Effect Of Family-centered Care On Treatment Compliance And Efficacy Of Children With Anisometropic Amblyopia

BackgroundAmblyopia is one of the common diseases affecting children’s visual development,which is the main factor leading to monocular visual impairment in children,and anisometropia is the common cause of amblyopia.If children’s amblyopia was not treated effectively in the early stage,their study,work and even health-related quality of life（HRQL）will be affected in adulthood.Refractive correction,covering therapy and amblyopia training can cure most of anisometropic amblyopia children.But in the process of treatment,due to various reasons lead to poor compliance,and then affect the treatment effect.With the change of modern medical model,family-centered care（FCC）has been gradually promoted,and has achieved positive results in disease treatment and health promotion of children with chronic diseases.ObjectiveTo explore the effect of family centered nursing mode on treatment compliance and curative effect of anisometropic amblyopia children,so then to seek out a more scientific and rational intervention project for the treatment of anisometropic amblyopia in children,at the same time,provide theoretical basis for improving the relevant intervention measures and empirical basis.MethodsThis study belongs to a kind of experimental study.We selected 124 children with anisometropic amblyopia（62 cases in each group）who visited the ophthalmic clinics of three hospitals（distributed in three districts）in Xinxiang City from June to September2019.The normal group was given routine treatment and nursing;The test group was given family centered nursing based on conventional treatment and nursing,including wearing glasses nursing,covering treatment nursing,comprehensive training guidance,psychological nursing,etc.the methods include establishing amblyopia education network platform,strengthening family visit.Demographic data of children with anisometropic amblyopia were collected by general information questionnaire.Treatment compliance score and best corrected visual acuity（BCVA）and effective rate of treatment were used as evaluation indexes.Data were collected before intervention（T0）,3 months（T1）,6 months（T2）,9months（T3）and 12 months（T4）to evaluate the intervention effect.All data were analyzed by spss25.0 software.The measurement data were described byx?s,and the count data were described by frequency and constituent ratio.Chi square test or Fisher exact probability method was used for counting data,and rank sum test was used for ordinal data.Repeated measurement data was analyzed by repeated measurement ANOVA.ResultsA total of 119 children with anisometropic amblyopia completed the whole study,the experimental group（n=60）and the control group（n=59）.Baseline characteristics were similar in the general information of amblyopia children and their families between these two groups（all P values>0.05）.1.Effect of family centered nursing on treatment compliance of children with anisometropic amblyopia（1）The treatment compliance scores of the experimental group at T1,T2,T3 and T4were significantly higher than those of the control group（t₁=12.13,P<0.001;t₂=8.08,P<0.001;t₃=6.59,P<0.001;t₄=9.91,P<0.001）.The effect of time on the treatment compliance of the experimental group was statistically significant（F=23.44,P<0.001）;The effect of time on treatment compliance in the control group was statistically significant（F=41.19,P<0.001）.（2）The compliance with refractive correction in the experimental group were higher than the other group at T1,T2 and T4（t₁=8.07,P<0.001;t ₂=6.42,P<0.001;t ₄=2.67,P<0.0125）;The effect of time on the treatment compliance of the experimental group was statistically significant（F=17.67,P<0.001）;The effect of time on treatment compliance in the control group was statistically significant（F=80.33,P<0.001）.（3）The scores of covering compliance at T1,T2,T3 and T4 in the experimental group were improved significantly in these two groups（t₁=11.13,P<0.001;t₂=8.07,P<0.001;t₃=7.34,P<0.001;t₄=9.66,P<0.001）;The influence of time factor on the treatment compliance of the experimental group was statistically significant（F=14.91,P<0.001）;The effect of time on treatment compliance in the control group was statistically significant（F=17.49,P<0.001）.（4）The comprehensive training compliance of the experimental group at T1,T2,T3 and T4 were significantly higher than that of the control group（t₁=11.43,P<0.001;t₂=7.84,P<0.001;t₃=7.82,P<0.001;t₄=8.07,P<0.001）;The effect of time on the treatment compliance of the experimental group was not statistically significant（F=4.75,P>0.0125）;The effect of time on treatment compliance in the control group was statistically significant（F=13.12,P<0.001）.2.The effect of family centered nursing on children with anisometropic amblyopia（1）At T0 stage before intervention,there was no significant difference in BCVA between the two groups（t₀=1.37,P=0.180）.At T1 and T2 stages of intervention,BCVA improved both in the experimental group（0.50±0.15,0.61±0.15）and the control group（0.46±0.17,0.54±0.16）,but the differences between the two groups were not statistically significant（t₁=1.32,P>0.01;t₂=2.48,P>0.05）.There were statistically significant differences at T3,T4 stages between the experimental group（0.71±0.15,0.81±0.13）and the control group（0.61±0.17,0.67±0.17）（t₃=3.52,P<0.01;t₄=5.27,P<0.001）;The influence of time on the visual acuity of the experimental group was statistically significant（F=423.77,P<0.0125）;The effect of time on visual acuity in the control group was statistically significant（F=182.29,P<0.001）.（2）At T1 stage,the treatment effective rate of the experimental group was 37.29%,and that of the control group was 33.33%.There was no significant difference between the two groups（Z₁=0.45,P=0.653）;At T2,T3 and T4,the effective rate of the experimental group（67.80%,90.00%,100.00%）was significantly higher than that of the control group（46.67%,65.00%,75%）（Z₂=2.32,P=0.020;Z₃=3.49,P<0.001;Z₄=4.00,P<0.001）。ConclusionsFamily-centered care can effectively improve the treatment compliance,bestcorrected visual acuity and treatment efficiency of children with anisometropic amblyopia.