The impact of an interactive, multifaceted education approach for congenital cataract on parental anxiety, knowledge and satisfaction: A randomized, controlled trial

Patient education in pediatric ophthalmology: a systematic review

BACKGROUND

Patient and caregiver education may have the potential to improve understanding, adherence, and disease outcomes in pediatric ophthalmology. Research suggests that common clinical practices may result in suboptimal patient understanding. We summarize the current literature on patient education interventions in pediatric ophthalmology.

METHODS

A predefined search strategy was used to systematically review the PubMed database. Peer-reviewed published studies that utilized a specific educational intervention regarding any condition in pediatric ophthalmology and measured its impact were included.

RESULTS

Our search method yielded 453 studies; 30 passed title and abstract screening, and 14 were included in the final analysis. Of the 14 studies, 9 were randomized controlled trials. Eight studies relied solely on printed information, 2 were computer-based, 1 was an animated video, and 3 were multifactorial. Outcome measures included adherence (6/14), caregiver knowledge (6/14), psychological impact (4/14), visual outcome (2/14), and clinic attendance (1/14).

CONCLUSIONS

The educational interventions varied widely in methodology, content, and focus of intervention; nonetheless, they were widely successful across outcome measures. A number of studies featured highly time- and cost-effective interventions that resulted in increased knowledge, decreased anxiety, enhanced adherence, and improved visual outcomes. Educational efforts may be especially beneficial among non-native language speakers, particularly via image-based means of communication.

Psychological Impact of Caregiving for Children With Eye Diseases: A Systematic Review and Meta-analysis

PURPOSE

To identify and characterize the psychological impact of caregiving for children with eye disease. Awareness of the caregiving experience and insight into the factors related to caregiver burden is necessary to support high-quality ophthalmic care and develop supportive interventions.

METHODS

The databases MEDLINE (Ovid), CINAHL, EMBASE, Cochrane Library, PsychINFO, PubMed, and Google Scholar were queried up to June 25, 2021. Studies included assessed the psychological impact of providing care to children with eye diseases. A risk of bias assessment was performed according to the Modified Downs and Black Checklist. Demographic data and measures of burden were extracted and tabulated.

RESULTS

A total of 2,823 articles were screened, 28 underwent data extraction, and 7 were included in the meta-analysis. The meta-analysis indicated significant levels of burden (40% mild, 95% CI: [0.28 to 0.53]; 59% moderate, 95% CI: [0.36 to 0.82]; 7% severe, 95% CI: [0.02 to 0.11]) and depression (26% mild, 95% CI: [0.17 to 0.35]; 8% moderate, 95% CI: [0.03 to 0.14]); 11% severe, 95% CI:[0.03 to 0.10]). Interventions such as educational programs, life skills training programs, and other home-based early intervention programs were shown to improve psychological well-being of families.

CONCLUSIONS

Caregivers experience significant levels of burden and depression, which may, in turn, affect the level of ophthalmic care they can provide for their children. Further studies investigating educational or psychological interventions for parents are needed, because the small number of studies that investigated these types of interventions have reported reduced parental stress and improved well-being. [J Pediatr Ophthalmol Strabismus. 20XX;X(X):XX-XX.].

Predictors of parental satisfaction with the pediatric ophthalmology care in a Brazilian hospital

The purpose of this cross-sectional study was to assess the satisfaction of parents of visually impaired children with the pediatric ophthalmology care in a Brazilian hospital and to associate parental satisfaction with predictor variables. The study enrolled children with a binocular and monocular visual impairment aged between 4 and 17 years from a single site in Brazil between June 2019 and May 2020. Parents or legal guardians answered the Brazilian version of the Pediatric Quality of Life Inventory^TM (PedsQL^TM 3.0) Healthcare Satisfaction Generic - Parents. Linear regression analysis was used to investigate the association between the PedsQL scores and predictor variables. The sample included 82 children and their respective parents. The mean PedsQL score was 90.3 ± 6.6 (out of 100). In the univariate model, child female sex (p = 0.056), child older age (p = 0.078), better eye visual acuity (VA; p = 0.016), and worse eye VA (p = 0.008) were significantly associated with higher scores. The multivariate estimates identified the worse eye VA (p = 0.034) as a predictor of parental satisfaction. In summary, parents' satisfaction with this pediatric ophthalmology care was high. Nevertheless, a continuous evaluation is warranted to keep up with parents' expectations and plan for possible improvements in clinical practice.

A Multifaceted Strategy to Enhance Glaucoma Knowledge and Reduce Anxiety in the Uyghur Population of Rural China

Purpose. The aim of the study is to assess the impact of a multifaceted education strategy for Uyghur patients with glaucoma on their anxiety, satisfaction, and comprehension of disease information in rural China. Methods. This study recruited 100 patients who were randomized into two groups: the control group that received a conventional consultation and the intervention group that received a multifaceted education approach. Information comprehension was evaluated using a 15-item questionnaire. A 6-item State-Trait Anxiety Inventory (STAI-6) score was used to assess patient anxiety levels. Satisfaction was evaluated on the day of discharge. Results. After education, patients in the intervention group scored significantly higher than those in the control group on their knowledge of glaucoma ( $p\le 0.001$ ). Education level, family history of glaucoma, and number of glaucoma clinic visits were independently associated with baseline scores (p = 0.038, 0.002, and 0.017, respectively). The age was negatively correlated with scores ( $p\le 0.001$ ) after education. The STAI-6 score of the intervention group was 28.50 ± 5.13, which was significantly lower than that of the control group (32.50 ± 6.47, p = 0.001). Income levels were negatively correlated and the duration of glaucoma was positively correlated with STAI-6 scores ( $p\le 0.001$ and $p=0.003$ , respectively). Overall satisfaction was significantly higher in the intervention group ( $p\le 0.001$ ). The knowledge score was positively correlated with overall satisfaction and follow-up probability (both $p\le 0.001$ ). The STAI-6 score was negatively correlated with overall satisfaction and follow-up probability ( $p=0.017$ and 0.006, respectively). Conclusions. This new multifaceted educational strategy can enhance patients’ knowledge of glaucoma, reduce their anxiety, and improve their satisfaction. ClinicalTrials.gov (No. 2100050926)

An exploratory study on support for caregivers of people with vision impairment in the UK

Purpose

Many of the UK's 2.5 million individuals living with vision loss receive support from relatives or friends (so‐called ‘informal caregivers’). However, there is limited understanding of how caregivers of people with visual impairment (PVI) are, or feel, supported by UK healthcare/statutory services and charities. This exploratory study was conducted to explore caregivers' experiences and their suggestions for enhancing support.

Methods

Participants self‐identifying as UK‐based caregivers of PVI (N = 100) volunteered to undertake an online survey, distributed through charity partners. The survey was comprised of the Client Satisfaction Questionnaire‐8 (CSQ‐8, a validated, self‐report measure of satisfaction with support services), Likert‐type questions and two open‐ended, free‐text questions. Interview participants (N = 22) were then selected from survey respondents, and semi‐structured interviews were conducted to focus on caregivers' ideas for improving support. The Framework Method was used for inductive analysis of the free‐text question responses and interview data.

Results

The mean (SD) CSQ‐8 score was 21.60 (7.2), with no significant differences by demographic, relationship or vision‐related factors, likely limited by the small subgroup sizes. Qualitative data demonstrated the heterogeneity of participating caregivers' experiences, highlighting the importance of personalised support for caregivers. Many participants advocated enhancing informational, practical, emotional and social support for caregivers, and stressed the importance of accessible services and consistent points of contact to turn to for support and advice.

Conclusions

Although our sample was arguably better connected to support services than the general caregiver population, this study identified concrete suggestions to improve practical, emotional and peer support for caregivers of PVI.

Efficacy of Scenario Simulation-Based Education in Relieving Parental Anxiety about Fever in Children

PURPOSE

This study was designed to evaluate the short- and long-term effects of a scenario simulation-based education intervention on parental anxiety about fever in their children.

DESIGN AND METHODS

This experimental research was conducted using a two-group pretest-posttest design. One hundred and sixty parents of 3-month to 5-year-old children enrolled in preschools and kindergartens with childcare services were recruited as participants using cluster random sampling. The participants were divided randomly into an experimental group (80) and a control group (80). The former participated in a scenario simulation-based education intervention and received a fever education booklet. The latter received the booklet only. Data were collected using the Children's Fever Anxiety Inventory at three time points: before the intervention (pretest, T1) and at six-month (T2) and 12-month (T3) posttests.

RESULTS

Significant intergroup differences in fever anxiety were found at both T2 and T3 (p < .001). For both groups, the scores at T2 and T3 were significantly lower than at T1 (p < .001) and the difference between T2 and T3 did not attain statistical significance (p > .05). Although both groups experienced reduced fever anxiety over time, this reduction was significantly greater in the experimental group than in the control group (p < .001).

CONCLUSION

Simulation-based education may be used in conjunction with the traditional fever education booklet to further reduce parent fever anxiety over time.

PRACTICE IMPLICATIONS

This simulation-based education approach significantly and positively impacts parental anxiety about fever in their children. Furthermore, the approach may be generalizable to other childhood healthcare settings.

Construction and validation of a Brazilian educational comic book for pediatric perioperative care

PURPOSE

Educational material can facilitate familiarization with the hospital and surgical contexts for children and guardians and minimize potential difficulties experienced during hospitalization. This study aimed to construct and validate a comic book for guiding children in perioperative care.

DESIGN AND METHODS

A descriptive study was conducted at a pediatric ward in a university hospital in Brazil. A content validity index with a concordance of 0.8 was used for validation.

RESULTS

The content was validated with the participation of 19 content judges (nurses, anesthesiologists, and surgeons); face validity was achieved with the participation of 22 parents and their respective children aged 7-12 years old. The contents of the comic book included perioperative care (hospitalization, fasting, surgical team, operating room, and anesthesia). Universal content validity indices of 0.89 and 0.99 were obtained for content and face validity, respectively. Free Portuguese educational material titled "Getting to know the Surgery Center" was created in the form of a 19-page comic book in print and digital formats. The comic book was face and content validated and considered relevant for children in perioperative care. The suggestions of the healthcare professional and families who participated contributed toward the final version of this educational comic book.

PRACTICE IMPLICATIONS

This study aimed to further the development of educational materials that help alleviate stress, fear, and anxiety among children awaiting surgery, as well as their parents/guardians. As such, it offers a positive and appropriate contribution to perioperative nursing. The study further contributes to a discussion on pediatric nursing, which goes beyond clinical care and procedure. In the context of pediatric surgery and the children themselves, the results indicate that the family must be included in the surgical process and that the language employed must be appropriate to the target audience. Our comic book can be used by nurses to develop similar resources for diverse needs.

Knowledge about cataract and associated factors among adults in Yirgalem town, Sidama National Regional State, southern Ethiopia, 2020: a community based cross sectional study design

BACKGROUND

Globally, at least 1 billion people have a vision impairment that could have been easily prevented or easily treated. Cataract is the leading preventable and most treatable causes of blindness and bilateral low vision among adults. Despite being the leading cause of preventable and most treatable blindness, the lack of knowledge about the disease and its option of treatment is still a major barrier in reducing the blindness owing to cataract in the developing countries particularly in Ethiopia. Hence, the aim of this study is to determine the level of knowledge about cataract and associated factors among adults in Yirgalem Town, Sidama National Regional State, Southern Ethiopia, 2020.

METHODS

A community-based cross-sectional study design was conducted among randomly selected 599 adult's age 18 years and above from May 10-30, 2020. A multi-stage sampling technique was used to select the study participants. Data were collected using pre-tested and structured face-to-face interview questionnaires. The collected data were entered to Epi data version 3.1 and then exported to SPSS version 21 for analysis. Bi-variable and multivariable logistic regression was used to identify associated factors of knowledge about cataract. Adjusted Odds Ratio (AOR) together with 95% Confidence Interval (CI) was used to declare the statistical association between dependent and independent variables.

RESULTS

Of the total study participants, 379 (64.7%), [(95% CI: 60.7-68.6%)] of them had good knowledge about cataract. Age (≥40 years) [AOR = 2.29(95% CI 1.18-4.44)], Elementary school completed [AOR = 2.31(95% CI 1.30-4.10)], High school & above [AOR = 5.55(95% CI 2.81-10.89)], governmental and non-governmental employed [AOR = 5.62 (95% CI 2.78-11.38)], Merchant [AOR = 1.72(95% CI 1.03-2.88)], Positive Attitude [AOR = 3.85(95% CI 2.94-6.47)] were positively significantly associated with knowledge about cataract. Whereas, rural residence [AOR = 0.19 (95% CI: 0.12-0.31)] was negatively associated with knowledge about cataract.

CONCLUSIONS

More than one third of the participants still had poor knowledge about cataract. This implies that health facilities should be engaged and raises the awareness of the community and empowers people about eye care needs.