-making. ECPs desired clarity on their duty of care obligations and were concerned over possible future litigation if they had not offered, or referred for, myopia management when indicated. The greatest barrier appears to be financial-treatment is expensive and ECPs are uncomfortable communicating this to parents. Many barriers were indicative of systemic problems within UK eyecare, such as commercial pressures, inadequate National Health Service funding and poor public awareness of paediatric eyecare.

CONCLUSION

Myopia management is not implemented consistently across the UK. To improve accessibility, changes are required at multiple levels, from individual ECPs through to wider stakeholders in UK eyecare provision.

摘要

目的

许多进展性近视的儿童仍被处方单光矫正。本研究旨在调查英国眼保健从业者(ECP)对近视管理的认知,以确定可能限制其在临床实践中实施和应用的因素。

方法与分析

采用在线焦点小组的方式对英国 ECP 进行调查。鼓励参与者讨论他们对现有的近视管理选择的了解,他们对英国近视管理实施情况的看法,以及限制 ECP 在实践中开具这些管理选择的任何障碍。讨论内容被转录并进行主题分析。

结果

共对来自初级和二级眼保健的 41 名 ECP 进行了焦点小组讨论。ECP 认为英国提供的近视管理措施各不相同。大多数 ECP 认为他们有足够的知识,但在决策和实践经验方面缺乏信心。经验较少的 ECP 寻求更明确的指导以支持他们的决策。ECP 希望明确其护理责任义务,并担心如果没有提供或转介近视管理,他们可能会面临未来的诉讼。最大的障碍似乎是经济方面的——治疗费用昂贵,ECP 不愿与家长沟通这一点。许多障碍表明英国眼保健存在系统性问题,例如商业压力、国家卫生服务资金不足以及公众对儿童眼保健的认识不足。

结论

英国各地的近视管理实施不一致。为了提高可及性,需要从个体 ECP 到英国眼保健提供者的更广泛利益相关者等多个层面进行改变。

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