Psychological causes of non-compliance with electronically monitored occlusion therapy for amblyopia.
OBJECTIVE
To analyse psychological causes for low compliance with occlusion therapy for amblyopia.


METHODS
In a randomised trial, the effect of an educational programme on electronically measured compliance had been assessed. 149 families who participated in this trial completed a questionnaire based on the Protection Motivation Theory after 8 months of treatment. Families with compliance less than 20% of prescribed occlusion hours were interviewed to better understand their cause for non-compliance.


RESULTS
Poor compliance was most strongly associated with a high degree of distress (p<0.001), followed by low perception of vulnerability (p = 0.014), increased stigma (p = 0.017) and logistical problems with treatment (p = 0.044). Of 44 families with electronically measured compliance less than 20%, 28 could be interviewed. The interviews confirmed that lack of knowledge, distress and logistical problems resulted in non-compliance.


CONCLUSIONS
Poor parental knowledge, distress and difficulties implementing treatment seemed to be associated with non-compliance. For the same domains, the scores were more favourable for families who had received the educational programme than for those who had not.
Loudon
S E
SE
Department of Ophthalmology, Erasmus MC University Medical Center Rotterdam, PO Box 2040, 3000 CA Rotterdam, The Netherlands. s.loudon@erasmusmc.nl
Passchier
J
J
Chaker
L
L
de Vos
S
S
Fronius
M
M
Harrad
R A
RA
Looman
C W N
CW
Simonsz
B
B
Simonsz
H J
HJ
D000550:Amblyopia / Q000523:psychology* / Q000628:therapy; D001294:Attitude to Health; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D008297:Male; D009042:Motivation; D010290:Parents / Q000523:psychology; D010349:Patient Compliance / Q000523:psychology*; D010353:Patient Education as Topic; D010465:Perception; D011446:Prospective Studies; D012683:Sensory Deprivation; D013240:Stereotyping; D013315:Stress, Psychological / Q000209:etiology; D011795:Surveys and Questionnaires