Osborne Daniel, McGowen Maddison, Bradshaw Jeremy, Ellis Helen, Evans Megan, Stallwood James, Fliege Joerg, Self Jay
University Hospital Southampton NHS Foundation Trust, Southampton, UK.
Faculty of Medicine, University of Southampton, Southampton, UK.
Br Ir Orthopt J. 2025 Apr 29;21(1):59-65. doi: 10.22599/bioj.404. eCollection 2025.
BACKGROUND: Patching therapy is the most common treatment for amblyopia (lazy eye) and is unsuccessful for approximately 40% of patients, leaving them with life-long unilateral visual impairment and increased risk of bilateral visual impairment later in life. Poor adherence to patching therapy is a major contributing factor in treatment failure yet we lack real-world understanding as to why this is a problem outside of controlled research studies. METHODS: In collaboration with patient contributors, we developed an online survey for past patients, parents/carers of children with amblyopia, health professionals, and schoolteachers. The survey included questions about when and where is best for children to wear the patch, the design of the patch, and facilitators and barriers to patching therapy. RESULTS: We received 631 responses to the survey (259 health professionals, 213 parents/carers, 110 people who patched as a child, 7 teachers, and 42 people matched to multiple categories). Healthcare professionals thought weekday (54.4% versus 14.3% preferring weekend and 31.3% no difference) and school (54.4% versus 21.6% preferred home and 23.9% no difference) patching was more successful. Past patients (52.4%) favoured 'force' as a technique to encourage patching; more than both health professionals (7.7%) and parents or carers (19.7%). Patients rated 'people making fun' of them as an important barrier to patching. CONCLUSIONS: We describe surprising differences in stakeholders' responses to the survey questions about barriers to successful patching treatment. We suggest these differences are used as a guide for further work to explore stakeholder's social experience of patching.
背景:遮盖疗法是治疗弱视( lazy eye )最常用的方法,但约40%的患者治疗效果不佳,导致他们终身单眼视力受损,且日后双眼视力受损的风险增加。遮盖疗法依从性差是治疗失败的一个主要因素,但我们缺乏对这一问题在对照研究之外为何成为问题的实际了解。 方法:我们与患者贡献者合作,为弱视患者、弱视儿童的父母/照顾者、健康专业人员和学校教师开展了一项在线调查。该调查包括关于儿童佩戴眼罩的最佳时间和地点、眼罩的设计以及遮盖疗法的促进因素和障碍等问题。 结果:我们共收到631份调查问卷回复(259名健康专业人员、213名父母/照顾者、110名曾在儿童时期接受遮盖治疗的人、7名教师以及42人属于多个类别)。医疗保健专业人员认为在工作日进行遮盖治疗(54.4%,而14.3%的人更喜欢在周末,31.3%的人认为无差异)以及在学校进行遮盖治疗(54.4%,而21.6%的人更喜欢在家中,23.9%的人认为无差异)更为成功。曾接受过遮盖治疗的患者(52.4%)倾向于采用“强制”手段鼓励遮盖治疗;这一比例高于健康专业人员(7.7%)和父母或照顾者(19.7%)。患者将他人“取笑”他们视为遮盖治疗的一个重要障碍。 结论:我们描述了利益相关者对关于成功遮盖治疗障碍的调查问题的回答中存在的惊人差异。我们建议将这些差异作为进一步工作的指导,以探索利益相关者遮盖治疗的社会体验。
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