Academic and Research Department, Hospital for Children Eye ENT and Rehabilitation Services, Bhaktapur, Nepal
Academic and Research Department, Hospital for Children Eye ENT and Rehabilitation Services, Bhaktapur, Nepal.
BMJ Open. 2024 Aug 13;14(8):e087287. doi: 10.1136/bmjopen-2024-087287.
This study aims to determine the factors influencing eye care service utilisation and compliance with spectacles wear among school students.
Mixed-methods study.
27 community schools from 6 districts of Bagmati province of Nepal.
Adolescents with mild vision impairment who were screened at schools by their trained peers for visual acuity measurement and subsequently received subsidised spectacles for refractive error correction. For the quantitative study, 317 students from 21 schools completed the survey. For qualitative study, 62 students from 6 schools participated in 6 focus group discussions.
Utilisation of eye care services and compliance with spectacles wear.
Among 317 students, 53.31% were aged 15-19, and 35.96% were male. More than half (52.68%, n=167) did not use eye health services. Among students who did not go, 51.50% reported eye health facilities being far away. Thematic analysis showed that distance, COVID-19 and awareness were influential in the utilisation of eye care. The multivariate analysis showed urban residents were likelier (adjusted OR (AOR) 4.347, 95% CI 2.399 to 7.877, p<0.001) to use eye care services. During an unannounced visit to schools after 3-4 months of spectacles distribution, 188 (59.31%) students were wearing spectacles. 20.16% of students not wearing spectacles reported they did not feel the need. Thematic analysis showed the influence of family and peers, affordability, aesthetic appearance, comfortability and symptomatic relief in spectacles compliance. The multivariate analysis showed that urban residents (AOR 2.552, 95% CI 1.469 to 4.433, p<0.001), older adolescents (AOR 1.758, 95% CI 1.086 to 2.848, p=0.022), mothers with paid jobs (AOR 2.440, 95% CI 1.162 to 5.125, p=0.018) and students visiting eye care centres (AOR 1.662, 95% CI 1.006 to 2.746, p=0.047) were more likely to be compliant with spectacles wear.
There are multiple barriers for students to use eye care services and stay compliant with spectacles wear. Eye health programmes should include eye health promotion and be accessible, affordable and equitable.
本研究旨在确定影响学生接受眼科保健服务和遵医嘱配镜的因素。
混合方法研究。
尼泊尔巴格马蒂省 6 个区的 27 所社区学校。
由经过培训的同伴在学校筛查视力，发现有轻度视力障碍的青少年，并为他们提供经补贴的矫正屈光不正的眼镜。在定量研究中，来自 21 所学校的 317 名学生完成了调查。在定性研究中，来自 6 所学校的 62 名学生参加了 6 个焦点小组讨论。
眼科保健服务的利用情况和遵医嘱配镜情况。
在 317 名学生中，53.31%的年龄在 15-19 岁之间，35.96%为男性。超过一半（52.68%，n=167）的学生未使用眼健康服务。在未去的学生中，51.50%的人表示眼健康设施距离遥远。主题分析表明，距离、新冠肺炎疫情和意识都会影响对眼科保健的利用。多变量分析显示，城市居民更有可能（调整后的比值比（AOR）4.347，95%置信区间 2.399 至 7.877，p<0.001）使用眼科保健服务。在发放眼镜 3-4 个月后，对学校进行了一次突击访问，发现 188 名（59.31%）学生正在戴眼镜。有 20.16%的不戴眼镜的学生表示他们不需要戴眼镜。主题分析表明，家庭和同伴、可负担性、美观、舒适性和症状缓解对戴眼镜的依从性有影响。多变量分析表明，城市居民（AOR 2.552，95%置信区间 1.469 至 4.433，p<0.001）、年龄较大的青少年（AOR 1.758，95%置信区间 1.086 至 2.848，p=0.022）、有薪工作的母亲（AOR 2.440，95%置信区间 1.162 至 5.125，p=0.018）和去眼科保健中心的学生（AOR 1.662，95%置信区间 1.006 至 2.746，p=0.047）更有可能遵医嘱配镜。
学生在使用眼科保健服务和遵医嘱配镜方面存在多种障碍。眼健康方案应包括眼健康促进，并应具有可及性、可负担性和公平性。
