Vision in sight : the relationships between knowledge, health beliefs and treatment outcomes : the case of amblyopia

Abstract: The research reported is an experimental study on the effects of intensified education of parents of children with amblyopia on their understanding of the nature of the disease, its origins and treatment. Parents in the control group were exposed to the ordinary information provided at two departments of pediatric ophtalmology, whereas parents in the experimental group, attending the same clinics, were asked to read a booklet aiming at enhancing their understanding of the meaning of amblyopia and amblyopia-related phenomena. Before these measures were taken, all parents were interviewed about their conceptions of amblyopia, strabismus and the treatment. Data were generated in single subject, semi-structured, in-depth interviews which were taped and transcribed in extenso. The interviews were analysed according to the phenomenographic approach. Parallel to the interviews the subjects had also filled out a questionnaire assessing general and specific attitudes towards disease and treatment (the Health Belief Model). After an interval of 6 - 8 months, these measures with the parents were repeated. Compliance with the regimen were measured after 18 months of treatment through the development of visual acuity of the children. Visual acuity was tested by methods suitable for the age of the child. The results of the study reveal a superior understanding among parents in the experimental group. This means that they have a deeper insight into the field of amblyopia and its treatment than the control group. The experimental group had also changed attitudes towards disease and treatment in a direction that would favour compliance more than the control group. The most interesting finding in this study is the significant relationship between the parents' knowledge about amblyopia and its treatment and compliance as measured through development of visual acuity. It is also emphasised that health care personnel would profit from being aware of the nature of common misconceptions of diseases and their treatment, in the sense that they would be better prepared for entering instructional dialogues with patients or, in this case, other persons responsible for the management of prescriptions provided.