Aim: To analyse psychological causes for low compliance with occlusion therapy for amblyopia.
Method: 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.
Conclusion: 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.
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Funding Health Research and Development Council of The Netherlands; MF: Albert von Metzler Foundation, Augenstern Association, Research Award of the German Society of Ophthalmology (DOG), Germany.
Competing interests None.
Provenance and Peer review Not commissioned; externally peer reviewed.
Ethics approval Ethics approval was provided by Erasmus MC University Medical Center Rotterdam.
Patient consent Obtained.
▸ A supplemental file is published online only at http://bjo.bmj.com/content/vol93/issue11
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