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Charlotte Schramm, Sybille Gräf, Natalia Radionova, Monika A Rieger, Dorothea Besch, Kai Januschowski; Problems in occlusion therapy - a qualitative study with parents and educators. Invest. Ophthalmol. Vis. Sci. 2015;56(7 ):2189.
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The main problem while treating amblyopia (weak-sightedness) is malcompliance of both - children and parents - to occlusion instructions/ guidelines. The aim of this study is a description of the current situation and problems of occlusion therapy in Germany using structured interviews.
We performed 25 single structured interviews with adults who are involved in occlusion therapy as parents, educators or former patients who were treated with occlusion therapy in their childhood. Interviews were performed with persons of each of the following groups: parents and day-care workers of children with well-functioning therapy as well as parents and day-care workers of children with mal-functioning therapy and adults who received an occlusion therapy themselves in their childhood. The interview partners were recruited over the outpatient clinic in the University Eye Clinic Tuebingen, Department for strabology, motility disorders and children diseases. For the interviews standardized questions were used and different sociodemographic data according to the interview partner assessed additionally. Qualitative data analysis was carried out using Mayring’s content analysis method.
The analysis shows that occlusion therapy works fine in public day-care centers in spite of the anxiety of the most parents. In the age of 2 to 6 years social discrimination or isolation is not common. But an important point and potential pitfall in therapy compliance is the missing information about amblyopia of day-care workers. Day-care workers in Germany are officially not authorized care about the childrens’ health issues like administering drugs. However, the interviewed day-care workers felt responsible and coped well with patching therapy. The social background of the patients seems not to have an impact on dealing with occlusion therapy.
Against current view performing occlusion therapy in day-care centers is a good alternative to patching at home. This is important considering that mothers tend to return to their working life soon following childbirth. Therefore day-care is more and more carried out in different forms (like kindergarten or nanny) and an official authorization for day-care workers to care about the childrens` health issues has to be politically discussed. Moreover, a better information of day-care workers about occlusion therapy is necessary.
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