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Why is compliance with occlusion therapy for amblyopia so hard? A qualitative study
  1. M Dixon-Woods1,
  2. M Awan2,
  3. I Gottlob2
  1. 1Department of Health Sciences, University of Leicester, Leicester, UK
  2. 2Department of Ophthalmology, University of Leicester
  1. Correspondence to:
    Dr Mary Dixon-Woods
    Department of Health Sciences, University of Leicester, 22–28 Princess Road West, Leicester LE1 6TP, UK; md11{at}le.ac.uk

Abstract

Objective: To explore parents’ perceptions and experiences of occlusion (patching) therapy for treatment of amblyopia in children.

Methods: Qualitative study involving semistructured interviews with 25 families of a child with amblyopia being treated at a specialist clinic. Interviews were tape recorded and transcribed verbatim. Data analysis was based on the constant comparative method, assisted by qualitative analysis software.

Results: Parents of children prescribed patching treatment found themselves obliged to manage the treatment. This involved dilemmas and tensions, with many parents describing children’s distress, particularly in the early stages of patching treatment. Parents were highly sensitive to the credibility of the treatment, but were sometimes confused by information given in the clinic or did not see clinic staff as authoritative. There was evidence that parents were likely to abandon or modify treatment if no improvement could be detected or if the child continued to suffer socially or educationally. Parents described a range of strategies for facilitating patching, including explanation; normalisation; rewards; customising the patch; establishing a routine; and enlisting the help of others. Whatever their practices in relation to patching, parents were keen to defend their behaviour as that of a “good parent”.

Conclusions: Interventions that aim to improve compliance should take account of the difficulties and tensions experienced by parents, rather than simply treating non-compliance as resulting from information deficits. Practical support that builds on strategies described by parents is likely to be of benefit.

  • amblyopia
  • patient compliance
  • qualitative research

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Footnotes

  • Published Online First 10 March 2006

  • Competing interests: none declared

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